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Oxygenation > Gas exchange and oxygenation > Flashcards

Gas exchange and oxygenation Flashcards

1
Q

Bronchoconstriction

A

Tightening of the bronchus due to the contraction of the smooth muscle

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2
Q

Bronchodilation

A

Expansion of the airway in the bronchus

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3
Q

pleural cavity

A

The space or cavity between the visceral and parietal layers of the lung

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4
Q

pleura

A

A protective layer or membrane covering the lungs

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5
Q

Where is gas exchange occuring

A

The alveioli

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6
Q

huff cough

A

pushing hair out quickly

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7
Q

quad coughing

A

coughing using the abdomen and accessory muscles

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8
Q

what will happen with positive pressure

A

will exhale all the way, and breath more air in.

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9
Q

What is happening when a person inhales

A

the diaphragm and the intercostal muscles contract, creating a negative pressure inside the lungs, and making the thorax increases.

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10
Q

Incentive spirometry

A

Good for people that hace had surgery, and teach before they go to sleep or before surgery. Decreases risk of developing atelectasis and reversing. Increases transpulmonary pressure, inspiratory volume and hyperinflate lungs.

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11
Q

What happens when a person exhales?

A

The diaphragm relaxes and the intercostal muscles contract, so that gas inside the lungs is expelled.

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12
Q

Surfactant

A

lubrication made in the lungs, keeps the alveoli from collapsing during exhalation. A lack of surfactant can cause a loss of tissue causing a loss of volume during expansion.

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13
Q

atelactasis

A

collapse of airways and small sections of the lung as a result of shallow breathing. The collapsing of the lung during expansion.

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14
Q

Ventilation

A

the flow of air inside or outside of the alveoli. Oxygen is transported into the alveoli and carbon dioxide is taken out.

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15
Q

Perfusion

A

The flow of blood, driven by cardiopulmonary system, into the alveolar capillaries.

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16
Q

Indications for suctioning

A
  1. Patency ( open and maintain open airway)
  2. Secretions
  3. Sample (when you want a culture)
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17
Q

4 key things to remember when you sunction

A

1) hyperoxygenate (correct or prevent hypoxia) before and after
2) suction pressure help prevent atelectasis
-120 to -150 adults
-100 to -120 p
-80 to 100 n
3) catheter size ( less than 50% of the size) airway times x2 go down to the next even number)
4) Suction time less than 15 seconds

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18
Q

Hazards to suctioning

A

Hypoxemia, bronchospasm, increased ICP, cardial dysrhythmias, tachycardia, bradycardia ( initiated a vagul response, stop suctioning, give 100% oxygen, give meds if it doesn’t stop)
PVC ( happens in response to trauma, or hypoxemia) ( stop and give oxygen.

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19
Q

Low-Flow Oxygen Delivery System

A

Nasal Cannula, Simple Face Mask, Partial Non-Rebreather Mask, Non-Rebereather Mask

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20
Q

Nasal Cannula

A

Most common Method, Deliver 23-44% Ensure nares are patent, COPD rule no more than 1-2 L/min supperess ventilation drive.
Use sterile water for more then 4 LPM

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21
Q

Simple Mask

A

Deliver 35-50% Flow rate no more than 6L/min must have must have enough pressure to blow out the clients CO2.

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22
Q

Partial rebreather mask

A

60-90% flow rate 8-11 LPM

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23
Q

how many liters for a tracheostomy patient

A

15 L

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24
Q

what must you do after puncture to arterial

A

apply pressure

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25
Q

what is a normal PaO2

A

80-100

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26
Q

Hypoxemia PaO2

A

< 60

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27
Q

Venous lab work for monitoring oxygen therapy

A

HGB and HCT

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28
Q

What is the CPAP

A

continuous pressure that helps you breath in and out. Same amount of positive pressure throughout insp and exp. Uses O2 if needed or RA

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29
Q

Bipap

A

2 levels positive airway pressure for intake and and exhale high pressure for inhale, drop pressure for exhale

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30
Q

VPap

A

ventilator

31
Q

artificial airways

A

oral airway, endotracheal and tracheal, invasive mechanical ventilation, noninvasive ventilation

32
Q

Tracheostomy

A

a surgical opening through the base of the neck into the trachea

33
Q

Nursing care for a tracheostomy

A

suctioning, cleaning q8h or as ordered, communication, teaching, emergency knowledge

34
Q

what do you put in a trach whole if it comes undone

A

orbitrator

35
Q

where does a tracheostomy sit

A

2 to 3, 3-4

36
Q

Why do you have an inner and outer cannula

A

It is easier to clean vs constantly change in the state of an emergency.

37
Q

difference between cuffed and uncuffed

A

cuffed prevents stomach content from comming up, uncuffed allows air through and ability to speak.

