NURS 221 Test 2

alveoli

grape-like, promote gas exchange and O2 exchange to our capillaries and into systemic circulation

pulmonary circulation main purpose

move blood to and from the alveolar-capillary membranes for gas exchange

carbon dioxide transport

product of cellular metabolism

regulation of ventilation

cerebral cortex

what happens if an artery gets occluded

everything below that gets affected; higher the damage, the worse the problem is

widowmaker

blood clot in the L anterior descending → whole left side of the heart goes down

decreased oxygen-carrying capacity

hypoxia, sickle cell, anemia

anemia

* low blood count
* S&S: lightheaded, dizzy, weak, SOB, and increased HR, low BP
* don’t have the O2 that the tissues need

hypovolemia

* not enough circulating fluid - dehydration
* S&S: low BP, high HR, vasoconstriction, blue extremities

decreased inspired O2 concentration

* when you don’t get good deep breaths
* high altitudes

increased metabolic rate

fever, exercising, thyroid overactive

* need more O2 → if body can’t keep up → hypoxic

conditions affecting chest wall movement

pregnancy, obesity, musculoskeletal abnormalities, trauma, neuromuscular diseases, CNS alteration, chronic lung disease

chronic lung disease

chronic inflammation, bronchitis, asthma, emphysema; oversized but not good gas exchange

hypoventilation

lox O2 and high CO2

hyperventilation

normal O2 and low CO2; panic attack

hypoxia

low oxygen;

A-fib

atrium doing its own thing, lose 20-30% BP, acute → circulates in heart and causes clots and stroke

myocardial ischemia

heart not getting enough O2

angina

decreased O2 but not completely shut off; S&S: chest pain, lightheaded, pain in jaws, nauseous, heartburn; nitroglycerin and O2 → vasodilates the coronary arteries

myocardial infarction

heart attack, complete blood flow obstruction to distal portion of the heart, heart has lost blood to particular area; everything below the clot gets no O2; S&S: elephant on chest, throwing up, sweating

L-sided HF

lung symptoms, LV not pumping effectively; S&S: SOB, chronic cough, wheezing, crackles in lungs, cough foamy pink, “i cant breathe”

R-sided HF

R side not pumping effectively, blood pumps up into the blood vessels → failure of other organs and edema in extremities; S&S: JBD, ascites, swollen ankles, blue feet

smoking

vasoconstriction and inflammation

respiratory infections

infectious material gets stuck in the alveoli and gas exchange cannot occur

nebulization

most effective way of them getting meds down into airway

what to do if pulse ox is low

cough and deep-breathe

open airway suctioning

single tube in & out, has to be sterile

closed airway suctioning

in sterile sleeve, does not need to be removed from ventilator

methods of oxygen delivery

nasal canula 50-60L, oxygen masks

CPAP

continuous positive airway pressure; used to treat obstructive sleep apnea and prevent atelectasis, keeps airway open all the time, provides the same pressure udring both inhalation and exhalation

BIPAP

controls the depth, rate, pressure; uses 2 pressures

nutrients

biochemical units of nutrition

carbohydrates

major source of energy, complex not simple

proteins

essential for growth and development, maintenance and repair of the body tissues; if too low → body takes from muscles → nitrogen imbalance

fats

unsaturated not saturated

vitamins

stored in fat, fat-soluble and water-soluble

fat-soluble

vitamin A, D, E, and K

water-soluble

vitamin C - can’t overdose

minerals

helps in acid-base balance

digestion system

digestion, absorption, metabolism and storage of nutrients, and elimination

overweight

BMI 25-29

obese

BMI >30

folic acid deficiency

spinal bifida

most accurate lab test

albumin and prealbumin

nitrogen in urine

when body doesn’t get enough protein and starts breaking down muscles

keep eye on weight

heart pts, dialysis pts, kidney failure pts

enteral tube feeding

tube goes in nose, down esophagus, into stomach; complications - aspiration, >30

parenteral

through the IV if the bowels aren’t tolerating at all; sterile, hangs for 24 hours, central line, check glucose every 6 hours

hyperglycemia

polydipsia, polyuria, polyphagia

chemical name

made of the chemicals in the medication

generic name

given by the manufacturer

trade name

how it is sold

classification for drugs

system, effect, symptoms

what happens when the kidneys fail

the medication won’t be distributed correctly

metabolism

process of body becoming less active or less potent

excretion

primarily through the kidneys

therapeutic effects

does what it is intended to do

adverse effects

side effects, toxic effects, idiosyncratic reactions, allergic reactions

side effects

expected

toxic effects

happens with med accumulation

idiosyncratic reactions

opposite things happen

allergic reactions

life threatening, emergency; steroids, epinephrine

troph

lowest amount of medicine in persons body

peak

highest med concentration in pts body

biological half-life

time it takes for body to get rid of 1/2 medicine

4 sites of injection

intradermal, subcutaneous, intramuscular, intravenous

standing order

implemented at one time

prn

as needed, has to have a reason

single-dose

need only once

STAT

within 15 min

Now

within 30 min

prescriptions

not hand written anymore

pain meds and narcotics

slow HR, low RR, low BP

insulin preparation

cloudy, clear, clear, cloudy

clear insulin

short-acting

cloudy insulin

long-acting and short-acting

subcutaneous injection sites

high butt, low stomach, tris, thighs, lats

intradermal

5-15 degrees, must do it until you get a wheel or a bubble, allergies and TB test

IV administration

Large-volume infusions - Liter bag

volume-controlled infusions

volume controlled infusions

* piggyback - antibiotics
* volume-control administration - for kids
* syringe pump - anesthesia

physiology of pain

transduction , transmission, perception, and modulation

acute physiological response to pain

pupils dilate, high HR, high RR, high BP

chronic physiological response to pain

may not always see changes

chronic episodic pain

chronic becomes acute because of reinjuring until inflammation goes down and pain goes back to chronic level

idiopathic pain

don’t know the cause

characteristics of pain

timing, onset, location, severity, quality, aggravating and precipitating factors, relief measures

concomitant symptoms

things that happen in addition to the pain

aspirin

clot prevention and most likely not pain

multimodal analgesia

combines drugs with different mechanisms, 2 forms of pain control

adjuvants

enhance the analgesics, enhance each other’s capabilities

narcotics/opioids

respiratory depression, low HR, low BP, low RR, constipation; higher chance of reducing pain

topical and transdermal analgesics

lidocaine patches

local anesthesia via injection

nerve blocks/regional blocks; they still have skin breakdown

placebos

only for scientific experiments

characteristics of body fluids

* fluid amount - volume
* concentration - osmolality
* composition - electrolyte concentration
* degree of acidity - pH

water

* 60% of our weight
* majority is intracellular

active transport

low → high concentration; requires energy in form of ATP

diffusion

high → low concentration; movement of solutes across a semi-permeable membrane

osmosis

water moves through a membrane that separates fluids with different particle concentrations

filtration

fluid and solutes move together from high to low pressure