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Chapter 38: Oxygenation and Perfusion Vocabulary

Alexandra Bozan Nursing 101: Fundamentals of Nursing English 107 cards

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  1. 1ECGelectrocardiogram. record produced by electrocardiography. used to identify myocardial ischemia and infarction, heart damage, rhythm and conduction disturbances, chamber enlargement, electrolyte imbalances, and drug toxicity
  2. 2The upper airway is composed ofnose, pharynx, larynx and epiglottis
  3. 3The upper airway's main fuction isto warm, filter and humidify inspired air.
  4. 4The lower airway is known asthe tracheobronchial tree
  5. 5The lower airway consists oftrachea, right/left main stem bronchi, segmental bronchi and terminal bronchioles
  6. 6The lower airway's main function isconduction of air, mucociliary clearance, and production of pulmonary surfactant
  7. 7The lung extend fromthe base at the level of the diaphragm to the apex, which is above the first rib
  8. 8alveoliclusters of small air sacs, at the end of the terminal bronchioles
  9. 9surfactanta detergent-like phospholipid; reduces surface tension between the moist membranes of the alveoli, preventing their collapse
  10. 10pleuraserous membrane that lines the lungs and thoracic cavity
  11. 11pulmonary ventilationmovement of air into and out of the lungs
  12. 12respirationgas exchange between the atmosphere air in the alveoli and blood in the capiallaries
  13. 13perfusionprocess by which oxygenated capillary blood passes through body tissues
  14. 14retractionaccessory muscles of the abdomen, neck and back are used to maintain respiratory movements at times when breathing is difficult
  15. 15lung complianceease with which the lungs can be inflated
  16. 16Diffusion of gases in lung is influenced by several factors:changes in the surface area available, thickening of alveolar-capillary membranes and partial pressure
  17. 17atelectasiscollapse of alveoli
  18. 18hypoxiaan inadequate amount of oxygen is available to cells
  19. 19dyspneadifficulty breathing
  20. 20common signs of hypoxiadyspnea, eleveated blood pressure, small pulse pressure, increased respiratory and pulse rate, pallor, and cyanosis
  21. 21hypoventilationdecreased rate or depth of air movement into lungs
  22. 22stroke volumequantity of blood forced out of the left ventricle w/each contraction
  23. 23cardiac outputamount of blood pumped per minute (avg 3.5 L/min - 8.0 L/min)
  24. 24cardiac output =stroke volume x heart rate
  25. 25internal respirationexchange of oxygen and carbon dioxide between the circulating blood and the tissue cells
  26. 26anemiaa decrease in the amount of red blood cells (erythrocytes) results in insufficient hemoglobin available to transport oxygen
  27. 27sinoatrial (SA) nodeaka pacemaker. mass of tissue in the upper right atrium, just below the opening of the superior vena cava. initiates the transmission of electrical impulses.
  28. 28atrioventricular (AV) nodepulse travels from SA node to AV node, located at the bottom of the right atrium
  29. 29atrioventricular bundleaka bundle of His; after impulse travels through AV node, it enters a group of fibers called the atrioventricular fibers, which divides into left/right branches
  30. 30Purkinje fibersthe smallest branches of the atrioventricular bundle, which branch off into the right/left ventricle, causing contractions in the ventricles
  31. 31cardiac cyclesingle heartbeat, constitutes contraction of the atrium and ventricle
  32. 32coronary arteriesmuscles own blood vessels. branch off the aorta, encircle the heart and branch out to all regions of the heart. fill w/blood during relaxation of the ventricles
  33. 33dysrhythmiadisturbance of the rhythm of the heart caused by an abnormal rate of electrical impulse generation
  34. 34dysrhytmia symptomsdecreased blood pressure, dizziness, palpitation (awareness of throbbing heart beats), weakness and fainting
  35. 35ischemiadecreased oxygen supply to the heart
  36. 36anginatemporary imbalance between the amount of oxygen needed by the heart and the amount delivered to the heart muscles
  37. 37myocardial infarctiondeath of heart tissue due to lack of oxygen, is also known as a heart attack
  38. 38heart failureoccurs when the heart is unable to pump a sufficient blood supply, resulting in adequate perfusion and oxygenation of tissues
  39. 39tachypnearapid breathing
  40. 40bradypneaslow breathing
  41. 41Arterial Blood Gas and pH Analysismeasures the adequacy of oxygenation, ventilation and perfusion. examines arterial blood to determine the pressure exerted by oxygen/carbon dioxide and blood pH.
