Exam 4: Chapter 39 Airway Management Flashcards
Factors Essential to Normal Functioning of the Respiratory System: Integrity
Integrity of the airway system to transport air to and from lungs
Factors Essential to Normal Functioning of the Respiratory System: Properly
Properly functioning alveolar system in lungs. Oxygenates venous blood and removes CO2 from blood
Factors Essential to Normal Functioning of the Respiratory System: Properly functioning cardiovascular and hematologic systems
Carry nutrients and wastes to and from body cells
Upper Airway Functions
Warm, Filter, Humidify Inspired Air
Upper Airway omponents
Nose, Pharynx, Larynx, Epiglottis
Lower Airway Functions
Conduction of air , mucociliary clearance, production of pulmonary surfactant
Lower Airway Components
Trachea
Right and Left Mainstem Bronchi
SEgmental Bronchi
Terminal Bronchioles
Lower Airway Cilia Function
Line and help clean out foreign matter to ensure that it does not go into the lungs
Anatomy of Lungs: Extend from
the base of the diaphragm to the apex above the first rib
The right side has how many lobes?
3
Left side has how many lobes?
2
Lungs composed of?
Elastic tissue (alveoli, surfactant, pleura)
Lung Listening: Be sure to listen to
front and back on both sides
What is inspiration?
The active phase of ventilation
What does Inspiration involve?
Involves movement of muscles and the thorax to bring air into the lungs
What is Expiration?
THe passive phase of ventilation
What does Expiration involve?
The movement of fair out of the lungs
What events occcur during inspiration?
Diaphragm contacts and descends, lengthening the thoracic cavityl the external intercostal muscles contact, lifting the ribs upward and outwward
Gas Exchange (REspiration) refers to
the intake of oxygen adn release of carbon dioxide
Gas Exchange mad possible by
respiration and perfusion
Gas Exchanges occurs via
Diffusion
Gas Exchange occurs in
Alveoli so O2 diffuses into blood and CO2 diffusees from blood to exhaled air
Transport of Repiratory Gases: Oxygen is carried
in the body via plasma and red blood cells
Transport of Repiratory Gases: Most oxygen (97%) is
carried by red blood cells in teh form ox oxyhemoglobin
Transport of Repiratory Gases: Hemoglobin also carries
CO2 in the form of Carboxyhemoglobin
Alterations in REspiraotry Functions: Hypoxia
Inadequate amount of oxygen available to cells (Low O2)
Alterations in REspiraotry Functions: Dyspnea
Difficulty breathing
Alterations in REspiraotry Functions: Hypoventilation
Decreased rate or depth of air movement into the lungs
Alterations in REspiraotry Functions: What can cause Hypoventilation?
Narcotics
Factors Affecting CArdiopulmonary Functioning and Oxygenation: Level of Health Examples
COPD, Asthma, Pheumonia
Factors Affecting Cardiopulmonary Functioning and Oxygenation: Developmental COnsiderations
Infant will be much higher than a adult
Factors Affecting Cardiopulmonary Functioning and Oxygenation: Medication Considerations
Nacrotics decrease respiration and breathing while increasing heart rate
Factors Affecting Cardiopulmonary Functioning and Oxygenation: Physchological Health Considerations
Stress, Anxiety
Respiratory Functioning in the Older Adult
Decreased gas excchange and increased work in breathing.
Decreased ventilation and ineffective cough
Respiratory Functioning in the Older Adult: Deep breathe, should use
spirometer
Respiratory Functioning in the Older Adult: Head of Bed
Head of bed should be elevated
Physical Assessment: Inspection
LOC, Orientation, General Appearance, Respiratory Rate, Any Distress, Skin Color
Are they using accessory muscles? Hunched over?
Physical Assessment: Palpation
Skin Temperature, Capillary Refill, Pulses
Physical Assessment: Auscultation
Bilateral Lungs, Anterior and Posterior
What do crackles sound like?
High Pitched
Heard During Inspirration
Not Cleared By Cough
What do Rhonchi sound like?
RUmbling
Course Sounds
Like a Snore
May Clear with Coughing
What does Wheeze sound like?
Muscial Noise During Inspiration/Expiration
Usually Louder During Expiration
What does Aterial Blood Gas measure?
