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Complex Nursing > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

Supplemental Oxygen Goals

A

correct hypoxemia

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2
Q

what is hypoxemia

A

decreased oxygen levels in the arterial blood available for profusion of tissues

heart works harder when hypoxemia is present in order to get oxygen to the tissue

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3
Q

Oxygen is ____________

A

drug! need an order to use it and requires frequent assessment required

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4
Q

What is the issue with respiration…

A

ventilation or oxygenation

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5
Q

if there is an issue with oxygenation

A

then need to increse FiO2 –> make FiO2 higher then room air (21%)

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6
Q

if there is an issue with ventilation

A

they need more floow –> like BiPAP and CPAP that provide continuous positive pressure in the airways

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7
Q

what if there is oxygenation and ventilation

A

they need both FiO2 and flow

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8
Q

factors that affect the success of supplemental oxygen

A

LOC, airway patency,

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9
Q

when considering LOC what are airway options

A

OPA
NPA

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10
Q

hypoventilation

A

O2 pools in the conducting airways because the lungs are not pullung it into the alveoli

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11
Q

hyperventilation

A

increased mixing of O2 that we are supplemnting with and room ai which dilues down the actual FiO2 numbers

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12
Q

depth of breathing

A

aka tidal volume
which is how much of the O2 the patient is actually pulling in

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13
Q

hemoglobin level

A

low hemoglobin = less ability to carry and bring oxygen to the tissues

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14
Q

electrolytes level

A

low phosphorus levels are associated with muscle weakness including the diaphragm

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15
Q

what would you want to consider for medical history of a patient with respiratory issues

A

pulmonary fibrosis
pleural effusion

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16
Q

secondary complications of respiratory issues

A
  1. skin breakdown
    drying of mucuos membranes
  2. epistaxis
  3. infection of the sinuses
  4. oxygen toxicity
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17
Q

oxygen toxicity

A

we want to use the least amount of oxygen needed to keep the SaO2 up
greater the 60% FiO2 for more then 24 hours has been shown to cause damage to the alveoli

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18
Q

effective oxygen therapy is all about finding the balance

A

we want to use the least mount of oxygen (FiO2) in order to achieve normal PaO2 on ABG or noraml oxygen sat on pulse oximetry reading

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19
Q

room air has what precent oxygen

A

room air has 21% oxygen

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20
Q

nasal canula O2 parameters in adults

A

1-6 liter flow

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21
Q

who uses the nasal canula

A

patients who need just little supplement

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22
Q

simple mask O2 parameters in adults

A

5 to 10 liters per minute

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23
Q

when would use the simple mask

A

need the higher flow oxygen to push out carbon dioxide through the holes on the sides

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24
Q

venturi/ venti mask O2 parameters in adults

A

ranges from 4L giving 25% FiO2 to 15L giving 60% depending on which device you use

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25
Q

venturi and venti mask information

A

Through the openings on the colored part, mixes a combination of room air and delivered oxygen which gets you your desired FiO2 depending on the piece and the flow rate

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26
Q

non-rebreather face mask

A

consider a high flow O2 device

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27
Q

Non-rebreather face mask O2 parameters

A

O2 parameters in adults: greater than 10 (give around 80% to 95% FiO2)
- Remember to move meter flow all the way up to 15 (100% O2)
- Helps to increase the flow of oxygen
- Anything less than 10, you interfere with patient’s oxygenation

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28
Q

High Flow O2 (Vapotherm)

A

**Can give up to 100% FiO2

Patients have their own set inspiratory volume that is decided by how much work the lungs are able to do

With Low Flow O2 you’re adding a higher concentration of oxygen but the patient is doing the work of bringing the extra oxygen in

29
Q

What are the o2 parameters with the vapotherm mask

A

O2 parameters in adults: can give 1 to 40 L/min

30
Q

trach collar

A

this is regulated delivery
needs to be humidified

31
Q

list the three types of low flow masks

A

non acute situations:
nasal canula
simple mask

acutly ill patients:
non-rebreather mask

32
Q

list the three types of high flow devices

A

high flow ocygen therapy
venturi mask
face tent

33
Q

Chest PT is also called

A

pulmonary toilet

34
Q

what does chest pt help the patient accomplish

A

helps the patients remove secretions and open up the aveoli

35
Q

what is considered forms of chest pt

A

posteral drainage
chest percussion and vibration
coughing and deep breathing
positoning
mobilizing patient
incentive spirometry

36
Q

non invasive mechanical ventilation includes

A

CPAP and BiPAP

37
Q

CPAP

A

continuous positive airway pressure

38
Q

CPAP accomplishes what ?