  42. 42cardiac biomarkerscan help determine the extent and timing of the damage after injury to the heart. ck and isoenzymes, and troponin (protein) is found in skeletal/cardiac muscle and released after injury to the heart
  43. 43complete blood count (CBC)can assist in evaluating the body's response to illness
  44. 44cytologic studydetermine organisms causing infection, and identify blood or pus in the sputum. microscopic examination of sputum.
  45. 45vesicularlow-pitched, soft sounds heard over peripheal lung fields
  46. 46broncho-vesicularmedium-pitched blowing sounds heard over the major bronchi
  47. 47adventitious soundsextra, abnormal sounds of breathing
  48. 48cracklesfrequently heard on inspiration, are soft, high pitched discontinous (intermittent) popping sounds. produced by fluid in the airways or alveoli and delayed reopening of collapsed alveoli
  49. 49wheezescontinous musical sounds, produced as air passes through airways constricted by swelling, narrowing, secretions, or tumors
  50. 50titrateadjust
  51. 51PQRSTECG complex
  52. 52tidal volumeTV: total amount of air inhaled an exhaled w/one breath
  53. 53vital capacityVC: max amount of air exhaled after max inspiration
  54. 54forced vital capacityFVC: max amt of air that can be forcefully exhaled after a full inspiration
  55. 55forced expiratory volumeFEV: amt of air exhaled in the first second after a full inspiration
  56. 56total lung capacityTLC: the amt of air contained w/in the lungs at max inspiration
  57. 57residual volumeRV: amt of air in the lungs at max expiration
  58. 58peak expiratory flow ratePEFR: max flow attained during the FVC; point of highest flow during forced expiration; reflects changes in the size of pulmonary airways; measured using a peak flow meter
  59. 59Spirometrymeasures the volume of air in liters exhaled or inhaled by a patient over time
  60. 60spirometeran instrument that measures lung volumes and airflow; used to promote deep breathing
  61. 61pulse oximetrymeasure the arterial oxyhemoglobin saturation of arterial blood. expressed as a percentage
  62. 62pulse oximetry is useful formonitoring patients receiving oxygen therapy, titrating oxygen therapy, monitoring those at risk for hypoxia, and monitoring postoperative patients
  63. 63capnographymonitor ventilation and indirectly, blood flow through the lungs. exhaled air passes through a sensor that measures the amount of carbon dioxide exhaled w/each breath
  64. 64capnography is useful forconfirming placement of advanced airways and nasogastric tubes, as well as identifying patients with low cardiac output and hypoventilation
  65. 65thoracentesispuncturing the chest wall and aspirating pleural fluid
  66. 66If supplemental oxygen is used, reinforce the importance ofwearing the cannula during and after meals. Eating and digestion require energy, which causes the body to use more oxygen.
  67. 67deep breathingused to overcome hypoventilation. should be done hourly while awake or 4x daily
  68. 68pursed-lip breathingWhile sitting upright, patient inhales through the nose while counting to 3, then exhales slowly and evenly against pursed lips while tightening the abdominal muscles
  69. 69Coughing is more effective when the patient issitting upright w/their feet flat on the floor and combined w/deep breathing
  70. 70Assisted coughfirm pressure is placed on the abdomen below the diaphragm in rhythm with exhalation
  71. 71expectorantsdrugs that facilitate the removal of respiratory tract secretions by reducing the viscosity of the secretion
  72. 72chest physiotherapyhelps loosen and mobilize secretions. includes percussion, vibration, and postural drainage
  73. 73percussion is never done onbare skin or performed over surgical incisions, below the ribs, or over the spine or breasts because of the danger of tissue damage
  74. 74vibratinguses manual compression and tremor on the patient's chest wall. can be done for several minutes, several times a day. never done over the patient's breasts, spine, sternum, and lower rib cage
  75. 75postural drainagemakes use of gravity to drain secretions from the lungs. done 2 - 4 times a day for 20 - 30 minutes.
  76. 76suctioning of the pharynx is formaintaining a patent airway and to remove saliva, pulmonary secretion, blood, vomitus, or foreign material from the pharynx
  77. 77suctioning of the oropharynx or nasopharynx is forpatients able to raise secretions from the airways but unable to clear from the mouth
  78. 78When performing suctioning, weargloves, goggles and a mask
  79. 79Many of the drugs used to dilate bronchial airways interact withcaffeine
  80. 80nebulizersdisperse fine particles of liquid medication into the deeper passages of the respiratory tract, where absorption occurs. treatment continues until all the med in the nebulizer cup has been inhaled
  81. 81bronchodilatorsopens narrowed airways
  82. 82mucolytic agentsliquefies or loosen thick secretions
  83. 83corticosteroidsreduce inflammation in airways
  84. 84metered dose inhalerdelivers a controlled dose of medication. activated while continuing to inhale.
