Oxygen Delivery QUIZ Answers Flashcards by Ebby K

What is the normal respiratory rate for an adult?

12-20 BREATHS PER MINUTE - up to 26 for older adult

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What do you assess for breathing pattern?

a. __Eupnea_______
b. __Tachypnea_____
c. __Bradypnea_____
d. __Dyspnea_______
e. __Orthopnea_____
f. __Apnea_______

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What do you assess for respiratory effort?

d. __Grunting_______________
b. __Retractions_____________
c. __Accessory muscle use_____
a. __Nasal flarring___________
f. __Conversational dyspnea___
e. __Orthopnia______________
g. __Body position

GRAN-COB

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What are signs and symptoms of respiratory distress?

a. Tachypnea
f. Acute Restlessness
g. Anxiety/agitation
h. Accessory muscle use
b. Nasal Flarring
d. SOB/Dyspnea
c. Pulse Oxy <90%
e. Cyanosis
i. Capillary refill >3

T-AAA-N-SPC-(CAP)

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What Lab values do you assess for respiratory?

ABG & CBC:
WBC, Hemoglobin and Hematocrit, RBC

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What nursing interventions will you perform for a patient in respiratory distress?

a. _HOB 90 degrees or Orthopneic position
b. __Check Pulse Oxy________
c. __Asses resp. rate/pattern/effort
d. __Assess lung sounds_____

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What are early signs and symptoms of hypoxia?

a.___Restlessness_____
b. ___Anxiety/agitation_
c. ___Confusion_______
d. ___Tachypnea/tachycardi

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A nurse can start how many liters of oxygen in an emergency?

2 L

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Nasal cannula delivers low flow oxygen, what are the benefits of this delivery?

a. _Allows Pt. to continue ADL__
b. __Pt. can eat_______________
c. __Pt. can drink ____________
d. __Pt. can talk______________
e. __Portable______________

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What are the disadvantages of oxygen?

Can be drying to nasal mucosa
Dislodges easily
May cause skin breakdown

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Humidification is used when?

___3L or >__________
b. ____Pt c/o dryed mucous membranes

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Nasal cannula delivers what range of L/min and what FiO2?

a. 1 - 6 L/min
b. 20% - 40% FiO2

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Nasal cannula prongs face ___
and wrap around __
then is secured ___

prongs face: Downward
wrap around:Ears
secured: Under the chin

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What can be done for drying of mucous membranes?

a. Humidification of oxygen
b. Water based lubricant (Nasal sprays/drops)
c. Frequent mouth care

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If a patient is a mouth breather what low flow system can be used in place of nasal cannula?

Simple face mask

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A simple face mask delivers what
L/min and FiO2 ?

6-10 L/min
40-60% FiO2

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How is the mask applied?

a. _Bridge of nose___
b. _Cover mouth & chin___
c. Elastic strap over head resting behind & above ears
d. _Ensure snug fit

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Where do you observe for irritation when masks are used?

Behind ears___
b. __Bridge of nose
c. __Face & chin where mask makes contact, esp. moisture_

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What can be used to alleviate pressure behind the ears?

Gauze behind ears

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What is the purpose of the holes on the side of a simple mask?

Allows CO2 to escape and room air enters diluting oxygen delivery

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The partial rebreather delivers
L/ min
FiO2

10-15 L/min
60%-95% FiO2

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What must you do before applying a partial rebreather mask?

a. Connect tubing to flow meter
b. Set enough Liters to partially inflate bag
c. Set ordered flow rate
d. Then place mask over bridge of nose, mouth & chin

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What is the purpose of the reservoir bag on a partial rebreather?

a. Allows for delivery of a higher oxygen concentration
b. On inspiration the patient breathes in oxygen from the bag
c. On expiration some CO2 exits the side vents and some ito the reservoir bag
i. There are no one way valves
1. This causes patient to rebreath some of their own CO2

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Which oxygen delivery system has inspiratory and expiratory valves?

Non-rebreather

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What is the purpose of the inspiratory valve?

When the Pt. breathes in the inspiratory valve lifts allowing for 100% oxygen to enter the mask from the reservoir bag

How does the expiratory valve work?

When the Pt. exhales the expiratory valve opens to allow the CO2 to exit the mask and not enter the bag

What is the FiO2 % for non-rebreather?

_80% - 100%

What is the range for L/min on a non-rebreather?

_10 - 15 L/min

What must you ensure with any rebreather in use?

__That the reservoir bag stays partially inflated__

Although respiratory therapy may set up the non-rebreather, what are you responsible to check?

__That the oxygen is being delivered as ordered - Patient is getting correct amount of Oxygen L/min - Pt is getting correct form of oxygen

If a patient does not improve from a non-rebreather and remains in distress, what is the next steps?

