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N242 > midterm > Flashcards

midterm Flashcards

1
Q

oxygen transport to tissues depends on

A
  • cardiac output
  • arterial oxygen concentration of hemoglobin
  • metabolic requirements
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2
Q

room air has how much oxygen

A

21%

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3
Q

what is the goal of oxygen therapy

A

provide adequate transport of oxygen in the blood while decreasing the work of breathing and reducing stress on the myocardium

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4
Q

what is hypoxemia

A

decrease in arterial oxygen tension in the blood

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5
Q

manifestations of hypoxemia

A
  • change in mental status
  • dyspnea
  • increased blood pressure
  • change in heart rate
  • dysrhythmia
  • diaphoresis
  • cool extremities
  • central cyanosis (late sign)
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6
Q

what does hypoxemia lead to

A

hypoxia

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7
Q

what is hypoxia

A

a decrease in oxygen supply to the tissues

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8
Q

rapidly developing hypoxia may resemble what

A

alcohol intoxication

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9
Q

hypoxemic hypoxia

A

decreased oxygen levels in the blood resulting in decreased oxygen perfusion to the tissues

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10
Q

causes of hypoxemic hypoxia

A
  • hypoventilation
  • high altitude
  • pulmonary embolism
  • shunts (alveoli collapsed)
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11
Q

treatment for hypoxemic hypoxia

A
  • increase alveolar ventilation

- oxygen

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12
Q

types of hypoxia

A
  • hypoxemic
  • circulatory
  • anemic
  • histotoxic
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13
Q

circulatory hypoxia

A

inadequate capillary circulation causes reduced tissue pressure (arterial oxygen remains normal)

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14
Q

causes of circulatory hypoxia

A
  • decreased cardiac output
  • local vascular obstruction
  • low flow (shock, cardiac arrest)
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15
Q

treatment for circulatory hypoxia

A

identify and treat the cause

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16
Q

anemic hypoxia

A

decreased effective hemoglobin concentration causes decrease in oxygen carrying capacity of blood
(rarely accompanied by hypoxemia)

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17
Q

what causes a similar effect as anemic hypoxia

A

carbon monoxide poisoning

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18
Q

histotoxic hypoxia

A

a toxic substance that interferes with the ability of tissues to use available oxygen
ex. cyanide

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19
Q

oxygen toxicity

A

when too high an oxygen concentration (>50%) is administered for extended periods (>48 hours)

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20
Q

what causes oxygen toxicity

A

overproduction of oxygen free radicals

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21
Q

what can help defend against free radicals

A

vitamin E, C and beta-carotene

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22
Q

S&S of oxygen toxicity

A
  • substernal discomfort
  • dyspnea
  • restlessness
  • fatigue, malaise
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23
Q

flow rate of nasal cannula

A

1-6 L/min

>4 requires humidification

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24
Q

simple face mask flow rate

A

6-12 L/min

25
Q

partial nonrebreather flow rate

A

10-15 L/min

26
Q

how do patients with COPD stimulate respiration differently

A

they use a decrease in oxygen to stimulate respiration rather than increased CO2
do not give oxygen because it removes this stimulation and can cause a progressive increase in arterial CO2 pressure

27
Q

what is an incentive spirometer used for

A
  • helps a patient to deep breathe

- should be used 10 times an hour

28
Q

what is an oropharyngeal airway for

A

allows airway patency in an unconscious patient

29
Q

what is postural drainage

A
  • allows gravity to assist in removal of bronchial secretions
  • 2-4 times a day, before meals and at bedtime
  • patient should remain in position for 10-15 minutes, breathe in slowly through nose and out slowly through pursed lips
  • chest percussion and vibration help dislodge mucus (performed 3-5 minutes in each position)
30
Q

how much urine should be collected for a culture

A

3mL

31
Q

how much urine should be collected for routine analysis

A

20mL

32
Q

how long should a catheter be clamped before collection

A

10-15 minutes

33
Q

medical asepsis

A

“clean technique”

hand hygiene, gloves, cleaning the environment

34
Q

in medical asepsis, something is considered contaminated if it

A

contains or is suspected to contain microorganisms

35
Q

surgical asepsis

A

“sterile technique”

eliminates microorganisms and spores

36
Q

in surgical asepsis, something is considered contaminated if it

A

touches something not sterile

37
Q

3 situations surgical asepsis should be used for

A
  • during procedure that perforates the skin
  • if the skin integrity is broken (trauma, burns, incisions)
  • during procedures that involve insertion of catheters or instruments into body cavities
38
Q

4 things that contaminate something sterile

A
  • out of vision
  • below waist
  • a wet contaminated surface (capillary action)
  • 2.5 cm edges of a field
39
Q

subQ: volume

A

0.5-1.5 mL

40
Q

an IM injection should have how much muscle penetration

A

5mm

41
Q

IM: needle length

A

1-2 inch

42
Q

subQ: needle length

A

3/8-1/2 inch

usually 5/8

43
Q

what type of insulin do you prepare first

A

short/rapid acting

44
Q

subQ: guage

A

25-27

45
Q

subQ: site

A

abdomen, back of arm, thigh

46
Q

subQ pediatrics: volume

A

< 0.5mL

47
Q

subQ pediatrics: guage

A

25-30

48
Q

subQ pediatrics: needle length

A

< 1/2 inch

49
Q

subQ pediatrics: site

A

either back of arm or thigh

50
Q

subQ butterfly: volume

A

2-3 mL

51
Q

subQ butterfly: guage

A

24g

52
Q

clean needle stick protocol

A
  • wash soap and water
  • if necessary: first aid attendant
  • review PPE and safe work practices
53
Q

splash on intact skin/clothing protocol

A
  • wash soap and water
  • change clothes if necessary
  • if necessary: first aid attendant
  • review PPE and safe work practices
54
Q

dirty needle stick
AND
splash on non-intact skin
protocol

A
  • wash soap and water
  • disinfect with alcohol swab
  • apply sterile dressing if necessary
  • DO NOT: squeeze, disinfect
55
Q

blood/body fluid splash in eyes/nose/mouth protocol

A
  • rinse membrane with tepid water/saline
  • notify CNL
  • ER within 2 hours
  • source blood exposure work complete
  • report exposure to occupational health nurse
56
Q

hypotonic solution osmolarity

A

< 250 mOsm/L

57
Q

isotonic solution osmolarity

A

250-375 mOsm/L

58
Q

hypertonic solution osmolarity

A

> 375 mOsm/L

N242 (1 decks)

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