Term
| dererminant of oxygen delievery |
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Definition
cardiac output- arterial supply
hemoglobin- O2 carrying capacity of RBCs
dissolved O2 in arterial blood (PaO2) |
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Term
| pulmonary secondary functions |
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Definition
acid base balance- by blowing off or retaining CO2
speech
fluid blance and heat balance- high temps respiratory rate increases, and helps to decrease heat |
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Term
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Definition
| process of moving air between atmosphere and lung alveoli |
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Term
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Definition
this airway;
warms/humidifies
cough/gag reflexes protect airway
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Term
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Definition
this airway includes alveoli and cells
- smooth muscle
- cilia
- muscus secreting plays a role in immune system
- alveoli
- surfactant
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Term
helps in bronco relaxation |
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Definition
| what action does a beta agonist have? |
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Term
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Definition
| this is the basic unit of gas exchange and theres two types |
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Term
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Definition
| this type is squamous cells |
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Term
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Definition
| this type is numocites that produce surfactant |
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Term
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Definition
| this reduces surface tension, prevents alveolar collapse |
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Term
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Definition
| this is the middle that protects treachea and heart |
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Term
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Definition
| if the lungs are not this, can develop disease like COPD, emphysema, pulmonary edema |
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Term
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Definition
| this is the space between the viseral pleura and partial pleura, pressure difference between the two |
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Term
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Definition
| this includes the brain stem and the cerebral |
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Term
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Definition
| this is involuntary, in medulla, people who have hdamage these patients usually need to be on a respirator |
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Term
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Definition
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Term
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Definition
| in aortic arch and carotid bodies, sensitive to change in blood levles of oxygen, carbon dioxide, and pH. they help correct changes that are occuring-- autonomic nervous system |
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Term
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Definition
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Term
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Definition
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Term
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Definition
| tital volume x RR/min = minute ventilation |
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Term
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Definition
| this is a process fo gas exchange, passive movement from higher conc to lower conc |
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Term
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Definition
| what percent of oxygen is carried by Hgb |
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Term
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Definition
| when Hgb carries 4 oxygen molecules it is what percent saturated? |
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Term
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Definition
what percent of gas is dissolved in blood
(PaO2)? |
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Term
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Definition
when this is low; Hgb has low affinity for O2, the release oxygen at tissue level ( may not pick up as much O2 and release it right away)
No releasing in tissues
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Term
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Definition
| when this is high; Hgb has high affinity for O2 (lungs) picks up oxygen in lungs. ( Hgb doesnt bing to this as efficiently so tissues are not getting as much as they need |
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Term
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Definition
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Term
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Definition
| can breathe when there sitting up but not lying down |
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Term
| Paroxysmal nocturnal dyspnea |
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Definition
| may be cardiac involvement, comes and goes, usually know there short of breath, feel better sleeping in a chair |
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Term
Kussmaul respiration
(abnormal breathing) |
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Definition
| hyperpnea- deep, increase rate (exercise metabolic acidosis) |
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Term
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Definition
| alternating perios of deep and shallow with periods of apnea, (death respirator pattern) |
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Term
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Definition
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Term
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Definition
bluish discoloration of skin, hgb desaturated by 5g/dl
cause: low PaO2, pulmonary disease, cardiac disease, decreased cardiac output hypothermia, vasoconstruction |
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Term
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Definition
| 1g of Hgb is how many grams of oxygen? |
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Term
physical assessment
vital signs |
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Definition
| respiratory rate, depth, pattern, spo2, color, including oral mucosa and nail beds |
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Term
| labs for pulmonary diagnostics |
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Definition
| ABGs, chest Xrays, pulmonary function test, tidal volume, bronchoscopy, CT, MRI, sputum culture |
