EX3 Module 8B Oxygination Flashcards

1
Q

Ventilation

A

Moving of air (02 & CO2) in the lungs

(External Respiration/Breathing)

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2
Q

Respiration

A
  • Exchange of 02 & CO2 between the
    atmospheric air in the alveoli and
    blood in the pulmonary capillaries
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3
Q

Diffusion

A
  • Movement of solute from higher to
    lower concentration

Alveoli Sac with high of O2
and low CO2 concentration

Red blood cells with high CO2
and low O2 concentration

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4
Q

Perfusion

A
  • Tissue perfusion – blood flow from Lt
    side of the heart, through systemic
    circulation; oxygenated capillary blood
    passes through body tissues

Internal Respiration – exchange of oxygen and carbon dioxide
between the circulating blood and the body tissues.

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5
Q

Assessment for Patient has panic attack

A

• Rapid respiration
• Sighing breaths
• Paresthesia
(numbness/tingling sensation)
• Loss of consciousness

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6
Q

Patient 68 y.o. diagnosed with
pneumonia couple with COPD
exacerbation.

Assessment

A
  • Lethargic
  • Dizziness
  • Disorientation
  • Cardiac Dysrhythmias
  • Electrolytes Imbalances
  • Convulsion
  • Coma
  • Cardiac Arrest
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7
Q

Nursing Diagnosis

A

 Ineffective airway clearance
 Ineffective breathing pattern
 Impaired gas exchange
 Decreased cardiac output
 Impaired tissue perfusion
 Activity intolerance
 Fatigue

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8
Q

Implementation

A

flower position
Nasal cannula 1L/MIN
chest physiotheraphy
ortopenic position
coughing
diaphrem breathing
suctioning
pursed lip breathing
increase fluid if not contraindicated

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9
Q

Oral Inhalation

A
  • (Fluticasone/Salmeterol) Advair
    corticosteroid/beta2-adrenergic
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10
Q

Nebulization

A
  • (Ipratropium) Atrovent
    anti-cholinergic
  • (Albuterol) Proventil
    beta2-adrenergic
  • (Acetylcysteine) Mucomyst
    Mucolytic
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11
Q

Factors Affecting Oxygenation

A

• Physiological Factors
- Hyperventilation/Hypoventilation
- Hypovolemia
- Hypoxia
- Decrease H & H
• Conditions Affecting Chest Wall Movement
• Influences of Chronic Disease
- COPD

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12
Q

1.Afterload

A

Resistance of the
ejection of blood from
the left ventricle

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13
Q

Stroke Volume

A

Amount of blood ejected
from the ventricles per
contraction

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14
Q

Preload

A

Amount of blood at
the end of ventricular
diastole

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15
Q

Nursing History & Physical Findings

A

• Patient has history of HTN, HF, hyperlipidemia,
smokes 1 pack/day, truck driver
• S/S include the following
o easily gets tired & confused
o dyspnea & SOB (shortness of breath)
o crackles upon auscultation
o LE pitting edema 3+
o upper right abdominal quadrant pain
o chest pain
o weight gain of 10 lbs in the last 5 days

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16
Q

• Patient has history of HTN, HF, hyperlipidemia,
smokes 1 pack/day, truck driver • S/S include the following

A

o easily gets tired & confused
o dyspnea & SOB (shortness of breath)
o crackles upon auscultation
o LE pitting edema 3+
o upper right abdominal quadrant pain
o chest pain
o weight gain of 10 lbs in the last 5 days

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17
Q

With the fluid in the alveoli sac, the diffusion of C02
and O2 is sluggish causing

A

hypoxemia

Deficiency of
oxygen in the
arterial blood

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18
Q

Patient’s left ventricle
Contractility
Preload &
Afterload. what happened

A

Contractility decrease
Preload &
Afterload increase
Cardiac output
- Easily gets tired, confused,
pale or dusky skin
Deficiency of oxygen in the tissue

Hypoxia

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19
Q

CBC ( Complete blood count)

A

RBC 4.1 x 1012/L L Male: 4.7 – 6.1 x 1012 /L
WBC 10 x 109/L 5.0 – 10.0 x 109/L
Hgb 12g/dL L Male: 14 – 18 g/dL
Hct 37% L Male : 42 – 52%
Platelets 156 x 109/L
Neutrophils 67% 55 – 70%
Lymphocytes 25% 20 – 40%
Basophils 1% 0.5 – 1%
Eosinophils 1% 1 – 4%
Monocytes 4% 2 – 8%

