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The atmosphere is _____ % oxygen.
20
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The process of moving gases in and out the lungs is called:
Ventalation
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The ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs is ______.
Perfusion
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Exchange of respiratory gases in the alveoli and capillaries is _______.
Diffusion
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How do we assess perfusion?
Capillary Refill / circulation
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How do we assess Ventilation?
Respiration count
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How do we assess Diffusion ?
Pulse Ox
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What is Surfactant?
chemical produced in the lungs to maintain surface tension of the alveoli and prevent them from collapsing
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Collapsing of the alveoli that prevents the normal exchange of oxygen and carbon dioxide?
Atelectasis
immobility is a big contributing factor leading to ventilator-associated pneumonia.
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How do we assess work of breathing?
- Are they using accessory muscles?
- Frequency / effort / pattern / Noisy?
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Oxygen transport includes what body systems?
Lungs & Cardiovascular
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Pulmonary circulation moves blood to and from the _______ membranes for gas exchange.
Alveolar capillary
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Inspiration is a process stimulated by chemical receptors in the ______.
Aorta
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Expiration is a ______ process.
passive
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Tidal lung volume=
amount of air exhaled after a normal inspiration
-
Forced vital capacity of the lungs:
the max amount of air that can be removed from the lungs during forced expiration
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what carries oxygen and carbon dioxide?
Hemoglobin
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The _____ of the alveolar capillary membrane affects the rate of diffusion.
Thickness
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CHF patients have compromised cardiovascular system leading to decreased _________.
Perfusion
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How many lobes are in the lungs on the right side?
3
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As the myocardium stretches the strength of the subsequent contraction increases. What is this called?
Starling's Law
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What is called when mitral and tricuspid close?
S1 sound
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What happens at S2?
Aortic and pulmonic close
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What do the coronary arteries do?
Supply the myocardium with nutrients and remove waste.
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What is collateral circulation?
adaptation/alteration of vessels to make up for or circumvent a compromised arteries (usually near the heart)
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What causes pain during an MI?
Lactic acid build up - give oxygen to help clear the acid - then give aspirin 81mg to stop platelet aggregation
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The amount of blood ejected from the left ventricle each minute:
Cardiac output
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Amount of blood ejected from the left ventricle with each contraction:
Stroke Volume
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Pre-load =
amount of end diastolic pressure
-
Afterload =
Resistance to left ventricle ejection -
in hypertension, the after load increases, making cardiac workload also increase.
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Heart chambers of the heart fill during ...
diastole
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The conduction system of the heart includes what?
- SA node (pacemaker)
- AV node
- Bundle of His
- Bundles
- Purkinjie fibers
-
Patients with compromised heart conduction system may be assessed for what?
low heart rate
-
What test is used to assess the hearts conduction system?
EKG
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What does the parasympathetic system do to the conduction system of the heart?
Decreases the rate of your heart
-
What does the Sympathetic nervous system do to the conduction system of the heart?
Increases the rate of impulse generation - fight or flight - see a lion, rate increases and blood goes to muscles
-
Normal hemoglobin for female:
12 - 15.1 grams per deciliter
-
Normal hemoglobin levels for male:
13.8 - 17.2 grams per deciliter
-
What are some physiological factors that may affect oxygenation:
- -decreased carrying capacilty
- -Hypovolemia
- -Decreased inspired O2 concentration
- -Increased metabolic rate
-
Conditions that may affect oxygenation:
- pregnancy
- obesity
- trauma
- musculoskeletal abnormalities
- neuromuscular diseases
-
Hyperventilation=
increased ventilation - letting off too much carbon dioxide
**Paper bag
-
Hypoventilation=
- inadequate ventilation to meet body's oxygen needs.
- low or shallow respiration
- ** reposition, give oxygen
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Hypoxia =
inadequate tissue oxygenation at the cellular level - either from poor delivery or use at cellular level
-
What test would find impaired valvular function in the heart?
