Exam2 Notes-OxygImmunGI. NURS 260.

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ALTERATIONS IN OXYGENATION Alveoli - Functional unit of lung interconnected by pores of Kohn that produce surfactant;  Each adult has 300 million alveoli arranged in clusters which are surrounded... by capillary bed  Gas exchange occurs via diffusion and depends on ventilation-perfusion ratio  Normal –fully-functional alveoli & good blood supply allow for maximum gas exchange  Impaired Gas exchange:  Alveoli is constricted, blocked or collapsed; blood passes alveoli without max gas exch.  Blood supply is blocked not giving alveoli adequate blood supply Lung Tissue Properties:  Compliance – Expandability of lung which depends on surface tissue of alveoli & connective tissue of lungs → elastin gives lungs stretchability  Normal – easily stretched when take a deep breath  Low – stiff/difficult to inflate → pulmonary fibrosis or morbid obesity  High – lungs lost elasticity (overdistended) → returning CO2 such as with emphysema r/t loss of some alveolar wall→ lose recoil → overinflation  Elastic Recoil – ability of lungs to reduce in volume after being stretched Respiratory Defense Mechanisms –  Filtration of air  Mucocilliary Clearance  Cough reflex  Reflex Bronchoconstriction  Alveolar Macrophages Respiratory System Age Related Changes - respiratory peak @ age 25  Lifetime exposure to environmental stimuli – pollution; occupational hazards  Concurrent chronic disease – CAD, CHF, DM, COPD, alcoholism  Structural alterations – decr ability to take a deep breath; diminished vital capacity ( max amt of air inhaled & exhaled in a cycle) ◦ ↓ in elastic recoil ◦ ↓ in chest wall compliance ◦ AP diameter increases ◦ Kyphoscoliosis with advancing age ◦ Alveolar surface decreases  Defense Mechanism Changes – decr ability to clear secretions, incr URI, Incr r/f aspiration ◦ ↓in cilia function ◦ ↓cough reflex ◦ ↓effectiveness of alveolar macrophages ◦ Muscle atrophy of pharynx and larynx  Decrease in Physical Mobility – pulling of secretions in lungs → r/f pneumonia Respiratory Assessment Interview  Current respiratory problem ◦ Restlessness → 1 st indication of problem with oxygenation ◦ changes in breathing pattern/dyspnea  dyspnea – shortness of breath → @ rest, exercise, climbing stairs??; factors that relieve/worsen; sudden/gradual; lying flat?; S/S of other diseases (CHF, anaphylaxis, etc.) [Show More]

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