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20
Q

BASIC METABOLIC PANEL (BMP)

A
  • *SODIUM** 132 mEq/L L 136 – 145 mEq/L
  • *POTASSIUM** 5.3 mEq/L H 3.5 – 5.0 mEq/L
  • *CHLORIDE** 101 mEq/L 98 – 106 mEq/L
  • *CO2** 31 mEq/L H 23 – 30 mEq/L
  • *BUN** 32 mg/dL H 10 – 20 mg/dL
  • *CREATININE** 2 mg/dL H 0.5 – 1.1 mg/dL
  • *GLUCOSE** 200 mg/dL H 70 – 110 mg/dL
  • *CALCIUM** 9.6 mg/dL 9 – 10.5 mg/dLBASIC METABOLIC PANEL (BMP)
  • *SODIUM** 132 mEq/L L 136 – 145 mEq/L
  • *POTASSIUM** 5.3 mEq/L H 3.5 – 5.0 mEq/L
  • *CHLORIDE** 101 mEq/L 98 – 106 mEq/L
21
Q

LIPID PROFILE

A
  • *CHOLESTEROL** 300 mg/dL H < 200 mg/dL
  • *HDL** 26 mg/dL L Male > 45 mg/dL
  • *LDL** 120 mg/dL < 130 mg/dL
  • *TRIGLYCERIDES** 290 mg/dL H 40 – 160 mg/dL

BNP (B-type Natriuretic Peptides)
BNP 500 pg/ml H < 100 pg/ml

22
Q

Nursing Diagnosis with Ineffective airway clearance

A

Nursing Diagnosis

 Ineffective airway clearance
 Ineffective breathing pattern
 Impaired gas exchange
 Decreased cardiac output
 Impaired tissue perfusion
 Activity intolerance
 Fatigue

23
Q

who Increase preload and
contractility?

Furosemide

A

Furosemide
- Decrease preload

Lisinopril
- Decrease preload and
afterload

Digoxin
- Increase preload and
contractility

24
Q

Right Side -Deoxygenated Blood

A

Superior/Inferior Vena Cava Right Atrium Tricuspid Valve Right Ventricle Pulmonic Valve Pulmonary Artery *Deoxygenated blood goes to the lungs*

25
Q
  • Left Side-Oxygenated Blood
    *
A
  • Pulmonary Vein
  • Left Atrium
  • Bicuspid/Mitral Valve
  • Left Ventricle
  • Aortic Valve
  • Aorta

*Oxygenated Blood goes to the body*

26
Q

Ventilation is the moving of air in the lungs

A
    • External respiration: inhale oxygen and exhale carbon dioxide leading to an exchange of O2 and CO2
      • Example: chest expansion
27
Q

Respiration

A
  • is the exchange of o2 and Co2 between the atmospheric air in the alveoli and blood in the pulmonary capillaries
28
Q
  • Diffusion is
A
  • the movement of solute from higher to lower concentration
29
Q
  • Perfusion
A
  • is the blood from the left side of the heart, through systemic circulation, oxygenated cappliary blood passes through body tissue
    • Example: capillary refill >3 seconds
30
Q

Internal respiration is

A

the exchange of oxygen and carbon dioxide between the circulating blood and body tissues

