NUR 242 Advanced Exam 2 Complete study guide|Galen College of Nursing.The lungs primary function is oxygenation and perfusion pg. 544
Remember: the right
... [Show More] lung has 3 lobes, and the left contains 2. The right bronchi branches from
the trachea first which is important for intubation and ventilation. We control our breathing rate
by a process of regulation of gas exchange related to meeting metabolic needs.
- Ventilation: movement of air into lungs
- Perfusion: movement and distribution of blood through pulmonary circulation.
- Diffusion: movement of O2 and Co2 across alveolar- capillary membrane.
Oxygen-Hemoglobin Dissociation Curve: watch video on slide 15!
Dissociation occurs depending on what the body’s perfusion needs are.
Pressure = Saturation
- Shift to the left: less oxygen need and metabolization happens slower.
Causes- RBC’s hold onto O2 causing an increase. Increased pH (aLkalosis), decreased
CO2 (Low), and decreased temperature (Low) = LEFT.
- Shift to the right: oxygen needs grow and metabolization happens faster.
Causes- RBC’s releases O2 into the tissues rapidly, decreased O2, decreased pH
(acidosis), increased CO2, and increase in temperature.
Ventilation & Perfusion (V/Q)
- Ventilation involves oxygen intake problems, the body isn’t getting enough blood or
body id unable to remove CO2. Examples = Chest and lung problems like
COPD/Emphysema, issue with the diaphragm, no control of respiratory center, or a CO2
above 45mmHg.
- Perfusion involves CO, and delivery of oxygen to the tissue. Examples = right to left
shunting and ARDS.
Acid Base Balance
Pulmonary Embolism (PE): MEDICAL EMERGENCY! A clot forms in the pulmonary vessels
leading to hypoxia. They are most commonly caused by a DVT, but none the less can come from
ANYWHERE.
- S/S: A feeling of impending doom. Pulmonary – dyspnea, chest pain, clear or crackles
present, dry cough, or bloody sputum. Cardiac – tachycardia, distended neck veins,
syncope (fainting), cyanosis, hypotension, T-wave and ST segment changes. Labs – at first
the patient is in respiratory alkalosis then shunting happens causing respiratory acidosis
followed by metabolic acidosis from the buildup of lactic acid. CT is standard for
diagnosis of a PE.
- Treatment involves PREVENTION including range of motion, ambulation asap, SCD, avoid
restrictive clothing, assess circulation often, elevate the feet to help with venous return [Show Less]