Ventilation
What is the first mechanism of pulmonary ventilation?
A. The diaphragm contracts
B. Central chemoreceptors in the medulla stimulate respiratory muscles
C. Carbon dioxide levels rise in the blood and CSF
D. The diaphragm and intercostals relax
C- Carbon dioxide levels rise in the blood and CSF
What are 2 pathophysiologic changes that happen with pneumonia?
- interstitial tissue changes
-alveolar septae changes
-alveoli changes
-impaired oxygen diffusion
-hypoxia
What kind of disorder is Cystic Fibrosis?
Genetic (Chromosome 7)
In advanced emphysema, your body breaths in response to?
low O2 instead of a rise in Co2 levels because they live with chronic high Co2 levels so their brain stops paying attention to Co2.
What is one treatment GOAL of asthma
- TERMINATE acute bronchospasms
-REDUCE frequency of asthma attacks
What is the 3rd mechanisms of pulmonary ventilation?
A. The diaphragm contracts, intercostal muscles contract to increase the size of the intrathoracic cavity
B. Central chemoreceptors in the medulla stimulate respiratory muscles
C. Pressure within the thoracic cavity decreases and air flows into the lungs
D. Intra-alveolar pressure exceeds atmospheric pressure
A. The diaphragm contracts (flattens), intercostal muscles contract (ribs and sternum rise) to increase the size of the intrathoracic cavity.
Your client is diagnosed with bacterial pneumonia- What treatment will they need for this?
Antibiotics-bacterial
supportive care= viral
What are the 2 types of asthma and the difference:
Extrinsic: overreacting to allergens
Intrinsic: airways themselves become sensitive and reacts
What are 2 things COPD leads to in clients?
- pulmonary HTN
-Cor pulmonale
-Respiratory failure
-Ongoing progression
What are the 2 types of Beta -adrenergic agonists?
1. SABA
2. LABA
What is the site for gas exchange?
Alveoli (tiny grapes on the branch)
Client presents with sudden shortness of breath, productive rusty-colored sputum, 102 fever, and says they have the chills. What do you suspect is the diagnosis?
Lobar (bacterial) Pneumonia
What are 3 things cystic fibrosis affects in the body?
- Lungs (clogs bronchioles=infections)
-Pancreas (blocks enzyme release= stratorrhea, poor growth, malnutrition)
-Sweat glands (release extra salt)
Client comes in with fatigue, weight loss, they are very anxious, distended chest, and can't get out a full sentence without having to take a rest. What is the client displaying signs of?
Emphysema (Pink Puffer)
What is a PRIORITY education piece before giving a corticosteroid inhaler to a client?
Rinse mouth out after using steroid inhalers
What triggers breathing?
Chemoreceptors
They detect Co2 (primary driver of breathing), PH, and O2
What type of Pneumonia will you hear scattered crackles throughout the lungs and see a diffuse pattern of infection on chest xray?
Bronchopneumonia
During the early phase of an asthma attack, the client displays what:
A. Respiratory acidosis
B. Respiratory alkalosis
C. Metabolic acidosis
D. Metabolic alkalosis
B
During the early phase the client is breathing TOO FAST blowing off too much Co2
Client comes in with a chronic productive cough that is yellow-green in color, fatigue, use of accessory muscles, cyanotic and VS as follows:
BP: 132/88
RR: 32
P: 102
o2: 88% RA
What is the client displaying signs of:
Chronic bronchitis (Blue bloater)
What is the primary action of how anticholinergics work AND what is the most common class?
-Block parasympathetic nervous system with bronchodilator effects
-Spiriva
What is the primary mechanisms that controls ventilation?
Hypercapnia (High Co2)- Cause= hypoventilation
Name the 2 epidemiological data for Pneumonia and the difference between the 2
1. Hospital acquired- develops 48 hours after admission, not present on admission (resistant bacteria=more dangerous)
2. Community- develops outside the hospital or within 48 hours of hospitalization
During an asthma attack, three things happen all at once:
- Airway swells on the inside
-Muscles squeeze tight around it
-Mucus fills the tube
What is the differences between emphysema and chronic bronchitis in relation to why it's difficult for them to breath?
Emphysema- air trapping d/t loss of elasticity= hard to exhale
Bronchitis- obstruction d/t mucus & swelling= hard to get air through bronchi
How do Beta-adrenergic agonists work?
Hint: 3 steps
1. Activates Beta 2 receptors in bronchial smooth muscle
2. Causes bronchodilation
3. Airways open- air can move in and out more easily