Download BSNC 1000 - module 4-6 and more Exams Nursing in PDF only on Docsity!
BSNC 1000 - module 4-
Define perfusion - โ๏ธ blood flow and oxygen delivery to body tissues
Perfusion is influenced by - โ๏ธ -volume of blood pumped from the heart -radius of blood vessels -viscosity of blood -velocity of flow -blood pressure
impaired perfusion is exemplified by: - โ๏ธ -hypertension
-myocardial infarction
-heart failure
-shock
how do you measure pulse pressure? - โ๏ธ systolic pressure - diastolic pressure
how do you measure BP? - โ๏ธ CO x peripheral vascular resistance
how do you measure CO? - โ๏ธ stroke volume x HR
how do you measure MAP? - โ๏ธ CO x TPR
what major factors influence peripheral resistance - โ๏ธ -vessel radius ***
-blood viscosity - resistance to flow (higher viscosity, higher resistance)
what is a sign? - โ๏ธ manifestation noted by observer ie/ temperature, swelling
what is a symptom? - โ๏ธ subjective, perceived by client ie/ pain, difficulty breathing, dizziness
what is an acute disorder? - โ๏ธ severe, but self limiting
what is a chronic disease? - โ๏ธ long term, continuous or exacerbations/remission
what is subacute disease? - โ๏ธ between acute and chronic
what defines hypertension? - โ๏ธ -systolic BP > 140 mm/Hg
-diastolic BP > 90 mm/Hg
-imbalance between CO or TPR
what is primary hypertension? - โ๏ธ cause is unknown but may be caused by: -poor kidney function (fewer glomeruli where waste products) -high dietary Na+ -lack of exercise -smoking -obesity
what is secondary hypertension? - โ๏ธ -structure of blood vessels supplying kidneys are altered -tumors of glands that secrete hormones to raise BP -atherosclerosis
what happens to the kidneys with hypertension? - โ๏ธ nephrosclerosis (small, rough, granular surface)
what happens to the brain with hypertension? - โ๏ธ hemorrhagic stroke
what happens to the eyes with hypertension? - โ๏ธ -retinopathy (retinal arterioles change in structure) -develop copper wire effect -hemorrhages may occur in retina -death of the light-sensing retinal cells
what happens to the heart with hypertension? - โ๏ธ -aneurysm -left ventricular hypertrophy -atherosclerosis
what is the suggested BMI? - โ๏ธ 18.5-24.9 kg/m
What is gas exchange? - โ๏ธ O2 diffuses into blood, CO2 diffuses out of blood
what is the most common cause of cell injury? and how do you define it? - โ๏ธ hypoxia - low oxygen tension (amount) in tissues
what is hypoxemia? - โ๏ธ low oxygen in the blood
what is anoxia? - โ๏ธ absence of oxygen
what is ischemia? - โ๏ธ insufficient flow of oxygenated blood to tissues
What is PaO2? - โ๏ธ The amount of oxygen dissolved in the plasma (partial pressure of oxygen) measured in mm/Hg normal value 80 mm/Hg
what is SaO2? - โ๏ธ The amount of oxygen bound to hemoglobin saturation measured by % normal range 97-99%
What is PaCO2? - โ๏ธ partial pressure of CO2 in arterial blood normal value 35-45 mm/Hg
What do central chemoreceptors respond to? - โ๏ธ increase respiration when PCO2 increases or pH decreases
What do peripheral chemoreceptors respond to? - โ๏ธ increase respiration when PO2 <60mm/Hg
what are some disorders that may lead to gas exhange issues? - โ๏ธ -asthma -pneumonia -COPD -emphysema -chronic bronchitis
what is ventilation? - โ๏ธ inhaling O2 and exhaling CO
when may impaired ventilation occur? - โ๏ธ -inadequate bone/muscle/nerve function to move air into lungs -narrowed airways from bronchoconstriction (asthma) or from obstruction (chronic bronchitis) -poor gas exchange in alveoli (pulmonary edema)
what is "transport"? - โ๏ธ availability of hemoglobin and its availability to carry O2 from alveoli to cells and CO2 from cells to alveoli
