CH 24

Emphysema

Abnormal distention of air spaces beyond the terminal bronchioles with destruction of the walls of the alveoli Decreased alveolar surface area increases in "dead space," impaired oxygen diffusion Hypoxemia results Increased pulmonary artery pressure may cause right-sided heart failure (cor pulmonale)

As status asthmaticus worsens, the nurse would expect which acid-base imbalance?

Respiratory acidosis

Atelectasis

collapsed lung; incomplete expansion of alveoli

which lung disorders are respiratory acidosis

severe asthma & COPD (includes ephysema and chronic broncitis) *think hyperventilating, trying to get more air *causes pH to lower, making blood acidic *trying to get MORE o2 and having LESS co2 means it is acidic.

ASTHMA

Chronic inflammatory disease of the airways that causes hyperresponsiveness, mucosal edema, and mucus production

Clinical Manifestations of COPD

-Three primary symptoms : 1. Chronic cough 2. Sputum production 3. Dyspnea -Weight loss due to dyspnea -"Barrel chest"

In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid-base imbalances?

Respiratory acidosis RATIONALE: Increased carbon dioxide tension in arterial blood leads to respiratory acidosis and chronic respiratory failure. In acute illness, worsening hypercapnia can lead to acute respiratory failure.

The nurse is caring for a patient with status asthmaticus in the intensive care unit (ICU). What does the nurse anticipate observing for the blood gas results related to hyperventilation for this patient?

Respiratory alkalosis - (low PaCO2) is the most common finding in patients with an ongoing asthma exacerbation and is due to hyperventilation.

status asthmaticus

a severe asthma episode that is refractory to initial therapy. It is a medical emergency. Patients report rapid progressive chest tightness, wheezing, dry cough, and shortness of breath. It may occur with little or no warning.

which lung disorders are respiratory alkalosis

pnemonia, PE (pulmonary embolism/clot) or asthma *think hypoventilation, not getting any air *causes pH to be higher, making blood basic *not getting air/o2 in, making there be more co2 in the lungs