Gas Exchange and Oxygenation

What is the respiratory system comprised of?

The respiratory system is comprised of the nose, oropharynx, larynx, trachea, bronchi, bronchioles, and lungs.

What structures make up the upper airway?

The upper airway consists of the nasopharynx (nose), oropharynx (mouth), and larynx.

What structures make up the lower airway?

The lower airway includes the trachea, bronchi, bronchioles, and alveoli.

What are alveoli?

Alveoli are tiny air sacs in the lungs where oxygen and carbon dioxide are exchanged.

How many lobes does the right lung have?

The right lung has three lobes: superior, middle, and inferior.

How many lobes does the left lung have?

The left lung has two lobes: superior and inferior.

What is bronchodilation?

Bronchodilation is the expansion or opening of the airways in the lungs.

What is bronchoconstriction?

Bronchoconstriction is the narrowing or restriction of the airways in the lungs.

Which nervous systems influence the lungs?

The lungs are controlled by both the sympathetic and parasympathetic nervous systems.

What is ventilation?

Ventilation is the movement of air into and out of the alveoli.

What is perfusion?

Perfusion is the flow of blood through the pulmonary capillaries surrounding the alveoli.

What occurs during gas exchange?

Oxygen diffuses from the alveoli into the blood while carbon dioxide diffuses from the blood into the alveoli.

What is hypoxemia?

Hypoxemia is a decreased amount of oxygen in the blood.

What is hypoxia?

Hypoxia is inadequate oxygen at the cellular or tissue level.

What are retractions?

Retractions occur when muscles pull inward between the ribs during inspiration and are a sign of respiratory distress.

What are intercostal retractions?

Intercostal retractions are inward pulling of muscles between the ribs during inspiration due to airway obstruction or respiratory distress.

What is lung compliance?

Lung compliance is the ability of the lungs to expand in response to increased pressure.

What is airway resistance?

Airway resistance is the resistance to airflow caused by narrowing of the airways.

What does increased work of breathing cause?

Increased work of breathing can cause use of accessory muscles and respiratory distress.

What is accessory muscle use?

The use of neck and chest muscles to assist breathing; it is a sign of respiratory distress.

What is COPD?

COPD is a chronic obstructive pulmonary disease characterized by airflow limitation and difficulty breathing.

What causes emphysema?

Emphysema develops when the walls between alveoli are damaged, making it difficult to move air out of the lungs.

What happens to the alveoli in emphysema?

The alveoli are destroyed, reducing surface area for gas exchange.

What causes chronic bronchitis?

Chronic bronchitis is caused by repeated or constant inflammation and irritation of the airway lining.

What is a hallmark finding of chronic bronchitis?

Excessive thick mucus production that obstructs airflow.

What are common lung sounds in chronic bronchitis?

Wheezes and crackles may be heard due to mucus accumulation.

What is pneumonia?

Pneumonia is an infection of the lungs caused by bacteria, viruses, or fungi.

How does pneumonia impair gas exchange?

Fluid and pus fill the alveoli, preventing normal oxygen and carbon dioxide exchange.

What nursing interventions are important for pneumonia?

Monitor respiratory effort, maintain airway patency, obtain cultures, encourage hydration and rest, and administer medications.

What is culture and sensitivity testing?

A test used to identify the causative organism and determine which antibiotic will be effective.

What are expectorants?

Expectorants loosen mucus to help patients cough up secretions.

What are bronchodilators?

Bronchodilators relax airway smooth muscle and open the airways.

What is atelectasis?

Atelectasis is the partial or complete collapse of a lung or portion of a lung.

Who is at risk for atelectasis?

Patients after surgery or those on prolonged bed rest.

What are causes of atelectasis?

Poor inspiration, compression (pleural effusion), and airway obstruction (mucus plug or mass).

What is the best device to prevent atelectasis?

The incentive spirometer.

What nursing interventions help prevent atelectasis?

Incentive spirometry, early ambulation, and getting the patient out of bed.

When should a focused cardiopulmonary assessment be performed?

When a patient has shortness of breath, decreased oxygenation, activity intolerance, or a history of respiratory or cardiac disease.

What vital signs are important in respiratory assessment?

Respiratory rate, oxygen saturation, heart rate, blood pressure, and temperature.

What chest abnormality is commonly associated with COPD?

Barrel chest.

What is barrel chest?

An increased anterior-posterior diameter of the chest commonly seen in COPD.

What position is commonly used by patients in respiratory distress?

The tripod position.

What is stridor?

Stridor is a high-pitched sound caused by upper airway obstruction, commonly heard in children.

What is cyanosis?

Cyanosis is a bluish discoloration of the skin and mucous membranes caused by inadequate oxygenation.

What is the priority nursing action for a patient with respiratory distress?

Raise the head of the bed to improve lung expansion.

Why must both the heart and lungs be assessed?

Because both systems work together to provide oxygenation and perfusion.

