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two main reasons for oxygenation problems

ineffective gas exchange (lungs) or ineffective pump (heart)

function of cardiopulmonary system

provides oxygen to the tissues and remove carbon dioxide and waste products from the body


the movement of air in and out of the lungs


the movement of gases between air spaces and the bloodstream


the exchange of oxygen and carbon dioxide during cellular metabolism


the movement of blood into and out of the lungs to the body's organs and tissues

the right lung has how many lobes


the left lobe has how many lobes



oxygen entering the lung

what are the 3 main conditions that affect ventilation

hypoxia, hypoventilation, hyperventilation


inadequate tissue oxygenation


partial pressure of oxygen

if your patient has low PaO2, what does this mean

the person is hypoxic


inadequate ventilation to meet the body's oxygen demand or eliminate CO2 (so CO2 levels rise)

what happens when hypoxia is left untreated

cardiac dysrhythmias and/or death

what happens when hypoventilation is left untreated

hypoxia, hypercapnia, or respiratory acidosis


elevated PaCO2 (arterial carbon dioxide) levels

S&S of hypoventilation

dizziness, occiptal headache upon awakening, lethargy, disorientation, decreased ability to follow instructions, cardiac dysrhythmias, electrolyte imbalances, convulsions, coma, cardiac arrest

what happens if you give a COPD pt too much oxygen

the stimulus to breathe is negated; resulting in hypoventilation; can lead to respiratory arrest


an increase in respiratory rate, resulting in excess amounts of CO2 elimination (so your CO2 level drops)

what hapens when hyperventilation is left untreated

hypocapnia and respiratory alkalosis

S&S of hyperventilation

tachycardia, shortness of breath, chest pain, dizziness, lightheadedness, decrased concentration, paresthesia, extremity numbness, tinnitus, blourred vision, disorientation, and tetany

what is the function of the circulatory system

delivers oxygen, nutrients, and othe rsubstances to the body's tissues to support cellular life


the contraction phase of the cardiac cycle, when blood is expelled from the heart's ventricles


the relaxation phase of the cardiac cycle, when the ventricles fill with blood

cardiac output (CO)

the amount of blood ejected from the left ventricle each minute

normal cardiac output for a healthy adult

4 to 6 L/min

angina is the result of what

decreased blood flow to the myocardium

myocardial infarction (MI) is the result of what

extensively decreased or completely blocked myocardial blood perfusion, leading to tissue necrosis

S&S of MI

severe or crushing chest pain, jaw pain, back pain, left arm pain, breathlessness, diaphoresis, and hypotension; pain usually lasts 30+ min

valvular heart disease

disorder of cardiac valve characterized by obstructed blood flow and regurgitation resulting in backflow of blood

left-sided heart failure

impaired functioning of the left ventricle, usually caused by increased preload or afterload


fluid volume overload


increased systemic vascular resistance

S&S of left-sided heart failure

pulmonary complications (congestion, crackles), and fatigue, dyspnea, and orthopnea (difficulty breathing while lying down)

right-sided heart failure

impaired functioning of the right ventricle, usually caused by pulmonary disease

what kind of blood does the right side of the heart pump

deoxygenated blood

what kind of blood does the left side of the heart pump

oxygenated blood

pulmonary edema

fluid buildup inside the lungs/alveoli

what is the best way to treat pulmonary edema

diuretics; it draws the fluid out of tissues

plueral effusion

fluid buidup outside the lungs

if the left side of the heart is failing, symptoms will be what


if the right side of the heart is failing, symptoms will be what

bilateral lower extremities / pedal edema


low blood volume


a disturbance in the elctrical impulse of the heart rhythm

sinus tachycardia

regular rhythm, rate 100-180 bpm

sinus bradycardia

regular rhythm, rate <60 bpm

atrial fibrillation (a-fib)

irregular rate and rhythm

ventricular tachycardia

rhythm slightly irregular, rate 100-200 bpm

ventricular fibrillation

irregular and chaotic rhythm


no discernable rate or rhythm


reduction in RBCs or decrease in hemoglobin


low oxygen level in the blood

patients with pulmonary disease ar at risk for what

hypoxemia and hypercapnia

nervous system disease

a type of disease that impairs nervous and muscular control, causing reduced ventilation


a chemical in the lungs that keeps the alveoli dry and keeps them from collapsing


