Gas Exchange and Perfusion
Gas exchange - correct answer ✔✔the process by which oxygen is transported to cells and carbon
dioxide is transported from cells
When delivery of oxygen is impaired... - correct answer ✔✔tissues become ischemic and lactic acidosis
contributes to cellular death.
When elimination of carbon dioxide is impaired... - correct answer ✔✔respiratory acidosis may cause
disorientation, tremors, seizures, and coma
Hypoxia - correct answer ✔✔insufficient oxygen reaching cells
Anoxia - correct answer ✔✔total lack of oxygen in body tissues
Hypoxemia - correct answer ✔✔reduced oxygenation of arterial blood (sign: cyanosis)
Three broad categories that describe gas exchange... - correct answer ✔✔ventilation, transport, and
perfusion
Causes of impaired ventilation - correct answer ✔✔Inadequate muscle or nerve function to move air
into the lungs
Narrowed airways from bronchoconstriction or from obstruction
Poor gas diffusion in the alveoli
Clinical manifestations of impaired ventilation - correct answer ✔✔work harder to breathe or must
change the route air enter the lungs
Transport is impaired when... - correct answer ✔✔amount of hemoglobin is low (i.e. anemic)
,Process of gas exchange - oxygen - correct answer ✔✔Medulla -> diaphragm contracts ->nose ->trachea
->bronchi -> alveoli -> pulmonary capillaries with hemoglobin to carry oxygen -> perfusion to transport
hemoglobin -> cell metabolism
Process of gas exchange - carbon dioxide - correct answer ✔✔Cell metabolism ->perfusion to transport
hemoglobin from cells ->pulmonary capillaries with hemoglobin carrying carbon dioxide ->alveoli -
>bronchi -> trachea -> nose -> diaphragm relaxes ->atmosphere
Nonmodifiable risk factors for impaired gas exchange - correct answer ✔✔age, air pollution, and
allergies
Modifiable risk factors for impaired gas exchange - correct answer ✔✔Tobacco
Adequate ventilation is apparent when the following occur: - correct answer ✔✔Breathing is quiet and
effortless
Oxygen saturation is above between 95%
Skin, nail beds, and lips are appropriate colors for the patient's race.
Thorax is symmetric with equal thoracic expansion bilaterally.
Spinous processes are in alignment
Anteroposterior diameter of the chest is about a 1:2 ratio of AP to lateral diameter.
Trachea is midline.
Breath sounds are clear bilaterally.
Baseline history regarding impaired gas exchange - correct answer ✔✔lifestyle behaviors including diet,
exercise, and smoking habits
Symptoms of impaired gas exchange - correct answer ✔✔cough, shortness of breath, and chest pain
Physical exam for impaired gas exchange - correct answer ✔✔collect vital signs
Inspection (cyanosis, clubbing of fingers?)
auscultation (wheezing, stridor or crackles?)
,Diagnostic tests for impaired gas exchange - correct answer ✔✔Arterial blood gases (ABGs)
Complete blood count
Sputum exam
Skin tests
Arterial blood gases - correct answer ✔✔measurements of pH and oxygen, carbon dioxide, and
bicarbonate concentrations in arterial blood
Respiratory acidosis - correct answer ✔✔carbon dioxide is retained (hypoventilation)
pH below 7.35
Respiratory alkalosis - correct answer ✔✔carbon dioxide is exhaled (hyperventilation)
pH above 7.45
Complete blood cell count - correct answer ✔✔includes measurements of red blood cell count (RBC),
hemoglobin (Hb), hematocrit (Hct), and white blood cell count (WBC
Radiologic exams for impaired gas exchange - correct answer ✔✔chest x rays
computed tomography
ventilation perfusion scans
poison emission tomography
pulmonary function studies
endoscopy exam
Related concepts to impaired gas exchange - correct answer ✔✔perfusion, anxiety, acid-base balance,
nutrition, mobility, fatigue
Mobility - correct answer ✔✔A state or quality of being mobile or movable
, Musculoskeletal mobility - correct answer ✔✔situations or conditions affecting the function of the
muscles or bones
Neurologic mobiltiy - correct answer ✔✔situations or conditions affecting the nerve impulses from the
brain to the target area (brain, spinal cord, nerves)
Neuromuscular mobility - correct answer ✔✔situations or conditions affecting adequate innervation of
the muscle tissues
Risk factors for impaired mobility - correct answer ✔✔older adults, traumatic injury (brain, spinal, brain,
joints, muscles), neurologic, conditions, many chronic conditions
Examples of Consequences of decreased Mobility - correct answer ✔✔Muscular [Atrophy, Contractors],
Neuromuscular [Cardiovascular (Venous Statis)], Neurologic [Loss of Speech, MS]
Physiologic process of optimal or full mobility - correct answer ✔✔bones, muscles and joint
Consequences of Immobility - correct answer ✔✔cardiovascular , respiratory , musculoskeletal,
integumentary, gastrointestinal, urinary complications, psychological effects
Assessment of Mobility - correct answer ✔✔History: fatigue, pain, sensation change, altered
gain/imbalance, falls, inability to complete ADL
Additional:past medications, family hx, current medications, occupation, social environment, problems
based on history
Exam of Mobility - correct answer ✔✔Musculoskeletal assessment: gait and posture. Assess joints and
muscle symmetry - size, shape, ROM, strength. Abnormals: asymmetry, deformity, edema, inflammation,
loss of or reduce function / movement, numbness (sensation)
Diagnostic Test of Mobility - correct answer ✔✔Radiographic: X-ray, Bone Scan, CT Scan, MRI Scan, Bone
Mineral Density Scan, Myelogram, Arthrogram, Arthroscophy, Electromyography, General Lab Tests