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Fundamentals > 28 Assisting With Respiration And Oxygen Therapy > Flashcards

28 Assisting With Respiration And Oxygen Therapy Flashcards

1
Q

Anoxia

A

Without oxygen, cell metabolism slows down and some cells begin to die

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2
Q

Inspiration of the lungs occurs due to this kind of pressure

A

Negative

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3
Q

Alveoli contain this, that quickly phagocytize, inhaled bacteria, and other foreign particles

A

Macrophages

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4
Q

Which nervous system controls respiration

A

Central nervous system

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5
Q

What indicates the changing of hydrogen ion levels?

A

pH

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6
Q

Changes in these three levels in the blood trigger the respiratory center in the medulla to send signals through the spinal cord to the nerves that control the respiratory muscles, causing an increase or decrease rate of respiration

A

Changing levels of hydrogen ions, carbon dioxide, and oxygen in the blood

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7
Q

What receptors that are located in the aorta and carotid arteries sense changes in oxygen or carbon dioxide levels; where do they send their signals

A

Chemoreceptors; brainstem

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8
Q

About how many mL of air moves in and out of the lungs with each normal breath

A

500

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9
Q

Oxygen is transported by the hemoglobin molecule, carbon dioxide is transported to the lungs in thIs portion of the blood

A

Plasma portion

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10
Q

After 70 there is an increase or decrease in elasticity of the thorax and respiratory issues

A

Decrease

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11
Q

Total body water decreases by what percent after the age of 70 leading to dry respiratory membranes and thicker mucus

A

50%

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12
Q

Due to the loss of this recoil during expiration, respiratory muscles must be used to complete expiration

A

Elastic

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13
Q

In the aging; oxygen saturation decreases with partial pressure of oxygen dropping to 75 to 80mm Hg from the usual 80 to 100mm Hg- this is due to what kind of changes in the tissues

A

Tissue changes, cause thickening of the alveolar membrane, decreasing the ease of gas diffusion across the membrane

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14
Q

The older adult has more or less respiratory reserve, which makes it more difficult for the body to meet increase oxygen demands

A

Less

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15
Q

The most common cause of respiratory insufficiency

A

Airway obstruction

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16
Q

This problem with the respiratory system is a disturbance in the levels of gases, oxygen and carbon dioxide in the blood stream

A

Respiratory insufficiency

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17
Q

Increased level of carbon dioxide in the blood is called

A

Hypercapnia

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18
Q

Five common causes of hypoxia

A

Obstruction of the airway, restricted movement of the thoracic cage, or the pleura, decreased neuromuscular function, disturbances in diffusion of gases, and environmental causes

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19
Q

Examples of obstruction of the airway

A

Occlusion of the tongue; remove his secretions, inflammation from croup, asthma, tracheobronchitis, or laryngitis; chemical and heat burns with inflammation; COPD, causing airway collapse; near drowning

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20
Q

Examples of restricted movement of the thoracic cage, or the pleura

A

Abdominal surgery; chest injuries; pneumothorax; extreme obesity; diseases (spinal arthritis, peritonitis, societies, or kyphosclerosis)

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21
Q

Examples of decreased neuromuscular function

A

Depressed central nervous system (drugs, including sedatives in anesthesia agents: brain trauma, stroke) ; coma; diseases (multiple sclerosis, Guillian-barre syndrome, myasthenia gravis)

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22
Q

Disturbances in diffusion of gases examples

A

Diseases (pulmonary fibrosis, or emphysema) ; trauma, emboli, fat embolus, tumors, respiratory distress syndrome

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23
Q

Environmental causes

A

High altitude

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24
Q

Early signs of hypoxia and respiratory insufficiency

A

Sits up to breathe, complaints of not being able to catch breath, memory lapse, mental dullness, restlessness, increased bp, pulse, respirations

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25
Q

RAT stands for what; early signs of what

A

restlessness, agitation, tachycardia; early sign of respiratory insufficiency

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26
Q

Later signs of hypoxia and respiratory insufficiency

A

decreased bp & pulse, arrhythmia, use of accessory muscles, stridor, cyanosis, muscle retractions

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27
Q

Tachypnea

A

fast breathing rate

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28
Q

Stridor

A

high-pitched, harsh, or musical sounds on inspiration

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29
Q

Retractions; what stage of respiratory insufficiency

A

muscles moving inward on inspiration- a late sign of respiratory insufficiency

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30
Q

Patients suffering from hypoxia are highly susceptible to respiratory tract infections- true or false

A

true

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31
Q

Why are patients suffering from hypoxia are highly susceptible to respiratory tract infections

A

inadequate inflation of the lungs results in a pooling of secretions and provides the perfect growing environment for microorganisms

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32
Q

Jaundice patients may not read on this device

A

pulse ox

33
Q

This is the most common cause of airway obstruction in the unconscious person

A

the tongue

34
Q

This is the simplest method of clearing the air passages is this

A

cough effectively

35
Q

Teaching forceful exhalation

A

Patient takes two deep breaths, inhales deeply again, then rapidly, and forcefully exhales with their mouth open

36
Q

Try and have patients in this position when teaching deep breathing and coughing

A

sitting up, leaning forward slightly. If pt can not sit up then sit them in high fowlers

37
Q

Teaching deep breathing

A

-Inhale through the nose; hold the breath for 3 to 5 seconds and then exhale through pursed lips. Keep the shoulders level and use the diaphragm and abdominal muscles to bring air into the lungs- repeat 4 more times
-Take 5 to 10 deep breaths every 2 hours while awake

