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respiratory care
module 2 phx college
42
Nursing
01/31/2010

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Term
Theraputic PaO2 range
Definition
80-100
Term
What does mechinal ventilation do?
Definition
assists or bypasses pt ability to breathe on their own
Term
PEEP
Definition
Positive end expitory pressure
Term
What is Ventilation?
Definition
The movement of air into and out of the airways is referred to as ventilation.
Term
What is Respiration?
Definition
The whole process of gas exchange is referred to as respiration
Term
What are normal  pulmonary pressures?
Definition
usually 20-30 mmHg over 5-15 mmHg
Term
What is  perfusion ?
Definition
 perfusion is the movement of blood through the pulmonary vasculature
Term
 What is Hypoxemia?
Definition
decreased arterial oxygen supply which can lead to a condition called hypoxia which is a decreased oxygen supply to tissues and cells.
Term
How do we measure Hypoxemia?
Definition
Hypoxemia can be measured through arterial blood gas analysis or indirectly through pulse oximetry monitoring
Term

What is

Hypoxia?

Definition
Hypoxia will occur if there is an inadequate amount of oxygen available for cellular metabolism. (tissue death)
Term
What is Partial pressure?
Definition
pressure exerted from a gas in a mixture of gasses. Partial pressure of oxygen in arterial blood is referred to as PaO2.
Term
What is a normal PaO2 range?
Definition
Normal PaO2 levels are 80 – 100 mmHg.
Term
What is a normal PaCO2 range?
Definition
Normal PaCO2 levels are 35-45 mmHg.
Term
Normal pH
Definition

Normal pH is 7.35-7.45

 

 A pH that is less than 6.8 or greater than 7.8 is incompatible with life.

Term
Respiratory Alkalosis values (directions)
Definition

pH up

pCO2 down

 

 

Term
causes of Respiratory Alkalosis
Definition

Hyperventilation

Mechanial ventialtion

 emboli, pneumothorax, or pneumonia

 

(loosing CO2 from the lungs)

Term
What are Pleural effusions?
Definition
an accumulation of fluid between the layers of tissue that line the lungs and chest cavity.
Term
Respiratory Acidosis values (up or down)
Definition

pH down

pCO2 up

 

(keeping CO2 in the lungs)

Term
Causes of Respiratory Acidosis
Definition
drug overdose, later stages of pulmonary emboli, pneumothorax or pneumonia, airway obstruction, chest trauma or neuromuscular diseases. Respiratory acidosis can be caused by any disorder that impairs ventilation causing the client to retain CO2.
Term
How to tell ifPartial compensation has occoured
Definition
 Partial compensation occurs when the lungs or kidneys are attempting to restore hydrogen ion concentration but have not completely done so yet. This can be identified in an arterial blood gas sample in which all three of the values (CO2, pH, and HCO3) are out of normal range.
Term
How to tell when Full compensation occurs
Definition
Full compensation occurs when the lungs and kidneys have restored hydrogen ion concentration back to normal values. This can be identified in an arterial blood gas sample in which the pH is normal but the CO2 and HCO3 are out of normal range.
Term
what is empyema?
Definition
is a collection of pus in the space between the lung and the inside of the chest wall (pleural space).
Term

Low-Flow Oxygen

Administration Systems

Definition

Nasal Cannula

Simple Mask

Partial Non-rebreather

100% Non-rebreather

Term

High-Flow Oxygen

Administration Systems

Definition

Ventrui Mask

Aresol Mask

T-piece

Tracheostomy Collar

Term
Signs and symptoms of oxygen toxicity
Definition
include chest pain, paresthesias, shortness of breath, restlessness, fatigue or malaise. The client may develop infiltrates on chest x-ray or refractory hypoxemia.
Term
When assessing A mechanical ventilator  nurse must know the following parameters:
Definition
  • Mode of ventilation
  • Tidal volume
  • Rate setting
  • Patient respiratory rate
  • FiO2
  • PEEP
  • Alarms
  • Term
    What is Atelectasis?
    Definition
    Atelectasis is the closure, blockage or collapse of alveoli.
    Term
    treatment of Atelectasis
    Definition

     frequent suctioning, chest physiotherapy, nebulizer treatments or intermittent positive pressure

