FUND Unit 2 O2 Comfort & Sleep
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A detergent-like phospholipid that reduces the surface tension b/w the moist membranes of the alveoli, preventing collapse.
Where is the site of gas exchange?
In respiration, diffusion refers to the movement of ______ and ______ between the _____ in the ______ and the ______ in the ______.
- O2 and CO2
- air, alveoli
- blood, capillaries
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
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.
Deoxygenated blood (low in O2, high in CO2) is carried from the _____ side of the heart to the _____.
LOW-pitched, SOFT sounds heard over peripheral lung fields.
Vesicular lung sounds
MEDIUM-pitched blowing sounds heard over the major bronchi.
LOUD, HIGH-pitched sounds heard primarily over the trachea & larynx.
What are adventitious breath sounds?
- Abnormal lung sounds,
- categorized as discontinuous or continous
SOFT, HIGH-pitched discontinuous popping sounds
How are crackles in the lungs produced?
- By fluid in the airways or alveoli and
- delayed reopening of collapsed alveoli
Continuous, MUSICAL sounds, produced as air passes through airways constricted by swelling, narrowing, secretions, or tumors.
What are sibilant wheezes?
originate in smaller airways and are high pitched and whistling
What are sonorous wheezes?
They can be heard over larger airways and sound like a snore.
In what type of patients are sonorous wheezes often heard?
asthma, tumors, or a buildup of secretions
What causes a pleural friction rub?
- inflammation of pleural surfaces and
- loss of lubricating pleural fluid
A pleural friction rub is a continuous, dry grating sound and resembles the sound made by what?
rubbing two leather surfaces together
What does pulse oximetry measure?
arterial oxyhemoglobin saturation of arterial blood
What is thoracentesis?
The procedure of puncturing the chest wall and aspirating pleural fluid.
What does a nebulizer do?
Disperses the fine particles of liquid medication into the deeper passages of the respiratory tract (where absorption occurs)
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
How are dry powder inhalers activated?
by a quick deep breath
What are some disadvantages of a nasal cannula?
- it can be dislodged easily
- can cause dryness of the nasal mucosa
FLUID in the pleural space.
BLOOD in the pleural space.
AIR in the pleural space.
What type of sleep comprises about 75% of total sleep and consists of 4 stages?
What are stages I & II of sleep?
- Light non-REM sleep
- 5% & 50% of sleep,
- light sleep
What are stages III & IV of sleep?
- each about 10% of sleep
- DEEP sleep
- delta sleep (slow-wave sleep)
When is the arousal threshold greatest in NREM sleep?
What are parasomnias?
patterns of waking behavior that appear during sleep
What are dyssomnias?
sleep disorders char by insomnia of excessive sleepiness
What is insomnia?
difficulty falling asleep, intermittent sleep, or early awakening from sleep.
What is hypersomnia?
excessive sleep, particularly during the day
What is somnambulism?
What is nocturnal myoclonus?
- muscle contractions that result in jerking of one or both legs during sleep
- occurs in 10-20% of insomniacs
Pain that is protective in nature and warns of tissue damage or organic disease.
Pain that lasts beyond the normal healing period.
_______ pain usually involves the skin or subutaneous tissue. What is an example?
- Cutaneous or superficial pain
- paper cut
Pain that is diffuse or scattered & originates in tendons, ligaments, bones, BV, and nerves.
deep somatic pain
What causes deep somatic pain?
- strong pressure on a bone or
- damage to tissue that occurs with a sprain
Pain that is poorly localized and originates in body organs in the thorax, cranium, and abdomen.
How does visceral pain occur?
- as organs stretch abnormally and become:
- ischemic, or
Type of pain that results from an injury to or abnormal functioning of peripheral nerves or the CNS.
What is intractable pain?
pain that is resistant to therapy and persists despite a variety of interventions
What is psychogenic pain?
a physical cause for the pain cannot be identified
What is transduction?
- The activation of pain receptors
- conversion of painful stimuli into electrical impulses
What are nociceptors?
The peripheral nere fibers that transmit pain
What is a neurotransmitter?
a substance that either excites or inhibits a target nerve cell
What are 3 examples of neurotransmitters in the pain process?
- Substance P
What is seratonin?
a hormone that can act to stimulate smooth muscles, inhibit gastric secretion, & produce vasoconstriction
The LOWEST intensity of a stimulus that causes a person to recognize pain.
The process by which the sensation of pain is inhibited or modified.
What is a neuromodulator?
a morphine-like chemical in the CNS that regulates or modifies the sensation of pain.
Which endorphin has the most potent analgesic effect?
What are enkephalins?
- less potent than endorphins,
- reduce pain sensation by inhibiting the release of substance P
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
What is an analgesic?
Examples of nonopioid analgesics.
- nonsteroidal anti-inflammatory drugs
What is an opioid analgesic?
- all controlled substances
- (morphine, codeine, methadone, hydromorphone)
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
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.
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.
An affective response is a _______ response to pain.
A mind-body interaction that decreases pain sensation by focusing on pleasurable images.
Dilation of pupils is a physiologic or involuntary response to what kind of pain?
What happens to the pulse rate when pain is severe and deep?
What type of response to pain is restlessness and protection of painful area?
What is delta sleep?
NREM stages III & IV
What happens to VS during REM sleep?
How many cycles of sleep does a person typically go through at night?
4 or 5, each lasting 90-100 minutes
Hypothyroidism can interfere with what stage of sleep?
NREM II and IV
Chest pain occurs more frequently during which stage of sleep?
Which stage of sleep do epileptic seizures frequently occur?
During which stage of sleep do gastric secretions occur?
What is fremitus?
a vibration of the chest wall that can be palpated
What is a pleural friction rub?
a dry grating sound that is caused by inflammation of pleural surfaces
Where are bronchial breath sounds heard?
over the trachea (and are normal)
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)
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
deoxygenated blood is carried from the _____ side of the heart to the lungs, then returned to the _____ side of the heart.
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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