38
Q

Effective coughing

A

-Take a deep breath and hold for 3-5 seconds, then exhale through pursed lips; take another deep breath, and in short segments, forcibly exhale in a ‘huff-cough’ with the mouth open.
(In huff-cough pt performs a series of coughs while saying the word huff, which prevents the glottis from closing and helps clear secretions. [use tissue to cover mouth]) Perform 3x or until all secretions have been cleared.
Use the huff-cough technique at least once every 2-hours while awake or once an hour is preferable

39
Q

Important to humidify what’s on the inside as well as the outside by doing what

A

ensuring intake of 1500- 2000mL intake daily

40
Q

Oxygen concentrations above 60% rarely used due to dangers of this

A

oxygen toxicity

41
Q

Purposes artificial airways are used

A

relieving an obstruction, protect the airway, facilitate suctioning and to provide artificial ventilation

42
Q

two types of pharyngeal airways-

A

nasopharyngeal and oropharyngeal airway

43
Q

pharyngeal airways used to; in this type of pt

A

keep the tongue from falling back into the throat, often used in postop pts until they have recovered from anesthesia; pt who can breath on their own

44
Q

Endotracheal tube (ETTs) use on this type of pt

A

pt’s who are unconscious or unable to breathe on their own

45
Q

ETTs usually removed after how long; but can stay in place for up to this long

A

48 - 72 hours; > week

46
Q

If intubation is needed for an extended period, pt should have this performed

A

tracheotomy

47
Q

nasopharyngeal suctioning purpose

A

to maintain a patent airway by removing accumulated secretions

48
Q

When pt has a need for nasopharyngeal suctioning, pt should be stimulated to do this to move the secretions up into the trachea

A

cough

49
Q

nasopharyngeal suctioning pressure should be set at

A

80 - 120 mm Hg

50
Q

Suction catheter based on what

A

size of pt’s tube and the thickness of the secretions to be removed

51
Q

What technique is used for all suctioning of the airway structures

A

aseptic technique

52
Q

Order between oral and nasal/ nasopharyngeal and tracheobronchial suctioning

A

nasal to oral, never oral to nasal

53
Q

Technique for deep suctioning in the tracheobronchial tree and for the intubated pt

A

sterile technique is mandatory

54
Q

When a tracheostomy tube has a cuff, it is inflated to seal the space between the tube and the tracheal wall to prevent fluid from being aspirated into the lungs, and aspirated to allow only minimal leakage of air. How often is the pressure check

A

8 hours

55
Q

Pharyngeal suctioning should be performed ______ deflating the cuff

A

before; esp. for new trachs

56
Q

Any disruption in the negative pressure in the _____ cavity will cause the lungs not to expand

A

pleural

57
Q

When would a pt need a chest tube

A

when air or fluid needs to be drained out of the pleural space and when air or fluid needs to be kept from being sucked back in

58
Q

When _____ drainage is inadequate to remove air and fluids from a pt with a large pleural leak suction can be applied using either wall suction or a portable suction machine

A

gravity

59
Q

The disposable chest drainage unit has a suction control chamber to prevent excessive _____ pressure in the pleural space, as well as a ____-seal chamber and a drainage chamber

A

negative; water

60
Q

If suction is used in the water-seal system, there should be constant _____ in the suction chamber

A

bubbling

61
Q

How to tell when a lung has reinflated

A

x-ray, pleural space has decreased

62
Q

Respiratory assessment is intertwined with _____ assessment

A

cardiac

63
Q

Why are respiratory and cardiac intertwined

A

if the heart is not functioning properly, oxygenated blood will not be delivered to the tissues in adequate amounts

64
Q

Why are respiratory and cardiac intertwined

A

if the heart is not functioning properly, oxygenated blood will not be delivered to the tissues in adequate amounts

65
Q

Atelectasis

A

collapsed area of the lung; alveoli collapse and fail to fill with air

66
Q

Which pt should turn, cough, and deep breath (TC & DB) every 2 hours

A

every pt with a respiratory problem or potential for one

67
Q

What are the risks of inadequate ventilation that can prolong hospitalization

A

hypoxia, pneumonitis, and atelectasis

68
Q

common respiratory complications can be prevented by reinflating the _____ and removing the _____

A

reinflating the alveoli and removing secretions

69
Q

With I.S.- The incentive is to reach a certain volume of air and hold it for

A

3 to 5 seconds

70
Q

Pt’s should be encouraged to take how many slow, deep breaths every hour when awake

A

10

71
Q

How can pillows help a pt with dyspnea when seated in high fowlers

A

placing pillows under pt’s forearms to relax the shoulder muscles

72
Q

Tracheostomy care is done every __ hours

A

8; or as needed to keep secretions from becoming dried, blocking the airway

73
Q

obturator

A

a curved guide that facilitates tube placement when it is inserted

74
Q

In tracheostomy care- When is suctioning carried out; what is the indication

A

only as needed; the need is indicated by audible respirations or dyspnea

75
Q

Can the same catheter be used to suction both the nasopharyngeal area and the trachea are suctioned; which technique is to be used

A

No, use separate catheters and aseptic technique

76
Q

Suction should last no longer than ___ ____

A

10 seconds

77
Q

Preoxygenating the pt is done when; why

A

before performing tracheal suctioning; hypoxemia can happen by prolonged suctioning and can lead to sudden death

78
Q

Always suction the nasopharynx before ____ the cuff

A

deflating

79
Q

immediately report drainage of more than ____ mL/h

A

report drainage of more than 100 mL/h

Fundamentals (6 decks)

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