31
Q
  • Describe common alterations in cardiopulmonary function and oxygenation
A
  • Arrhythmia
  • P and T waves abnormal
  • Hypoxia
32
Q
  • Identify factors affecting cardiopulmonary function and oxygenation
A
  • Hyperventilation
  • Hypoventilation
  • Hypoxia
  • Decrease H&H
  • Conditions affecting chest wall movement COPD
33
Q
  • Discuss changes in cardiopulmonary function and oxygenation related to older adults
A
  • Previous smoker
  • Other conditions
  • Decrease mobility
34
Q
  • Create a care plan for a patient with ineffective airway clearance, ineffective breathing pattern and impaired gas exchange
A
  • Ineffective airway clearance
    • Elevate head of bed during and after meals
    • Encourage coughing and deep breathing
    • Possible aspiration precautions
    • Monitor sputum
    • Assess and monitor respiratory status
    • Perform chest physiotherapy if needed
    • Provide exercise and activity
    • Suction pt airway as needed
    • Monitor ABG
  • Ineffective breathing pattern
  • Impaired gas exchange
    • Assist ADLs
    • Auscultate breath sounds
    • Monitor respiratory status
    • Monitor signs of respiratory problems
    • Perform chest physiotherapy
    • Limit agitation
    • Encourage incentive spirometry
    • Monitor ABG
    • Maintain airway
35
Q
  • Afterload, Preload, Stroke Volume
    *
A
  • Afterload- resistance of blood from L. ventricle
    • Inversely proportional
    • Increase in resistance is in aorta, vasoconstriction
    • Decrease in resistance, vasodilation
    • Increase in afterload causes decrease in stroke volume
    • Decrease in afterload causes increase in stroke volume
  • Preload- amount of blood at end of ventricular diastole
    • Increase in preload causes increase in stroke volume
    • Directly proportional to stroke volume
  • Stroke volume- amount of blood pumped out ventricle w each beat/contraction
    • Directly proportional
    • If contractility increase stroke volume increase or vice versa
36
Q
  • Heart Failure
    • Left Sided HF
      • Backward flow
      • Related to lungs & Cardiac output
        • Examples: SOB, dyspnea, crackles, easily tired, confusion and chest pain r/t cardiac output
    • Right Sided HF
      • Symptoms related to systematic except cardiac output
        • Edema
        • Pain not r/t cardiac output decrease
        • Weight gain
A
  • Left Sided HF
    • Backward flow
    • Related to lungs & Cardiac output
      • Examples: SOB, dyspnea, crackles, easily tired, confusion and chest pain r/t cardiac output
        *
37
Q
  • Right Sided HF
    *
A
  • Symptoms related to systematic except cardiac output
    • Edema
    • Pain not r/t cardiac output decrease
    • Weight gain
38
Q
  • Differentiate types of oxygen delivery systems
A
  • Regular nasal cannula
  • mustache/ pendant cannula
  • Simple face mask
  • Partial rebreather with reservoir bag
  • Non rebreather with reservoir bag
  • High flow nasal cannula
  • Venturi mask
39
Q
  • Regular nasal cannula O2
A
  • 1-6 L/min
  • 24%-44%
    *
40
Q
  • Mustache or Pendent cannula o2
    • 3x-4x more than regular cannula with same flow rate
    • No humidifier
  • Simple face mask o2
    • 5-8 L/min
    • 40%-60%
  • Partial rebreather with reservoir bag 02
    • 8-11 L/min
    • 50%-75%
  • Non Rebreather with reservoir bag o2
    • 10-15 L/min
    • 80%-95%
  • High flow nasal cannula o2
    • Max flow 60 L/min
    • 10 L/min-65%
    • 15 L/min-90%
    • Humidifier
  • Venturi mask o2
    • Deliver precise, high flow rates
    • Masks available of 24%, 28%, 31%, 35%, 40%, 60%
  • Which o2 methods are low flow?
    • Regular cannula
    • Mustache or pendant cannula
    • Simple face mask
    • Partial rebreather
    • Non Rebreather
  • Which o2 methods are high flow?
    • High flow nasal cannula
    • Venturi mask
  • Which o2 methods are used with a humidifier?
    • Regular nasal cannula
    • Simple face mask
    • High flow nasal cannula
A
  • 3x-4x more than regular cannula with same flow rate
  • No humidifier
    *
41
Q
  • Simple face mask o2
    • 5-8 L/min
    • 40%-60%
  • Partial rebreather with reservoir bag 02
    • 8-11 L/min
    • 50%-75%
  • Non Rebreather with reservoir bag o2
    • 10-15 L/min
    • 80%-95%
