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Chapter 48 Respiratory Function


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Physical process of moving gases in and out of lungs
Molecules move from an area of greater concentration or pressure to an area of lower concentration or pressure
When oxygen attached to the hemogoblin molecules, they are called......
Factors that affect the rate of oxygen transport from the lungs to the tissues are?
Cardiac Output
Number of Erythrocytes (RBCs)
Blood carries Carbon Dioxide in several forms
1.) 65% in dissociated form (chemicaaly combines with water and forms into HCO3)
2.) 30% combines with hemogoblin
3.) 5% combines with water and transports as carbonic acid
Part of the brain where the control of ventilation is located
Respiratory center located at the Reticular Formation
When does the chemosensitive center in the medulla oblangata react to?
Reacts when there is an increase in Carbon Dioxide or Hydrgoen Ion Concentration
What makes the Neuroreceptors in the carotid bodies and aortic bodies?
Decrease in Oxygen COncentration
Among all the 3 blood gases (Hydrogen, Oxygen and Carbon Dioxide, which stimulates respirations most strongly?
Carbon Dioxide
What are the defenses of the Respiratory System?
Sneeze and Cough
Mucous Membrane
Normal Respiration Rate for Teen Years
Normal Respiration Rate for Adult Years
Normal Respiration Rate for Older Adult
What is the nursing diagnosis for Toddler and Preschooler?
Risk for Aspiration Related to Putting things in the mouth
A physically fit athlete breathes ......
What is the best body position?
Upright position since it allows fullest lung expansion.
Why is it harder to breath using the supine position?
Abdominal contents press against the diaphragm
What is the stable FIO2 when breathing in room air?
Around 21%
At higher altitude, there is lower oxygen pressure. What does this mean to the oxygen content at this altitude?
Less Oxygen Available
What does air pollution do?
Interfere with oxygenation and prone for development of severe breathing problems
What does allergens/pollens to the respiratory system?
Cause inflammatory response which leads to tissue damage.
Can lead to bronspasms
What does smoking cause?
Likely to acquire Emphysema, Chronic Bronchitis, Lung Cancer, Bladder Cancer, CV disease and oral cancer. Inhibit mucous removal.
Cause airway blockage, promote bacterial colonization and infection
What drugs causes decrease in Respiratory rate?
How does alcohol affect the respiratory rate?
Alcohol depresses the system thus decreasing the resp rate
Who are at risk in terms of respiration/immune system due to nutrition?
Obesity (restrict lung capacity and oxygen demands) and alcoholics
What is Atelectasis?
Alveoli collapse
What are abnormal breath sounds from air passing through narrowed passageways?
Adventitious Breath Sounds
What is the absense of respiration?
What is Apneustic Breathing
Prolonged Inspirations
What is Bradypnea?
Slow respirations; Usually 10 per min
What are Biot's respirations
Shallow Breaths interrupted by Apnea
What is a broncho-vesicular Breathing SOunds?
Normal Breathing Sounds; moderate-intensity and moderate pitched blowing of air moving through the bronchi.
Where can you hear the Broncho-vesicular Breathing Sounds?
Between the Scapula and Lateral to the Sternum at the 1st and 2nd intercostal space
What is Bronchial Breathing SOunds?
Normal Breathing Sounds, High pitched, harsh sounds created by air moving thru the trachea
What is the difference between the Bronchial Breathing Sound and Broncho-vesicular Breathing Sound?
The Bronchial sound is louder than the broncho-vesicular breathing sound.
What is vesicular Breathing Sounds?
Normal Breathing Sound, soft-intensity., low intensity, gentle sighing sounds created by air moving through the aveoli and bronchioles
What is Cyanosis?
Bluish discoloration of the skin, nailbeds, mucous membranes caused by lack of Oxygen/respiratory distress
What is the Chynes-Stokes Breathing?
