Exam 2: Oxygenation, Metabolism, CNS
correct!!!
On a CXR the air is...
Black
- the tissue and fluid is GREY
- bone is WHITE
Common abnormalities seen in oxygenation are:
Pleural effusion
Pulmonary edema
Pneumonia
Atelectasis
COPD
Pneumothorax
ARDS
On the CXR, pleural effusion shows...
at the base of the lung because it is fluid
On the CXR, pulmonary edema shows as...
patches of white because it is air
Oxygenation NANDAs:
Impaired gas exchange
Activity intolerance
Ineffective breathing pattern
Impaired spontanous ventilation
Dysfunctional ventilation weaning
Ineffective airway clearance
Risk for aspiration
Acute pain
Excess fluid volume
Decreased cardiac output
Risk for low tissue perfusion
The best position for patients with severe hypoxia is...
Prone (on the back )
- larger lung surface than in supine
,- better chest expansion
- no gravity on lungs
Where does gas exchange occur?
alveoli
A normal VQ scan will show...
nice transfer of oxygen and carbon dioxide at alveoli
- O2 is residual therefore no mouth to mouth needed if chest compressions are done right
The hemoglobin-oxygen dissociation curve shows:
Left shift: causes Loading of O2 in Lungs
Right shift: causes Release of O2 from Hb
A Left shift in hgb O2 curve is caused by:
Alkalosis
Hypothermia
Low CO2
A left shift in O2 curve causes...
hypoxia because tissues try hard to pull o2 off the RBCs
- O2 is locked
- high O2 in lungs
A right shift is caused by:
Acidosis
Hyperthermia
High CO2
high 2,3 DPG
A right shift will cause...
Hypoxemia - it is harder to load O2 and RBCs release it more readily
If a patient has fever, to improve oxygenation I give him..
cooling blanket
Tylenol
Tracheal breath sounds
Loud and harsh
- listen over trachea
Bronchial breath sounds
,loud, high-pitched, hollow
- listen over trachea and large bronchi
Vesicular sounds
soft, rustling
- periphery of the lung fields
Intervention for Rhonchi
TCDB
Suction
Crackles
- fluid present
- high pitched
- heard during inspiration
- may change with cough
Rhonchi
- mucous in the lungs
- rumbling, coarse sounds like a snore
- heard during inspiration or expiration
- may clear with coughing or suctioning
Wheeze
- airway is narrowed
- musical noise during inspiration or expiration
- first heard on expiration
Kussmal Respirations
Deep labored breathing pattern; increased rate, large volumes often seen in Diabetic Ketoacidosis
Tachypnea
fast breathing pattern
Bradypnea
slow breathing rate
Biots
Irregular breathing; breaths vary in depth and rate with periods of apnea; often associated with
increased intracranial pressure or damage to the medulla
Cheyne-Stokes respiration
, pattern of breathing characterized by a gradual increase of depth and sometimes rate to a maximum
level, followed by a decrease, resulting in apnea
Respiratory Patterns
Kussmaul, tachypnea, bradypnea, biots, cheyne-stokes
Lung sounds
crackles, rhonchi, wheezes
Geriatric Considerations for structural respiratory changes
- chest wall: stiffer, decreased compliance
- pharynx & larynx muscles atrophy, airways lose cartilage, vocal cords start to slack
- alveoli lose elasticity & surface area
- alveolar capillary membrane thickens = impaired gas exchange
What is the oxyhemoglobin dissociation curve representing?
Relationship between available oxygen and amount of oxygen carried by hemoglobin.
Geriatric Considerations for defense mechanisms and respiratory control
- decreased cell mediated immunity
- specific antibodies
- decreased cilia functioning
- decreased force of cough
- decreased response to hypoxemia & hypercapnia
6 P's of Dyspnea (potential causes)
- Pulmonary Bronchial Constriction
- Possible foreign body
- Pulmonary embolus
- Pneumonia
- Pneumothorax
- Pump Failure
6 P's of Dyspnea (visual)
(visual)
- Pulmonary Bronchial Constriction
- Possible foreign body
- Pulmonary embolus
- Pneumonia
- Pneumothorax
- Pump Failure
What causes dyspnea in a pneumothorax?
correct!!!