     

     

    Term
    prevention of Atelectasis
    Definition
    frequent turning of the immobilized client, frequent ambulation of the mobile client, instruction and encouragement in the use of incentive spirometry as well as coughing and deep breathing
    Term
    Risk factors for pneumonia
    Definition
    Risk factors include prolonged immobility, the COPD client, the immunosupressed client, the smoker, client with advanced age, the client who has undergone anesthesia for a surgical procedure, the client on a ventilator, or any client with an alteration in level of consciousness
    Term
    what is a positive Mantoux test or PPD skin test?
    Definition

    An induration and not just redness measuring10 mm or greater in diameter after 72 hours is considered positive

     

    A positive reaction does not mean that the active disease is present, but indicates exposure to TB or the presence of inactive (dormant) disease.

    Term
    What is the definative TB dx test?
    Definition
    Sputum culture of M. Tuberculosis is the only diagnostic that confirms the diagnosis (1 - 3 weeks)
    Term
    What is Pulmonary edema?
    Definition
    Pulmonary edema is the abnormal accumulation of fluid in the interstitial lung tissue, the alveolar space or both.
    Term
    What are the clinical symptoms of pulmonary edema?
    Definition
    central cyanosis, air hunger, retractions, crackles/rales, anxiousness, tachycardia, confusion in elderly, and cool and clammy skin. The hallmark sign of pulmonary edema is pink frothy sputum
    Term
    How can Pleural effusion be diagnosed?
    Definition
    CXR, CT, as well as in combination with assessment findings. Thoracentisis may also confirm the presence of fluid.
    Term
    How to Diagnosis pulmonary edema?
    Definition
    through physical assessment, CXR, and ABG analysis. The fluid overload will result in crackles or rales. It is essential to document lung sounds and over exactly which lung fields are affected.
    Term
    Treatment of Acute respiratory failure?
    Definition
    pulse oximetry monitoring, ABG analysis, oxygen administration, and possibly assisting with intubation. Pulse oximetry may show decreased oxygen saturation but ABG analysis is needed for the most accurate assessment of oxygenation. Metered dose inhalers may be administered to dilate bronchioles and decrease inflammation
    Term
    How to treat pulmonary edema?
    Definition
    aimed at correcting the underlying condition, administration of oxygen to relieve dyspnea may be sufficient or the client may require endotracheal intubation. Morphine can be used to bronchodilate and diuretic therapy can be administered intravenously to reduce fluid volume excess. Positive inotropic agents or Natrecor may also be considered to relieve the symptoms of acute heart failure.  Positioning the client with the head of bed elevated and lower extremities dangling will decrease venous return and reduce preload.
    Term
    What is Acute respiratory distress syndrome?
    Definition
    Acute respiratory distress syndrome (ARDS) is disease process that results in a cascade of events that result from an acute lung injury to a client with no previous lung/heart disease
    Term
    Clinical manifestaion of Acute respiratory distress syndrome (ARDS)?
    Definition
  • Hypoxia that persists with 100% O2 – also called refractory hypoxemia
  • Decreased pulmonary compliance – stiff lungs
  • Sudden and progressive pulmonary edema – that occurs in the absence of left sided heart failre
  • Dense pulmonary infiltrates – throughout both lung fields
  • Clinically, the client may display intercostal retractions, crackles in all lung fields, cyanosis, hypotension, tachycardia, restlessness and anxiety as well as rapid shallow breathing.

     

    Term
    How is Acute respiratory distress syndrome (ARDS) diagnoised?
    Definition
    through physical assessment and refractory hypoxemia, arterial blood gas analysis, CXR, as well as the events leading up to the respiratory failure.
    Term
    treatment of ARDS?
    Definition
    Supplemental O2 is the first step in the treatment of ARDS. These patients generally require intubation and mechanical ventilation to maintain adequate gas exchange.  Positive End Expiratory Pressure (PEEP) Patients in ARDS have a tendency to continue to hyperventilate and breathe against the mechanical ventilator - The use of sedation and paralytic medication may be indicated