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Np3 > L1+2 Oxygen And Suction > Flashcards

L1+2 Oxygen And Suction Flashcards

1
Q

Process of gas exchange

A

Pulmonary ventilation
Alveolar gas exchange
Transport of oxygen and carbon dioxide
Systematic diffusion

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2
Q

Transportation of oxygen and carbon dioxide
Flow of co2 and o2
Where o2 goes?
What affect rate of oxygen transport

A

O2 from lung goes into tissue
Co2 goes from tissue to lung (exhale)

o2 combined lossely with hemoglobin in rbs into tissue as oxyhemoglobin

Exercise, cardiac output

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3
Q

Factors that affect respiratory function

A

Age
Environment
lifestyle
Health status
Stress
Medication

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4
Q

Affecting respiratory function-age

A

Neonate
Lung filled with amniotic fluid
Fully expand by 2wks old

Older adult
More rigid chest wall and less elastic
Less cough reflex

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5
Q

Environment

A

Higher altitude=lower po2cold or too hot, cold-) must expend more energy to maintain temperature

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6
Q

How lifestyle affect respiratory function?
Have exercise vs didnt

A

Lifestyle with physical exercise will increase rate and depth of respiration
Sit-) lack of alveolar expansion and deep breath pattern

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7
Q

Health status& medication affecting respiratory function

A

Respiratory system disease affect oxygenation of blood

Medication can reduce rate and depth of breathing such as diazepam and opioid
RR has to be monitored with nurse when administering these drugs

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8
Q

Stress affecting respiratory function

A

Pow increase and pco2 decrease as hyperventilation
Light head, numbness of finger and tows and mouth
Short term symptoms

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9
Q

Other a alteration in respiratory function
Airway patency

A

Upper airway obstruction
Due to foreign object obstruction e.g. fall tongue

Lower respiratory obstrution
Due to accumulate of mucus or inflammatory exudates
Client may have restlessness, dyspnea

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10
Q

Tachypnea
Bradypnea

A

Tachypnea: fever, pain, hypoxemia
Brady: drug affected, brain injury

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11
Q

Heath history taking related to respiratory disease

A

History of respiratory disease
Presence of risk factors
Lifestyle related to respiratory problems
Current respiratory problems
Presence of cough and sputum
Present of chest pain
Environmental history
Medical history

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12
Q

Inspection to sputum

A

White/ clear: viral infection
Yellow or green: bacteria infection
Black: coal dust
Rusty (blood): pneumococcal pneumonia, TB
Hemoptysis: small to large amount of frank blood
Pink& frothy (泡）
Foul smelling (臭

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13
Q

Other assesment for physical examination

A

Palpation
Pulse
Skin tempt
Tenderness

Percussion敲
Area of consolidation/ air pocket

Auscultation
Breathing sound
Heart sound

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14
Q

Assesment- pulse oximeter

A

SpO2=95-100

remove acrylics nails
Remove dirt and skin oil
Minimize patient movement

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15
Q

Assesment- arterial blood gases (ABG)

A

Sample taken from radial, bradial, femoral pulse

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16
Q

Assesment-sputum samples
-chest x ray
- allergy test

A

Microscope evaluation of sputum

Xray: provide anterior-posterior view of heart& lung

Allergy test: indentify antigen that may cause hypersensitivity

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17
Q

Assesment- spirometry- peak flow monitoring

A

Measure the amount of air can be exhale with forcible effort

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18
Q

Diagnosis
-have what problem?

A

Impaired gas exchange
Activity intolerance

19
Q

Planning

A

To expectorate secretion clearly
Maintain patent airway
Improve comfort
Improve on ability to physical activity

20
Q

Implementation to facilitate pulmonary ventilation

A

Chest tubes
Artificial airway
Oxygen therapy
Suctioning
Hydration
Incentive spirometry

21
Q

Promote oxygenation

A

Raise the bed to semi fowlers or fowlers position

Encourage frauent change if position

Encourage taking deep breath

22
Q

Deep breathing
Aims*2

A

Aims
1. Remove secretion
2. Avoid dyspnea

Inhale slowly& evenly thru nose until greatest chest expansion
Hold the breath for 2-3 sec

