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Respiratory System

Respiratory System Ch 25

Primary purpose of the respiratory system gas exchange; the transfer of O2 and CO2 between the atmosphere and blood
Normal tidal volume 500ml - volume of air exchanged with each breath
Alveoli small sacs that form the functional unit of the lungs
Surfactant a lipoprotein that lowers teh surface tension in the alveoli, reduces the amount of pressure needed to inflate the alveoli and decreases the tendency of alveoli to collapse
What two types of circulation do the lungs have pulmonary and bronchial
Pulmonary circulation provides the lungs with blood for gas exchange
Bronchial circulation provides oxygen to the bronchi and other pulmonary tissue
How many ribs are in a human body total of 24 - 12 on each side
Thoracic cages refers to the ribs and sternum
Parietal pleura a membrane that lines the chest cavity
Visceral pluera the membrane that lines the lungs
Which pleura does not have nerve endings or afferent pain fibers visceral pleura
Which pleura has afferent pain fibers parietal pleura
Intrapleural space the space between the pleural layers
What is the purpose of the intrapleural space provides lubrication, allowing the layers of the pleura to slide over each other during breathing; it increases cohesion between the pleural layers
How much fluid is normally in the pleural space 20-25ml
Empyema purulent pleural fluid with bacterial infection
The major muscle of respiration diaphragm
What is the flow of gas from an area of higher pressure (atmospheric) to one of lower pressure (intrathoracic)
Elastic recoil the tendency for the lungs to recoil after being stretched of expanded
Compliance (distensibility) a measure of the elasticity of the lungs and thorax
What happens when compliance is decreased the lungs are more difficulty to inflate
Diffusion How O2 and CO2 are moved back and forth across the alveolar capillary membrane
PaO2 arterial oxygen tension
PaO2 represents what The amount of oxygen disolved in the plasma
SaO2 arterial oxygen saturation
SaO2 represents what The amount of oxygen bound to hemoglobin in comparison with the amount of oxygen the hemoglobin can carry
PaO2 is expressed in millimeters of mercury (mm Hg)
SaO2 is expressed in %
ABG analysis includes the measurement of PaO2, PaCO2, acidity (pH), and bicarbonate (HCO3-) in arterial blooc
Blood for ABG's can be obtained by arterial puncture or from an aterial catheter in the radial or femoral artery
pH 7.35-7.45
PaO2 80-100 mm Hg
SaO2 >95%
HCO3- 22-26 mEq/L
S/S of inadequate oxygenation on the CNS unexplained apprehension, restlessness/irritability, confusion/lethargy (early or late), Combativeness (late), Coma (late)
S/S of inadequate oxygenation on the respiratory system Tachypnea, Dyspnea on exertion, Dyspnes at rest (late), Use of accessory muscles (late), Retraction of interspaces on inspiration (late), Pause for breath between sentences/words (late)
S/S of inadequate oxygenation on the Cardiovascular system Tachycardia, Mild HTN, Arrhythmias (ex:PVC'S)(early or late), Hypotension (late), Cyanosis (late), Cool / clammy skin (late)
Other S/S of inadequate oxygenation Diaphoresis (early or late), Decreased urinary output (early or late), Unexplained fatigue (early or late)
Normal SpO2 >95%
SpO2 the oxygen saturation value obtained by pulse oximetry
Sites of pulse oximetry finger, toe, ear, forehead , or bridge of nose
Hypoxemia an abnormal deficiency in the concentration of oxygen in arterial blood
Hypoxia abnormally low oxygen availability to the body or an individual tissue or organ
What is the first evidence of hypoxemia apprehension, restlessness or irritability
The mechanism that stimulates the release of surfactant is alveolar stretch from deep breathing
During inspiration, air enters the thoracic cavity as a result of decreased intrathoracic pressure relative to pressure at the airway
The ability of the lungs to adequately oxygenate the arterial blood is determined by examination of the aretiral oxygen tension
The most important respiratory defense mechanism distal to the respiratory bronchioles is the alveolar macroophage
A rightward shift of the oxygen-hemoglobin dissociation curve facilitates release of oxygen at the tissue level
During the respiratory assessment of the older adult, the nurse would expect to find increased anteroposterior chest diameter
When assessing activity-exercise patterns related to respiratory health, the nurse inquires about dyspnea during rest or exercise
The vibration of tactile fremitus is best assessed using the nurse's palms
Which of the following finding is an abnormal assessment finding of the respiratory system? presence of rhonchail fremitus
A diagnostic procedure done to remove pleural fluid for analysis is thoracentesis
Hypercapnia excess CO2 in the blood
Structural changes r/t aging dec. Elastic recoil, dec. Chest wall compliance, Inc. Anteroposterior diameter, dec. Functioning aveoli
Defense mechanism changes r/t aging dec cell-mediated immunity, dec specific antibodies, dec. cilia function, dec. cough force, dec. alveolar macrophage function
Respiratory control r/t aging dec. response to hypoxemia, dec. response to hypercapnia
If a patient is a smoker, sputum is usually clear to gray with occasional specks of brown
If patient has COPD, sputum may be clear, whitish, or slightly yellow, especially in the morning on rising
Normal sputum is clear to slightly whitish; odorless
These respiratory conditions can cause chest pain pleurisy, fractured ribs, and costochondritis
Description of pleuritic pain sharp, stabbing pain associated with movement or deep breathing
Description of fractured rib pain localised sharp pain asssociated with breathing
Description of costochondritis pain along the the borders of the sternum and is associated with breathing
Assessment of the nose mucous mem should be pink and moist, with no evidence of edema (bogginess), exudate or bleeding
Assessment of the pharynx should be smooth and moist with no evidence of exudate, ulcerations, swelling or postnasal drip
Gagging response indicates that cranial nerves IX (glossopharyngeal) and X (vagus) are intact
Assessment of the neck symmetry an dpresence of any tender or swollen areas; palpate the lymph nodes
Normal respiratory rate 12-20 breaths per minute
Normal respiratory rates in the elderly 16-25 breaths per minute
Kussmaul rapid, deep breathing
Cheyne-Stokes abnormal patterns of respiration characterized by alternating periods of apnea and deep, rapid breathing
Biot's irregular breathing with apnea every 4-5 cycles
Cyanosis is best observed where in dark-skinned people conjuctiva, lips, palms, and soles of feet
Causes of cyanosis hypoxemia or decreased cardiac output
Clubbing an increase in the angle between the base of the nail and the fingernail - usually accompanied by sponginess of the end of the finger
What is normal tracheal position midline
Resonance low-pitched sound heard over normal lungs
Hyperresonance loud, lower-pitched sound than normal resonance heard ofver hyperinflated lungs, such as in chronic obstructive lung disease and acute asthma
Tympany Drumlike, loud, empty quality heard over gas-filled stomach or intestines, or pneumothorax
Dull Medium-intensity pitch and duration heard over areas of "mixed" solid and lung tissue, such as over the top area of the liver, partially consolidated lung tissue (pneumonia) or fluid-filled pleural space
Flat Soft, high-pitch sound of short duration heard over very dense tissue where air is not present
Created by: okrecota