333 oxygenation interventions/therapy Flashcards

1
Q

nursing diagnoses related to oxygenation

A

ineffective airway clearance (thick secretions), risk for aspiration (cough), impaired gas exchange (chronic lung disease, infections), activity intolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

long term preventative measures

A

vaccines, healthy lifestyles, environmental & occupational exposures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Dyspnea mgt

A

(difficult to treat), treat underlying condition, oxygen therapy, pharm treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when might someone not be able to maintain their airway

A

choking, recent anesthesia, overdose of pain meds, if pt is slumped over

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

managing pulmonary secretions

A

mobilize , hydrate, humidification, nebulization, meds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what does deep breathing do

A

increases air to the lower lobes of the lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how often should we encourage pt’s to cough when experiencing lung conditions/upper res problems

A

every 2 hours (we learned 1 last block)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

cascade cough + considerations when teaching / what pts are best for them

A

he patient takes a slow, deep breath, holds it for 1 to 2 seconds, then opens the mouth and performs a series of coughs throughout exhalation / for pts with large amounts of sputum like CF pts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

huff cough + considerations when teaching / what pts are best for them

A

The patient inhales deeply and then holds the breath for 2 to 3 seconds. While forcefully exhaling, the patient opens the glottis by saying the word huff. With practice the patient inhales more air and is able to progress to the cascade cough / weaker pts like those w/ COPD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

quad cough + considerations when teaching / what pts are best for them

A

While the patient breathes out with a maximal expiratory effort, the patient or nurse pushes inward and upward on the abdominal muscles toward the diaphragm, causing the cough / for patients without abdominal muscle control, such as those with spinal cord injuries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is nursings best defense

A

turn, cough, deep breathe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

chest physiotherapy goal

A

mobilize pulmonary secretions (this is after other interventions do not work, need HCP order)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

chest physiotherapy activities

A

postural drainage, chest percussions, chest vibration **follow these activities w/ coughing & deep breathing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

what pt indicates chest physiotherapy

A

pt’s w/ thick secretions, low effectiveness of cough, hx of pulmonary problems successfully relieved by CPT, abnormal lung sounds, conditions such as atelectasis, pneumonia, vital signs or change in O status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what pts are contraindicated for chest physiotherapy

A

pregnant, rib/chest injuries, increased intracranial pressure, recent abdominal/thoracic surgery, bleeding disorders, osteoporosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

postural drainage

A

lay on unaffected side to promote drainage of one particular lobe, usually transdelenburg is best **ex: infiltration seen on right lower lobe, lay pt on left side in transdelenbury

17
Q

suctioning

A

sterile orotracheal & nasotracheal common, it is extremely uncomfortable and stimulates extreme coughing (should be less than 10 secs)

18
Q

goal of oxygen therapy

A

prevent or relieve hypoxia

19
Q

what is room FiO2

A

21%

20
Q

fraction of inspired O2

A

% of O2 in inspired air

21
Q

what is the exception to give O2 without an order

A

emergency situation & your pt is destating

22
Q

can O2 be delegated to a CNA

A

yes -> CNA’s can apply nasal cannulas and oxygen masks **nurse must assess res system, response to therapy, setup, & adjustment responses

23
Q

Nasal Cannula

A

-FiO2: 1-6L/min, 24-44%
-safe & well tolerated
-can lead to skin breakdown, tubing dislodges easily
-use humification if greater than 4L of flow

24
Q

Simple Face Mask

A

-FiO2: 6-12L/min, 35-50%
-best for short periods (transport)
-not great for claustrophobic pts, skin breakdown, higher risk of aspiration
-assess for fit, watch for aspiration
-contraindicated for pt’s retaining CO2 (COPD)

25
Q

Partial Rebreather Mask

A

-FiO2: 6-11L/min, 60-75%
-used for short period of dyspnea or other increased oxygen needs
-pt rebreathe up to 1/3 of exhaled air, helps w/ humidification
-keep reservoir bag partially inflated
-watch for aspiration & hourly assessment of masks

26
Q

Non breather mask

A

-FiO2: 10-15L/min, 80-95%
-best for pts in critical need of oxygen (steps before intubation)
-one way valve allows for client to inhale max O2 con & two exhalation ports that restrict exhaled air from being rebreathed
-watch for aspiration & hourly assessment of masks

27
Q

Venturi Mask

A

-FiO2: 4-12L/min, 24-60%
-provides the ability to deliver precise oxygen concentration w/ humidity
-not preferable for long periods of time
-used for pts who need highly regulated O2 cons (chronic lung disease)

28
Q

face tent (aerosol mask)

A

-fits loosely around face & neck
-24-100% O2
-provides relatively high humidity
-seen a lot in post opt

29
Q

High flow nasal cannula

A

-80-100L/min O2
-forces the air down, pressurized
-usually for ICU pts
-caution if pt is eating

30
Q

nasal cannula w/ ETCO2 monitor

A

flat goes over the mouth and we can obtain a CO2 reading

31
Q

when should humidification be used

A

always when greater than 4 lpm or g reater than 24 hrs of supplemental oxygen

32
Q

oxygen toxicity: general

A

pleuritic chest pain, chest heaviness, coughing and dyspnea, muscle twitching, nausea/GI upset

33
Q

oxygen toxicity: eyes

A

-loss of visual field
-near sightedness
-cataract formation
-bleeding
-fibrosis

34
Q

oxygen toxicity: muscular

A

twitching

35
Q

oxygen toxicity: CNS

A

seizures

36
Q

oxygen toxicity: respiratory

A

jerky breathing, irritation, coughing, pain, SOB, tracheobronchitis, acute respiratory distress syndrome

37
Q

complications of oxygen therapy

A

-drying effects of respiratory mucous membrane
-oxygen toxicity
-skin breakdown