Gas Exchange & Oxygenation - ATI Flashcards

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what is the significance of surfactant in the lungs?

it prevents alveoli from collapsing during exhalation by reducing surface tension, due to it being a lubricant produced in the lungs

how should a client be positioned during a postural drainage to target secretions in the lower - middle lung lobes?

the client’s head should be positioned downwards while alternating between prone and supine positions, allowing gravity to assist in draining secretions

how does the parasympathetic system regulate bronchial activity?

it causes bronchoconstriction

how does the sympathetic system regulate bronchial activity?

it leads to broncodilation

what is a nonrebreather mask?

a medical device that has valves that prevent exhales gases from returning to the reservoir bag, ensuring the client inhales only oxygen

what is a rebreather mask?

a medical device that allows a mixture of oxygen, and exhales carbon dioxide to enter the reservoir bag

how can the nurse verify that the collected sample is sputum?

its opaque and thick

how can the nurse verify that the collected sample is saliva?

it is thin and watery

what are the benefits of chest physiotherapy for clients with conditions like COPD or fibrosis?

helps clear lung secretions, promotes alveolar expansion, reduces risk of infection, and strengthens respiratory muscles

what is the impact of unmanaged stress of cardiopulmonary health?

it triggers the fight-or-flight response, increasing cortisol levels and heart rate. this raises BP, promotes weight gain, and can lead to long-term cardiopulmonary issues

which clinical signs must suggest hypoxia at the cellular level?

restlessness, tachycardia (rapid heart rate), tachypnea (rapid breathing rate), cyanosis, and irritability due to insufficient oxygen in the tissues

what is the point of intermittent suctioning while withdrawing and rotating the catheter?

it minimizes damage to the trachael mucosa and reduces the risk of hypoxia during the procedure

how does the structure of alveoli facilitate gas exchange?

the small air sacs with thin walls surrounded by capillaries allow oxygen to diffuse into the blood and allow carbon dioxide to diffuse out

how does intercostal retraction during inhalation signal a medical emergency?

when this process occurs, the muscles are pulled inward between the intercostal spaces during inhalation, indicating reduced chest pressure and potential airway blockage

what are the flow rates and oxygen concentrations associated with a simple face mask?

delivers oxygen at a flow rate of 5 - 10 L/min, resulting in 35% - 60% oxygen concentration

why do we use water-soluble lube for nasopharyngeal / nasotracheal suctioning?

it eases catheter insertion and reduces tissue trauma during the procedure

regarding venturi masks, how can the nurse ensure the prescribed oxygen concentration is delivered correctly?

the nurse should attach the correct jet orifice, adjust the flow to the prescribed oxygen liter, and set the ____ barrel to the prescribed oxygen concentration

how does exercise improve cardiopulmonary health?

it improves blood circulation, strengthens the heart muscle, lowers blood pressure, reduces cholesterol levels, and helps maintain a healthy weight

what are the three primary objectives of therapeutic interventions in improving oxygenation for clients with cardiopulmonary complications?

preventing the onset of illness, terminating the disease process, and shortening the course of progression of the disease

which oxygen delivery device is suitable for delivering 60% - 90% oxygen concentration?

the nonrebreather mask

how should a nonrebreather mask be positioned on a client?

it should be positioned over the client’s nose and mouth, with elastic straps stretched over the head and adjusted snugly for the tight seal

why is it important to check the water seal chamber for tidaling during chest tube care?

it indicates that there is no air leak and that the lung has not re-expanded

why should the suction pressure be set between 80 - 120 mmHg during airway suctioning?

this range ensures effective removal of secretions while minimizing damage to the tracheal mucosa

what is the rationale for collecting 5 - 10 mL of sputum during specimen collection?

it ensures adequate sample for lab testing and analysis

if a client is unable to provide a sputum sample through expectoration, what should a nurse do?

the nurse can reposition the client, use chest percussion, or prepare for suctioning to assist in mobilizing secretions for collection

which environmental factors contribute to impaired cardiopulmonary function?

air pollution, second-hand smoke, and occupational hazards (like dust coal dust)

why must a nurse collect a sputum specimen in the morning before eating / drinking?

it ensures that the sample is from the lower respiratory tract, where secretions have accumulated overnight. it also reduces the risk of contamination

how can suctioning affect a client who has recently eaten?

it can trigger the gag reflex, leading to vomiting and aspiration

how is the right lung anatomically different from the left lung?

it has three lobes, while the other has two lobes, which accommodate space for the heart

what is the function of the pleural fluid within the pleural cavity?

it reduces friction between the visceral and parietal pleura, allowing the lungs to expand / contract smoothly during respiration

how does positioning the client in high-fowlers / semi-fowler’s assist with sputum collection?

