Card Set Information
A PaO2 less than 60 mm Hg
Anesthesia slows the mucociliary transport rate
Low oxygen levels at the tissue level
Assessment for Hypoxemia
Respiratory rate and rhythm may be normal in hypoxemia
What occurs in subacute hypoxemia
Oxygen saturation falls to consistently loer but noncritical level
Which interventions may help decrease metabolic demand
Sedation, analgesia and antipyretics
Oxygen dissolved in the plasma is defined as
What occurs in episodic hypoxemia
Oxygen saturation may fall quickly and unexpectedly
Imparied oxygen diffusion may cause?
Inadequate lung ventilation can be caused by?
Hyperventilation is likely to cause
Increase pH from CO2 depletion
After use of incentivie spirometer u note increase in percentage of pulse ox this is related to?
The increased oxygen diffusion from alveoli to capillaries
After GI surgery hat breath sounds would lead you to call physician immediately?
Expiratory wheezes througout
If acidosis results from a slow, shallow respiratory rate you'd expect the following change in acid/base balance
pH decrease and PaCO2 increase
During inspiration air enters the thoracic cavity because of
decrease in 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
Arterial oxygen tension (PaO2)
Most important respiratory defense mechanism ddistal to the respiratory bronchioles is the
A rightard shift of the oxygen-hemoglobin dissocation curve
facilitates release of oxygen at the tissue level
Signs and Symptoms of inadequate oxygenation include all of the following except
increased peripheral perfusion, increased urine output
The left mainstream bronchus is
more angulated than the right
Respiration is more affected by
Which of the folloing shift the oxyhemoglobin dissociation curve to the left?
Decrease temp, increase in pH
During normal quiet relaxed breathing what will the intrapleural pressure be?
Equal to the atmospheric pressure
Adventitious breath sounds include all the following except
Your patients tidal volume is 1000cc's he is breathing 15 times a min what is his minute volume?
Early signs of o2 toxicity include
numbness in the extremities and dry, hacking cough
Which of the folloing is a high-flow O2 delivery
What is the percent of O2 in normal room air (ambient)
The bloods O2 carrying capacity can be limited to
What range of O2 concentration does a nasal cannula provide
Between 24-40 percent
Lower than normal O2 saturation in arterial blood is
Oxygen toxicity can occur when a patient receives O2 at?
50 % or greater for more than 24 hours
A healthy person's respiratory drive depends on?
Non-Rebreather Face Mask
6-15 L/min 60-100%
6-10 L/Min 35-60%
Which oxygen mask? Mild dyspnea related to anemia
Which oxygen mask?
Order for a specific concentration of O2
High dose of O2
Which mask? Someone who is very groggy and requires greater than 50% of oxygen concentration
The bloods O2 carrying capacity can be limited to
Lower than normal O2 saturation in arterial blood is called
A health persons respiratory drive depends on?
Early signs of O2 toxity include:
Numbness in the extremities and dry hacking cough
Difference between SpO2 and ABG
pulse ox provides continous monitoring
Which is required to acheive a reliable reading from a pulse oximetry?
good arterial blood flow
SpO2 values should always be considered in the content of which other value?
Most common cause of inaccurate SpO2 reading is?
What color of nail polish is most likely to affect SpO2 reading?
A signal strength indicator and plethysmographic waveform help the nurse to assess?
Reliability of readings
Pulse ox sensor should NOT be placed on the
Finger on an arm that has an automatic blood pressure cuff
Normal AP to lateral ration of chest
Normal costal angle is no more than
What sound would you expect to percuss over healthy lung tissue?
Early sign of hypoxia?
Change in mental status
Breath sound heard of the majority of the posterior lung fields of a health patient
What occurs at the Alveoli
How does the shape of your spine influence the ability to inspire deeply?
Skeletal deformities may limit thoracic cage excursion, limits lung expansion within the thorax
Purpose of Surfactant?
