FUND Unit 2 O2 Comfort & Sleep

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MeganM
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264305
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FUND Unit 2 O2 Comfort & Sleep
Updated:
2014-03-01 18:14:29
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Fundamentals
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Oxygenation & Sleep
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  1. A detergent-like phospholipid that reduces the surface tension b/w the moist membranes of the alveoli, preventing collapse.
    surfactant
  2. Where is the site of gas exchange?
    alveoli
  3. In respiration, diffusion refers to the movement of ______ and ______ between the _____ in the ______ and the ______ in the ______.
    • O2 and CO2
    • air, alveoli
    • blood, capillaries
  4. What is partial pressure and what can it affect in respiration?
    • pressure resulting from any gas in a misture depending on its concentration;
    • can affect diffusion
  5. What is internal respiration?
    • It happens once the RBCs reach the tissues.
    • It's the exchange of O2 and CO2 between the circulating blood and the tissue cells.
  6. Deoxygenated blood (low in O2, high in CO2) is carried from the _____ side of the heart to the _____.
    • right
    • lungs
  7. LOW-pitched,  SOFT sounds heard over peripheral lung fields.
    Vesicular lung sounds
  8. MEDIUM-pitched blowing sounds heard over the major bronchi.
    bronchovesicular sounds
  9. LOUD, HIGH-pitched sounds heard primarily over the trachea & larynx.
    Bronchial sounds
  10. What are adventitious breath sounds?
    • Abnormal lung sounds,
    • categorized as discontinuous or continous
  11. SOFT, HIGH-pitched discontinuous popping sounds
    crackles
  12. How are crackles in the lungs produced?
    • By fluid in the airways or alveoli and 
    • delayed reopening of collapsed alveoli
  13. Continuous, MUSICAL sounds, produced as air passes through airways constricted by swelling, narrowing, secretions, or tumors.
    Wheezes
  14. What are sibilant wheezes?
    originate in smaller airways and are high pitched and whistling
  15. What are sonorous wheezes?
    They can be heard over larger airways and sound like a snore.
  16. In what type of patients are sonorous wheezes often heard?
    asthma, tumors, or a buildup of secretions
  17. What causes a pleural friction rub?
    • inflammation of pleural surfaces and
    • loss of lubricating pleural fluid
  18. A pleural friction rub is a continuous, dry grating sound and resembles the sound made by what?
    rubbing two leather surfaces together
  19. What does pulse oximetry measure?
    arterial oxyhemoglobin saturation of arterial blood
  20. What is thoracentesis?
    The procedure of puncturing the chest wall and aspirating pleural fluid.
  21. What does a nebulizer do?
    Disperses the fine particles of liquid medication into the deeper passages of the respiratory tract (where absorption occurs)
  22. What are some common mistakes a pt makes when using a metered-dose inhaler (MDI)?
    • failing to shake the canister
    • holding the inhaler upside down
    • inhaling thru the nose instead of mouth
    • inhaling too rapidly
    • stopping the inhalation when the cold propellant is felt in the throat
  23. How are dry powder inhalers activated?
    by a quick deep breath
  24. What are some disadvantages of a nasal cannula?
    • it can be dislodged easily
    • can cause dryness of the nasal mucosa
  25. FLUID in the pleural space.
    pleural effusion
  26. BLOOD in the pleural space.
    hemothorax
  27. AIR in the pleural space.
    pneumothorax
  28. What type of sleep comprises about 75% of total sleep and consists of 4 stages?
    NREM
  29. What are stages I & II of sleep?
    • Light non-REM sleep
    • 5% & 50% of sleep,
    • light sleep
  30. What are stages III & IV of sleep?
    • each about 10% of sleep
    • DEEP sleep 
    • delta sleep (slow-wave sleep)
  31. When is the arousal threshold greatest in NREM sleep?
    Stage IV
  32. What are parasomnias?
    patterns of waking behavior that appear during sleep
  33. What are dyssomnias?
    sleep disorders char by insomnia of excessive sleepiness
  34. What is insomnia?
    difficulty falling asleep, intermittent sleep, or early awakening from sleep.
  35. What is hypersomnia?
    excessive sleep, particularly during the day
  36. What is somnambulism?
    sleepwalking
  37. What is nocturnal myoclonus?
    • muscle contractions that result in jerking of one or both legs during sleep
    • occurs in 10-20% of insomniacs
  38. Pain that is protective in nature and warns of tissue damage or organic disease.
    acute pain
  39. Pain that lasts beyond the normal healing period.
    chronic pain
  40. _______ pain usually involves the skin or subutaneous tissue. What is an example?
