NUR 155 Cardiac & Respiratory exam study guide with 100% correct answers already graded A+(verified for accuracy)

Factors Affecting Respiratory Function -Age -Environment -Lifestyle -Health Status -Medications -Stress Conditions that can alter Respiratory Function -Patency -Movement of air into or out of lungs -The diffusion of oxygen and carbon dioxide between the alveoli and the pulmonary capillaries -Transportation of oxygen and carbon dioxide via the blood to and from the tissue cells Respiratory Assessment -Listen to lung sounds/see if they are having difficulty breathing -What is their general appearance? Are they a bluish color/cyanosis? -SOB or coughing? -What about their respiratory system? Rapid or shallow breathing? Producing sputum? -ABG results -What is their depth, rhythm, quality of breathing like? -Level of consciousness? -Trachea = can deviate -Thorax = even on both?? Or collapsed lung? -AP Diameter Nursing Interventions for Oxygenation -Sitting in tripod position or Orthopneic position. -Incentive spirometer -Deep breathing -Huff coughing or purse lip breathing -Increase fluids if can -No smoking or 2nd hand smoke -Ambulation -Administer O2 and call Dr. -Make sure O2 has no kinks in cords -Conserving energy ABG -Taken in the radial, brachial, femoral arties -Determines how much Co2 and O2 is dissolved in the blood Blood Gas Values -pH= 7.35 to 7.45 of the blood -pCO2 = 35-45 The levels of CO2 in blood supply remaining after perfused tissues and organs The respiratory component This is different then the CO2 in charts for Lab -HCO2 = 22-28 Metabolic component Bicarbonate -Increased CO2 = Acid build up or Acidosis = Hypercapnia -Increased HCO2 = Alkaline build-up or alkalosis Acute Respiratory Failure -Progressive or sudden, deterioration of the gas exchange function of the lungs. -PaO2 of less than 50 mmHg = Hypoxemia Shows low circulation of O2 -PaCO2 greater then 50 mmHg = Hypercapnia To much CO2 circulating in the blood will be on continuous bipap or put on vent Max on 2 weeks if longer people usually end up on trachs -pH less than 7.35 Pulmonary Toileting -Use mucus clearing device such as flutter valve (Causes vibration to loosen mucus) -Suctioning -Huff coughing -Vibration from bed, vest or percussion -Medications such as Bronchodilators, steroids, decongestants. Always use Albuterol first. -Spirometer -Fluids Cause of Acute Respiratory Failure -Decreased respiratory drive (opioids, morphine) -Obstruction of the airways = sputum don't belong in the airways supposed to cough and clean that, called mucus plugs buggers and obstruct your airway. Suctioning helps get rid of these, *restlessness = First sign and symptom of lack of oxygen -Trauma o Injury to lung tissue or chest wall. An open area in the lungs that isn't supposed to be there, chest tube might be used. Causes to go into respiratory failure. -Dysfunction of the chest wall o Any condition that affects breathing o Can tell when someone has a "smokers cough", COPD they are use to operating on higher levels of CO2 vs. O2 and if you give a high dose of O2 could kill a COPD -Disorders o Sleep apnea o Overdose of opioids (morphine) or alcohol Signs of Acute Respiratory Failure 1. Early: -Impaired oxygenation -Restlessness -Fatigue -Headache -Dyspnea -Air hunger = gasping for air -Tachycardia -Increased BP 2.Progressive -Confusion = go from mature adult to a 2-year-old quickly. Not getting O2 to the brain -Lethargy -Tachycardia = heart starts working faster to get more O2 -Tachypnea -Central cyanosis -Diaphoresis = sweating a lot -Respiratory arrest Tachypnea -Rapid Respirations -Seen with fevers, metabolic acidosis, pain, & hypoxemia Bradypnea -Abnormally slow respiratory rate -Seen w/ morphine or sedatives, metabolic alkalosis, or increased intracranial pressure Apnea -Absence of any breathing Hypercapnia -Increased levels of carbon dioxide -Hypoventilation can cause this Hypoxemia -Reduced oxygen levels Hyperventilation -Increased movement of air into and out od the lungs -The rate and depth of respirations increase and more CO2 is eliminated than produced Orthopnea -inability to breathe easy unless sitting upright or standing Dyspnea -Difficulty breathing or shortness of breath (SOB) -Signs= flaring of nostrils, labored-appearing breathing, increased heart rate, cyanosis, & diaphoresis Hypoxia -Insufficient oxygen anywhere in the blood -Body can only tolerate 3-5 mins before permanent damage occurs -Signs= Rapid pulse, rapid shallow respirations & dyspnea, increased restlessness or light headedness, flaring or nares, substernal or intercostal retractions, cyanosis Cardiac Output -Amount of blood pumped by the ventricles in 1 minute Stroke Volume -The amount of blood ejected with each contraction Contractility -Inotropic state of the myocardium, strength of contraction Preload -Left ventricular end diastolic volume, stretch of myocardium Afterload -Resistance against which the heart must pump Hemoglobin -Major component if red blood cells (erythrocytes), the predominant cells present in blood -Easily binds with oxygen releasing it to the body tissue Atherosclerosis -Buildup of fatty plaques within the arteries -Primary contributor to cerebrovascular disease Nonmodifiable Risk Factors for CVD -Heredity -Age -Gender -Ethnic origin Modifiable Risk Factors for CVD -Smoking -Elevated cholesterol levels -Obesity -Blood Pressure -Diabetes -Sedentary lifestyle Signs of Myocardial Infarction -Chest Pain; substernal and/or radiating to the left arm, jaw -Nausea -SOB -Diaphoresis (sweating) -Cyanosis -Syncope = Fainting -Palpitations = heart funky beats/irregular beats -Edema -Epigastric discomfort = stomach -Fatigue = Women often have several weeks of fatigue before having a heart attack Pulmonary Edema -When fluid escapes into the alveoli and interfere with gas exchange Signs & Symptoms of Heart Failure -Pulmonary congestion; adventitious lung sounds -SOB -Dyspnea on exertion -Increased Heart Rate -S3 heart sound -Increased respiratory rate -Nocturia -Orthopnea -Distended neck veins Ischemia -Lack of blood supply due to obstructed circulation Signs of impaired peripheral arterial circulation -Decreased peripheral pulses -Pain or Parathesias -Pale skin color -Cool extremities -Decreased hair distribution Pulmonary embolism -one or more arteries in the lungs become blocked by a blood clot -Signs = sudden onset of SOB & pleuritic chest pain Anemia -blood doesn't have enough healthy red blood cells -Signs= Chronic fatigue, pallor, SOB, hypotension