On a CXR the air is...
Black
- the tissue and fluid is GREY
- bone is WHITE
Common abnormalities seen in oxygenation are:
Pleural effusion
Pulmonary edema
Pneumonia
Atelectasis
COPD
Pneumothorax
ARDS
On the CXR, pleural effusion shows...
at the base of the lung because it is fluid
On the CXR, pulmonary edema shows as...
patches of white because it is air
Oxygenation NANDAs:
Impaired gas exchange
Activity intolerance
Ineffective breathing pattern
Impaired spontanous ventilation
Dysfunctional ventilation weaning
Ineffective airway clearance
Risk for aspiration
Acute pain
Excess fluid volume
Decreased cardiac output
Risk for low tissue perfusion
The best position for patients with severe hypoxia is...
Prone (on the back )
- larger lung surface than in supine
,- better chest expansion
- no gravity on lungs
Where does gas exchange occur?
alveoli
A normal VQ scan will show...
nice transfer of oxygen and carbon dioxide at alveoli
- O2 is residual therefore no mouth to mouth needed if chest compressions are done right
The hemoglobin-oxygen dissociation curve shows:
Left shift: causes Loading of O2 in Lungs
Right shift: causes Release of O2 from Hb
A Left shift in hgb O2 curve is caused by:
Alkalosis
Hypothermia
Low CO2
A left shift in O2 curve causes...
hypoxia because tissues try hard to pull o2 off the RBCs
- O2 is locked
- high O2 in lungs
A right shift is caused by:
Acidosis
Hyperthermia
High CO2
high 2,3 DPG
A right shift will cause...
Hypoxemia - it is harder to load O2 and RBCs release it more readily
If a patient has fever, to improve oxygenation I give him..
cooling blanket
Tylenol
Tracheal breath sounds
Loud and harsh
- listen over trachea
Bronchial breath sounds
,loud, high-pitched, hollow
- listen over trachea and large bronchi
Vesicular sounds
soft, rustling
- periphery of the lung fields
Intervention for Rhonchi
TCDB
Suction
Crackles
- fluid present
- high pitched
- heard during inspiration
- may change with cough
Rhonchi
- mucous in the lungs
- rumbling, coarse sounds like a snore
- heard during inspiration or expiration
- may clear with coughing or suctioning
Wheeze
- airway is narrowed
- musical noise during inspiration or expiration
- first heard on expiration
Kussmal Respirations
Deep labored breathing pattern; increased rate, large volumes often seen in Diabetic Ketoacidosis
Tachypnea
fast breathing pattern
Bradypnea
slow breathing rate
Biots
Irregular breathing; breaths vary in depth and rate with periods of apnea; often associated with
increased intracranial pressure or damage to the medulla
Cheyne-Stokes respiration
, pattern of breathing characterized by a gradual increase of depth and sometimes rate to a maximum
level, followed by a decrease, resulting in apnea
Respiratory Patterns
Kussmaul, tachypnea, bradypnea, biots, cheyne-stokes
Lung sounds
crackles, rhonchi, wheezes
Geriatric Considerations for structural respiratory changes
- chest wall: stiffer, decreased compliance
- pharynx & larynx muscles atrophy, airways lose cartilage, vocal cords start to slack
- alveoli lose elasticity & surface area
- alveolar capillary membrane thickens = impaired gas exchange
What is the oxyhemoglobin dissociation curve representing?
Relationship between available oxygen and amount of oxygen carried by hemoglobin.
Geriatric Considerations for defense mechanisms and respiratory control
- decreased cell mediated immunity
- specific antibodies
- decreased cilia functioning
- decreased force of cough
- decreased response to hypoxemia & hypercapnia
6 P's of Dyspnea (potential causes)
- Pulmonary Bronchial Constriction
- Possible foreign body
- Pulmonary embolus
- Pneumonia
- Pneumothorax
- Pump Failure
6 P's of Dyspnea (visual)
(visual)
- Pulmonary Bronchial Constriction
- Possible foreign body
- Pulmonary embolus
- Pneumonia
- Pneumothorax
- Pump Failure
What causes dyspnea in a pneumothorax?
