Lecture 10: Resp Flashcards

1
Q

alveoli vs trachea

A

alveoli has TONS of surface area for gas exchange

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2
Q

what is the main goal of ventalation

A

air in and out
- to get our tissues and remove CO2 from out of the body

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3
Q

what is respiration

A

similar to ventilation, but has more to do with gas exchange

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4
Q

what does our O2 stat do

A
  • measures O2 level of hemoglobin
  • saturated hemoglobin absorbs different amount of light from the O2 stat, in comparison to unsaturated hemoglobin in the finger
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5
Q

normal o2 sat

A

target >95%
- in hospital 92%

o2 85% = bad = hemoglobin not delivering enough o2 patient will crash

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6
Q

how does an oximeter work

A
  • 2 wavelengths emitted
  • light is absorbed (partially) by hemoglobin
  • amount differs depending on whether it is saturated or unsaturated w o2
  • processor can compute the proportion of hemoglobin which is oxygenated
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7
Q

Optimizing and ventilation of patient

A

positioning: tripod position

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8
Q

incentive spirometry

A
  • mech device
  • makes them take a deep breath, and get more o2 into their body
  • make sure pt breathes in and holds it to see how high the ball will go
  • try to get ball higher each time
  • mimics normal intake and breathing
  • helps pt get off o2 faster
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9
Q

atelectasis

A
  • complete or partial collapse of the lung segment
  • alveoli become deflated
  • can allow fluid to build up in the bottom
  • won’t hear anything in a stethoscope, most common in post op patients

most common cause: postoperative hypoxemia

diagnoses: hypoxemia, mild leukocytosis, chest x-ray

treatment: continuous positive airway pressure

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10
Q

pneumonia

A
  • acute inflammation and infection of lower airway
  • BIG hospital admission
  • defense mech become overwhelmed
  • may allow aspiration
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11
Q

how do you get pneumonia

A

microbes present in air, inhaled

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12
Q

types of pneumonia

A
  1. community-acquired (CAP): lower resp infection of lung in community or during first 2 days of hospitalization
  2. Hospital-acquired (HAP): acquired 48 hrs or longer after admission and not incubating at time of hospitalization
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13
Q

Community-aquired pneumonia bacteria

A

streptococcus pneumoniae

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14
Q

hospital acquired pneumonia bacteria

A

many of organisms enter lungs after aspiration of the particles from the pt’s own pharynx

pt has feeding tube - make sure at 30 degrees or higher

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15
Q

pneumococcal pneumonia

A

harder to treat bc its becoming resistant

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16
Q

pneumonia nurse interventions

A
  • vaccinations
  • reposition client q2h
  • assist clients at risk for aspiration
  • follow strict asepsis
17
Q

how can pneumonia be diagnosed?

A

leukocytosis

18
Q

what is leukocytosis?

A
  • elevated WBC
  • normal counts are 5-10x109/L or 5000-10,000/mm3 (microlitres)
19
Q

hypoxemia vs hypoxia

A

hypoxemia: low oxygen in the blood
hypoxia: low o2 levels in the tissue

hypoxemia is most common cause of hypoxia

20
Q

what goes up after surgery

A

WBC

21
Q

supplemental oxygen

A
  • ordered by physician
  • you want to maintain at least 92%
  • for COPD 88%
22
Q

complications of oxygen therapy

A
  • combustion
  • o2 toxicity
  • co2 narcosis
23
Q

what is combustion

A

supports combustion and increases rate of burning

24
Q

o2 toxicity

A
  • from prolonged exposure to high levels of o2
  • sympt: cough, chest pain, etc
25
Q

co2 narcosis

A
  • copd pts develop tolerance for high co2 levels
26
Q

resistant organism examples

A
  • methicillin-resistant staphylococcus aureus (MRSA)
  • Vancomycin-resistant enterococci (VRE)
  • Carbapenemase-producing organism (CPO)
  • penicillin-resistant streptococcus pneumoniae
27
Q

what % of HAI’s can be prevented

A

30%

28
Q

Standard precautions

A
  • all pt’s
  • gloves, gown (when body fluids flowing), mask (within 1m), goggles/face shield (within 1 m w body fluids or coughing)
29
Q

contact precautions

A
  • c. dff, influenza, meningitis, MRSA, varicella
  • gloves, gown
30
Q

droplet precautions

A
  • influenza, meningitis, pertussis
  • private/semi-private room
  • everything
31
Q

airborne

A
  • measles, TB, varicella
  • private room w negative. airflow
  • everything, + negative pressure, and N-95
32
Q

enhanced resp and contact precautions

A
  • hemorrhagic fevers, pandemic influenza, SARS
  • private room w neg airflow
  • n-95 and all precautions