Reduced the surface tension of the fluid lining the alveoli and prevents alveolar collapse
Normal breath sounds
Bronchial, bronchiovesicular, vesicular
What sound predominates over lung fields with percussion?
If pt has a fever how does that affect his oxygenation status?
Pt has more O2 sat and less CO2
a substance secreted by Type II cells that lowers surface tension and prevents alveolar collapse
Respiration is more affected by
Sputum example is used for diagnosis of
Cancer of the lung, Pneumonia, turberculosis
If you were blowing out the candles on a birthday cake which lung volume would you be using?
ERV Expiratory reserve volume
Incentivite Spirometer measures
Total lung capacity
People who can hold their breath under the water for a long period of time without passing out are using
Inspiratory reserve volume IRV
Test gag reflex before giving oral food or fluid after this test
7.35 to 7.45
Low is Acidosis, High is Alkalosis
low is alkalosis, high is acidosis
Low is acidosis, High is Alkalosis
Dextromethorphan (Benylin) works by
Inhibition of the cough center in the Medulla
Dextromethorphan has what type of side effects?
Few minor adverse side effects
Pseudoephedrine (Sudafed) works by
Mimicking the action of the sympathetic nervous system
Pseudeophedrine (Sudafed) is indicated for the treatment of?
Viral Upper Respiratory Infection
Which of the following adverse effects may occur during pseudoephedrine (Sudafed) therapy?
How does Afrin(Oxymetazoline) differ from Sudafed?
Route and decrease incidince of adverse effects
Which nasal spray is a steroid anti-inflammatory drug?
Dexamethasone sodium phosphate (Turbinaire)
Antihistamines such as Fexofenadine (Allegra) are the treatment choice for
Allegra (Fexofenadine) a second generation anti-histamine differs from first generation anti-histamine suach as diphenhydramine (Benadryl) by
An expectorant drug such as Guaifenesin (Robitussin) is used to relieve a
Dry hacking cough
Cromoly sodium (NasalCrom) works by
Preventing the break down of mast cells
Hydrocodone can cause?
Pts with ___ should avoid Sudafed (Pseudoephedrine) therapy
What pt should avoid Allegra
Pt receiving Benylin should be told not to..
Drive until they see how the drug affects them
Volume of air inspired or expired in a single breath during regular breathing
Inspiratory reserve volume
Maximal volume of air that can be inahled after normal respiration
Volume of gas that can be taken in lungs in a full inhalation starting from resting inspiratory position equal to tidal volume and inspiratory reserve volume
Expiratory reserve volume
max amount of gas that can be exhaled from the resting end expiratory level
amount remaining (gas) in the lungs at the end of maximal exhalation
Functional residual capacity
volume of air present in the lungs at the end of passive expiration
Volume of gas that can be expired from lungs from position of full inspiration ith no limit to duration of imspiration equal to inspirate capacity plus expiratory level
Oxyhemoglobin dissassociation cruve
Relationship between the partial pressure of O2 and the percent of saturation of O2 (SpO2)
If the PaO2 drops from 100-80 mmHg as a result of lung disease or heart disease the hemoglobin of the arterial blood remain almost max saturated 94% and
Tissues do not suffer from hypoxia
When arterial blood passes into tissue capillaries and is exposed to the tissue tension of O2 hemoglobin will
give up large quantities of O2 for the use by the tissues
Rhythm of breathing
Respiratory centers in the brain
Rate and Depth of Ventilation
Inspiratory and Expiratory centers in Medulla Oblongata and the pons
Deep prolonged inspirations
Apneustinc center in lower pons
Control pattern of respirations
Pneumatoaxic center in upper pons
Absense or abnormally low amount of O2 in the blood can occur during cardiac arrest, anemia, heart failure
Collapsed, airless condition of alveoli
Sound created with closing and snapping opening of alveoli
Undissolved matter in blood stream
Excess Carbon Dioxide in blood
Air within pleural cavity
Combined form of hemoglobin and oxygen
Sounds made by fluid in the larger airways most use the term course crackles or wheezes to describe
Whistling or sighing sound resulting from narrowing of lumen size of bronchi, high pitched musical sound heard mainly on expiration
Hairlike projection of the nasal epithelium are known as
Which bronchi is straigher
What is the space between the lungs called?