What is the purpose of a chest x-ray?

A chest x-ray evaluates the lungs, heart, and surrounding structures.

What can a chest x-ray reveal?

Pneumonia, pneumothorax, heart enlargement, fluid, or increased lung density.

What is a pneumothorax?

A pneumothorax is a collapsed lung caused by air entering the pleural space.

What is an ECG/EKG?

An electrocardiogram measures the electrical activity of the heart.

What information does an ECG provide?

Heart rate, rhythm, blood supply, conduction abnormalities, and dysrhythmias.

What is an echocardiogram?

An echocardiogram is a noninvasive ultrasound of the heart.

What does an echocardiogram evaluate?

Heart size, cardiac output, valve disorders, congenital defects, and pericardial effusion.

What is cardiac output?

The amount of blood pumped by the heart each minute.

What is impaired gas exchange?

A nursing diagnosis describing problems with oxygen and carbon dioxide exchange.

What is ineffective airway clearance?

A nursing diagnosis describing the inability to clear secretions or airway obstructions.

What nursing diagnoses are associated with pulmonary disorders?

Impaired Gas Exchange, Ineffective Airway Clearance, Volume Overload, Acute Confusion, Activity Intolerance, Imbalanced Nutrition, Self-Care Deficit, Anxiety, and Fear.

What is the main goal of cardiopulmonary nursing care?

To restore optimal cardiopulmonary function.

What is evaluation in the nursing process?

Determining whether interventions were effective and modifying the plan of care as needed.

Who are members of the interdisciplinary team for respiratory patients?

Nurses, physicians, respiratory therapists, speech therapists, physical therapists, and occupational therapists.

What is the role of a respiratory therapist?

Administer inhaled medications and assess respiratory status.

What is the role of speech therapy in respiratory care?

Assess and treat aspiration risk.

What is the role of physical and occupational therapy?

Assist patients with activity intolerance and self-care deficits.

What are the three categories of oxygen delivery systems?

Low-flow systems, reservoir systems, and high-flow systems.

What is a nasal cannula?

A low-flow oxygen delivery device placed in the nostrils.

What is a simple face mask?

A mask that delivers a moderate concentration of oxygen.

What is a partial rebreather mask?

A mask with a reservoir bag that allows delivery of higher oxygen concentrations.

What is a nonrebreather mask?

A mask with a reservoir bag and one-way valves that delivers high concentrations of oxygen while preventing rebreathing of CO₂.

What is the nursing priority when applying an oxygen mask?

Ensure the mask fits properly.

What is chronic hypercapnia?

Elevated carbon dioxide levels in the blood.

Why should oxygen be used cautiously in patients with chronic hypercapnia?

Excess oxygen may suppress respiratory drive.

What oxygen concentration can increase the risk of atelectasis during anesthesia?

FiO₂ greater than 50%.

Why is oxygen considered a fire hazard?

High oxygen concentrations support combustion and increase fire risk.

What infection risk is associated with nebulizers and inhalers?

Improper cleaning can lead to bacterial contamination.

What should be documented before oxygen therapy begins?

Baseline respiratory assessment and oxygen saturation.

What should be documented after oxygen therapy starts?

Flow rate, oxygen percentage, device used, and patient response.

When should oxygen delivery systems be checked?

When receiving a patient, after diagnostic testing, and after sudden changes in condition.

What is a nebulizer?

A device that converts liquid medication into a mist for inhalation.

What is an inhaler?

A handheld device that delivers medication directly into the lungs.

What is chest physiotherapy?

Treatments used to improve airway clearance and lung expansion.

What are examples of chest physiotherapy?

Coughing, deep breathing, incentive spirometry, and postural drainage.

What are complications of postural drainage?

Hypoxemia, increased ICP, hypotension, vomiting, bronchospasm, pain, and dysrhythmias.

Why are anticoagulants used in some cardiac patients?

To prevent clot formation that could lead to thromboembolism.

What does INR stand for?

International Normalized Ratio.

Why is INR monitored?

To determine the effectiveness and safety of anticoagulation therapy.

What should nurses monitor in patients receiving anticoagulants?

Signs and symptoms of bleeding.

What bleeding symptoms should patients report?

Rectal bleeding, oral bleeding, unusual bruising, or prolonged bleeding.

Why is smoking cessation important?

It reduces the risk of pulmonary and cardiovascular disease and improves oxygenation.

What smoking cessation medications may be recommended?

Chantix, Wellbutrin, and nicotine gum.

What nonpharmacologic smoking cessation methods are available?

Behavioral therapy and community support groups.

What vaccines are recommended annually for adults?

Influenza vaccine.

Who should receive the pneumococcal vaccine?

Adults over 65 and adults with chronic pulmonary or cardiovascular disease.

Who should receive the RSV vaccine?

Adults over 60 years old.

Why are vaccinations important for respiratory health?

They reduce the risk of infections that impair oxygenation and gas exchange.