Exam (elaborations)
PEDIATRIC AACN CCRN: Pulmonary (27 Questions and Answers.)
- Course
- Institution
PEDIATRIC AACN CCRN: Pulmonary (27 Questions and Answers.)
[Show more]
Seller
Follow
JayGracey
Content preview
PEDIATRIC AACN CCRN: Pulmonary (27Questions and Answers.)
# of lobes in right lung
# of lobes in left lung -
\3
2
3 divisions of lungs -
\1. Bronchi - cartilaginous
2. Bronchioles - membraneous
3. Alveoli - gas exchange units, lined by epithelial cells (2 types)
2 types of alveoli -
\Type 1 - gas exchange
Type 2 - surfactant
Muscle of inspiration -
\diaphragm
Part of brain that controls breathing -
\medulla (phrenic nerve - C 3,4,5 keep you alive)
Compliance of lungs -
\ability to stretch when there is a change in volume or pressure
- how easily lungs stretch
- affected by surfactant and lung tissue elasticity
- greater compliance in young infants
- decreased by pulmonary edema, pneumothorax, atelectasis
Resistance of lungs -
\factors that cause less air to reach alveoli
- inversely related to airway diameter (smaller airway = higher resistance)
- increased in asthma, CF, BPD, bronchiolitis, respiratory secreations
Which provides more resistance: ETT or TRACH -
\ETT (longer airway = more resistance)
Increased Resistance = Increase or Decreased tidal volume? -
\Decreased
Ventilation Perfusion Matching:
V/Q = 0.8 -
\Ventilation (V): air ventilating the alveoli
,Perfusion (Q): blood perfusion the alveoli
- usually more perfusion than ventilation
Low V/Q vs. High V/Q -
\Low: decerase in ventilation compared to perfusion
- hypoxia
- pulmonary edema
(O2 doesn't help)
High: decrease in perfusion relative to ventilation
- shock
Pulmonary Vascular Resistance -
\resistance that must be overcome to push blood through the vasculature of the lungs
- RIGHT VENTRICLE pushes blood through PULMONARY ARTERY
What increases pulmonary vascular resistance? -
\- decreased area
- CF
- ASD
- AVC flooding lungs
- polycythemia - thick blood
Different in Kids Lungs: -
\- Smaller alveoli - more likely to collapse
- Lung volume increases 4 times in 1st year of life
- Chest shape: infant - cylindrical shape; AP > transverse diameter until 3 years of age
- Upper airway: elongated epiglottis - high in pharynx (obligatory nose bleeders until 6
months); pharynx is musculomembraneous tube; larynx - funnel shaped (connects
pharynx and trachea, thyroid cartilage, vocal cords, epiglottis, cricoid cartilage); trachea
- membraneous rigid thin walled tube
- Chest wall becomes less compliant as child ages: retractions d/t intercostal muscles
not strong enough to stabilize chest against stronger diaphragm contraction
* eligible for uncuffed ETT - cricoid cartilage is "natural cuff" if less than 24 kg or 8 years
of age
Lung Tests and Monitoring -
\- Total Lung Capacity
- Vital Capacity
- Functional Residual Capacity
- Residual Volume
Lung Tests and Monitoring: Total Lung Capacity -
, \volume in lungs at max inspiration
Lung Tests and Monitoring: Vital Capacity -
\maximum expired with maximum expiration
Lung Tests and Monitoring: Functional Residual Capacity -
\volume remaining after normal expiration
Lung Tests and Monitoring: Residual Volume -
\volume remaining after forced expiration
Acid Base Balance: what keeps pH normal -
\- respiratory and renal buffering
- pH of blood changes and lungs/kidneys respond
More H+ ions = high or low pH?
Less H+ ions = high or low pH? -
\LOW
HIGH
(inverse relationship)
Normal Blood Gas Values: ARTERIAL -
\pH: 7.35-7.45
PO2: 80-100
PCO2: 35-45
HCO3: 22-26
Base Excess: -2 to +2
Normal Blood Gas Values: MIXED VENOUS -
\pH: 7.31-7.41
PO2: 35-40
PCO2: 40-50
HCO3: 22-26
Base Excess: -2 to +2
Normal Blood Gas Values: CAPILLARY -
\pH: 7.35-7.45
PO2: less than arterial
PCO2: 35-45
HCO3: 22-26
Base Excess: -2 to +2
*NOT accurate if dehydrated
PaO2 vs PaCO2 -
\PaO2: evaluation of oxygenation
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller JayGracey. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $22.29. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
81989 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now