Gas Exchange and Oxygenation

What is the definition of Ventilation?

The flow of air inside or outside of the alveoli.

What is the definition of 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.

Tightening of the bronchus due to smooth muscle contraction.

Bronchoconstriction

Expansion of the airway in the bronchus.

Bronchodilation

What is the role of Surfactant?

A lubricant made in the lungs to keep the alveoli from collapsing during exhalation.

Define Atelectasis.

The collapse of airways and small sections of the lung resulting from shallow breathing; the collapsing of the lung during expansion.

A protective layer or membrane covering the lungs.

Pleura

The space between the visceral and parietal layers of the lung.

Pleural cavity

What is the function of the Diaphragm?

A muscle innervated by nerves that separates the chest cavity from the abdominal cavity.

What are the key Dietary Assessments for cardiopulmonary health?

• DASH Diet: 6-8 servings whole grains, 4-5 servings vegetables/fruits, 2-3 servings low-fat dairy, <6 servings lean meat/poultry/fish.

• Mediterranean Diet: Rich in vegetables, fruits, fiber, whole grains, and omega-3 fatty acids.

What environmental and lifestyle factors are assessed?

• Smoking: Nicotine causes vasoconstriction; cigarettes increase COPD/cancer risk.

• Stress: Increases BP, HR, and cortisol; enhances fight-or-flight.

• Environment: Dust, second-hand smoke, construction, chemicals.

Fluid in air sacs; sounds like music/whistling on exhalation.

Crackles

High-pitched whistling due to narrowed airways.

Wheezing

Rattling sound due to airway obstruction.

Rhonchi

Music/whistling sound on inhalation due to airway narrowing.

Stridor

What are signs of Hypoxemia?

Confusion, irritability, restlessness, dyspnea, tachypnea, tachycardia, hypertension, cyanosis, accessory muscle use, and hyper/hypoventilation.

What are specific Inspection findings for cardiopulmonary issues?

• Barrel Chest: Seen in COPD.

• Tripod Position: Helps with breathing.

• Jugular Venous Distention (JVD): Indicates increased workload on the right side of the heart.

Heart rate < 60 bpm

Bradycardia

Heart rate > 100 bpm (Normal sinus rhythm is 60-100 bpm)

Tachycardia

What are the risks and treatments for Atrial Fibrillation?

• Risk: Atria quiver, causing blood clots (risk of heart attack/stroke).

• Symptoms: Chest discomfort, palpitations, or asymptomatic.

• Treatment: Blood thinners.

Compare Left-Sided vs. Right-Sided Heart Failure.

• Left-Sided (Brain/Lungs): Backs up into pulmonary veins; causes hypoxia, crackles, and shortness of breath.

• Right-Sided (Feet/Organs): Congests peripheral circulation; causes peripheral edema (lower extremities, abdomen, organs) and JVD.

What is Myocardial Infarction (MI) and how does it respond to Nitroglycerin?

irreversible heart damage from decreased O2; symptoms include chest pain radiating to back/shoulders, diaphoresis, and anxiety. Nitroglycerin does NOT relieve MI chest pain.

What are the characteristics of COPD (Emphysema and Bronchitis)?

• Emphysema: Damaged alveoli and "blebs" from trapped air; leads to barrel chest.

• Bronchitis: Mucus and inflammation in the airway.

• Note: Patients live with lower O2 (approx. 88%) and chronic CO2 retention. Do NOT over-oxygenate.

1-6 LPM (24-44%); start first for mild drops; watch for skin breakdown.

Nasal Cannula

5-10 LPM (35-60%); not for CO2 retention.

Simple Face Mask

10-15 LPM (80-95%); bag must be inflated BEFORE placing on patient; gases are not mixed.

Nonrebreather

What is a Venturi Mask used for?

Delivering a precise amount of oxygen using different barrels (4-15 LPM, 24-60%).

Differentiate CPAP vs. BiPAP.

• CPAP: Constant flow of air; keeps airway open for sleep apnea.

• BiPAP: Higher pressure on inhalation, lower on exhalation; for collapsing airways or muscle weakness.

What are the signs of Oxygen Toxicity?

• Acute: CNS damage (hand twitching, nausea, convulsions, tinnitus).

• Chronic: Pulmonary damage (atelectasis, coughing, dyspnea, substernal heaviness).

What are critical Home Oxygen Safety rules?

No smoking/open flames, no petroleum-based products (use water-based), no aerosol hairspray, 100% cotton bedding, keep tanks upright, and tubing under 50 feet.

How is a Sputum Specimen correctly collected?

Collect in the morning before eating; have client take deep breaths and perform a deep cough to produce 1-2 teaspoons into a sterile cup.

What are the components of Chest Physiotherapy?

Percussion, vibration, and postural drainage to enhance secretion clearance; often used with aerosol meds and suctioning.

What is the proper technique for Cough and Deep Breathe?

Repeat every 1-2 hours; take deep breath, hold, exhale (5x), then deep cough. Splint abdomen/chest with a pillow to avoid dehiscence.

What are the rules for Chest Tube management?

• Keep system BELOW the patient's chest.

• Tidaling is normal; Bubbling is BAD (indicates air leak).

• Document drainage and keep patient upright.

How is an Incentive Spirometer used?

Patient inhales deeply through the device to expand lungs and prevent atelectasis.