Nursing Respiratory Patient

Question 1

How would you assess the respiratory function of a patient?

Answer 1

1. RR and Effort ( is air moving in and out of the lungs?)
   - observe
   - auscultation
2. Oxygenation ( how well is it oxygenating the tissues)
   - MM colour
   - pulse ox
   - arterial blood gas
   - capnograph

Question 2

What are the aims of respiratory therapy?

Answer 2

• increase oxygen saturation of blood and tissues

- decrease respiratory effort

Question 3

What nursing interventions can we do to lower respiratory effort and increase oxygenation?

Answer 3

• o2 therapy
• minimise stress
• control temperature
• minimal handling
• IV cannulisation if emergency
• bed baths/suction to ease breathing
• coupage and nebulisation
• oral MM care

Question 4

What the pros and cons of flow by o2?

Answer 4

+ no restraint
+ stress-free
- wastes oxygen

Question 5

What are the pros and cons of mask oxygenation?

Answer 5

+ good oxygen saturation to patient
+ good for non-responsive patients
- cannot see or evaluate face
- stressful

Question 6

What are the pros and cons of using nasal prongs or cannula?

Answer 6

\+ patient can be mobile
\+ generally well-tolerated
\+ Good saturation and good control 
- Need local anaesthetic for cannula
- May irritate nasal cavity or dry it out

Question 7

What are the pros and cons of using an oxygen cage/tent/incubator?

Answer 7

+ incubator has heating ability which is good for small furries

• tents can get humid and warm
• opening doors can cause massive loss of oxygen

Question 8

What are the pros and cons of intubation +/- ventilation?

Answer 8

+ can induce and manage respiratory function better under GA
+ Measurable oxygen delivery straight to lungs
+ can put humidifier into system to help maintain lung function
- need to be anaesthetised/unconscious

Question 9

When would you use a tracheostomy?

Answer 9

When there is some sort of obstruction

Question 10

What position should be avoided in dyspnoeic patients ?

Answer 10

Dorsal recumbency

Question 11

If oxygenating a patient for more than 2 ours, what is required?

Answer 11

Humidifier to prevent drying of oral mucosa

Question 12

What can occur if a patient is on oxygen for more than 12 hours?

Answer 12

Oxygen toxicity

Question 13

What can be done to avoid oxygen toxicity?

Answer 13

Start at 100% oxygen, when the patient is back to normal, lower the oxygen until it has a negative impact on the patient. Then turn back up slightly - this is the minimum - keep on this and continue monitoring

Question 14

What is atelectasis?

Answer 14

When the alveoli fill up with fluid. Low intensity mobilisation should help this, as will neb and coupage.

Question 15

How can we evaluate a respiratory patient and its progress?

Answer 15

• SPO2 >95%
• Normal MM colour
• reduction of RR and effort
• reduction of any paradoxical breathing