O2 & Health Promotion

Question 1

What should patients know about screenings for cancer?

Answer 1

(Breast/testicular/skin for farmers)

Monthly self-exam
Yearly mammogram

Question 2

Medication hx

Answer 2

Nurses do this as part of admission. The first part of assessing a client’s regimen & compliance.

Question 3

Effect of stress on blood glucose

Answer 3

Blood glucose rises w/increased stress.

Question 4

Considerations for Home oxygen use

Answer 4

Monitor for ear/nare skin breakdown.
O2 concentrator must be plugged into a grounded outlet.
Secure O2 tank in a holder away from sunlight/heat/open flame.
Use short tubing (long=fall risk!).

Question 5

O2 delivery systems

Answer 5

LF nasal cannula: 1-6L
HF nasal cannula: 10-15L (60L is max)
Simple mask: 5-8L
HF Venturi: 4-6L
Exact delivery amount
Non rebreather: 10-15L

Question 6

CPAP vs BiPAP

Answer 6

Keeps airways open. MUST clean to prevent respiratory infections.

C: 1 pressure
B: 2 pressures for inhale & exhale

Question 7

Endotracheal tube

Answer 7

Temp airway through nose or mouth. Used to suction secretions or bypass airway obstructions.
O2 delivered w/mechanical ventilation.
Monitor cuff pressure.

Question 8

Tracheostomy

Answer 8

Long-term airway.
2nd-3rd ring of trachea.
Mechanical ventilation.
Monitor cuff pressure to prevent trachea damage.
Clean to prevent respiratory infections.

Question 9

Ventilator

Answer 9

In ICU
Gives o2 for tracheostomy or endotracheal tube.
Oral care!!! - to prevent resp infection

Question 10

What must you know before giving patient more than 2L of O2?

Answer 10

If they have a hx of COPD.

COPD body is used to lots of co2 in the blood. The O2 in the blood triggers ventilation (not co2 like normal). Body will stop breathing and die if they are given too much o2.

Question 11

What part of the brain controls breathing & heartbeat?

Answer 11

The brain stem (medulla).

Question 12

Signs of hypoxia

Answer 12

Dyspnea
ALOC
Anxiety
High BP
High RR & HR
Pallor, restless

Question 13

Risks of altered cardiopulmonary fx

Answer 13

Congestive Heart Failure (CHF)
Obesity
Asthma

Question 14

Infants + premi respiration

Answer 14

Infants: alveoli are closed w/secretions when born.
Short lungs = high RR.
High risk of aspiration bc of short airways.
Premi babies don’t develop surfactant, so it’s difficult to get good oxygenation. Can give synthetic surfactant to reopen alveoli.
Normal to hear crackles at end of deep respiration.

Question 15

Respiratory: school-age kids

Answer 15

Freq. respiratory infections.
High risk of asthma (microorganisms or 2nd-hand smoke).
Encourage tissue/hygiene.

Question 16

Respiratory: older adults

Answer 16

Rigid airways/tissues & less efficient diaphragm.
V high risk of pneumonia.
Kyphosis.
Barrel chest from COPD/smoking: increased anteroposterior diameter.

Question 17

Abnormal things to promote respiratory fx

Answer 17

Reduce anxiety
Eat good nutrition
Coughing
Chest physiotherapy
Breathe out with pursed lips (lower RR & the pressure will open alveoli)

Question 18

Degrees of semi- & fowlers position

Answer 18

Semi: 15-45
F: 45-60

Question 19

Airway suctioning

Answer 19

Invasive & can introduce bacteria.

Also removes o2 which can cause hypoxia — so must preoxygenate patient before suctioning, and sometimes after. And stop every 10-15sec to allow breathing.

Question 20

Peak expiratory flow rate

Answer 20

Highest flow during forced exhale. Measures the severity of asthma disease.

Question 21

Capnography

Answer 21

End tidal co2 content of exhale. Assess the risk of respiratory compromise with ventilation/artificial airways.

Question 22

Thoracentesis

Answer 22

Surgical asepsis.
MD punctures chest wall with needle to aspirate air of pleural fluid for culture or to remove excess air/fluid.

Question 23

How often & with what do you do oral care on ventilated patients?

Answer 23

Every 2 hours
With chlorhexidine (antiseptic)

Mouth can dry out, get cracks, can cause infection (VAPnumonia)

Question 24

What diseases can poor oral care cause?

Answer 24

Cardiovascular (endocarditis)
Respiratory (especially pneumonia)

Question 25

What are the steps for developing an exercise plan?

Answer 25

Get MD clearance
Assess patient goals & ability
Tailor
Follow-up!