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what are the structures of the upper respiratory
what are the parts of the lower respiratory system
- pulmonary capillary network
- pleural membranes
What are the special functions of the nose?
air enterers the nose where it is warmed, humidified and filtered
what is special about the larynx?
- voice box, forms speech
- it is made of cartilage and identified on the outside as the Adam's apple
what is the special feature of the epiglottis?
- it is the gatekeeper
- it is open when you breath but closed when you eat or drink
what factors effect ventilation?
- clear airways
- intact CNS and respiratory (medulla & pons)
- intact thoracic cavity
- pulmonary compliance & recoil
how does clear airway effect ventilation?
when mucous builds up it blocks the pathway to alveoli and slows or stops gas exchange
how do drugs effect ventilation
decrease the respiratory rate ND Cuse CNS depresion
amount of air in and out in 1 breath
increasing # of breaths
- waning and waxing
- very deep, very shallow and stop breathing (apnea)
shallow breaths interrupted by apnea
inability to breath easily unless sitting up
when symptoms reappear
how does alveoli gas exchange occure?
diffusion of O2 from alveoli to pulmonary blood vessels.
what is diffusion?
movement of gases from an area of higher pressure to an area of lower pressure
What is Partial Pressure?
the pressure exerted by each individual gas in a mixture according to its concentration in the mixture
what is partial pressure of Oxygen in the Alveoli?
what is the partial pressure of Carbon Dioxide in the pulmonary capillaries?
What is the partial pressure of Oxygen in the pulmonary capillaries?
What is the partial pressure of Carbon Dioxide in the Alveoli?
What factors affect the transportation of O2 from the lungs to the tissues of the body
- Cardiac Output
- # of RBCs and Erythrocytes
How does Cardiac Output affect transportation of O2 from the lungs to the tissue?
when CO decreases, the transportation of O2 to the tissues will decrease. the O2 goes through the blood stream to the tissues so if the Heart is not pumping the O2 has now way to get there
how does the # of RBCs and erythrocytes affect the transportation of O2?
- too many RBC/erythrocytes would increase blood viscosity making the blood too thick to flow easliy
- too little would not give the O2 enough rides to the tissue (o2 attaches to the RBC)
how does exercise affect the transportation of O2 from the lungs to the tissues?
CO increases and cell metabolism increases
hos is carbon dioxide transported from the tissues to the lungs?
- it is transported in 3 ways
- carried inside RBC back to lungs
- combines with hgb
- transported in a solution in the plasma carbonic acid
how is the majority of CO2 transported from the tissue to the lungs?
65% is carried in the RBCs as bicarbonate back to the lungs
How is a moderate number of CO2 transported from the tissue to the lung?
30% combines with Hgb as carbhemoglobin for transport back to the lungs
how is the smallest amout of CO2 transported from the tissue to the lung?
5% transported in a solution in thee plasma as carbonic acid a compound formed when Co2 mixes with water
how do healthy peoples bodies know when to breath?
Medulla Oblongata senses increased CO2 and tells the body to increase RR and depth
how do people with COPD or emphysema know when to breath?
- to carotid and aortic bodies sense decrease O2 levels and tell body to breath
- (the CNS gets used to increased CO2)
what is a "code" or "code blue"?
- cardiac arrest
- Respiratory arrest
- start CPR immediately
how should nurse respond if they find pt in resp arrest
what clinical manifestations of hypoxia
- slow, rapid respirations/dyspnea
- restlessness/ lightheadedness
- flaring of nares
- substernal or intercostal reactions
- cyanosis/central cyanosis/peripheral cyanosis
when might a patient who is experiencing hypoxemia not have cyanosis?
when would you expect to see finger clubbing?
after long term lack of O2 in arterial blood supply
what nursing Dx would be appropriate for the various oxygenation alterations
- impaired gas exchange
- activity intolerance
what are specific things nurses implement in order to help the client reach their goals r/t oxygenation
- frequent position changes
- position pt for maximum chest expansion
- suction airway
- promote comfort (pain meds/antianxiety meds)
- Deep breathing
- Meds (bronchiodilator, steroids, expectorant, digoxin O2)
red pigment in blood that carries Oxygen
% of blood that is erythrocytes
what is cardiac output?
the amount of blood pumped in one min
what is incentive spirometry
- a device used to: improve pulmonary ventilation
- counteract the effects of anesthesia or hypoventilation
- loosen respiratory secretions
- facilitate respiratory gaseous exchange
- expand collapsed alveoli
controlled breathing and coughing exercises
- Pursed lip breathing (alleviate dyspnea)
- controlled and huff coughing
- Diaphragmatic breathing
what are the different types of SMIs?
- Flow oriented
- Volume Oriented
describe pursed lip breathing
- exhale through pursed lips
- more exchange (alveoli stays open longer because pursed lips slow the exhale)
- if cant purse lips breath through hand/fist
describe normal forceful coughing
inhale deep and cough 2 time while exhaling
describe exhalation through pursed lips (huff)
breath deep and exhale through pursed lips during mid exhalation make huff sound/cough
what are safety issues regarding Oxygen?
- O2 is an accelerant
- no smoking
- nothing with spark or static
what are the different types or o2 delivery systems
- Face Mask
- Face Tent
- transtracheal catheter
- Oxygen Hood
- Oxygen Tent
- Bag Valve Mask
- Artificial Airways
what is FiO2?
friction of inspired oxygen
what is an ambu bag?
pushes o2 into the lungs
how many liters of o2 should Ambu bag be connected to?
what are the parts to a tracheostomy
- curved trach tube
- outer cannula-inserted in trachea
- flange- rests against the neck and secures it in place
- obturator- used to insert outer cannula then removed
- inner cannula-inserted inside and locked in place
- cuffed trach tubes have a air filled cuff to aspiration and air leakage
which methods require sterile suctioning?
sterile is recommended for all, but some places use clean for oropharynx and nasopharynx
Nasotracheal requires Sterile
transporting chest tube pt
- keep the water seal unit below chest level and upright
- Disconnect the drainage system from suction and make sure the vent is open
- use standard precautions PPE