Cough:
Take deep breath and hold for 2-3 sec, then cough 1-2

23
Q

Deep breathing for dypsnea client

A

Ask client to take deep breath as usual using nose
Exhale thru pursed lips
Ask client to tighten abdominal muscles

24
Q

Incentive spirometry

A

Sit in upright position
Hold the meter in upright position
Exhale normally
Lips cover the mouthpiece and inhale slowly and deeply
Hold the breath for 2-6 sec
May have cough—) deep breath may loosen mucus
Cough can facilitate removal.
Repeat 4-5 times hourly

25
Q

Hydration

A

Nebulizers （面罩）deliver humidity
Humidifier

26
Q

Artificial airway
Aims?
Types of artificial airway?

A

Maintain patent airway to client whose airway is obstructed

Oropharyngeal airway
Can hold falling tongue
No gag reflex

Nasopharyngeal airway
Flexible tube insert into nose
Reinsert every 8hrs avoid mucosa necrosis

Endotracheal tube
Thru mouth or nose into trachea

Tracheostomy
Opening into trachea to form a new airway

27
Q

Concentration of oxygen given? xx%

Why client have hypoxemia?

A

21%

Loss of lung tissue
Decreased ability to diffuse O2
Anemia leads to not enough rbc to carry O2

28
Q

Oxygen supply system have what?

A

Portable system
Wall outlet
Connect humidifier bottle filled with distilled water to the wall outlet
4L/min

29
Q

Type of flow system

A

Nasal cannula
Face mask
Oxygen tent
Transtracheal catheter

30
Q

Introduce oxygen delivery systems- nasal cannula

A

Nasal cannula
Most common
Inexpensive
Relatively comfy
Flow rate 2-6L

31
Q

Introduce oxygen delivery system- face mask

A

Difficult in fit and tolerance to some client
5-8L

32
Q

Introduce oxygen supply system-transtracheal catheter

A

Surgically created tract
Clean 2-4 times a day
>15L per minute

33
Q

Introduction to oxygen supply system (high flow)
Venturi mask, non-rebreathing mask

A

Venturi mask
4-10L

Non-rebreathing mask
Highest concentration 95-100%
>10L/min

34
Q

Safety precautions of oxygen therapy

A

No smoking
Stay up- secretion will drain down to airway

35
Q

Percussion, vibration, postural drainage

A

Percussion: rhythmic clapping of chest wall with cupped hand

36
Q

Suctioning type

A

Oropharyngeal suctioning
Nasopharyngeal suctioning
Endotracheal suctioning
Tracheostomy suctioning

37
Q

Indication to suctioning

A

Dyspnea
Unable to cough up secretion
Tachycardia

38
Q

Suctioning precauction

A

Dont apply too frequently cuz:
Will increase intracranial pressure
Cause bronchospasm
Cause o2 saturation decrease

39
Q

Nasopharyngeal suctioning IMPORTANT STUFF

A

use sterile water
Use sterile gloves
Do not apply suction when insertion
10-15cm

40
Q

Medication for oxygenation

A

Bronchodilators
Cough depressant
Expectorant
Anti-inflammatory drugs

41
Q

Bronchodilators

A

Inhalator
Reduce bronchospasm
Open tight airway
Avoid increase of hr/ bp
Increased BP—) do ECG

42
Q

Medication for oxygenation—) anti-inflammatory drugs

A

E.g. glucocorticoid
Decrease edema and inflammation
MOUTH WASH AFTER ADMINISTRATION
First broncodilator then anti-inflammatory

43
Q

Medication- expectorant

A

Expectorant helps in break up mucus
Cough suppressant given when chronic cough affect sleeping e.g. codeine

44
Q

Diagnosis of oxygenation problem

A

Ineffective airway clearance
Inability to clear secretions/ obstruction in respiratory tract to maintain a clear airway

Ineffective breathing pattern
Inhale or exhale do not have adequate ventilation

Impaired gas exchange
Excess of deficit of carbon dioxide elimination at alveolar -capillary membrane

Np3 (4 decks)

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