Oxygenation

• ventilation: the process of moving gas into and out of lungs
• perfusion: blood flow to the lungs (pulmonary circulation)
• diffusion: the exchange of respiratory gases in alveoli and capillaries

Mouth, nose, pharynx, larynx

trachea, bronchi, bronchioles, alveoli, pulmonary capillary network, pleural membrane

• Compliance is how open the air way is, the ability of lungs to distend and expand. This decreases is pulmonary edema, fractured ribs, interstitial and pleural fibrosis.
• Resistance is how closed the airway is.This increases due to airway obstruction, asthma, and tracheal edema.

• Diaphragm and intercostals contract
• Thoracic cavity size increases
• Lung volume increases
• Intrapulmonary pressure decreases
• Air rushes in lungs to equalize pressure

• Diaphragm and intercostals relax
• Intrapulmonary pressure rises
• Air is expelled

• vomiting, shock, severe dehydration.
• this increases heart rate and peripheral vasoconstriction

albuterol

decrease

• circulating blood count
• if it is low... hypoxia

airway resistance

• anemia: result of decreased hemoglobin production, increased RBC destruction, or blood loss
• Carbon monoxide poisoning: CO strongly binds to hemoglobin, making the hemoglobin unavailable for O2 transport

upper and lower airway obstructions, high altitudes, or drug overdoses

They affect the pts ability to expand and contract the chest wall

Spinal cord and medulla oblongata

Dysrhythmias occur as a primary conduction disturbance, such as in response to ischemia, valvular abnormality, anxiety, or drug toxicity; as a result of caffeine, alcohol, or tobacco use; or as a complication of acid-base or electrolyte imbalance

a transient imbalance between myocardial oxygen supply and demand. The condition results in chest pain that is aching, sharp, tingling, or burning, or that feels like pressure

• a heart attack. Infarction occurs because of ischemia (which is reversible) and necrosis (which is not reversible) of myocardial tissue.
• usually described as crushing, squeezing, or stabbing. The pain is often in the left chest and sternal area.

Anxiety, infections, drugs, or an acid-base imbalance induce hyperventilation, as well as hypoxia associated with pulmonary embolus or shock.

collapse of alveoli

• decreased hemoglobin
• diminished concentration of inspired o2
• the inability of the tissues to extract oxygen from the blood, as with cyanide poisoning;
• decreased diffusion of oxygen from the alveoli to the blood, as in pneumonia
• poor tissue perfusion with oxygenated blood, as with shock;
• impaired ventilation, as with multiple rib fractures or chest trauma.

• apprehension, restlessness, inability to concentrate, declining level of consciousness, dizziness, and behavioral changes.
• The client with hypoxia is unable to lie down and appears fatigued and agitated.
• Vital sign changes include an increased pulse rate and increased rate and depth of respiration.

is inadequate tissue oxygenation at the cellular level

Shortness of breath or difficulty breathing

bloody sputum

inserting a needle into the chest wall and into the pleural space, usually to remove fluid for diagnostic or therapeutic purposes

when pt can cough effectivly but cannot remove secretions

when pt is unable to manage secretions

a complete blood count. A CBC determines the number and type of red and white blood cells per cubic millimeter of blood.

Culture and Sensitivity test. Obtained to identify a specific microorganism or organism growing in the sputum. Identifies drug resistance and sensitivities.

• AFB= Acid Fast Bacillus
• Used to screen for the presence of AFB for detection of TB by early morning specimens on 3 consecutive days.

Obtained to identify abnormal lung cancer. Differentiates type of cancer cells (small cell, oat cell, large cell).

Activity intolerance•Anxiety•Decreased cardiac output•Fatigue•Impaired gas exchange•Impaired spontaneous ventilation•Impaired verbal communication•Ineffective airway clearance•Ineffective breathing pattern•Ineffective health maintenance•Risk for imbalanced fluid volume•Risk for infection

• Annual influenza vaccines are recommended for children 6 to 59 months, adults over 50, and clients with chronic illnesses (especially of the heart, lung, or kidneys), diabetics and clients with immunosuppression or severe forms of anemia. also anyone with frequent contact with any of the above listed conditions.
• Pneumococcal vaccine is recommended for clients at increased risk of developing pneumonia, those with chronic illnesses or immunosuppression (such as HIV/AIDS), those living in nursing homes or the Native American population, and clients over the age of 65.
• Exercise

prevents thick secretions

• a group of therapies used to mobilize pulmonary secretions. These therapies include postural drainage, chest percussion, and vibration
• recommended for clients who produce greater than 30 mL of sputum per day or have evidence of atelectasis by chest x-ray examination

involves deep inspiration and prolonged expiration through pursed lips to prevent alveolar collapse

• deep breathing and coughing exercises
• pursed lip breathing
• diaphragmatic breathing

A pneumothorax is a collection of air in the pleural space. The loss of negative intrapleural pressure causes the lung to collapse.