  85. 85metered dose inhaler mistakes1. failing to shake the canister
    2. holding the inhaler upside down
    3. inhaling through the nose rather than the mouth
    4. inhaling too rapidly
    5. stopping the inhalation when the cold propellant is felt in the throat
    6. failing to hold their breath after inhalation
    7. inhaling 2 sprays w/one breath
  86. 86dry powder inhalersbreath activated; activated by the patient's inspiration; medication will clump if exposed to humidity
  87. 87oxygen flow ratemeasured in liters per minute, determines the amount of oxygen delivered to the patient; does not reflect the oxygen concentration actually inspired b the patient. precise doses are prescribed in terms of percentage of inspired oxygen
  88. 88nasal cannula(nasal prongs) most commonly used; disposable; can cause dryness of the nasal mucosa; difficult to determine the % of O2 inhaled 1-6 L/min
  89. 89nasopharyngeal catheterinfrequently used. uncomfortable, may cause trauma. inserted through nose, end resting in the oropharynx
  90. 90simple maskmost common. 6 - 10 L / min. cuz of risk of retaining carbon dioxide, never apply w/a delivery flow rate < 5 L / min. used when u need to provide more oxygen than a cannula
  91. 91rebreather masksimilar to simple mask w/reservoir bag for the collection of the first part of patient's exhaled air, rest exits via vents. Air in reservoir is then mixed w/100% oxygen for next inhalation. 6 - 15 L / min. 70 - 90 % oxygen. monitor reservoir; should deflate slightly w/inspiration if deflated increase flow rate until slight deflation
  92. 92non-rebreather maskdelivers the highest concentration via a mask. 6 - 15 L / min. 60 - 100%. has reservoir filled w/oxygen that enters the mask on inspiration. expired air does not mix w/oxygen
  93. 93venturi maskallows the mask to deliver the most precise concentrations of oxygen. colored ports say the percentage of oxygen delivered.
  94. 94oxygen tentcommonly used w/children. humidified air quickly creates moisture.
  95. 95liquid oxygen / oxygen concentration / transtracheal catheterrather than cylinders, used more commonly in the home setting. oxygen concentrators are portable, cannot deliver more than 5 L / min. catheter delivers oxygen throughout repiratory cycle.
  96. 96Positive Airway Pressure (PAP)uses mild air pressure to keep airways open
  97. 97pleural effusionfluid in the pleural space
  98. 98hemothoraxblood in the pleural space
  99. 99pneumothoraxair in the pleural space
  100. 100endotracheal tubeinserted through the nose or mouth into the trachea. used to administer oxygen by mechanical ventilator, suction secretions, or bypass upper airway obstructions (tongue/tracheal edema). orotracheal insertion is method of choice. nasotracheal route requires smaller tube.
  101. 101cuffed endotracheal tubemost commonly used. prevents air leakage and bronchial aspiration while allowing precise control of oxygen and mechanical ventilation. careful monitoring necessary to decrease risk for tracheal necrosis
  102. 102tracheostomyartificial opening made into the trachea, usually at the level of the 2nd/3rd cartilagaginous ring
  103. 103tracheostomy tubeconsists of an outer cannula, main shaft, inner cannula and an obturator (guides the direction of the outer cannula, removed once it is in place); outer cannula remains in place, inner cannula is removed for cleaning/replacement
  104. 104cuffed tracheostomy tubealways deflate it before oral feeding unless there is high risk for aspiration. if left cuffed, the balloon can cause pressure that extends through the trachea and onto the esophagus, possibly impeding swallowing/erosion of tissue
  105. 105intermittent positive-pressure breathing (IPBB)forces deeper inspiration b positive-pressure inhalation and then permits passive exhalation
  106. 106manual resuscitation bag (Ambu bag)assist ventilation in patients whose respirations have ceased
  107. 107CABC - chest compression
    A - airway
    B - breathing
    D - defibrillation

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Unit VII: Promoting Healthy Physiologic Responses Chapter 38: Oxygenation and Perfusion
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