10834055
Descripción
Fichas por Alexandra Bozan, actualizado hace más de 1 año
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Creado por Alexandra Bozan
hace alrededor de 7 años
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| Pregunta | Respuesta |
| ECG | electrocardiogram. record produced by electrocardiography. used to identify myocardial ischemia and infarction, heart damage, rhythm and conduction disturbances, chamber enlargement, electrolyte imbalances, and drug toxicity |
| The upper airway is composed of | nose, pharynx, larynx and epiglottis |
| The upper airway's main fuction is | to warm, filter and humidify inspired air. |
| The lower airway is known as | the tracheobronchial tree |
| The lower airway consists of | trachea, right/left main stem bronchi, segmental bronchi and terminal bronchioles |
| The lower airway's main function is | conduction of air, mucociliary clearance, and production of pulmonary surfactant |
| The lung extend from | the base at the level of the diaphragm to the apex, which is above the first rib |
| alveoli | clusters of small air sacs, at the end of the terminal bronchioles |
| surfactant | a detergent-like phospholipid; reduces surface tension between the moist membranes of the alveoli, preventing their collapse |
| pleura | serous membrane that lines the lungs and thoracic cavity |
| pulmonary ventilation | movement of air into and out of the lungs |
| respiration | gas exchange between the atmosphere air in the alveoli and blood in the capiallaries |
| perfusion | process by which oxygenated capillary blood passes through body tissues |
| retraction | accessory muscles of the abdomen, neck and back are used to maintain respiratory movements at times when breathing is difficult |
| lung compliance | ease with which the lungs can be inflated |
| Diffusion of gases in lung is influenced by several factors: | changes in the surface area available, thickening of alveolar-capillary membranes and partial pressure |
| atelectasis | collapse of alveoli |
| hypoxia | an inadequate amount of oxygen is available to cells |
| dyspnea | difficulty breathing |
| common signs of hypoxia | dyspnea, eleveated blood pressure, small pulse pressure, increased respiratory and pulse rate, pallor, and cyanosis |
| hypoventilation | decreased rate or depth of air movement into lungs |
| stroke volume | quantity of blood forced out of the left ventricle w/each contraction |
| cardiac output | amount of blood pumped per minute (avg 3.5 L/min - 8.0 L/min) |
| cardiac output = | stroke volume x heart rate |
| internal respiration | exchange of oxygen and carbon dioxide between the circulating blood and the tissue cells |
| anemia | a decrease in the amount of red blood cells (erythrocytes) results in insufficient hemoglobin available to transport oxygen |
| sinoatrial (SA) node | aka pacemaker. mass of tissue in the upper right atrium, just below the opening of the superior vena cava. initiates the transmission of electrical impulses. |
| atrioventricular (AV) node | pulse travels from SA node to AV node, located at the bottom of the right atrium |
| atrioventricular bundle | aka 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 |
| Purkinje fibers | the smallest branches of the atrioventricular bundle, which branch off into the right/left ventricle, causing contractions in the ventricles |
| cardiac cycle | single heartbeat, constitutes contraction of the atrium and ventricle |
| coronary arteries | muscles 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 |
| dysrhythmia | disturbance of the rhythm of the heart caused by an abnormal rate of electrical impulse generation |
| dysrhytmia symptoms | decreased blood pressure, dizziness, palpitation (awareness of throbbing heart beats), weakness and fainting |
| ischemia | decreased oxygen supply to the heart |
| angina | temporary imbalance between the amount of oxygen needed by the heart and the amount delivered to the heart muscles |
| myocardial infarction | death of heart tissue due to lack of oxygen, is also known as a heart attack |
| heart failure | occurs when the heart is unable to pump a sufficient blood supply, resulting in adequate perfusion and oxygenation of tissues |
| tachypnea | rapid breathing |
| bradypnea | slow breathing |
| Arterial Blood Gas and pH Analysis | measures the adequacy of oxygenation, ventilation and perfusion. examines arterial blood to determine the pressure exerted by oxygen/carbon dioxide and blood pH. |
| cardiac biomarkers | can 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 |
| complete blood count (CBC) | can assist in evaluating the body's response to illness |
| cytologic study | determine organisms causing infection, and identify blood or pus in the sputum. microscopic examination of sputum. |
| vesicular | low-pitched, soft sounds heard over peripheal lung fields |
| broncho-vesicular | medium-pitched blowing sounds heard over the major bronchi |
| adventitious sounds | extra, abnormal sounds of breathing |
| crackles | frequently 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 |
| wheezes | continous musical sounds, produced as air passes through airways constricted by swelling, narrowing, secretions, or tumors |
| titrate | adjust |
| PQRST | ECG complex |
| tidal volume | TV: total amount of air inhaled an exhaled w/one breath |
| vital capacity | VC: max amount of air exhaled after max inspiration |
| forced vital capacity | FVC: max amt of air that can be forcefully exhaled after a full inspiration |