    • Cutaneous or superficial pain
    • paper cut
  41. Pain that is diffuse or scattered & originates in tendons, ligaments, bones, BV, and nerves.
    deep somatic pain
  42. What causes deep somatic pain?
    • strong pressure on a bone or
    • damage to tissue that occurs with a sprain
  43. Pain that is poorly localized and originates in body organs in the thorax, cranium, and abdomen.
    visceral pain
  44. How does visceral pain occur?
    • as organs stretch abnormally and become:
    • distended,
    • ischemic, or
    • inflamed
  45. Type of pain that results from an injury to or abnormal functioning of peripheral nerves or the CNS.
    Neuropathic pain
  46. What is intractable pain?
    pain that is resistant to therapy and persists despite a variety of interventions
  47. What is psychogenic pain?
    a physical cause for the pain cannot be identified
  48. What is transduction?
    • The activation of pain receptors
    • conversion of painful stimuli into electrical impulses
  49. What are nociceptors?
    The peripheral nere fibers that transmit pain
  50. What is a neurotransmitter?
    a substance that either excites or inhibits a target nerve cell
  51. What are 3 examples of neurotransmitters in the pain process?
    • Prostaglandins
    • Substance P
    • Seratonin
  52. What is seratonin?
    a hormone that can act to stimulate smooth muscles, inhibit gastric secretion, & produce vasoconstriction
  53. The LOWEST intensity of a stimulus that causes a person to recognize pain.
    pain threshold
  54. The process by which the sensation of pain is inhibited or modified.
    modulation
  55. What is a neuromodulator?
    a morphine-like chemical in the CNS that regulates or modifies the sensation of pain.
  56. Which endorphin has the most potent analgesic effect?
    dynorphin
  57. What are enkephalins?
    • less potent than endorphins,
    • reduce pain sensation by inhibiting the release of substance P
  58. What is the gate control theory?
    • explains that excitatory pain stimuli carried by small-diameter nerve fibers can be blocked by inhibiting signals carried by large-diameter nerve fibers
    • recognizes a relation b/w pain & emotions
  59. What is an analgesic?
    relieves pain
  60. Examples of nonopioid analgesics.
    • acetaminophen
    • nonsteroidal anti-inflammatory drugs
  61. What is an opioid analgesic?
    • all controlled substances
    • (morphine, codeine, methadone, hydromorphone)
  62. What is an adjuvant drug?
    • used to enhance the effect of opioids by providing additional pain relief
    • may reduce side effects from prescribed opioids or lessen anxiety about pain
  63. What is breakthrough pain (BTP)?
    temp flare-up of moderate to severe pain that occurs even when the pt is taking ATC meds for persistent pain.
  64. Any med OR procedure, including surgery, that may produce an effect because of its implicit or explicit intent & not b/c of its specific physical or chemical properties.
    PLACEBO
  65. An affective response is a _______ response to pain.
    psychological
  66. A mind-body interaction that decreases pain sensation by focusing on pleasurable images.
    Imagery
  67. Dilation of pupils is a physiologic or involuntary response to what kind of pain?
    moderate
  68. What happens to the pulse rate when pain is severe and deep?
    decreases
  69. What type of response to pain is restlessness and protection of painful area?
    behavioral
  70. What is delta sleep?
    NREM stages III & IV
  71. What happens to VS during REM sleep?
    they increase
  72. How many cycles of sleep does a person typically go through at night?
    4 or 5, each lasting 90-100 minutes
  73. Hypothyroidism can interfere with what stage of sleep?
    NREM II and IV
  74. Chest pain occurs more frequently during which stage of sleep?
    REM
  75. Which stage of sleep do epileptic seizures frequently occur?
    NREM
  76. During which stage of sleep do gastric secretions occur?
    REM
  77. What is fremitus?
    a vibration of the chest wall that can be palpated
  78. What is a pleural friction rub?
    a dry grating sound that is caused by inflammation of pleural surfaces
  79. Where are bronchial breath sounds heard?
    over the trachea (and are normal)
  80. What is the risk of an O2 rate higher than 2 L/min for a nasal cannula?
    It may destroy the hypoxic drive that stimulates respirations (in a pt with chronic lung disease)
  81. When inserting a suction catheter thru a tracheostomy tube, why should you be careful not to occlude the Y port?
    It causes suction and may cause trauma to the tracheal mucosa
  82. deoxygenated blood is carried from the _____ side of the heart to the lungs, then returned to the _____ side of the heart.
    • right,
    • left
  83. How does a hemorrhage affect internal respiration?
    Can cause a decrease in CO, which cuases a decrease in the amt of circulating bld that is available to deliver O2 to tissues

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