-
normal ph balance
7.35-7.45
-
if ph goes up blood becomes
alkaline
-
if ph goes down blood becomes
acidic
-
name the upper airway in order
- nasel cavity
- pharynix
- epiglottis
- larynx
- trachea
-
kreps cycle
- the glucose is broken down and burned, the end
- cycle is co2
-
internal resp
at the tissue level or cell level
-
external resp
takes place at the alveoli
-
what too organs work together in resp
heart and lungs
-
-
shallow breathing is a problem with
ventilation
-
persed lip breathing
opens the airway
-
alveoli what happens
o2 and co2 change takes place
-
o2 above what level should be humidified
4lt
-
what is. the middle of the branch of lungs called
carina
-
in a co2 retainer what happenes
airway collapse
-
how many lobes do the right side of lung have
3
-
-
-
how do u collect a sputum sample
get first thing in morning, a big luggy from deep down
-
if sputem is green it endicates
infection, they will fever and look sick
-
blue bloaters
is from copd, chronic broncitis, it is from right sided heart failure so they get edema
-
pink puffers
- is caused from emphysema, it is more inside the alveolis, this person is skinny from energy used
- high fowlers, orthopnic(standing or sitting up)
-
if a person has pneumonia what are some signs
- diminished sounds in the localized area of the lung
- pain
-
nx: for pneumonia
ineffective gas exchange r\t pneumonia
-
name 2 types of pneumonia
- bacterial and viral
- bacterial being the worse
-
what is pneumocystis carinii pneumonia{PCP}
- it is a opertunestic pneumonia
- usually cause of death in aids pt and immunecompromised pt
-
what is the diff between c-pap and bi-pap
- c- is continous positive airway and bi- adjusts to the pressure needed
- always ask if they snore or use a cpap
-
epiglotitis
is a dangourous bacteral infection
-
croup(Laryngotracheobronchitis)
is a virous
-
ryanitis
is inflamation of the nose (allergies)
-
what can interfer with a pulse ox and what do we check if pt looks normal
nail polish, dirty, pt must be still, ck wires, hypotension, hypovolemia(dehydrated), hypothermia(cold)
-
-
crackles
- fluid
- will not clear with coughing
-
what is co2
- it is the waste productof energy production in cells
- it is your acid
-
co2+h2o(bound hydrogen)=
h2co3 + h+(hydrogen)
-
free hydrogen creates
acid
-
-
priority is too
allways maintain airway
-
nx:copd
- ineffective airway clearance r\t airway obstruction
- increase nutrition bal r/t work load to breath
-
things to do for copd
- increase fluides if not contraindecated
- cal intake
- periods of rest and stagered activities
- eating may take them an hour
-
nasal polyps
benign overgrowth scar tissue
-
PE s/s treatment
- pain sob impending dume,antiquags
- ted hose or scd and do not take no as an answer
- in labodomy pos clots are formed
-
what is the difference to know if it is heart or pe
- cpr heart you get a pulse
- pe you get edema
-
what must be bound with o2 to get to the cells
hemaglobin (HGB)
-
-
-
what is resp acidosis/alkalosis
- pco2 up and ph down/ acid
- pco2down and ph up/alk
- see saw effect
-
what is metabolic acidosis/alkalosis
- hco3 and ph down/acid
- hco3 andph up /alk
- elevator effect
-
-
strider
- high pitch sound
- airway obstruction
- croup or epglotitis
-
early s/s of hypoxia(dec o2)or hypercapnia(inc co2
loc change, pick at sheets,restless,tackycardia
-
cardiac output =
stroke volume * heartrate per min
-
po2 is
o2 disolved in blood
-
-
Emphysemia is
- primarly an aveoli disease
- co2 is no longer ther stemulation to breath
- the medulla normally tells them to breath when co2 gets high,
- they now have o2 as there drive to breath
- if you give them too much o2, they quit breathing
-
if they can't breath what do we do
bag them
-
polycythemia
- increased red blood cell production
- heart works harder, more blood volume
- some times have to take blood out
-
NX: ineffective airway clearence
- pt deep breath
- hit chest/vest
- fluids
- suction
- mucusdrugs expectorants
-
hypervent causes
resp alkolosis
-
ketoacidosis
increased acid
-
diareha causes
loss of bicarb, pancreous(gut) produces bicarb
-
vomiting causes
alkolosis, due to loss of stomach acid
-
(PRIMARY BASE)bicarbs bind with
acid to nutralize it
-
metabolic acidosis is
too much acid and decrease in bicarb
-
metabolic acids produced
- bun ketones,uric acid
- kidneys gets rid of it
-
-
too much co2 acid =
h+ or free hydrogen
-
-
Intubation
- relief of obstruction
- ease of suctioning with a tube
- in mouth
-
trachemotomy
- keep hole open to maintain airway
- surgery placement
- if comes out stay with them and get help
-
-
thoracentesis cause and treat
- plural space has fluid
- go in and remove the fluid so lungs dont collapse
- watch bleeding, vitals, sit semi fowlers,infections,pain control, lay on uneffected side
-
transudate/exudate
- trans-internal
- ex-fluid outside body
-
pulmonary function test
- laryngoscope-throtand vocalcords
- bronchoscopy-into lungs
- PFT-title volume normal in out breathing about 500cc
-
co2 retainers
airways collapse, chest enlarges
-
with clots
perfusion can not happen
-
-
-
good lungs
airflow into alveoli and perfusion has to happen
-
inspiration
- diaphram expands and lets air in
- pressure of least resestance
-
expiration
elasticity in lungs pushes air out
-
scar tissue
is hard and will not expand
-
pneumothorax open and closed
- open is from puncture or tramatic event
- closed internal ruptures air goes into plural space and it clapses
- will hear no breath sounds over the claps area
-
pulmonary edema s\s
dyspia, sob, red foamy sputem
-
chf is
backwards heart failure into lungs
-
-
insentive spirometer teach
suck in
-
asthma
- reactive airway disease
- constrictive/spasms
-
dyspnea
difficult rapid breathing using excessive muscles
-
-
tachypenia
fast breathing
-
apneustic
periods of apnea
-
-
adventitious breath sounds
abnormal breath sounds
-
rhonchi
wheeze may clear with cough
-
diff between plural friction rub and pericardial rub
- low pitch , if you hold breath and it goes away
- its plural rub
-
tictile freemitus
feel vibration when they say 123
-
crepitus
in blood gases gangreen
-
most common diagnosis related group in usa
chf
-
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