Arterial Blood gas (ABG)
reports the status of oxygenation and acidbase balance of the lbood
pH
the amount of free hydrogen ions in the arterial blood
Normal range 7.35-7.45
PaO2
Normal range 80-100mm Hg- the partial pressure of oxygen
PaCO2
the partial pressure of carbon dioxide
Normal range- 35-45 mm Hg
HCO3
the concentration of bicarbonate in arterial blood- Normal range 22-26mEq/L
SaO2
percentage of oxygen bound to hemoglobin as compared to the total amount that can be possibly carried Normal range 95-100%
Blood pH level below 7.35 reflect ___________, while levels above 7.45 reflect __________.
acidosis, alkalosis
Hypoxemia
a condition of inadequate levels of oxygen in the blood
signs and symptoms of hypoxemia- early
early- tachypnea, tachycardia, restlessness, pallor of the skin and mucous membranes, elevated blood pressure, symptoms of respiratory distress (use of accessory muscles, nasal flaring, tracheal tugging, adventitious lung sounds)
Signs and Symptoms of Hypoxemia-late
confusion and stupor, cyanosis of skin and mucous membranes, bradypnea, bradycardia, hypotension, cardiac dysrhythmias
Asthma
chronic inflammatory disorder of the airways. It is an intermittent and reversible airflow obstruction that affects the bronchioles- occurs by either inflammation or airway hyper-responsiveness
Manifestations of Asthma
mucosal edema, bronchoconstricion, excessive secretion production
Pneumonia
inflammatory process in the lungs that produces excess fluid. is triggered by infectious organisms or by the aspiration of an irritant.
Community acquired pneumonia (CAP)
most common type and often occurs as a complication of influenza
Hospital acquired pneumonia (HAP)
also known as nosocomial pneumonia, has a higher mortality rate and is more likely to be resistant to antibiotics
Atelectasis
airway inflammation and edema leads to alveolar collapse and increase the risk of hypoxemia
diminished or absent breath sounds over affected area
chest x-rays shows area of density
Bactremia (sepsis)
can ocur if pathogens enter the bloodstream from the infection in t he lungs
Tuberculosis (TB)
infectious disease caused by Myobacterium tuberculosis
TB transmission
airborne route- a droplet becomes airborne when an individual coughs, sneezes,... inhalation of this droplet allows transmission of the bacteria
TB primarily affects the ________ but can spread to any organ through the blood.
lungs
Preventing transmission of TB
Wear an N95 or HEPA respirator
place the client in a negative airflow room
airborne precations
barrier protection
have client wear mask
Signs and Symptoms of TB
persistent cough, purulent sputum, possibly blood-streaked, fatigue, lethargy, weight loss, anorexia, night sweats, fever
respiratory acidosis- Signs and symptoms
apprehension, confusion, decreased deep tendon reflexes, dyspnea with rapid shallow respiration, nausea and vomiting, restlessness, tachycardia, tremors, warm flushed skin
Allen Test
Continually make fists while compressing radial and ulnar arteries --> Have pt open palm, relase pressure and see whether bld flow is restored. + exam = bld flow not restored and compromise of artery
Physiotherapy
therapy that uses physical agents: exercise and massage and other modalities, treatment to help loosen secretions
Respiratory alkalosis
anxiety, panic attack, diaphoresis (profuse sweatin), increased respiratory rate and depth, EKG changes, parethesia, tachycarida, tetany
Tetany
clinical neurological syndrome characterized by muscular twitching and cramps and (when severe) seizures
Hyperventilation
breath into a paper bag, breathing exhaled CO2 will raise the CO2 level
Metabolic Acidosis signs and symptoms
abdominal cramping, diarrhea, muscle weakness, ECG changes, Kussmal's respiration, lethargy , warm, dry, skin