A

Maintains a constant minimum airway pressure throughout the respiratory cycle

Keeps airway/alveoli open at the end of expiration

Improves oxygenation

Set PEEP level

Increases functional residual capacity

39
Q

what type of patient can CPAP be used on

A

Can only be used on patients who are spontaneously breathing

40
Q

when is CPAP most commonly used

A

obstructive sleep apnea

41
Q

what is a little more difficult for the patient when they are on CPAP

A

expiration

42
Q

what is CPAP called in neonates or pediatrics

A

SIPAP

43
Q

CPAP decreases the ________________

A

work of breathing

44
Q

BiPAP

A

bilateral positive pressure ventilation

45
Q

what does BiPAP do

A

a. Works by facilitating an increase in tidal volume, preventing alveoli collapse (because of expiratory pressure support), and decreasing work of breathing
b. Allows for provider to order both inspiratory pressure-support (IPAP) and expiratory pressure support (EPAP)
c. Increases ventilation

46
Q

primary function of the respiratory system

A

to deliver oxygen to the lungs (ventilation) where through diffusion, oxygen is released into the blood at the alveolar-capillary membrane (perfusion); the oxygen is then transported to the tissues, and the CO2 is transported by the blood to the lungs and released at the alveolar-capillary membrane through diffusion and then released as a gas

47
Q

respiration is

A

process of the transport of oxygen from the inhaled air to the cells and the transport of CO2 in the opposite direction

48
Q

ventilation is

A
  1. The movement of air between the atmosphere and the alveoli by inhalation/exhalation (higher to lower pressure)
49
Q

lung compliance

A

Increased compliance means easier to expand lung tissue

Decreased compliance means difficult to expand the lung tissue

50
Q

what causes the lungs to have increased resistance

A

secretions
bronchospasm

51
Q

work of breathing

A

this becomes important with certain disease processes. Remember expiration is a passive process caused by elastic recoil of the lung. SO it is in inspiration that WOB takes place: it can be divided into compliance work (expand lungs against lung/chest wall elastic forces), tissue resistance work (required to overcome viscosity of lung/chest wall structures) and airway resistance work (required to overcome airway resistance during movement of air into lungs

52
Q

what is diffusion

A

Exchange of O2 ad CO2 between pulmonary capillaries and alveoli (movement of solutes between area of high concentration to an area of low concentration)

53
Q

what is perfusion

A

Flow of blood through the pulmonary capillary bed
Perfusion is required for diffusion to take place

54
Q

in what position are the lungs best perfused at

A

sitting upright the bases of the lungs are best perfused

55
Q

what is the upper respiratory tract

A

Air enters the body through the upper airway (nose, mouth, pharynx, nasopharynx, oropharynx, laryngopharynx, and larynx), the air is humidified, and filtered as it passes though these structures into the lower respiratory tract

56
Q

what is the lower respiratory tract

A

i. As the air enters the lower respiratory tract (the trachea, bronchi, bronchioles, and into the alveoli), the air continues to be filtered by hairlike cilia that line the respiratory tract

57
Q

conducting airways

A

the gas highway that shuttles oxygen and CO to where it needs to go

58
Q

does gas exhange happen in the conducting airways

A

no

59
Q

what is conducting airways considered

A

anatomic dead space

60
Q

what is primary function of the conducting airways alongside shuttling air

A

humidifying and filtering the air

61
Q

what is included in the conducting airways

A

nasopharynx, oropharynx, trachea, bronchi, bronchioles, and terminal bronchioles

62
Q

what is part of the respiratory airways

A

respiratory bronchioles, aveolar ducts, and aveolar sacs

63
Q

Type 1 aveolar cells

A

responsible for rapid gas exchange

64
Q

type 2 aveolar cells

A

secrete surfactant which decreases surface tension and keeps the aveoli from collapsing

65
Q

Lobule

A

where gas exchnge taks place = smallest component where the pulmonary capillaries, arterioles, and venules

66
Q

why is it important to differentiate the conducting and respiratory airways

A

mechanical ventilation – need to provide warming, humidification and filtering of the air being mechanically provided

67
Q

ventilation-perfusion relationship (V/Q)

A

V=ventilation (air going in and out of lungs)

Q=perfusion (gas exchange of oxygen and CO2 in the alveoli)

68
Q

why is V/Q not 1:1

A

dead space and shunting of air

Complex Nursing (2 decks)

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