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z_NUR112: MIDTERM_NOTES > Notes: Ch 41 - Oxygenation > Flashcards

Notes: Ch 41 - Oxygenation Flashcards

1
Q

What is the normal range of pH?

A

7.35 - 7.45

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2
Q

What is the normal range for PaCO2?

A

45-35

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3
Q

What is the normal range for HCO3?

A

22-26

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4
Q

PaCO2 is related to what system?

A

Respiratory

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5
Q

HCO3 is related to what system?

A

Metabolic

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6
Q

What are the three compensations for acidosis/alkalosis issues?

A
  1. Uncompensated
  2. Partially-compensated
  3. Fully-compensated
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7
Q

How would you layout the Acidotic/Alkalotic tic-tac-toe chart?

A

AC / N. / ALK

pH

(R) PaCO2

(M) HCO3

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8
Q

When using the Acidosis/Alkalosis tic-tac-toe method, how is an uncompensated issue indicated?

A
  • Either PaCO2 or HCO3 will be in the Normal column
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9
Q

When using the Acidosis/Alkalosis tic-tac-toe method, How is partial compensation indicated?

A

One both PaCO2 and HCO3 are abnormal and pH is not in the normal column

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10
Q

When using the Acidosis/Alkalosis tic-tac-toe method, How is fully compensanted indicated?

A
  • pH is normal
  • PaCO2 and HCO3 are both abnormal to opposite sides.
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11
Q

What is the diagnosis?

pH = 7.5

PaCO2 = 22

HCO3 = 16

A

Partially Compensated Respiratory Alkalosis

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12
Q

What is the diagnosis?

pH = 7.39

PaCO2 = 35

HCO3 = 20

A

Uncompensated Metabolic Acidosis

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13
Q

What is the diagnosis?

pH = 7.31

PaCO2 = 30

HCO3 = 14

A

Partially Compensated Metabolic Acidosis

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14
Q

What is the diagnosis?

pH = 7.59

PaCO2 = 49

HCO3 = 30

A

Partially Compensated Metabolic Alkalosis

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15
Q

What is the diagnosis?

pH = 7.45

PaCO2 = 30

HCO3 = 24

A

Uncompensated Respiratory Alkalosis

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16
Q

Is Hypoventilation associated with Acidosis or Alkalosis?

A

Acidosis

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17
Q

Hypoventilation results in the retention of _____ and the need for _____.

A

CO2, O2

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18
Q

What type of drugs result in respiratory depression?

A

opioids

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19
Q

Name six opioids that can lead to respiratory depression.

A
  1. Fenanyl
  2. Percocet
  3. Dilaudid
  4. Oxycodone
  5. Codeine
  6. Morphine
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20
Q

Accumulation of fluid around or in the lungs can cause…

A

CHF

Congestive Heart Failure

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21
Q

What other item can lead to CHF?

A

Pulmonary Edema

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22
Q

What is the major characteristic of pneumonia?

A

fluid in the lungs

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23
Q

Fluid in the lungs is also called…

A

consolidation

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24
Q

How do we assess for consolidation?

A

Auscultation and checking for fremetis

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25
Q

How would consoidation be indicated during auscultation?

A

crackles

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26
Q

Absent, weak, or altered fremetis vibrations indicate…

A

possible consolidation

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27
Q

Name some things that can cause hypoventilation that could lead to acidosis

A
  • Opioids
  • Fluid in or around lungs
  • Pneumonia
  • Pulmonary Edema
  • Asthma/bronchiole constriction
  • COPD
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28
Q

Chronic bronchitis and Emphysema are two types of…

A

COPD

Chronic Obstructive Pulmonary Disorder

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29
Q

CPD is a _____ retainer

A

CO2

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30
Q

Emphysema is an overinflation of…

A

the alveoli

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31
Q

What is the biggest factor that leads to COPD?

A

smoking

32
Q

RR for hypoventilation is…

A

< 12

33
Q

RR of < 12 can lead to…

A

acidosis

34
Q

RR of > 20 can lead to…

A

alkalosis

35
Q

Hyperventilation leads to loss of

A

CO2

36
Q

How would you supply CO2 to someone who is hyperventilating?

A

Give them a mask/bag so they breathe back in the expelled CO2

37
Q

What are some factors that cause hyperventilation?

A
  • Anxiety
  • Hysteria
  • Excitement
  • Panic attacks
  • Fever
  • Aspirin toxicity
  • Person on ventilation
    • may get over oxygenated causing hyperventilation in attempt to get rid of O2
38
Q

Hyperventilation will require _____.

A

CO2

39
Q

Hypoventilation will need _____.

A

O2

40
Q

Name seven early signs of hypoxia.

A
  1. Restless
  2. Irritable
  3. Confusion
  4. Heart/Respiration increased
  5. Decreased LOC
  6. Tachypnea
  7. Tachycardia

or RAT (early),

Restless, Anxiety, Tachycardia/Tachypnea

BED (late)

Bradypnea/Bradycardia, Extreme restlessness, Dyspnea (severe)

41
Q

Name five late signs of hypoxia.

A
  1. Bradypnea
  2. Bradycardia
  3. In/out of Conciousness
  4. Sleepy
  5. Cyonosis
42
Q

What are the characteristics of Stridor?

