CH 40: Oxygenation and Perfusion

These vocabulary flashcards cover the key concepts of the cardiopulmonary system, types of respiration and ventilation, common alterations in function, age-related changes, and nursing interventions for oxygenation and perfusion based on Chapter 40.

Oxygenation

The process of providing oxygen to body tissues, depending on ventilation, respiration, and perfusion.

Perfusion

The process of oxygenated capillary blood passing through the tissues of the body.

Ventilation

Defined as breathing; the movement of air into and out of the lungs.

Respiration

Gas exchange between oxygen ($O_2$) and carbon dioxide ($CO_2$) occurring at the alveolar level via diffusion.

Inspiration

The process of bringing air into the lungs, triggered by increased lung volume and decreased intropulmonic pressure.

Expiration

The process of air leaving the lungs through relaxation and recoil, which decreases lung volume and increases intropulmonic pressure.

Diaphragm

The primary muscle of respiration that contracts and descends to lengthen the thoracic cavity during inspiration.

Intercostal muscles

Muscles that contract during inspiration to lift the ribs up and out.

Sternum

The breastbone which is pushed forward during inspiration to enlarge the chest cavity.

Lung Compliance

The ease with which the lungs can be inflated, aided by the elasticity of lung tissue and surfactant.

Surfactant

A substance that helps maintain lung compliance and prevents alveolar collapse.

Diffusion

The mechanism by which gas exchange occurs across the capillary-filtration membrane.

Atelectasis

Incomplete lung expansion or the collapse of alveoli, resulting in decreased gas exchange.

Cardiovascular System

Consists of the heart and blood vessels, functioning together to circulate blood.

Red Blood Cells (RBC)

Cells that use hemoglobin to transport oxygen and carbon dioxide to and from body tissues.

Hemoglobin (Hgb)

The protein in red blood cells responsible for carrying oxygen ($O_2$) and carbon dioxide ($CO_2$).

Hypoxia

A condition of inadequate oxygen available to cells due to problems in ventilation, respiration, or perfusion.

Dyspnea

Difficulty breathing or shortness of breath; a common sign of hypoxia.

Hypoventilation

A decrease in the rate or depth of air movement into the lungs.

Dysrhythmia

A disturbance in the rate or rhythm of the heart, also referred to as an arrhythmia.

Myocardial Ischemia

A condition characterized by an inadequate blood supply to the heart muscle, often causing chest pain (angina).

Angina

Chest pain resulting from myocardial ischemia.

Myocardial Infarction

The death of heart tissue due to a lack of blood supply.

Heart Failure

A condition where the heart is unable to pump a sufficient blood supply, leading to inadequate perfusion.

Vagus Nerve Stimulation

An occurrence where bearing down causes the heart rate to decrease.

Renal Disorders

Health conditions that often compromise the lungs due to Fluid Volume Excess (FVE) and impaired tissue perfusion.

Muscle Wasting

Also known as atrophy; results in decreased ventilation and inadequate heart function.

Anemia

A condition where decreased oxygen supply and increased carbon dioxide can lead to myocardial ischemia and decreased perfusion.

Scoliosis

A spinal curvature that can influence breathing and cause air trapping.

Obesity

A factor that can lead to shortness of breath, a sedentary lifestyle, and atelectasis.

Stress/Anxiety

Psychological factors that can lead to hyperventilation and bronchospasms.

Hyperventilation

An increased rate and depth of breathing often associated with anxiety.

Bronchospasm

The narrowing of the airways, which can be triggered by stress.

Age-related Airway Changes

The airways, lung tissue, and alveoli become less elastic in older adults.

Age-related Muscle Changes

In older adults, reduced muscle power leads to less movement of the diaphragm.

Age-related Ventilation Changes

Decreased depth of ventilation in older adults increases the risk of atelectasis and pneumonia.

Age-related Cardiac Changes

Older adults experience stiffer blood vessels and heart valves, leading to a decline in heart function.

Residual Volume

The amount of air remaining in the lungs after maximal expiration; this increases in older adults.

Vital Capacity

The maximum amount of air a person can expel from the lungs after maximum inhalation; this decreases in older adults.

Pallor

A sign of less than optimal oxygenation characterized by pale skin.

Cyanosis

A bluish discoloration of the skin indicating poor blood oxygenation and decreased blood flow.

Edema

Swelling that can indicate Fluid Volume Excess (FVE), congestive heart failure, overhydration, or renal failure.

Kyphosis

An exaggerated outward curvature of the thoracic spine that limits ventilation.

Barrel Chest

A physical abnormality seen in COPD patients, typically associated with an $SpO_2$ of $88-92\%$.

Nostril flaring

An objective sign of respiratory distress that requires further investigation.

Accessory muscle use

The use of muscles other than the diaphragm to breathe; a sign of health deviation.

Tachypnea

An abnormally rapid respiratory rate.

Bradypnea

An abnormally slow respiratory rate.

Ineffective Airway Clearance

A nursing diagnosis characterized by fatigue, retained secretions, and thick yellow secretions.