| forced expiratory volume | FEV: amt of air exhaled in the first second after a full inspiration |
| total lung capacity | TLC: the amt of air contained w/in the lungs at max inspiration |
| residual volume | RV: amt of air in the lungs at max expiration |
| peak expiratory flow rate | PEFR: 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 |
| Spirometry | measures the volume of air in liters exhaled or inhaled by a patient over time |
| spirometer | an instrument that measures lung volumes and airflow; used to promote deep breathing |
| pulse oximetry | measure the arterial oxyhemoglobin saturation of arterial blood. expressed as a percentage |
| pulse oximetry is useful for | monitoring patients receiving oxygen therapy, titrating oxygen therapy, monitoring those at risk for hypoxia, and monitoring postoperative patients |
| capnography | monitor 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 |
| capnography is useful for | confirming placement of advanced airways and nasogastric tubes, as well as identifying patients with low cardiac output and hypoventilation |
| thoracentesis | puncturing the chest wall and aspirating pleural fluid |
| If supplemental oxygen is used, reinforce the importance of | wearing the cannula during and after meals. Eating and digestion require energy, which causes the body to use more oxygen. |
| deep breathing | used to overcome hypoventilation. should be done hourly while awake or 4x daily |
| pursed-lip breathing | While sitting upright, patient inhales through the nose while counting to 3, then exhales slowly and evenly against pursed lips while tightening the abdominal muscles |
| Coughing is more effective when the patient is | sitting upright w/their feet flat on the floor and combined w/deep breathing |
| Assisted cough | firm pressure is placed on the abdomen below the diaphragm in rhythm with exhalation |
| expectorants | drugs that facilitate the removal of respiratory tract secretions by reducing the viscosity of the secretion |
| chest physiotherapy | helps loosen and mobilize secretions. includes percussion, vibration, and postural drainage |
| percussion is never done on | bare skin or performed over surgical incisions, below the ribs, or over the spine or breasts because of the danger of tissue damage |
| vibrating | uses 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 |
| postural drainage | makes use of gravity to drain secretions from the lungs. done 2 - 4 times a day for 20 - 30 minutes. |
| suctioning of the pharynx is for | maintaining a patent airway and to remove saliva, pulmonary secretion, blood, vomitus, or foreign material from the pharynx |
| suctioning of the oropharynx or nasopharynx is for | patients able to raise secretions from the airways but unable to clear from the mouth |
| When performing suctioning, wear | gloves, goggles and a mask |
| Many of the drugs used to dilate bronchial airways interact with | caffeine |
| nebulizers | disperse 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 |
| bronchodilators | opens narrowed airways |
| mucolytic agents | liquefies or loosen thick secretions |
| corticosteroids | reduce inflammation in airways |
| metered dose inhaler | delivers a controlled dose of medication. activated while continuing to inhale. |
| metered dose inhaler mistakes | 1. 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 |
| dry powder inhalers | breath activated; activated by the patient's inspiration; medication will clump if exposed to humidity |
| oxygen flow rate | measured 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 |
| nasal 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 |
| nasopharyngeal catheter | infrequently used. uncomfortable, may cause trauma. inserted through nose, end resting in the oropharynx |
| simple mask | most 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 |
| rebreather mask | similar 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 |
| non-rebreather mask | delivers 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 |
| venturi mask | allows the mask to deliver the most precise concentrations of oxygen. colored ports say the percentage of oxygen delivered. |
| oxygen tent | commonly used w/children. humidified air quickly creates moisture. |
| liquid oxygen / oxygen concentration / transtracheal catheter | rather 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. |
| Positive Airway Pressure (PAP) | uses mild air pressure to keep airways open |
| pleural effusion | fluid in the pleural space |
| hemothorax | blood in the pleural space |
| pneumothorax | air in the pleural space |
| endotracheal tube | inserted 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. |
| cuffed endotracheal tube | most 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 |
| tracheostomy | artificial opening made into the trachea, usually at the level of the 2nd/3rd cartilagaginous ring |
| tracheostomy tube | consists 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 |
| cuffed tracheostomy tube | always 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 |
| intermittent positive-pressure breathing (IPBB) | forces deeper inspiration b positive-pressure inhalation and then permits passive exhalation |
| manual resuscitation bag (Ambu bag) | assist ventilation in patients whose respirations have ceased |
| CAB | C - chest compression A - airway B - breathing D - defibrillation |
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