ch41: oxygenation Flashcards
what muscles are responsible for inspiration?
diaphragm and external intercostals –> increase size of thorax
what is the difference between ventilation, perfusion, diffusion?
ventilation: process of moving gases into and out of the lungs
perfusion: ability of cardiovascular system to pump oxygenation blood to tissues + return deoxygenated blood to the lungs
diffusion: exchange of respiratory gases in alveoli + capillaries
what is starling’s law?
as the myocardium stretches, the strength of the subsequent contraction increases
what makes the S1 sound?
mitral and tricuspid (AV) valves close
what makes the S2 sound?
aortic and pulmonic (SL) valve close
what is the natural pacemaker of the heart?
SA node
what is the path of conduction throughout the heart?
sa node –> av node –> bundle of his –> purkinje fiber
what are some factors that affect oxygenation? (and explain each)
- physiological factors
- affected chest wall movements
- disturbances in conductions
- alterations in cardiac functioning
what are developmental considerations with oxygenation for infants/toddlers?
- at risk for upper respiratory infections
- should recover from upper respiratory infections easily
- risk for airway obstruction
what are developmental considerations with oxygenation for school age children + adolescents?
- exposed to respiratory infections + and risk factors
- vaping
- unhealthy diets
- obesity
- inactive lifestyle
- caffeinated beverage `
what are lifestyle factors affecting oxygenation?
- nutrition
- hydration
- exercise
- smoking
- substance abuse
- stress
what are all the parts of an EKG and what happens in all?
- p wave: atrial depolarization
- qrs complex: ventricular depolarization
- t wave: ventricular repolarization
what are signs that a patient may be experiencing profound hypoxia?
- sudden changes in vital signs
- change in LOC
- change in behavior
t/f: perform tracheal suctioning before pharyngeal
true
what to inspect for when assessing oxygenation?
- skin and mucous membrane color
- LOC, breathing patterns
- chest wall movement
- general appearance
- circulation
what to palpate for when assessing oxygenation?
- chest
- feet
- legs
- pulses
what to percuss for when assessing oxygenation?
- presence of abnormal fluid/air
2. diaphragmatic excursion
what to auscultate for when assessing oxygenation?
- normal/abnormal heart sounds
2. normal/abnormal lung sounds
what is the purpose of testing arterial blood gas?
assess pt’s respiratory and metabolic acid/base balance and adequacy of oxygenation
what are some ventilation studies?
- pulmonary function
- peak expiratory flow rate
- oximetry
- bronchoscopy
- lung scans
what does the peak expiratory flow rate (PEFR) assess?
reflects change in large airway sizes (assess resistance in asthmatic patients)
what position is best for effective breathing and why?
high fowlers = good for respiratory distress to reach maximum lung expansion
albuterol vs steroids
albuterol (beta agonist): attach to beta-receptors –> helps relax the muscles in your airways, –> easier for you to breathe
steroids: reduce the swelling in the airways
what is humidification?
process of adding water to gas → IMPORTANT for pts receiving O2 at 4L or more
helps to thin out secretions
what is chest physiotherapy?
external wall manipulation using percussion, vibration, or high freq. chest wall compression
to MOBILIZE secretions
what pressure should suctioning be at and why?
should be at 100-150mmHg of pressure or else you can suck out tissue
when to use oro/nasopharyngeal suctioning?
patient can COUGH EFFECTIVELY but CAN’T CLEAR secretions
when to use oro/nasotracheal suctioning?
patient CAN’T COUGH EFFECTIVELY, CAN’T CLEAR secretions, and does NOT have artificial airway
when to use endotracheal suctioning?
short term: to relieve upper airway obstruction and protect against aspiration
when to use tracheostomy?
long term: surgical incision into trachea
purpose of invasive mechanical ventilation? what are some examples?
lifesaving technique with artificial airways
- endotracheal
- tracheostomy
what is the purpose of noninvasive ventilation? what are some examples?
to maintain positive airway pressure + improve alveolar ventilation
- CPAP
- BiPAP
what is the purpose of chest tube?
to remove air and fluids from pleural space, to prevent re-entering of air, to re-establish pressures
purpose of oxygen therapy?
to prevent/relieve hypoxia
nasal cannula
low flow; 25-40% O2
2-4 L/min
simple face mask
35-50% O2
6-12 L/min
bag valve mask
high flow; 100% O2
10-15 L/min
non-rebreather mask
60-90% O2
10-15 L/min
venturi mask
high flow; 24-60% O2
4-12 L/min
when to use a face tent?
relatively low [O2]
- when facial/oral injuries prevent the use of other masks
what is the purpose of an AED?
automatic external defibrillator
- used to restore normal conduction of the SA node
what are two types of breathing exercises?
- pursed lip breathing
2. diaphragmatic breathing
t/f: an order is not needed in order to administer oxygen
FALSE