Impaired Gas Exchange

A diagnosis where the patient may exhibit circumoral cyanosis, respiratory acidosis, or a respiratory rate of $40\,breaths/min$.

Impaired Breathing

A diagnosis where a patient may be hyperventilating, tachypneic at $40\,breaths/min$, and report tingling in fingers.

Circumoral Cyanosis

A bluish discoloration around the mouth, indicating impaired gas exchange.

Respiratory Acidosis

An acid-base imbalance often identified through altered blood gases in patients with impaired gas exchange.

High Fowler Position

A sitting position that aids respiratory function and is a priority intervention for dyspnea.

Incentive Spirometer

An intervention used to encourage deep breathing and improve cardiopulmonary function.

Pursed-lip Breathing

A breathing technique used to improve gas exchange and manage shortness of breath.

Nasal Cannula

An oxygen delivery system with prongs that provide low flow or high flow oxygen.

Simple Mask

A low flow oxygen delivery system that requires a minimum of $5\,L/min$ to prevent carbon dioxide rebreathing.

Nonrebreather Mask

A low flow oxygen delivery system that provides higher concentrations ($80-95\%$) and utilizes a reservoir bag.

Venturi Mask

A high flow oxygen delivery system that provides the most precise concentration of oxygen.

FiO2

Fraction of Inspired Oxygen; the concentration of oxygen delivered to the patient.

Nasal Cannula 1-2 L/min

Delivers an $FiO_2$ of $24-28\%$.

Nasal Cannula 3-5 L/min

Delivers an $FiO_2$ of $32-40\%$.

Nasal Cannula 6 L/min

Delivers an $FiO_2$ of $44\%$.

High Flow Nasal Cannula

An oxygen delivery method with a maximum flow of $60\,L/min$; often better tolerated by children.

Simple Mask FiO2

Delivers $40-60\%$ oxygen at a flow rate of $5-8\,L/min$.

Nonrebreather Mask FiO2

Delivers $80-95\%$ oxygen at a flow rate of $10-15\,L/min$.

Venturi Mask FiO2

Delivers $24-40\%$ oxygen at a flow rate of $4-6\,L/min$.

Reservoir Bag

A component of the nonrebreather mask that should only collapse slightly during inspiration.

Pulse Oximeter

A device used to monitor arterial oxygen saturation ($SaO_2$).

Splinting

A technique where the patient supports the thorax while coughing to make it more effective and less painful.

Pneumococcal Vaccination

A health promotion measure used to prevent pneumonia, especially in older adults.

Static Electricity

A fire hazard; patients on oxygen should avoid wearing synthetic fabrics that build it up.

Oxygen Fire Hazards

Includes open flames, smoking, faulty electrical equipment, synthetic fabrics, oils, and alcohol sanitizers.

Frontal Sinus

A paranasal sinus located in the forehead area.

Nasal Cavity

The internal portion of the nose that air passes through.

Sphenoidal Sinus

A paranasal sinus located behind the nasal cavity.

Nasopharynx

The uppermost part of the pharynx, located behind the nasal cavity.

Oropharynx

The middle part of the pharynx, located behind the oral cavity.

Laryngeal pharynx

The lower part of the pharynx that connects to the larynx.

Larynx

The voice box containing the vocal cords.

Epiglottis

A flap of cartilage that prevents food from entering the trachea during swallowing.

Trachea

The windpipe that connects the larynx to the bronchi.

Alveoli

Microscopic air sacs where gas exchange between air and blood takes place.

Visceral pleura

The serous membrane that covers the surface of the lungs.

Parietal pleura

The serous membrane that lines the thoracic cavity wall.

Pleural space

The potential space between the visceral and parietal pleurae.

Mediastinum

The central compartment of the thoracic cavity between the two lungs.

Terminal bronchiole

The end of the conducting zone in the respiratory system.

Diffusion Factors

Includes changes in surface area, thickening of the alveoli-capillary membrane, and partial pressure.

Pallor Significance

An indicator of less than optimal oxygenation.

Cyanosis Significance

Indicates coolness, decreased blood flow, and poor blood oxygenation.

Edema Significance

Can indicate Fluid Volume Excess (FVE), Chronic Heart Failure (CHF), overhydration, renal failure, or Peripheral Vascular Disease (PVD).

Older Adult Respiratory Changes

Includes drier mucous membranes and altered pain sensation.

Thorax Splinting

A technique taught to older adults to assist in effective coughing.

Fluids and Oxygenation

Increasing fluid intake to $\text{1.5-2 L}$ (especially water) is encouraged to thin secretions.

Cool-mist Humidifier

A device recommended for older adults to moisten air; requires proper cleaning techniques.

Pulmonary Exercise Rehabilitation

A program recommended for older adults to combat physical deconditioning.

Milk Products and Oxygenation

Some patients are taught to avoid these if they contribute to troublesome secretions.

Adventitious Breath Sounds

Abnormal lung sounds like wheezing that may clear after expectorating sputum.