A
  • EMERGENT
  • Indicative of occlusion,
  • complete blockage of airway by the soft structures and tissues and narrow airway in children
43
Q

What does URI stand for?

A

Upper Respiratory Infection

44
Q

What does GERD stand for?

A

Gastroesophageal reflux disease

45
Q

What are four early signs of hypoxia for children?

A

FINES

  • Feeding difficulty
  • Inspiratory Stridor
  • Nares Flare
  • Expiratory grunting
  • Sternal retractions
46
Q

What are six things that trigger Asthma?

A

E.A.R. H.U.G.

  1. Exercise
  2. Air pollutants
  3. Respiratory Infections
  4. Hypersensitivity
  5. URI
  6. GERD
47
Q

True or False

Asthma tends to run in the family.

A

True

48
Q

Define Hypoxia

A

Hypoxia is a condition or state in which the supply of oxygen is insufficient for normal life functions

49
Q

Define Hypoxemia

A

Hypoxemia is a condition or state where there is a low arterial oxygen supply

50
Q

What are three indicators of Hypoxemia?

A
  1. Tachycardia
  2. Tachypnea
  3. Restlessness
51
Q

What are six characteristics of Asthma?

A
  1. Productive cough
  2. SOB
  3. Wheezing/Prologned expiration
  4. CO2 retention
  5. Chest tightness
  6. Retractions
52
Q

What are respiratory retractions?

A

The areas below the ribs, between the ribs, and in the neck sink in with each attempt to inhale.

53
Q

Define Asthma

A

Asthma is a condition in which your airways narrow and swell and produce extra mucus

54
Q

What are the characteristics of Status Asthmaticus?

A
  • Status asthmaticus is more commonly known as acute severe asthma or a severe asthma exacerbation.
  • It refers to an asthma attack that doesn’t improve with traditional treatments, such as inhaled bronchodilators
  • It is EMERGENT
55
Q

If Asthma symptoms do not respond to usual treatment within 30 minutes, what is it indicative of?

A

Status Asthmaticus

56
Q

Asthma is also known as a _____ _____ _____.

A

reactive airway disease

57
Q

Those with Chronic Bronchitis are in need of…

A

O2

58
Q

What are some symptoms of Chronic Broncitis?

A
  • Darker to cyanotic color
  • Productive cough
  • Hypoxia
  • Hypercapnia
  • Respiratory acidosis
  • Inc RR
  • Inc Hbg
  • Exertional Dyspnea
  • Clubbing
59
Q

Chronic bronchitis can lead to

A
  • Cardiac enlargement
  • Use of Accessory Muscles to breathe
  • right-sided heart failure
60
Q

Define Emphysema

A

It is an overinflation of the alveoli which inhibits gas exchange

61
Q

What are some characteristics of emphysema?

A
  • CO2 retention
  • Pursed lip breathing
  • Orthopneic
  • Barrel chest
  • Exertional dyspnea
  • Prolonged expiration
  • Speaks in bursts as breath allows
  • Anxious
  • tri-pod stance common
62
Q

COPD shares symptoms with _____ and _____ as they are components of COPD.

A

emphysema and chronic broncitis

63
Q

What is the order of physical assessment for respiratory ailments?

A
  • Inspection
  • Palpation
  • Percussion (advanced practice only)
  • Auscultation
64
Q

What are we assessing during Inspection?

A
  • Skin and mucous membranes
  • LOC
  • Breathing patterns
  • Chest wall movement
65
Q

What are we assessing during Paplation?

A

Pulses at chest, feet, and legs.

66
Q

What are we assessing during Percussion?

A
  • Presence of abnormal fluid/air
  • Diaphragmatic excursion
67
Q

What are we assessing during Auscultation?

A
  • Normal and abnormal heart and lung sounds
68
Q

What are the Nursing Responsibilities for physical assessment in oxygenation issues?

A
  • Lung auscultation and breathing pattern
  • Abdominal use in breathing
  • Urine output
  • Skin and mucous membranes
  • Heart souns
  • Circulation
  • Edema
  • DVT
69
Q

What are the three oxygen delivery devices?

A
  1. Nasal cannula
  2. Simple face mask
  3. Venturi mask
70
Q

What is the volume of oxygen that can be delivered via nasal cannula?

A

1-6 Liters

71
Q

What is the volume of oxygen that can be delivered via a simple face mask?

A

5-8 Liters

(can go over 8, but O2 would stay at 60% max)

72
Q

What is the volume of oxygen that can be delivered via a venturi mask?

A

4-12 Liters

(Can go up to 15L for 100% O2)

73
Q

What are four advantages to nasal cannula?

A
  1. Safe and simple
  2. Easily tolerated
  3. Does not impede eating or talking
  4. Inexpensive and disposable
74
Q

What is an advantage of a simple face mask?

A

Provides humidified oxygen automaticaly due to higher delivery rate

75
Q

Advantage of the Venturi mask?

A
  • most accurate
  • allows control for a specified oxygen concentration
76
Q

Disadvantage of the nasal cannula?

A
  • can dry out mucus membranes
  • will require order for humidified O2

z_NUR112: MIDTERM_NOTES (14 decks)

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