Membrane that lines each lung called
Membrane that lines the inside of the thoracic cavity called
Space between the visceral and parietal is called
Pleural space (fluid)
How many lobes of left lung
How many lobes of the right lung
Wher does gas exchange occur
Primary muscle of inspiration
Three accessory muscles that are used for forced inhalation
Does the intrathoracic increase or decrease with inspiration?
Where are the neurogenic mechanisms controlling respirations located?
Medulla and Pons
Ventilation normal absense of perfusion
Air there blood isn't
Ventilation absent perfusion normal
Blood there air isn't
Example Pneumonia, Collapsed Alveoli
Shift to left
Increase in pH and Decrease in PaCO2, Holding in CO2, Alkalosis
Anything lower than 60 bad body can't compensate organs fail
People that are drowning
Shift to right
Decrease in Ph, Increase PaCO2, Acidosis, People that are sick, Fever,
Pulmonary Lung Function tests measure
Ventilation and Perfusion
Differentiate beteen obstructive and restrictive lung diseases
Minute volume is
Volume of air exchanged in one minute
How many days for Kidneys and Lungs
3 days for kidnesy and seconds for lungs
BiCarb is produced by the
Upper Airway Infection also known as
Incubation period contagious (2-3 days)
Expectorant, only works if not dehydrated
Non drowsy formula means
blocks mast cells from relasing histamine
Opiates as Antitussives when should take?
Dry out sinuses, Increase HR, Decrease appetites
Don't take before bed
If interferring with sleep
Histamines should be taking when
With meals or right after
Antitussive.. take with
Full glass of water, for non productive, dry cough
When is it unsafe for an antitussive
Pregnant, alcohol, asthma or emphysema
How do antitussives interact with opiates
Cause CNS depression if taken together
How much fluid should the patient drink/day when on an expectorant?
up to 10 glasses to loosen secretions
Antitussives can cause
Drowsiness, mild dizziness, nausea
Vasoconstricting agent used to shrink engages nasal mucous membranes in mild URI's
Action of decongestants
Shrink engorged nasal mucous membrane in mild URI and relieves Nasal stuffiness
Increase in BP in HTN pts, Increase dizziness, increase blood glucouse in DM pts, Increase headaches, Increase CNS stimulations or nervousness, Increase Insomnia, Increase restlesness, Increase Irritability
Decongestants interact ith
Increase systemic vascular resistance and decrease renal perfusion
Anti coagulants such as aspirin for 2 weeks
Trach right after no
Tape change for 24 hours
Trach pts do not have
a sense of smell
What do opioids and detromethophan have in common
Trachs are used to bypass upper or lower resp problem
Conditions that predispose pt to OSA
HTN, Over 50, Men, Overweight, Smoking
What is a CPAP
Continous Positive Airway pressure
keep alveoli open by keeping pressure so air can be passed
Surgical procedure that helps OSA
Trach feel bubbly feeling on skin??
Misplaced tube or dislodged
Feeling of popping under skin
An air leak ill be noted by bubbling in
H2) seal chamber with expiration and or cough
Purpose of Chest Tube
Reestablish negative pressure
Reservoir for fluid coming from pt
Prevent air from going back in pt
Create neg pressure promote drainage
Water seal chamber must have water in it because
it prevents air from going back in the chest
Dextrose 10 in H2O
Dextrose 5% in NaCL 0.9% or D5Normal Saline
Dextrose 5% or 10% in LR
D5LR or D10LR
D 5 1/2 is
Isotonic in the bag
Hypotonic in the body because..
Sugar goes into RBCs
Trachea will be pulled to side