__Intubation__

How long can a patient stay on a non-rebreather?

__1 - 1 ½ hours

Which high flow system decreases the likelihood that a patient will breathe in less room air?

Venturi Mask__

Which patient would benefit the most from a Venturi Mask and why?

COPD Patients,as it delivers a precise amount of oxygen. You don't want COPD patients to lose hypoxic drive to breathe

What must you verify when selecting a Venturi mask valve/adapter?

That it correlates with the physician order, ensures patient is getting the correct specific amount of oxygen

Where can you locate the FiO2 & L/min delivered on a Venturi Mask?

On the valves/adapters

What FiO2 does the Venturi mask deliver?

__ 24-60%_

What is the Liter range for the Venturi Mask?

4 - 12 Liters

Where do you find the number of doses that remain for a MDI?

Look at the dose indicator or on the canister

How many times should you shake the canister prior to delivering?

5-6 times

After delivering 1 puff how long should the patient inhale then hold their breath?

Inhale for 3-5 seconds & hold breath for 10 seconds

If two puffs are ordered how long do you wait to give the same medication?

1 minute

If a bronchodilator and corticosteroid are ordered, which do you give first?

Bronchodilator then the corticosteroid

What are some side effects of bronchodilators?

a. Tachycardia b. Palpitations

What must you instruct the patient to do after inhaling corticosteroids?

Rinse their mouth to prevent candidiasis

How do you instruct or perform cleaning of a spacer?

Disassemble, hand wash the holder, spacer & cap with warm water and a drop of dish soap. Let air dry on a paper towel. Never put in the dishwashe

Nebulizers deliver medication solution in the form of a __________ through the use of an air compressor

Mist

Nebulizers are used on which patients?

a. Asthma b. COPD c. Cystic Fibrosis d. Other respiratory disorders

Where do you instill the medication on a nebulizer?

Into the cup after twisting it off the connector

How do you ensure the patient is and has received all of the medicated solution?

a. Tell patient to keep the cup upright throughout the treatment b. Keep the mouthpiece in their mouth c. Encourage patient to breathe deeply d. Occasionally flick the side of the cup with their fingers to allow condensation to fall back into the cup. e. Continue the treatment until there is no more mis

How do you clean a nebulizer?

a. Remove the mouthpiece, t connector from the cup. Rinse ONLY the mouthpiece and T connector under warm running water, NO SOAP and let air dry . b. DO NOT CLEAN CUP WITH WATER, LET IT AIR DRY. WATER HAS MICROORGANISMS WHICH LOVE MOIST ENVIRONMENTS SO THEY CAN GROW & REPLICATE!

On the wall what is the: - Green - Yellow - Cannister

Green: Oxygen Yellow: Air Cannister: Suction

Why may a Simple Facemask be used over a Nasal Cannula?

If the patient is a mouth breather

How long should a pt be on a rebreather / nonrebreather mask?

1 - 1.5 hours

How do the non-rebreather valves work?

- Mask has inspiratory and expiratory masks - On inspiration, inspiratory valve lifts and allows 100% oxygen to enter mask. Valve closes when inhalation stops - Upon exhalation, the expiratory valves open which allows CO3 to exit mask. Valve closes when exhalation stops.

How does Venturi mask effect amount of O2 being delivered?

- Valve adapter connected to tubing controls specific amount of O2 delivery - Adapter must correlated with PCP order

What should you do if cannister is new or hasn't been used in a while?

Prime cannister away from you

What should you educate the patient on prior to using MDI?

Rinse mouth, decreases amount of bacteria on mouth piece

How to use MDI?

Put cannister in holder, shake 5-6 times Prime away from you Don gloves Have patient rinse mouth Inhale, exhale Put mouth piece in mouth Push cannister down and inhale for 3-5 seconds, hold breath for 10 seconds Slowly exhale

How long to wait between MDI puffs?

1 minute if the same medication 5 minutes if different medications

How to set up a nebulizer?

- Place compressor on solid surface near outlet, pluh it in - Connect air tubing to nebulizer base - Attach mouthpiece and cup to t-shaped connector - Unscrew top from cup, instill correct dose medication, replace top - Turn on nebulizer

What to instruct patient on after setting up nebulizer?

- Keep cup upright throughout treatment - Close mouth tightly around mouthpiece - Breathe deeply throughout treatment (but breathing normally is ok) - Flick side of cup to allow condensation to fall pack into cup - Continue until no more mist

What does FiO2 mean?

Fraction of Inspired Oxygen - estimation of the oxygen content a person inhales

What is in your respiratory assessment?

Rate Rhythm Auscultate for adventitious lung sounds Depth Accessory muscle use Pallor Cyanosis RRADAPC