12-20 breaths per min; normal breathing rate


>35 breaths per min


<10 breaths per min


periods of no resp lasting >15 sec


usually >35; may be slow or normal


abnormal pattern of breathing, varying btwn apnea and tachypnea

when is humidification necessary

when pts are receiving oxygen therapy at more than 4 L/min


using the aerosol principle to suspend a maximum number of water drops or particles of the desired size in inspired air

what are the three interventions to maintain a patent airway

coughing techniques, suctioning, insertion of artificial airway

coughing is beneficial for what patient

pts with chronic pulmonary diseases or resipratory tract infections

suctioning is beneficial for what patient

pts who are unable to effectively clear respiratory tract secretions with coughing

artificial airways are beneficial for what patient

pts with decreased levels of consciousness, airway obstruction, mechanical ventilation

what is incentive spirometry useful for

to promote lung expansion; prevents atelectasis in a post-op patient

breathing exercises are beneficial for what patient

pts who need to improve ventilation and oxygenation; improves respiratory strength and andurance, resulting in improved activity tolerance

what techniques are good for COPD pts/why

breathing exercises/may prevent respiratory failure

what are the 3 typres of breathing exercises

deep breathing/coughing, pursed-lip breathing, and diaphragmatic breathing

nasal cannula

simple, comfortable device to deliver low-concentration O2

nasal cannula flow rate

<6 L/min

simple face mask

device for short-term O2 therapy

flow rate for simple face mask

5-8 L/min

partial non-rebreather

device that delivers high concentrations of O2

flow rate of partial non-rebreather

6-10 L/min

Venturi mask

device that delivers precise, high-flow rates of O2

flow rate of Venturi mask

4-12 L/min

simple face masks are contraindicated for what pt

pts with carbon dioxide retention

pathway of pulmonary circulation

right ventrical -> pulmonary artery -> pulmonary vein -> left atrium

subcutaneous emphysema

air that has leaked into the tissues surrounding the lungs, usually from a chest tube that is leaking

how to fix subcutaneous emphysema

plug the hole, and it will reverse itself

how to assess for subcutaneous emphysema

palpate upper chest area; it will feel like they have rice krispies under the skin

how to fix pleural effusion

if not severe it may go away on its own; if severe, thoracentesis can draw more than a liter off

S&S of hypoxia

restlessness, increased agitation, hyper-respiratory response

cyanosis is a sign of what


S&S of altered respiratory function

mental status change, decreased LOC, dysrhythmia, respiratory and/or cardiac arrest

interventions for altered respiratory function

treat underlying cause, restore ventilation/ tissue oxygenation, restore acid-base balance

what is the #1 cause of infant cardiac arrest

repiratory failure

why can't a simple mask be run at <5 lpm

the pt will re-breathe CO2

what is perfused during systole

body tissue

what is perfused during diastole

cardiac tissue

S&S of angina

radiating pain that lasts 1-15 min

how to fix angina

give nitroglycerin SL

why is nitroglycerin given for angina

vasodilator; more blood can get through

myocardial ischemia

a narrowing in coronary artery blood flow; usually reversible

myocardial necrosis

heart tissue is destroyed due to blocked cardial perfusion; irreversible

how to read a 6-second strip

count the numberof beats, and multiply by 10

dependent lower edema may be a sign of what

right-sided heart failure

dependent edema

edema present even when someone's lying down

what is a COPDer's trigger to breathe


what is a healthy person's trigger to breathe

carbon dioxide

what should you do for someone with COPD who has low O2 stats

put them on LOW O2 (like 2 L or less)

right sided heart failure results from what

impaired functioning of the right VENTRICLE

what is a LATE sign of hypoxia


left sided heart failure results from what

impaired functioning of the left VENTICLE


air in the pleural space

pleural effusion

fluid in the plueral space

what should you tell the pt to do if a chest tube becomes disconnected


restlessness is a sign of what


splinter hemorrhages can be a sign of what

cardiopulmonary abnormality

pulmonary congestion can be due to what

left ventricular CHF

peripheral bilateral pedal edema can be due to what

right ventricular CHF

pain with inspiration can be a sign of what

inflammation of the pericardial sac

how often is the pnuemococcal vaccine given

every 10 years

the movement of gases into and out of the lungs depends on what

pressure gradient between the atmosphere and the alveoli

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