- Echo cardiogram -
- can measure ejection fraction rate (EFR) normal is 60-70%
-
Health Promotions would include:
- Vaccines (FLU annual/bacterial pneumococcal)
- Healthy Lifestyle (food/exercise)
- Environmental Pollutants (secondhand smoke, pollutants, work chemicals)
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This prevents obstruction of trachea by displacement of the tongue into the oropharynx :
Oral airway
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What are endotracheal airways?
SHORT TERM - used to administer mechanical ventilation, relieve upper airway obstruction, protect against aspiration and clear away secretions.
-
How would you measure for the correct size oral airway?
measure the distance from the corner of the mouth to the angle of the jaw, just below the ear. The length is equal to the distance from the flange of the airway to the tip.
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What are tracheal airways ?
LONG term (more than 2 weeks)
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Volume =
- FLuid amount
- this can change with I&O, drainage, fever, sweating, hemorrhage
-
Osmolality =
Fluid concentration of something
-
Fluid Composition =
electrolyte concentration
-
Homeostasis range for human pH :
7.35 - 7.45
-
Intracellular = found where?
2/3 or 60% of total body water is inside our cell
-
Extracellular = found where?
1/3 or 40% found outside of our cells
-
interstitial fluid is found where?
- in between cells (outside blood vesseles)
-
Intravascular fluid is found where?
- liquid portion of blood (plasma)
-
Transcellular fluid is found where?
- minimal
- pleural fluids
- cerebrospinal fluids
- peritoneal cavity (abdomen)
- synovial (joints)
-
The main electrolyte found outside of the cells =
Sodium
-
Electrolytes found outside of the cells?
Sodium & Chloride
-
Electrolytes found inside cells?
Potassium & Phosphate
-
What is our normal sodium level? or isotonic fluids would be ...
0.9% normal saline
or Isotonic / Lactated Ringers / 5% dextrose
-
Hypertonic solutions are what % saline?
above or > 0.9%
-
Hypotonic fluids put fluids in or out of cell?
IN
-
Osmosis is the movement of ____.
water
-
Active transport = define & given an example
movement of particles across the cell membrane from lower to higher concentration.
ex: sodium-potassium pump
-
Give an example of diffusion:
gas exchange in the alveoli - movement of substance from higher to lower concentration
-
Fluid Intake should be ________ daily .
2300mL/day
-
What organ produces the antidyeretic hormone? what is it?
Kidneys - angeotensin I
-
Hypovolemia =
- ECV deficit
- decreased vascular volume
- this is extracellular fluid volume (ECV)
- is usually isotonic
-
Hypernatremia =
- water deficit
- HYPERtonic - water leaves the cells by osmosis
-
Hyponatremia =
- water excess or water intoxication.
- Caused by gain of relatively more water than salt OR loss of more water than salt.
could be caused by CHF, kidney problems, fluid retention,
-
Fluid volume excess clinical S/S:
- crackles in the lungs (not clear with coughing)
- distended corroded veins
- cerebral dysfunction
- fast heart rate
- increased BP
- increased weight
-
Hypokalemia =
low potassium (K+)
normal levels 3.5 - 5.0
-
Hyperkalemia =
High K+
normal level = 3.5 - 5.0
-
Hypocalcemia =
Low calcium (Ca2+)
normal levels = 8.4 - 10.5
-
Hypercalcemia =
High Calcium (Ca2+)
normal levels = 8.4 - 10.5
-
Hypomagnesemia =
low magnesium (Mg2+)
normal level = 1.5 - 2.5
-
Hypermagnesemia =
High magnesium (Mg2+)
normal level = 1.5 - 2.5
-
Normal body pH =
7.35 -7.45
-
Normal Bicarbonate =
22-26 mEq/l
-
What are the bodies two acid-excretion systems?
lungs & kidneys
-
The lungs excrete what acid?
carbonic acid
-
The kidneys excrete what acid?
metabolic acid and all others (except carbonic acid)
-
-
-
Respiratory Acidosis :
Hypoventilation = COPD patients can't breathe off enough Co2
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