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Term
| what conditions increase oxygen demand? |
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Definition
| these conditions increase what? exercise, revovery from surgery, disease, fever |
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Term
| what are S/S of increased oxygen demand? |
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Definition
| what do these s/s do? cyanosis, shortness of breath, clubbing, increased respiratory rate, increase pulse rate |
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Term
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Definition
low oxgen in blood
caused by low PaO2, hypoventilation, diffusion abnormalities, ventilation perfusion mismatch, shunting |
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Term
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Definition
| pulmonary edema, ventilation is impaired but perfusion is okay |
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Term
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Definition
| pulmonary embolus, perfusion is not okay but ventation is |
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Term
| VQ (ventilation perfusion mismatch) |
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Definition
| inadequate circulation or ventilation, normal rate is 1.8-1 |
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Term
| what would interfere with gas passing across the alveolar capillary membrane? |
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Definition
| happen if they interfere with what; pulmonary edema, pumonary embolism, exudates for pneumonia |
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Term
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Definition
forward pump failure, fluid backs up into the lungs, cant sleep lying down, so they can have better diaphragm movment
classic S/S- orthopnea, crackles, productive cough |
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Term
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Definition
loss of protective airway reflexes. left bronchi is narrower so you would turn them on there left side, right bronci is big
unconscious
emesis
acid contents of stomach are very irritating to elastic lung tissue--serious pneumonia |
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Term
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Definition
| collapsed alveoli, loss of gas exchange, shunting of unoxygenated blood through lungs to heart (low VQ) |
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Term
Respiratory infection
(upper) |
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Definition
these are common in what kind of infection;
common cold, pharyngitis, laryngitis |
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Term
Respiratory infection
(lower) |
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Definition
| pneumonia, virus bacteria, fungi, protozoa, parasites |
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Term
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Definition
risk factors: very young/very old, co-morbid conditions-- asthma, COPD, chronic bronchitis, diabetes.
Altered LOC, risk for aspiration,immobilization
vices: bad habits- smoking, alcohol, poor oral hygiene
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Term
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Definition
gram - (E coli, strep, mircoplasma, staph orius)
gram + ( need to know if gram - or + becuase it can show what you need to give them for treatment.) |
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Term
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Definition
| 70% are Pneumoniae, < 5% mortality |
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Term
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Definition
E coli, P Aeruginosa, S aureus
50% mortaility, more likely to develop sepsis, lung necrosis |
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Term
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Definition
| (HIV, transplant) pneumocystis, carinii, mycobacterium tuberculosi, very difficult to treat high mortality |
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Term
| Important lines of defense |
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Definition
| intact cough/gag reflex, mucociliary clearance, alveolar macrophages |
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Term
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Definition
This is vasodilation-- redness, warmth
increase capillary permeability, interstitial edema
, leaks into alveoli, leaks into bronchioles, lung abscess, necrosis |
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Term
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Definition
| fever, leukocytosis, plasma proteins |
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Term
| Local inflammatory response |
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Definition
| biochemical mediators damage bronchial mucous membranes, alveolocapillary membranes, causing the acini and terminal cronchioles to fill with infectious debris and exudates |
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Term
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Definition
release of endotoxins from gram bacteria increase capillary permeability, clotting cascade hypotension septic shock
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Term
Pneumonia
clinical manifestations |
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Definition
| fever, chills, elevated WBC > 10,000, pain-pleural, Sortness of breath, crackles, Low pO2, pCO2, respiratory alkalosis, tachypnea, tachycardia, hypoxia |
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Term
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Definition
| impaired gas exchange poor O2 diffusion through consoildation, CO2 diffuses more redily |
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Term
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Definition
these are the S/S for?;
- Rapid Breathing
- Cyanosis
- Poor Coordination
- Lethargy/Lassitude
- Executing Poor Judgment
- Air Hunger
- Dizziness
- Headache
- Mental and Muscle Fatigue
- Nausea
- Hot and Cold Flashes
- Tingling
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Term
| Diagnositc and lab tests for pnemonia |
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Definition
| sputum culture and sensitivity, stat gram stain, CXR, CBC with differential blood culture for T> 38.5C |
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Term
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Definition
Abx therapy, O2 therapy
RT- T, C, DB
incentive spirometer, CPT
rest, ambulate QID, hydration, assess- vital signs spO2 lung sounds |
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Term
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Definition
improvement within 24 hours of ABx treatment
oxygenation status |
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Term
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Definition
paO2- < 50
PaCO2- > 50mmHg
pH- < 7.25
RR- >30 or <8 |
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