Respiratory REVIEW 2

Leukotriene allergic reactions; inflammatory & broncho constriction

Bleb large blister filled with fluid
Parenchyma functioning tissue of an organ
CPAP continuous positive airway pressure air pressure NOT oxygen
PEEP positive end-expiratory pressure; method of mechanical ventilation pressure is maintained to
increase volume of gas left in the lungs after exaltation
NC nasal cannula
VM venturi mask
ET tube endo tracheal (in nose pharynx to trach)
OT tube oral tracheal (in mouth to trach)
Trach pertaining to the trachea
PFT pulmonary function tests
RA room air (contains 21% of oxygen)
Pharynx (throat) nasopharynx (behind nose) oropharynx (behind mouth) laryngopharynx (behind
larynx)
Larynx (voice box) contains cartilage thyroid cartilage (Adams Apple)
Epiglottis leaf shaped - protects the larynx when swallowing
Trachea (windpipe) divides into left and right bronchi; contains c-shaped cartilage rings
Lungs left side (2 lobes) right side (3 lobes) receive their blood directly from the heart
Alveoli saclike grapestructure; main function is gas exchange between oxygen and carbon dioxide;
surrounded by blood capillary where this diffusion takes place; covered by surfactant enzyme reduces
surface tension and prevents collapsing after each breath
Visceral pleura (inside) surface of each lung; thin moist serous membrane (mickey)
Parietal pleura (outside) walls of the thoracic cavity covered with same type of membrane (round
balloon) Airtight vacuum that contains negative pressure
Pleural effusion if too much serous secretion (membranes) fluid accumulates in the pleural space
Pleuracy accumulation of fluid in the pleural space
Thoracentesis inserting a needle into the pleural space and removing fluid; usually no more than
1300ml 1900ml of pleural fluid should be removed in a 30min period After procedure place patient on
good side
Normal range of respiration for an adult is 12-20 (WNY) if 10 or below no narcotic meds. Woman
usually 16-18 Newborn 40-60
Pons most important for regulating respiration (top of brain stem midbrain-pons-medulla )
Carbon dioxide (carbonic acid in blood) chemical stimulant for us to breath; triggered to breath by
carbon dioxide levels in our body not oxygen. More carbon dioxide in blood the more acidic blood
becomes - after exculpation blood becomes more alkaline (base) normal ph 7.35-7.45 Remember COPD
patients keep on low O2 setting 2 or less
Dyspnea difficulty breathing
Orthopnea abnormal condition in which a person must sit or stand to breathe deeply or comfortably

Adventitious sounds abnormal sounds superimposed on breath sounds

Adventitious Breath sounds

Crackles (rales) more common on inspiration hairs rolled between fingers; fluid mucus or pus alveoli
are popping open because of fluid
Sonorous wheezes (rhonchi) like a snore inspiration or expiration; secretions tumor or spasm
trapped; have pt cough may alter sound if mucus in trachea or large bronchi NOT sonorous
Sibilant wheezes (wheezes) musical whistlelike on expiration; narrowed or restricted passages in lungs;
most common asthma pts
Pleural friction rub dry creaking low pitched sound inspiration or expiration; originates outside
respiratory tree caused by inflammation; over lung fields suggests pleurisy; have pt hold breath if you
still hear it is pericardial friction rub
Hypoxia low oxygen in the body (usually in respiratory system) s/s any behavior change, increased
pulse rate, bradycardia (as hypoxia gets worse) elevated blood pressure, cyanosis, clubbing (chronic)
hypoxia, dyspnea
Tests or breathing
CT (chest) diagonal or cross-sectional
Helical CT (spiral or volume-averaging) 30 seconds or one breath hold
Pulmonary angiography pulmonary embolism (PE)
Ventilation-perfusion (V/Q) is you suspect PE do this first! Pt inhales radioactive gas that outlines alveoli
PFTs (pulmonary function tests)
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Vital capacity - maximum exhalation

Residual volume amount of air in lungs remaining after expiration
Total lung capacity maximum inhalation

Mediastinoscopy (from outside of body not down the throat) performed to gather a sample of lymph
nodes for biopsy for tumor diagnosis
Bronchospcope (down the throat inside the lungs) balloon is inflated with 1.5 to 2ml of air to occlude
the airway - fluid introduced then lavage (sucking out) Keep pt on NPO until gag reflex returns (approx
2hrs) semi fowlers ; monitor for edema or spasms
Sputum Specimen; collect sample before antibiotics are started, before meals to avoid emesis from
coughing, spit (expectorate) sterile sputum container early morning samples 3 consecutive days, saline
aerosol mist will help secretions, inhale deeply and cough then spit no gum or cigarettes 30 min
before, sputum samples can be obtained thru suctioning (physicians order)
- Color, amount, consistency, odor, and blood
Lung Biopsy transbronchial involves getting specimen thru forceps or needle with scope
Open-lung biopsy chest is opened with thoracotomy incision ( in chest wall)and specimen is obtained

Arterial Blood Gases (ABG) essential test in diagnosing and monitoring patients with respiratory
disorders (ICU nurse Dr or RT respiratory therapist)
Carbon Dioxide balance controlled by lungs Pco2
Bicarbonate ions balance controlled by kidneys Hco3
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Arterial oxygen tension (Pao2) oxygen dissolved in plasma beginning phase; PA means partial
plasma pressure
Arterial oxygen saturation (Sao2) oxygen combined with hemoglobin; normal 90%; SA means
saturated with hemoglobin
Oxygen must first dissolve in blood (Pao2) before it can bind to hemoglobin (Sao2)
Pco2 partial pressure of carbon dioxide in the blood; respiratory component in acid-base
determination because this value is primarily controlled by the lungs. As carbon dioxide level
increases ph levels decreases (Less carbon dioxide the higher the ph) CO2 opposite of ph
In metabolic acidosis (pH is low) the lungs attempt to compensate by blowing off carbon
dioxide to raise pH
In metabolic alkalosis (pH is high) the lungs attempt to compensate by retaining carbon
dioxide to lower pH
HCO3 bicarbonate ion; measure of the metabolic (renal-kidney) component of the acid-base
equilibrium (balance) as the HCO3 increases the pH level increases; kidneys compensate

Arterial blood gas (ABG) testing yields definitive information on the patients respiratory status and
metabolic rate. Samples for ABG place syringe in crushed ice water to preserve the gas and pH levels of
the specimen
Pulse Oximetry quickest way to access ox saturated % - blood gas is the most accurate (sao2
saturation of oxygen)
ABG results reflect a patients oxygenation status at only one moment in time

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