lung expansion is facilitated and made easier for the client to cough effectively

what precaution should be taken when storing a pressurized oxygen cylinder to prevent damage or rupture?

it should be stored upright, away from heat or corrosive materials, and at least 20 feet from flammable gas cylinders

what is the point of using a pulse oximeter during tracheostomy suctioning?

its used to monitor oxygen saturation before, during, and after suctioning, as suctioning temporarily removes oxygen from the airway

what should the nurse do if resistance is felt while inserting the suction catheter into the artificial airway (trachea)?

the nurse should check for blockages in the tracheostomy tube, as this could indicate the need for immediate tube change

why do we put clients in a semi-fowler’s position before suctioning?

this causes the airway to open, and allows easier access to the tracheostomy tube

how do peripheral and central chemoreceptors regulate respiration?

located in the aortic arch and carotid arteries, changes are detected in blood CO2 and O2 levels, signaling the central chemoreceptors in the medulla oblongata to adjust respiratory rate and depth

why must we ensure the closed chest drainage system is positioned below the level of the client’s chest?

this prevents backflow of fluid into the pleural space and ensures proper drainage

atelectasis

the collapse of alveoli or lung tissue, often caused by shallow breathing

what are common causes of atelectasis?

general anesthesia, opioids, or thoracic / abdominal surgery

what is the primary diagnostic purpose of collecting a sputum specimen?

to identify disease-causing microorganisms or abnormal cells related to cancer in the lower respiratory tract

if resistance is felt during catheter insertion, what should be done?

do not force it. instead, remove it and attempt insertion in the other naris

why is it essential to use sterile 0.9% sodium chloride or sterile water during tracheostomy care?

they’re used to clean the stoma site and inner cannula, which reduces the risk of infection

why is hyperoxygenation important before / during suctioning?

it prevents hypoxia caused by suctioning, ensuring adequate oxygenation is maintained throughout the procedure

why should suctioning be discontinued if the client’s heart rate decreases by 20 beats per minute from the baseline?

this indicates the client is not tolerating the procedure, possibly due to vagus nerve stimulation

what are the recommended suction pressure settings for an adult during nasotracheal suctioning?

100 - 150 mm Hg

what are the recommended suction pressure settings for pediatric clients during nasotracheal suctioning?

50 - 100 mm Hg

what does the recommended suction settings prevent in adults and pediatric clients?

mucosal damage and hypoxia

why hyperoxygenate a client before removing the tracheostomy tube / inner cannula?

to minimize the risk of hypoxia during a procedure

what is the purpose of adjusting the flow rate on an oxygen flowemeter during oxygen administration?

adjustment controls the fraction of inspired oxygen (FiO2) delivered to the client, ensuring prescribed oxygen concentration is provided

what steps should be taken if hypoxia / bradycardia occurs during suctioning?

immediately stop suctioning, apply supplemental oxygen, and notify the provider

what safety precautions should be taken when using oxygen therapy at home?

avoid smoking or open flames near oxygen equipment, keep oxygen cylinders upright and secured, use cotton bedding, avoiding petroleum-based products (like vaseline), and ensuring proper ventilation around oxygen concentrators

how does an incentive spirometer help prevent atelectasis in clients recovering from surgery?

the medical device promotes deep breathing, improves lung expansion, mobilizes secretions, and provides visual feedback to encourage sustained inspiratory effort

why is it necessary to wait at least one minute between suctioning passes?

this allows for the client’s oxygen levels, heart rate, and respiratory effort to stabilize, minimizing the risk of hypoxia and allowing for reassessment

which methods can be used to collect a sputum specimen?

expectoration, usage of a bronchodilator, or by nasotracheal suctioning. the latter two methods cannot be delegated to AP

what is the function of the pulmonary circulation in the respiratory system?

it moves deoxygenated blood from the right ventricle to the lungs for gas exchange and returns oxygenated blood to the left atrium

why is it important to use commercially prepared tracheostomy dressing instead of cutting a gauze pad?

to prevent frayed fibers, which could obstruct the airway if introduced near the tracheostomy site

ventilation

the movement of air in / out the alveoli

perfusion

the flow of blood into the alveolar capillaries for gas exchange

what is the point of purse-lipped breathing?

to bring more oxygen into the lungs. this allows airways to stay open longer, and remove stale air

how is purse-lipped breathing performed?

by breathing in through the nose, and out via the lips— sort of in a “duck lips” fashion

tactile fremitus

vibrations felt on the chest wall during speaking

what does the flutter valve do?

it helps loosen and clear mucus, prevent atelectasis, reduces air trapping in the lungs, and facilitates easier breathing by allowing the client to cough up secretions effectively

what are the advantages of a high-flow nasal cannula?

simple use, good humidification, and reduced risk of gastric distention

what are the disadvantages of high-flow nasal cannula?

