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Respiratory/Pulmonary

Part I


DISORDERS OF THE RESPIRATORY SYSTEM

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ACID-BASE BALANCE


Hydrogen ion concentration expressed as pH "Power of Hydrogen"

UNBALANCED RELATIONSHIP

I. ACIDOSIS

Neurologic dysfunction is an early indicator

  1. Lethargy
  2. Confusion
  3. Disorientation
  4. Headache
  5. Muscle twitching
  6. Stupor
  7. Coma

Key Point: In acidosis, both pH and CNS function are depressed

II. ALKALOSIS

pH > 7.45 causes over excitability of CNS and produces:

BASE as mnemonic:

Key Concepts:


The body has (3) defense or Regulatory Systems it used to keep the pH 7.35 to 7.45:

I. The Chemical Buffer System

H2CO3 is a weak acid that dissociates into hydrogen ions and bicarbonate ions that are excreted by the kidneys and H2O and carbon dioxide that are excreted by the lungs

When bicarbonate-carbonic buffer system neutralizes either a strong acid or a strong base the end products are excreted by the kidney and lungs

Normally to maintain acid-base balance


II. RESPIRATORY SYSTEM

Carbon Dioxide (CO2) that we exhale comes from carbonic acid (H2CO3)


III. RENAL SYSTEM

When blood pH decreases (becomes more acidotic) the kidneys respond by excreting hydrogen ions and forming and retaining bicarbonate ions


COMPENSATION:

Occurs when plasma pH changes the buffers

React together to return the plasma pH to normal by restoring the 20:1 ratio of bicarbonate (HCO3) to carbonic acid (H2CO3)

Key Concepts with Compensation:


CAUSES OF ACID-BASE INBALANCES:


UPPER AIRWAY DISORDERS (on your own)



LOWER AIRWAY DISORDERS:

Risk Factors

Categories of Pulmonary Disorders


PROBLEMS OF THE LOWER AIRWAY:

Statistics:

PREVENTION:


CLASSIFYING PULMONARY DISORDERS

Infections of the Lower Airways may be ACUTE or CHRONIC; VIRAL or BACTERIAL


FLU - Responsible for 30-50% time lost from work Patient Education -- wash hands, cover mouth and nose when coughing, proper disposal of tissues, flu shots - "SHOOO the FLU" Management -- fluids, rest, ASA, pseudophendrine, nasal spray, guaifenesin



PNEUMONIA --

Acute infection of lung tissue resulting from inhalation or transport via bloodstream of infectious agents, noxious fumes, or radiation therapy. An acute inflammation of the lung parenchyma associated with the production of exudate.

Etiology

EPIDEMIOLOGY:

PREVENTION --

Same as for colds, flu. Pneumonia is often associated with URI. Pneumonia vaccine.

RISK FACTORS (for nosocomial infection)

ASSESSMENT:

LAB FINDINGS/DIAGNOSTIC TESTS:

NURSING DIAGNOSES:

PLANNING & MANAGEMENT:


References


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