Intro to Resp
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| nose | turbonates (conchae)
paranasal sinuses
smell receptors
nasolacrimal ducts
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| pharynx | nasopharynx
oropharynx
laryngopharynx
eustachian tubes
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| external respiration | exchange of O2 and CO2 between lungs and environment
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| Internal Respiration | Exchange of O2 and CO2 at the cellular level
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| Bronchial tree | left and right bronchus
bronchioles
terminal bronchioles (alveolar ducts)
alveoli
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| Gas exchange in lungs | via diffusion
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| blood from lungs then... | returns to heart via pulmonary veins for distribution to the body
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| visceral pluera | thin, moist serous membrane that coverst the surface of each lung
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| pariental pleura | thin, moist serous membrane that covers the thoracic cavity
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| pleural cavity | airtight vacuum that contains negative pressure that helps keep lungs inflated
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| right bronchus is | larger in diameter
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| what allows air to be inhaled and exhaled | rhythmic movements of the chest wall, ribs, and muscles
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| what regulates respiration | nervous control-medulla oblongata and pons of the brain
chemoreceptors-in the carotid and aorta
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| surfactant | reduces surface tension
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| Right lung | more apt to recieve foreign body
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| reasons you may perform extensive respiratory assessment | chronic respiration or cardiac conditions;
history of respiratory impairment related to trauma;
recent surgery or anesthesia
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| subjective data | shortness of breath; dyspnea; cough
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| objective data | expression, chest movement, and respirations;
respiratory distress, wheezes, or orthopmea;
hypoxia;
adventitious breath sounds (sibilan wheezes, sibilant wheezes, sonorous wheezes, crackles, pleural friction rubs )
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| chest radiographs (Roentgenogram) is used to... | visualize the lungs + major thoracic vessels;
view alterations in size & location of pulmonary structures;
identifies lesions, infiltration, foregn bodies, or fluid;
shows disorder involving the parachyma or interstitial spaces;
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| what can a Roentgenogram confirm | pneumothoraax, pneumonia, pleural effusion, and pulmonary edema
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| before a roentgenogram, what must be removed | any jewelry
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| what does Computed Tomography (CT) do | scans the lungs; can be viewed diagonal or cross-sectional
requires patient teaching to decrease anxiety
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| Pulonary Function Test (PFT) is.... | performed to assess the large and small airways;
obtain information on lung volume, ventilation, pulmonary spirometry, and gas exchange
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| what information does a pulmonary function test obtain | lung volume, inspiratory compacity, and total lung capacity
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| Mediastinoscopy | surgical endosopic procedure to obtain lumph nodes for biopsy for tumor diagnosis
performed under general anesthesia
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| Laryngoscopy | allows for direct or indirect visualization of larynx
requires local or general anestesia
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| Bronchoscopy | Exam for the tracheobronchial tree for abnormalities, tissue biopsy, secretions for cytological or bacteriological studies
patient is treated as a surgical patient
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| nursing interventions for a bronchoscopy | *informed consent must be signed
*NPO until gag reflexes return
*Placed in semi-flowlers position and turned to one side
*monitored for signs of laryngeal edema or spasms
*monitor sputum for signs of hemorrhage if biopsy is taken
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| what are sputum specimens obtained for | microscopic evaluation
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| guidlines for sputum collection | *Inhale and exhale 3xs, inhale swiftly, cough forcefully, and expectorate into the steril sputum container
*provide hypertonic saline aerosol mist if unable to raise sputum
*if necessary, obtain sample through endotracheal suctioning
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| cytology studies | performed on sputum or pleural fluid to detect teh presence of abnormal or malignant cells
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| thoracentesis | surgical perforation of the chest wall and pleural space with a needle for the aspiration of fluid
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| nursing interventions for thoracentesis | *explain the procedure and obtain informed consent
*procedure performed at bedside, sitting upright, and leaning over a bedside table or on side with affected side up
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| Nursing interventions for thoracentesis | *monitor VS, general appearance, and respiratory status
*risk for subsequent pulmonary edema due to fluid shifts if >1300mL removed within a 30 minute procedure
*place PT on unaffected side after procedure
*obtain CXR after procedure
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| arterial blood gases (ABGs) | measure the lungs' ability to exchange o2 and co2 and the body's acid-base balance
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| normal ABG | pH 7.35-7.45
PaCO2 35-45 mmHg
PaCO2 80-100 mmHg
HCO2 22-28 mEq/L
SaO2 >95%
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| oxygenation..carried in the bloodstream in two forms | oxygen dissolved in plasma-expressed as PaO2
oxygen combined with hemoglovin-expressed as SaO2 represents the amount of oxygen bound to hemoglobin
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| ventilation is.. | *respiratory component of acid-base balance
*relationship between pH and PaCO2
*HCO3 is a measure of the metabolic component of acid-base
*Kidneys respond to change in pH due to respiratory condition by wasting or retaining HCO3
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| Allen's test is performed to... | check ulnar circulation before a radial artery stick
*heparinized syringe to draw 3-5ml from artery
*after obtained, pressure is held at the puncture site for five minutes
*syringe is callped, labeled, placed in ice water and sent to lab for analysis
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| Pulse oximetry monitoring is | noninvasive method for continuous monitorig of SaO2; used to assess small changes in the respiratory status; the prove measures the amound of light being absorbed by oxygenated and deoxygenated blood and displays a percentage value
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| a Sa02 of _____ is needed to adequately replentish oxygen in the _____ | 90-100%
plasma
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| An SaO2 below _____ is life threatening | 70%
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| Do not's with pulse ox | *attatch probe to extremity with diminished circulation
*place probe over pulsating vascular bed
*Avoid excess movement
*hypothermia can affect readings
*do not place in light
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Created by:
sydcpepper
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