Measures the acidity (pH) and the levels of oxygen and CO2 in the blood from the artery
Arterial Blood Gas test is used to check how
well the lungs are able to move oxygen into the blood and remove CO2 from the blood
Normal pH range?
7.35 - 7.45
If pH higher than 7.45, whats it called
Alkalosis
If pH lower than 7.35, whats it called
Acidic
What happens if PO2 is low?
O2 is low
What does PCO2 represent?
partial pressure of CO2 in blood
What does HCO3 represent?
Bicarb-Matabolic Acidosis/Alkalosis
Normal PO2 range?
80-100
Normal PCO2 range?
35-45
Normal HCO3 range?
22-28
What is Pulse Oximetry?
Measurs the arterial oxyhemoglobin saturation of arterial blood
Normal range for Pulse Oximetry?
95-100%
Pulse Oximetry: What does a value less than 90% indicate?
oxygenation to the tissues is inadequate and requires immediate intervention
Promoting Proper Breathing: DEep breathing used for
Surgery Pts
Promoting Proper Breathing: Position
High Fowler is position of choice. Increase of fluids can help thin secretions
Promoting Proper Breathing: Using Incentive Spirometry Goal
Goal is to breathe deep enough to get dial to raise up to goal
Promoting Proper Breathing: Pursed Lip Breathing
This is slow and prolonged and results in improve air exchange and decreased dyspnea
Promoting Proper Breathing: Diaphragmatic Breathing
Useful for those with COPD. THis reduces the respiratiory rat, increases alveolar ventilation, and sometimes helps expel as much air as possible during expiration
Chest Physiotherapy: Percussion
CUpped hands over back to break up
Chest Physiotherapy: Vibration
Helps get secretions moving
Chest Physiotherapy: Postural Drainage
Change position to facilitate drainage
Chest Physiotherapy: Used for
Loosening secretions
Chest Physiotherapy: When should this be done
1 hour before or after meal. Vomiting and Aspiration can occur. Can also be done at bedtime
What is a nasal cannula?
Most commonly used oxygen delivery device. Plastic device with two protruding prongs that are inserted into the nostrils
What is a simple face mask?
Connected to oxygen tubing, a humidifer, and a flow meter. Has vents on its side that allow room air to leak in at many places, therby diluting the source oxygen
When is a simple face mask used?
Used when an increased delivery of oxygen is needed for short periods (less than 12 hours)
Flow rate for simple face mask?
Less thran 5 L/min
What is a Partial Re-breather Mask?
Like a simple face mask, but is equuipped wiht a reservoir bag for the collection of the first part of the patietns exhaled air . CAn inhale oxygen from teh room
What is a Nonrebreather mask
Deliverys the highest concentration of oxygen via a mask to a spontaneously breathing patient. Similar to the parital rebreather mask except that two one way valves prevent the patient from rebreathing exhaled air
What is a Venturi Mask
allows the mask to delivery the most precise concentration of oxygen. Mask has large tube with oxygen inlet. As the tube narrows, the pressure drops
Precautions for Oxygen Administration: Avoid open
flames in patients room
Precautions for Oxygen Administration: Place
“no smoking” signs in conspicous places
Precautions for Oxygen Administration: Check
to see that electrical equipment in the room is in good working order
Precautions for Oxygen Administration: Avoid wearing
and using synthetic fabrics (build up static electricity)
Precautions for Oxygen Administration: Avoid using
oils in the ara (oils ignite spontaneously in oxygen
What is a Oropharyngeal Airway?
Semicircular tube of plastic or rubber inserted into the back of the pharynx. Used to keep tongue clear fo airway
What is a nasopharyngeal airway?
Inserted through the naris and protrudes into teh back of the pharynx.
What is a tracheostomy?
An artificial opening made into the trachea, usually at the level of the second or third cartilaginous ring
Suctioning Key Points: Assess
For pain prior
Suctioning Key Points: Position
Semi-Fowlers position if patietn can tolerate it
Suctioning Key Points: Adjust
Suction to appropriate pressure
Suctioning Key Points: Suction
On teh way out for no more than 10-15 seconds at a time
Suctioning Key Points: Allow
at least 30 seconds before additional attempt, no more than two passes
Suctioning Key Points: Oxygenate
between suction passes. Maintain patient airway