What happens when the lungs fail to work?
Hint: CO2
Carbon dioxide (CO2) accumulates in the blood.
CO2 combines with water to form hydrogen ions.
An accumulation of hydrogen ions results in acidosis.
What are the causes of impaired ventilation?
- upper airway obstruction: foreign body, infection, trauma.
- lower airway obstruction: disease, mucus, edema.
- chest wall impairment: flail chest, pneumonia, restrictive condition (Eg. scoliosis).
- neuromuscular impairment: Lou Gehrig’s disease, overdose.
Define:
Guillain-Barré Syndrome
Progressive muscle weakness and paralysis that moves from the feet to the head.
Define:
Pickwickian Syndrome
Obesity Hypoventilation Syndrome
OHS
- Caused by obesity, chronic hypercapnia, and sleep apnea, which results in constant low levels of oxygen and high levels of carbon dioxide.
- Do not lay the patient flat if at all possible.
Fill in the blank:
A serious injury to the spinal cord above _____ may block the nerve impulses that stimulate breathing.
C5
Define:
Botulism
It is acquired by giving infants raw honey.
Can cause muscle paralysis and ultimately hinder breathing and is very rare in typical populations.
What effect do alcohol, narcotics, and opiates have on the respiratory drive?
They reduce the respiratory drive.
What causes hyperventilation within the body?
It occurs when rapid or deep breathing lowers CO2 levels in the blood, causing respiratory alkalosis.
- Capnography will typically reveal decreased values (end tidal CO2 < 40 mmHg) on the monitor.
- blood pH > 7.40
- Symptoms: peripheral numbness/tingling, dizziness, muscle spasms
What causes hypoventilation within the body?
It occurs when breathing is too shallow or slow, leading to acidosis within the blood as a result of retaining CO2.
What causes respiratory alkalosis?
It is caused by hyperventilation that results in numbness and tingling in the hands, feet, and mouth.
Define:
Carpopedal spasm
Hands and feet are clenched like a claw due to hyperventilation.
Why breathing into a bag is bad?
- Rebreathing too much carbon dioxide can cause hypoxia.
- The hyperventilation may be compensatory and does not need to be fixed.
What causes hyperventilation?
- internal or external stressors
- psychological
List examples of psychological support for hyperventilation.
- Breathe with the pt and count to two between breaths.
- Talk to the pt or sing a song.
- Reassure the pt that you are there for them.
- Make a detailed assessment to rule out illness or injury.
What is the function of turbinates?
Trap a particulate matter within the nasal passages.
- Network of bones, vessels, and tissue within the nasal passageways that are highly vascular and covered in mucus.
- The large surface area allows air to be warmed and humidified.
What causes Angioedema?
ACE inhibitors and allergic reactions.
Vascular reactions that are characterized by swelling of the eyes, lips, and mouth.
Where is the Hypopharynx located?
Below the oropharynx
Define:
Larynx
It protects the lower airways and is responsible for audible sounds.
Otherwise known as the “voice box”.
Define:
Polycythemia
Thick blood.
COPD patients generate a surplus of RBCs that cause strain on the right side of the heart due to the blood trying to push through tiny capillaries.
Define:
Cor pulmonale
Right-side heart failure.
Caused by chronic lung disease.
Give examples of restrictive lung diseases.
- Kyphosis
- Lordosis
- Scoliosis
Limits air movement.
What causes purulent sputum?
infection
What causes a clear or white sputum?
Bronchitis
What does an antitussive do?
Cough suppressant
Use cautiously in patients with productive cough, as coughing clears secretions. May be helpful in dry or irritating coughs.
