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Respiratory System
Respiratory System Ch 25
| Question | Answer |
|---|---|
| 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
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