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Med Surg > Oxygen Therapy > Flashcards

Oxygen Therapy Flashcards

1
Q

Oxygen Therapy Purpose

A

relieves hypoxemia and hypoxia

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2
Q

Hypoxemia

A

low levels of oxygen in the blood

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3
Q

Hypoxia

A

decreased tissue oxygenation

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4
Q

Oxygen Therapy Goal

A

use lowest fraction of inspired oxygen for acceptable blood oxygen level without causing harmful side effects

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5
Q

ABG analysis

A

an ABG sample reports the status of oxygenation and acid-base balance in the blood
-need to go on ice and brought to the lab immediately

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6
Q

Capnography

A

the measurement of carbon dioxide in a pts exhaled breath over time. Monitors the Waves
-looks like a thick nasal cannula

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6
Q

Capnography

A

the measurement of carbon dioxide in a pts exhaled breath over time. Monitors the Waves
-looks like a thick nasal cannula

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7
Q

Oxygen Therapy: Interventions-Take Action

A

-Recognize: oxygen hazard
-Check: perscription
-Use: humidification if delivered at 4L/min or > (too make sure pt doesn’t get to dry)
-Check: skin for pressure points
-Provide: mouth care; lubricate nostrils, face, lips
-Clean: cannula, mask (soap & water, make sure its dry)
-Collaborate: collaborate with repository therapist

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8
Q

Hazards and Complications of Oxygen Therapy

A

-Combustion
-Oxygen toxicity: concentration of O2 is too much for the pt
-Absorption atelectasis: crackles
-Drying of mucous membranes
-Infection: skin breakdown, dirty mask, humidification can create bacteria

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9
Q

Oxygen Delivery Systems

A

Types used depends on:
-required oxygen concentration
-oxygen concentration that can be achieved by a delivery system
-importance of accuracy and control of the oxygen concentration
-pt comfort
-use of humidity
-pt mobility

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10
Q

Low-Flow Oxygen Delivery Systems

A

-Nasal cannula (1-6L/min)
-Face-mask (simple, partial rebreather, non-rebreather)
-easy to use
-comfortable
-amount of oxygen delivered varies

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11
Q

Nasal Cannula

A

-flow rates of 1-6L/min
-O2 concentration of 24-44%
-flow rate >6L/min does not increase gas exchange because anatomical dead space is full
-often used for chronic lung disease or long-term therapy

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12
Q

Simple Facemask

A

-minimum of 5-8L/min
-deliver O2 up to 40-60% for short-term therapy
-ensure appropriate fit

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12
Q

Partial Rebreather Mask

A

-flow rate 6-11L/min
-60-75% O2
-pt rebreathes one third exhaled tidal
-bag should be slightly inflated with inspiration

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13
Q

Non-Rebreather Mask

A

-maintaining reservoir bag 2/3 full
-delivers highest O2 level (of the low-flow systems)
-can deliver FIO2 greater than 80-95%
-used for unstable pts who may require intubation
-ensure valves are patent and functional
-pt is very unstable, O2 is very low

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14
Q

High-Flow Nasal Cannula

A

-30-60 L/min
-combination of heat and humidity minimizes damage to mucous membranes
-gives the best flow, with adapters

15
Q

Venturi Mask

A

-4-10L/min
-adaptor located between bottom of mask and O2 sources
-24-50%
-pulls in a proportional amount of room air for each liter flow of oxygen
-most accurate concentration without intubating pt

16
Q

T-Piece

A

-delivers desired FIO2 to clients with tracheostomy, laryngectomy, ET tube
-aerosol should appear on exhalation side

17
Q

noninvasive Positive-Pressure Ventilation (NPPV)

A

-uses positive pressure to keep alveoli open, improve gas exchange
-used to manage: dyspnea, hyperbarbia, and acute exacerbations of chronic ovstructive pulmonary disease, pulmonary edema, and acute asthma attacks

18
Q

CPAP (NPPV)

A

delivers a set of positive airway pressure throughout each cycle of inhalation and exhalation

19
Q

Volume-limited or flow-limited (NPPV)

A

delivers a set tidal volume with the pts inspiratory effort

20
Q

BiPAP (NPPV)

A

cycles different pressures at inspiration and expiration

21
Q

Transtracheal Oxygen Delivery (TTO)

A

-long-term delivery of O2 directly into lungs
-small flexible cath is passed into trachea through small incision
-flow rates prescribed for rest, activity

22
Q

Tracheotomy

A

surgical incision into trachea to create an airway to maintain gas exchange

23
Q

Tracheostomy

A

stoma (opening) that results from tracheotomy

24
Q

Tracheostomy Complications

A

-tube obstruction
-tube dislodgment and accidental decannulation
-pneumothorax
-subq emphysema
-bleeding
-infection

25
Q

Preventing Tissue injury: Tracheostomy

A

-tissue injury can occur where the inflated cuff presses against the tracheal mucose
-inflate the cuff to form a seal between the trachea and the cuff using the least amount of pressure
-*check the cuff pressure once a shift

26
Q

Ensuring Air Warming and Humidification: Tracheostomy

A

-if humidification and warming are not adequate, tracheal damage can occur
-inadequate humidity causes thick, dry secretions to occlude the airway and increase the risk of infection

27
Q

Suctioning: Tracheostomy

A

-suctioning maintains a patent airway and promotes gas exchange
-consider best practices for airway suctioning
-preoxygenation pt 3-5 minutes before suctioning
-never suction more than 10-15 seconds
-after, oxygenate pt
-continue as needed for 3 passes

28
Q

Providing Tracheostomy Care: Assess

A

-assess for cyanosis
-check O2 sat
-assess the trach site
-assess skin around the tracheostomy and neck
-auscultate lung sounds

29
Q

Providing Tracheostomy Care: Secure

A

-secure using twill tape ties or commercial tube holders
-change devices when soiled or at least daily to keep clean, prevent infection, and assess tissue integrity under ties

30
Q

Providing Bronchial and Oral Hygiene

A

-turn/ reposition q1-2 hrs, support out-of-bed activities, encourage early ambulation
-coughing and deep breathing, chest percussion, vibration, and postural drainage promote pulmonary hygiene
-avoid glycerin swabs or mouthwash containing alcohol for oral care, use sponge tooth cleaner or soft-bristle toothbrush moistened in water

31
Q

Ensuring Nutrition

A

-swallowing can be difficult
-teach pt to keep head of bed elevated for at least 30 min after eating
-small frequent meals
-while eating cuff can be partially deflated, small/ slow bites
-position upright while eating

32
Q

Maintaining Communication

A

-writing tablets
-board w/ pictures and letters
-flashcards
-hand signals
-smartphone
-phrase questions with yes/no answers
-mark central call light to indicate pt cannot speak
-SLP

33
Q

Supporting Psychosocial Needs and Self-Esteem: Trach

A

-acknowledge frustration
-use a normal tone of voice
-provide social contact
-allow sufficient time for communication
-address changes in self-image

34
Q

Weaning Trach

A

-gradual decrease in tube size; ultimate removal of tube
-cuff is deflated when the pt can mange secretions; does not need assisted ventilation
-change from cuffed to uncuffed tube
-capping
-tracheostomy button

35
Q

Tracheostomy: Care Coordination and Transition Management

A

-pt should be able to provide self-care
–Teach
-trach tube care
-shower shield
-cover loosely with small cotton cloth during the day
-increase home humidity
-wear a medical alert bracelet
-follow-up w/ ptovider

Med Surg (12 decks)

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