JU MedSurge Respiratory
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| Respire | breathe again
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| Inspire | to breathe in or fill with spirit
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| Expire | breath out or die
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| Upper respiratory | trachea and up
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| Lower respiratory | anything having to do with the lungs and aveoli
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| Obstructive Disease | having to do within the lungs and aveoli
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| Purpose of respiratory | gaseous exchange (oxygen and carbon dioxide), upper tract includes the nose, pharynx, adenoids, tonsils, epiglottis, larynx an trachea, Lower tract includes bronchi, branchioles, alveolar ducts and alveoli
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| Right lung has how many lobes | 3 lobes - upper, middle, lower
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| Left lung has how many lobes | 2 lobes - upper, lower
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| Surfactant | lowers the surface tension in the alveoli thus reducing the amount of pressure needed to inflate the alveoli and decreasing the chances of alveoli collapse. Surfactant is like a detergent, is thin, slimy and keeps the walls of the alveoli from sticking to
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| Sigh | After each 5 – 6 breaths a person sighs. The sigh is a deep breath that stretches the alveoli and causes surfactant to be released. Without the deep sigh, surfactant will not be released. Normal lung function depends on surfactin production.
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| Alveoli | The lung is a collection of 300 million “BUBBLES” called alveoli. Each is unstable and have a tendency to collapse.
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| What are the 2 types of cellsin? | TWO types of cellsin the alveolar surface…TYPE 1 provide structure and TYPE 2 secreate surfactant.
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| Atelectasis | airless alveoli. Post op patients are at risk for this due to pain. IN ARDS (acute respiratory distress syndrome – seen in ICU), fluid enters the alveoli as a result of damage and can’t produce alveoli. This results in destruction of surfactant.
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| Blood supply | Pulmonary – provides lungs with blood for gas exchange. Bronchial – starts from bronchial arteries which are from the thoracic aorta.
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| Chest wall | 24 ribs and sternum protect the lungs and heart from injury, Chest cavity is lined with parietal pleura, Lungs are lined with the visceral pleura, join and form a double wall sac
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| Intrapleural space | The space between the layers of the chest wall.
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| What happens to the intrapleural space of a normal adult? | The space is filled with fluid that provides lubrication and adheres the layers together.
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| How much intrapleural space is present in a normal adult? | 20-25 cc
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| What affects breathing? | Anything that changes the pressure of the lung.
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| Name some disease processes which causes an increase in fluid. | Bacterial infection, CHF, pleural effusion
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| What represents spinal cord injuries? | If the diaphragm doesn’t work, you can’t breathe. Spinal cord injuries above C3 result in complete respiratory paralysis (won’t every be able to breathe on their own – spontaneously – which also cuts the person’s life expectancy).
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| What bone affects paralysis? | Connected to the spinal cord between C4 and C4. C4 injury may or may not result in complete paralysis.
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| What is included in the upper respiratory system? | nares, sinuses, throat, esophagus, trachea
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| What is included in the lower respiratory system? | bronchi, bronchioles, alveoli, surfactant
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| What is alveoli? | air sacs where gas exchange occurs, surrounding by capillaries
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| What happens when the diaphragm descends? | it creats pressure less than atmosphere, causing inspiration.
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| What happens when the aveoli expands? | O2 diffuses into capillaries, CO2 moves from blood to alveoli
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| What is elastic recoiling? | returning to relaxed state after stretching. Lungs are elastic because they stretch out and then return to their original size
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| Name the 2 ways oxygen is in the blood. | Combined with hemoglobin and dissolved in plasma
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| What does PaO2 mean? | plasma O2 – how much oxygen is in the blood – arterial oxygen pressure
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| What does SaO2 mean? | oxygen saturation – the amount of oxygen that hemoglobin can carry
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| What is the relationship between PaO2 and SaO2? | Big changes in PaO2 cause small changes in SaO2.
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| What are things nurses must do when a client's PaO2 and SaO2 are out of wack? | Recheck the pulse ox, have client deep breathe, do an assessment, nailbeds, ALL before calling the doctor.
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| How is respiration controlled? | Controlled by chemoreceptors (in the brain) and mechanical sensors. Chemoreceptor – in medulla respond to changes in Hydrogen ion concentrations.
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| What happens when H+ increases or decreases? | An increase in H+ causes the medulla to increase resp. rate and vent. A decrease in H+ causes the opposite effect.
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| What are mechanical receptors? | located in the lungs, upper airways chest wall and diaphragm. They are stimulated by irritants (smoking, polin, dust), stretching, alveolar wall distortion.
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| What is air filtration? | nasal hairs filter the inhaled air, large particles stick to the mucous membranes
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| What is Mucociliary clearance? | small particles are trapped in mucus and expectorated after coughing. Ciliary action is impaired by dehydration, smoking, alcohol, anesthesia, and recreational drugs.
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| Identify an example of mucociliary clearance? | A smoker will have more mucuous in their lungs than a nonsmoker. So when the client wakes up after surgery, they are more likely to get pneumonia and have a bad cough because their mucuciliary clearance is not working properly.
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| Name the diagnostic studies. | Chest X-ray, CAT, PET, MRI, Bronchoscopy, Pulmonary angiogram, Lung biopsy, Thoracentesis, and Pulmonary function tests.
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| What is a chest x-ray? | the general, least expensive starting place to identify if there is a problem
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| What is a CT Scan? | cross-sectional.
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| What is a MRI? | to determine if something is vascular or not
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| What is a Pulmonary angiogram? | x-rays taken after dyes
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| What is a PET? | determine benigh from malignant tumors
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| What is a Bronchoscopy? | fiberoptic tube passed into the lung. The patient is not asleep.
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| What could be done at the same time as a bronchoscopy? | Lung biopsy.
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| What is the purpose of a lung biopsy? | To diagnosis lung tumors.
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| What is a Thoracentesis? | inserts the needed through the chest wall into the pleural space to obtain specimens or remove excel fluid or instill medication. This is done at the bedside with assist of the nurse. Patient is sitting up leaning on bedside table.
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| What is the purpose of a pulmonary function test? | To measure lung volumes (how much you breathe in, breathe out), is important with asthma.
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