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Problems of Oxygenation VentilationMedical Surgical Nursing

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Where are the peripheral chemoreceptors for respiration located?
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-In the carotid bodies at the bifurcation of the common carotid artery -In the aortic bodies above and below the aortic arch
What do the peripheral chemoreceptors of respiration respond to?
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-Decreases in PaO2 -decreases in pH -Increases in PaCO2
Lethargy and Combativeness are both early or late CNS signs of inadequate oxygenation?
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Late
Dypnea at rest, use of accessory muscles, retraction, and/or pausing in between words or sentences for breath are early or late respiratory signs of inadequate oxygenation?
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Late (dyspnea at rest can be early or late)
Dysrhythmias, hypotension, cyanosis and/or cool clammy skin are early or late cardiac signs of inadequate oxygenation?
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Late (dysrhythmias can be early or late)
Diaphoresis, decreased urinary output, and/or unexplained fatigue are early or late signs of inadequate oxygenation?
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Both early and late
What would you expect if a patient's PaO2 is 39% and their SpO2 is 74%?
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Tissue hypoxia and cardiac dysrhythmias
What are the considerations for a patient with a PaO2 of 60% and an SpO2 of 90%?
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The patient is adequately oxygenated, but not optimally. They are more at risk for a quick onset problem with oxygenation.
What are the considerations for a patient with a PaO2 of 55% and an SpO2 of 88%?
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If the patient has chronic hypoxemia (like with COPD), this is adequate as long as no cardiac probs occur. These values suggest a need for oxygen therapy.
What are the considerations for a patient that has a PaO2 of 40% and an SpO2 of 75%?
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This is inadequate, but acceptable on a short term basis if the patient is also retaining CO2. Oxygen at low concentrations (24%-28%) will gradually increase PaO2. MONITOR FOR DYSRHYTHMIAS
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What type of mechanical receptors signal the pulmonary stretch receptors to activate the pulmonary center to inhibit further lung expansion?
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Juxtacapillary and irritant mechanical receptors
Where are the mechanical receptors of respiration located? (4)
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Lungs, upper airways, chest wall and diaphragm
What is the Hering-Breuer reflex?
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It is the action of the mechanical receptors that inhibits lung expansion due to an irritant, muscle stretching or alveolar wall distortion. It prevents overdistention of the lungs.
Impulses from the mechanical receptors of inspiration are sent through the _______ nerve to the brain.
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Vagus
________ receptors are believed to cause tachypnea when a patient with pulmonary edema.
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Juxtacapillary (J) receptors
What are the respiratory defense mechanisms?
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-Filtrations of air -mucociliary clearance system -reflex bronchoconstriction -cough reflex -alveolar macrophages
What structures in the respiratory system are involved in the filtering of air?
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Nasal hairs, nasopharynx & larynx, mucosa lining, and bronchi
What is sedimentation as it relates to the respiratory system?
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Particles between 1-5 micrometers settle in the nasopharynx or bronchi
Particles greater than _____ micrometers are filtered, never reaching the alveoli. Those that are smaller, like coal dust, can be dangerous.
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5 micrometers
Where does the mucociliary clearance system begin?
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Below the larynx
Mucus is continually secreted at a rate of about _____ mL a day by goblet cells and submucosal glands.
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100 mL
  
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