Marked rythmic waxing and waning of respiration from very deep to very shallow breathing and temporary apnea
In what cases do you hear the Chynes-Stokes Breathing?
CHF, Increase intracranial pressure and drug overdose
What are crackles?
Fine, short interrupted cracling sounds
What is the cause of crackles?
Caused by air passing thru fluids or mucus in any air passage
Where is the crackles most commonly heard
Base of the lower lung lobes
What is Dyspnea?
Difficult or uncomfortable breathing
What are gurgles (rhonchi)?
Continuous, low pitched, coarse, gurgling, harsh, louder shounds with a moaning or snoring quality.
What is the costs of gurgles?
Air passing thru narrowed air passages as a reslt of secretions, swelling and tumors.
Where do you hear gurgles?
Most lung areas but predominately over the trachea and bronchi?
What is Eupnea?
Normal Breathing
What is Friction Rub?
Superficial grating or creaking sounds heard during inspiration and expiration
What is the cause of Friction rub?
Caused by rubbing together of inflamed pleural surfaces
Where can you hear the friction rub?
Heard most often in the areas of greater thoracic expansion
Whast is Hemoptysis?
Expectoration of blood or bloody sputum
What is Hypercarbia (Hyper Capnia)?
Increased Carbon Dioxide in Blood.
What is Hypoventilation?
Less often and not as deep breaths
What is Hypoxia?
Condion of insufficent oxygen anywhere ion the body, from the inspired gas to the tissues.
What is Kussmaul's breathing?
Body attempts to compensate for an acidic condition by blowing off the CO2 thru deep and rapid breathing
What is Orthopnea
Difficulty breathing except upright
What is SOB?
Shortness of Breath (being unable to get enough air)
What is Stridor
Harsh, high pitched, squeky musical sounds.
Where can Stridor be heard?
Heard in lower airway obstruction
Where can you hear a wheeze?
All over lung field
What is a wheeze?
Continous high pitched, squeky musical scores
How did the lungs sound like a wheeze?
Air passing through a constricted bronchus a result of secretions
What is a surfactant
Lipoprotein porduced by specialized alveolar cells
What is the surfactant for?
Reduced the surface tension of alveolar fluids
What is tachypnea
Rapid rate of breathing
When does tachypnea occur>
Fevers, metabolic acidosis, pain and with hypercapnia or hypoxemia
What is tidal volume?
Amount of air inspired and expired with each breath.
WHat is the normal tidal volume?
500 ml of air
What are the symptoms of early Hypoxia?
R (Restlessness)
A (Anxiety)
T (Tachycardia/Tachypnea)
What are the symptoms of late Hypoxia?
B (Bradycardia)
E (Extreme Restlessness)
D (Dyspnea)
How do you the Physical Examination of the lungs?
What do you determine when you inspect
Rate and Pattern of breaths
What do you determine when you Palpate?
Extent and pattern of thoracic expansion
What do you determine when you percuss?
Detect Fluid or consolidated areas
What do you determine when you Ausculate?
Determine Air movement
What are the diagnostic test and procedures?
Visulatizaiton Procedures, Pulmonary Function Tests, Sputum Culture, ABG Monitoring, Pulse Oximetry, Skin Tests
What is a Chest xray for?
To identify pathological changes in the lung fields
What does a Pulmonary function test measure?
Measures lung size and airway capacity
What does ABG monitoring show?
Accurate picture of gas exchange
What does pulse oximetry do?
Measures arterial blood oxygen saturation.
Why is skin tests important?
To identify allergies and sensativities to certain antigens or diseases
What is the nursing diaagnosis when one is unable to clear secretions or obstruction?
Ineffective Airway Clearance
What is the nursing diagnosis when one's inhalation or exhalation pattern doesn't allow adequate, pulmonary inflation or deflation
Ineffective breathing patters
When do you use Impaired Gas Exchage as a nursing diagnosis?
When there is a decreased passage of oxygen and/or Carbon disoxide between alveoli and vascular system

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