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Terms in this set (82)
pH: (acid) 7.35-7.45 (base)
PaCO2: (base) 35-45 (acid)
Normal Blood Gas Ranges Bicarbonate (HCO3): (acid) 22-26 (base)
PaO2: 80-100
SaO2: > 95%
breath faster = "Blow off acid" (reduced acid)
Carbon dioxide (CO2)=
breathe slower= retain acid
Acid
Lungs/respiratory
retain bicarb= become more alkaline
Bicarbonate (HCO3)= Base lower bicarb= become more acid
Kidneys/metabolic
Respiratory acidosis
-High CO2: narcotic administration, retention of CO2 in
COPD patients
Respiratory Alkalosis
What will the gases look -Low CO2: hyperventilation
like Metabolic Acidosis
-Low HCO3: sepsis, MI (lactic acid, anaerobic)
Metabolic Alkalosis
-High HCO3: Loss of GI fluids (NG suction,
Gastic/enternal drains)
Respiratory compensates for metabolic
Metabolic compensates for respiratory
Blood Gas Interpretation: - compensation works to "normalize" the pH; it doesn't
Compensation correct the orginal problem that caused the abnormal
ABG
-compensation is partial or complete
, turbinates and nasal hairs
-warm, humidify, filter
Upper airway
epiglotis
-protects foreign objects from entering lungs
bronchi
bronchioles
Lower airways alveoli
- intake oxygen]
- diffusion of gases
-located in the medulla, bifurcation of the carotid
arteries, aortic arch
Chemoreceptors - respond to changes in pH and send message to the
lungs
-respond very quicklu in healthy lungs
-located in the lungs, upper airway, diaphragm, and
chest wall
Mechanical receptors
-stimulated by irritants, stretching
-keep the lungs from overinflating, in part
-filtration of air
-mucociliary clearance system
-cough reflex
Defense mechanisms
- reflex bronchoconstriction
-aveolar macrophages
- gas exchange
-smoking harms nearly every organ in the body and is a
main cause of lung cancer and COPD. It also is a cause
of coronary heart disease, stroke and a host of other
cancers and diseases
Smoking -smoking is the number one cause of preventable
disease and death worldwide
-smoking is directly responsible for approximately 90%
of lung cancer deaths and approximately 80% deaths
caused by COPD
, -much remains to be determined about the lasting
health consequences of these products, the American
Lung Association is very troubled by the evolving
evidence about the impact is has on the lungs
-e-cigerattes produce a number of dangerous
E-cigarettes/vaping
chemicals. These can cause lung disease, as well as
cardiovascular disease
-e-cigarettes also contain a herbicide primarily used to
kill weeds. It can cause acute lung injury and COPD and
may cause asthma and lung cancer
Know reasons for quitting
-health, cost, convenience, family and friends
(secondhand smoke), quality of life
understand what to expect (cravings, need to prepare
food substitutions, stress management)
Get help (support groups/buddy, acupuncture,
biofeedback)
Smoking Cessation Talk to a health care provider (medications/resources)
Set a quit date
Build a social support
Learn how to relax and control weight
Plan how to deal with urges
Use quit-smoking medications to help (patches, gum,
lozenges)
EVERY SMOKER CAN QUIT!
oxygen and carbon dioxide diffuse across the alveolar
Pulmonary Diffusion (gas
capillary membrane with ease due to concentration
exchange in the lungs)
differences in the gases
Pulmonary Perfusion From right ventricle to pulmonary artery and then
(blood flow to the lungs) throughout the blood vessels
V/Q
Ventilation/perfusion ratio:
ventilation to perfusion
, How well the lungs "move" within our thoracic cavity
-compliance is increased: when lungs can easily inflate
within the thoracic cavity. They can become over
Lung/Alveolar compliance: distended and lose their elastic recoil with increased
How easily lungs are compliance. Disease example-emphysema
moving -compliance is decreased when the lungs do no easily
inflate within the thoracic cavity. They meet resistance
and can not fully inflate. (can cause scaring) Disease
example-pulmonary fibrosis
Hemoglobin saturation and a pressure of oxygen in blood at 60 and below is
pressure of oxygen in respiratory failure. 60=90% of SPO2 and could lead to
blood losing O2 in the brain and tissue
We breath in and out a mix of gases
The amount of pressure each gas exerts is its "part" in
Partial Pressure of Gases in
the total gas mix, or its partial pressure
the Lung
-pO2= the partial pressure of oxygen
-pCO2= the partial pressure of carbon dioxide
Blood
-Hgb, Hct, Arterial blood gas (ABG)
Other labs
-sputum and blood cultures
Radiology
-chest x-ray, CT, MRI, V/Q, angiogram, PET (lung CA)
Endoscopy
-bronchoscopy, mediastinoscopy
Pulse oximetry
-measures saturation of oxygen in blood
-indications: signs or symptoms of increased work of
Pulmonary Function
breathing, confusion, wheezing, rales
Diagnositics
Pulmonary Function Tests (PFTs)
-measure lung volume
-measure air flow
-diffusion capacity (how effectively gas travels from the
lungs to the blood)
Bronchoschopy
-what preparation will the client need? NPO, conscious
sedation, numb back of the throat
-What is the nurse role? get pic, mucous
-Post procedure nursing care? NPO, elevate HOB,
suction