38
Q

Are inner cannulas disposable

A

yes

39
Q

fenestrated

A

allows to talk and breath more easier

40
Q

complications of tracheostomy

A

grow into the skin ( sutures remain attatched because they are in the chest wall)
change must always be done by the physician.
Consdieration:
Make sure you are able to communicate with patient.
disloging of the tube
granulation of the tissue in the trachea or at the stoma site
always look for pressure injuries
respiratory and or cardiovasular collapse
air leak including pneymothorax, pheumomediastinum or subcutaneous emphysema

41
Q

how often do you need to clean a trach persons mouth

A

every two hours

42
Q

number 1 complication

A

obstruction

43
Q

what does over inflation cause

A

necrosis, pressure injuries, reduced senses of smell and taste, difficulty swollowing, anchor the larynx, reduced sensation of the larynx reducing the cough reflex.

44
Q

clinical complications with trach

A

loss of voice, psychological distress, speech and lang delays, loss of smell and taste, comp nutritional status, imaired swollowing, decreased oxygenation with PEEP

45
Q

When to suction

A

coughing, dyspnea, rhonchi/bubbling, breath sounds, client unable to clear, before eating, before/after sleeping

46
Q

tracheostomy suctioning is clean or sterile

A

sterile

47
Q

What is inline suctioning

A

a sheath that attaches a sheath and is considered a clean procedure

48
Q

document sectretions

A

color, amount, consistancy

49
Q

oropharynx

A

Yankaur clients can cough effectively but cannot swallow or experctorate

50
Q

closed in-line suctioning

A

multi use suctioning, enclosed in plastic sheath, sterile in sheath but clean gloves

51
Q

Why check respirotory q8 hours

A

To make sure the treatment is being effective.

52
Q

How often do you do trach care

A

every 8 hours

53
Q

What is a oropharyngeal

A

Upper airway patency for obstructions of tongue or secretions, variety of sizes, measure from corner of mouth to angle of jaw, used for altered LOC, stimulate gag reglex, client can’t be concouse.

54
Q

Nasal artificial airway

A

Used for upper airways patency, softer more flexible, used for more alert clients not used for facial or head injuries.

55
Q

Conditions requiring chest drainage (tube)

A

pneumothorax- air trapped between the pleurae, causes lung to become more compact and become smaller.

56
Q

Pleural effusion

A

a colelction of fluid in the pleural space

57
Q

tension pneumothorax

A

pneumothoax occurs when a closed pneumothorax creates positive pressure in the pleural space continues to build. That pressure is then transmitted to the mediastinum (heart and great vessels)

58
Q

Symptoms of tension pneumothorax

A

shortness of breath, acute chest pain, decreased blood pressure, decreased blood O2, Increased heart rate.

59
Q

causes of pheumothorax (tension)

A

trauma, spontaneous primary w/o underlying lung disease, simple with underlying lung disease.

60
Q

Collapsed lung

A

SOB/DOE, chest pain, cough, absent or decreased sounds on affected side, shallow respirations, asymmetrical chest movement, decreased O2 saturation

61
Q

RN role for collapsed lung

A

Educate pt. and family, administer pain meds, set up chest drainage unit, obtain consent, assists with insertion PRN, Verify occlusive dressing is intact (oily), Tape all connections from CT to drainage system to prevent air leaks, Assess the patient and document appropriately.

62
Q

Restore negative pressure in the pleural space

A

1st vacuum source, water source, drainage bottle (optional)

63
Q

Water seal chamber

A

Creates a one-way valve that prevents air or fluid from returning to the patients chest
Monitor:
airl leaks (bubbling) = abnormal finding
Tidaling (fluctuations in fluid levels) = getting worse
Increased negative pressure
How much suction you have is physician ordered

64
Q

Air leaks

A

Clamp tube off first, if bubbling stops its a leak from the patient

65
Q

continuous bubbling initially is ok

A

true

66
Q

Crepitus

A

There is a leak between the air and the skin. subcutaneous emphysema

67
Q

When would your milk or strip the tubing of a chest drainage system

A

only if there is a suspected clot (controversial) may cause damage to the lung tissue as increased negative pressure is exerted.

68
Q

What should you do when a client has a chest tube to transport

A

keep the drainage system lower than the pt. chest, may open suction end to air whcih equals a water seal, may clamps (rubber tipped hemostats) should be kept at the bedside.

69
Q

Assess CCD

A

Check dressing, check tubing- dependent loops, check drainage in tubing and collection chamber, Check water seal chamber (bubbling, tidaling), check level of water (water seal chamber, suction control chamber)

70
Q

What do you do when their is an accidental disconnection of the tube?

A

Reconnect asap or place tube in sterile water bottle until new system arrives. Monitor for s/s of resp distress, notify physician.

71
Q

Accidental DC of chest tube

A

Seal off insertion site (dry sterile dressing or petroleum ause dressing 3 side secure
Notify physician
assess pt. prepare to assist with reinsertion
watch for tension pneumothorax

72
Q

what is expected in the water seal chamber

A

tidaling

73
Q

what is expected in the suction control container

A

bubbling

Oxygenation (1 decks)

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