higher cost and the need for specialized flowmeter

why is a venturi mask preferred for clients needing precise oxygen delivery?

it delivers a fixed and precise oxygen concentration, regardless of the client’s respiratory rate or depth

what clinical manifestations might indicate hypoxemia in an infant?

nasal flaring, intercostal retractions, use of accessory muscles, and cyanosis

what structures are included in the upper airway?

pharynx and larynx

what are the functions of the structures in the upper airway?

the pharynx warms, filters, and humidifies air, and the larynx houses the vocal cords and is located at the top of the trachea

what is cardiac output?

the volume of blood pumped by the left ventricle in 1 minute

what part of the brain monitors the body’s oxygen and carbon dioxide demands?

brainstem

perfusion

the flow of blood by the cardiopulmonary system into the alveolar capillaries where deoxygenated blood is exchanged for oxygenated blood in the heart, and delivered to the rest of the body

pulmonary circulation

the movement of blood from the heart to the lungs from capillaries for gas exchange and back

what is known as the “pacemaker” of the heart?

SA node

what flow rate and oxygen concentration can a nasal cannula deliver?

at a rate of 1 - 6 L/min, which gives 24% - 44% oxygen concentration

what are the signs / symptoms of oxygen toxicity?

confusion, headache, nausa, seizures, uncontrolled coughing, and increased work of breathing

what role does the diaphragm play in ventilation?

it contracts to create negative pressure in the lungs, drawing air in, and relaxes during exhalation to expel air

why are elevated carbon dioxide levels from hypoventilation problematic for blood pH?

they increase carbonic acid in the blood, decreasing pH and causing acidosis

what’s the primary purpose of a chest tube in a client with pneumothorax?

to remove air from the intapleural space, allowing the lung to re-expand and restore normal respiratory function

what dietary changes can help reduce the risk of cardiopulmonary diseases?

fruits, fiber, whole grains, fish, and omega-3 fatty acids. limiting foods high in sodium, added sugars, and processed carbs is also recommended

how can the nurse ensure the oxygen cylinder has an adequate supply before use?

by applying the key or wrench on the valve stem, turn it fully counterclockwise, and check the gauge for the amount of available oxygen

what should the nurse assess before administering oxygen to a client with COPD?

evaluate baseline oxygen saturation and respiratory status

tidal volume

the amount of air inspried and expired with each breath

vital capacity

the max amount of air expelled after maximal inspiration

what is the primary purpose of using an inline closed suction system for clients with a tracheostomy tube or ETT?

it allows for suctioning of secretions without disconnecting the client from the ventilator, helping maintain airway patency while reducing the risk of hypoxia

what are the physiological effects of hyperventilation?

leads to excessive loss of carbon dioxide, causing an increase in arterial pH— results in alkalosis

what should be documented after performing tracheostomy suctioning?

date and time of suctioning, method used, size of suction catheter, pre / post-suctioning, assessment findings, client response, complications, and any education provided

what symptoms might be observed in a client experiencing hypoventilation?

dyspnea with exertion, confusion, disturbed sleep patterns, weakness, and impaired cough

which suction pressure range is recommended for adults when using an inline closed suction system?

80 - 140 mm Hg. this range clears secretions without damaging the tracheal mucosa

if a client has COPD, what should the nurse expect as a finding?

clubbing of the fingers

when assisting with a client who has a chest tube, what action can a nurse be expected to monitor for?

look for subcutaneous emphysema, which can indicate a leak or blockage of the system

a nurse is reinforcing teaching with a newly licensed nurse about pulmonary function tests. the nurse should include that which of the following is the vital capacity?

the maximum volume of air that is expired after a maximum inspiration

while auscultating a client’s heart sounds, if a low-pitched whooshing / blowing sound is observed over the heart, what could this indicate?

heart murmur

if a client needs 7L of oxygen to maintain oxygen saturation, what can a nurse be expected to use?

simple face mask, which ranges from 5 - 8 L/min

if a client has a history of asthma and wheezing, what is most important for a nurse to obtain?

an oxygen saturation. the greatest risk to the client is hypoxia

what is arterial fibrillation caused by?

electrical signals outside the SA node, causing irregular heart beat

how often should an incentive spirometer be used?

every hour while awake

what can indicate oxygen toxicity in a patient?

ringing in the ears, headache, disorientation, and muscle twitching

if a client needs 1L of oxygen, which device can a nurse be expected to administer?

nasal cannula. this device ranges from 1 - 6 L/min

if a client has prescription for home oxygen, what are some instructions a nurse can give that will promote client safety?

post a “no smoking” sign inside the home, attach oxygen containers to a fixed object, and notify the fire department that oxygen is used inside the home

what should a nurse expect a client who has heart disease and a narrowed valve to have?

stenosis— a narrowing of stiffening of the heart valve that causes backflow of the blood