  • High flow nasal cannula o2
    • Max flow 60 L/min
    • 10 L/min-65%
    • 15 L/min-90%
    • Humidifier
  • Venturi mask o2
    • Deliver precise, high flow rates
    • Masks available of 24%, 28%, 31%, 35%, 40%, 60%
  • Which o2 methods are low flow?
    • Regular cannula
    • Mustache or pendant cannula
    • Simple face mask
    • Partial rebreather
    • Non Rebreather
  • Which o2 methods are high flow?
    • High flow nasal cannula
    • Venturi mask
  • Which o2 methods are used with a humidifier?
    • Regular nasal cannula
    • Simple face mask
    • High flow nasal cannula
A
  • 5-8 L/min
  • 40%-60%
    *
42
Q
  • Partial rebreather with reservoir bag 02
    • 8-11 L/min
    • 50%-75%
  • Non Rebreather with reservoir bag o2
    • 10-15 L/min
    • 80%-95%
  • High flow nasal cannula o2
    • Max flow 60 L/min
    • 10 L/min-65%
    • 15 L/min-90%
    • Humidifier
  • Venturi mask o2
    • Deliver precise, high flow rates
    • Masks available of 24%, 28%, 31%, 35%, 40%, 60%
  • Which o2 methods are low flow?
    • Regular cannula
    • Mustache or pendant cannula
    • Simple face mask
    • Partial rebreather
    • Non Rebreather
  • Which o2 methods are high flow?
    • High flow nasal cannula
    • Venturi mask
  • Which o2 methods are used with a humidifier?
    • Regular nasal cannula
    • Simple face mask
    • High flow nasal cannula
A
  • 8-11 L/min
  • 50%-75%
    *
43
Q
  • Non Rebreather with reservoir bag o2
    • 10-15 L/min
    • 80%-95%
  • High flow nasal cannula o2
    • Max flow 60 L/min
    • 10 L/min-65%
    • 15 L/min-90%
    • Humidifier
  • Venturi mask o2
    • Deliver precise, high flow rates
    • Masks available of 24%, 28%, 31%, 35%, 40%, 60%
  • Which o2 methods are low flow?
    • Regular cannula
    • Mustache or pendant cannula
    • Simple face mask
    • Partial rebreather
    • Non Rebreather
  • Which o2 methods are high flow?
    • High flow nasal cannula
    • Venturi mask
  • Which o2 methods are used with a humidifier?
    • Regular nasal cannula
    • Simple face mask
    • High flow nasal cannula
A
  • 10-15 L/min
  • 80%-95%
    *
44
Q
  • High flow nasal cannula o2
    • Max flow 60 L/min
    • 10 L/min-65%
    • 15 L/min-90%
    • Humidifier
  • Venturi mask o2
    • Deliver precise, high flow rates
    • Masks available of 24%, 28%, 31%, 35%, 40%, 60%
  • Which o2 methods are low flow?
    • Regular cannula
    • Mustache or pendant cannula
    • Simple face mask
    • Partial rebreather
    • Non Rebreather
  • Which o2 methods are high flow?
    • High flow nasal cannula
    • Venturi mask
  • Which o2 methods are used with a humidifier?
    • Regular nasal cannula
    • Simple face mask
    • High flow nasal cannula
A
  • Max flow 60 L/min
  • 10 L/min-65%
  • 15 L/min-90%
  • Humidifier
    *
45
Q
  • Venturi mask o2
    • Deliver precise, high flow rates
    • Masks available of 24%, 28%, 31%, 35%, 40%, 60%
  • Which o2 methods are low flow?
    • Regular cannula
    • Mustache or pendant cannula
    • Simple face mask
    • Partial rebreather
    • Non Rebreather
  • Which o2 methods are high flow?
    • High flow nasal cannula
    • Venturi mask
  • Which o2 methods are used with a humidifier?
    • Regular nasal cannula
    • Simple face mask
    • High flow nasal cannula
A
  • Deliver precise, high flow rates
  • Masks available of 24%, 28%, 31%, 35%, 40%, 60%
    *
46
Q
  • Which o2 methods are low flow?
    • Regular cannula
    • Mustache or pendant cannula
    • Simple face mask
    • Partial rebreather
    • Non Rebreather
  • Which o2 methods are high flow?
    • High flow nasal cannula
    • Venturi mask
  • Which o2 methods are used with a humidifier?
    • Regular nasal cannula
    • Simple face mask
    • High flow nasal cannula
A
  • Regular cannula
  • Mustache or pendant cannula
  • Simple face mask
  • Partial rebreather
  • Non Rebreather
    *
47
Q
  • Which o2 methods are high flow?
    *
A
  • High flow nasal cannula
  • Venturi mask
    • Which o2 methods are used with a humidifier?
      • Regular nasal cannula
      • Simple face mask
      • High flow nasal cannula
48
Q
  • Which o2 methods are used with a humidifier?
    *
A
  • Regular nasal cannula
  • Simple face mask
  • High flow nasal cannula