what happens with impaired transport? - โ๏ธ if there is insufficient # of erythrocytes or hemoglobin available
what is perfusion (gas exchange) - โ๏ธ ability of blood to transport O2 containing hemoglobin to cells and return CO2 containing hemoglobin to alveoli
what are consequences of impaired gas exchange? - โ๏ธ -HR and RR increase in attempt to increase O2 to cells -decreased O2 at cellular level = decreased mitochondrial respiration and oxidative metabolism
who is at risk of impaired gas exchange? - โ๏ธ -infants (have fetal hemoglobin) -young kids (have less alveolar surface area and narrow branching of peripheral airways) -older adults (anatomic/physiological changes that occur with aging)
movement of the chest cage depends on: - โ๏ธ -chest compliance (property of chest cage to expand) -lung compliance (property of lungs to inflate) -airway conductance (property of airways to allow flow) -intrapleural pressure (low pressure in pleural cavities)
what is the pressure during INSPIRATION? - โ๏ธ pressure of atmosphere > pressure of alveoli
what is the pressure during EXPIRATION? - โ๏ธ pressure of atmosphere < pressure of alveoli
what 2 key factors influence lung compliance? - โ๏ธ elasticity surface tension
What is distensibility? - โ๏ธ ease with which the lungs can be inflated
โ๏ธ obstruction of the small airways
what are mechanisms of COPD - โ๏ธ -Inflammation and fibrosis of the bronchial wall -Hypertrophied mucous glands -Obstructed airflow -Decreased surface area for gas exchange -Loss of elastic lung fibers & alveolar tissue -Airway collapse, obstructed exhalation, air trapping
What is emphysema also called? - โ๏ธ pink puffer
what is the mechanism behind emphysema? - โ๏ธ inflammation -> release trypsin from neutrophils (neutrophils are released because of irritants) -> emzymes breakdown the elastin in alveolar walls -> damage
what is the mechanism behind COPD? - โ๏ธ
what are the risk factors of COPD? - โ๏ธ -tobacco use -genetics (inherited alpha 1 antitrypsin deficiency) -inhalation of irritants (occupational dusts/fumes)
what are clinical manifestations of COPD? - โ๏ธ -chronic cough (intermittent or constant) -sputum production -dyspnea -barrel chest -chronic respiratory failure -recurrent respiratory tract infections
how do you assess adequate ventilation? - โ๏ธ -breathing rate -O2 saturation -color of skin/lips/nails -chest/back symmetry -clear breath sounds -trachea midline
what is tidal volume? - โ๏ธ amount of air in and out of lungs during a normal breath
What is inspiratory reserve volume? - โ๏ธ additional inspired air over and above tidal volume
What is expiratory reserve volume? - โ๏ธ air that can still be breathed out after normal expiration
What is vital capacity? - โ๏ธ the greatest volume of air that can be expelled from the lungs after taking the deepest possible breath
What is residual volume? - โ๏ธ amount of air remaining in the lungs after a forced expiration
What is total lung capacity? - โ๏ธ total volume of air in lungs.
what is forced expiratory volume? - โ๏ธ Amount of air exhaled in the first second after a full inspiration
what are primary preventative measures for gas exchange? - โ๏ธ infection control smoking cessation immunizations
what are tertiary preventative measures for gas exchange? - โ๏ธ -smoking cessation -drugs that affect upper airway (antihistamines, decongestants) -lower airway bronchodilators (puffers) -agents to help cough up mucus -agents to supress cough -antimicrobrials -oxygen therapy -nutritional therapy
what are smoking cessation strategies? - โ๏ธ -NRT -motivational interviews/counselling -conquering cravings -smoking cessation programs
