Oxygen/Trach/Respiratory Assessment Flashcards
PaO2 range
80-100 mmHg
pH range
7.35-7.45
PaCO2 range
35-45 mmHg
HCO3 range
22-26 mEq/L
Respiratory acidosis
results when respiratory function is impaired and causes retention of CO2
Conditions that result in Respiratory acidosis
respiratory depression due to anesthetics
electrolyte imbalance
inadequate chest expansion
airway obstruction
reduced alveolar capillary diffusion
treatment for respiratory acidosis
focus on improving ventilation and oxygenation and maintaining a patent airway
metabolic acidosis
state of excess acid or reduced base bicarbonate in the body
conditions that result in metabolic acidosis
excessive oxidation of fatty acids
hyper metabolism
excessive ingestion of acids
kidney failure
pancreatitis, liver failure, or dehydration
diarrhea
treatment for metabolic acidosis
focused on hydration and drugs or treatments to control the problem causing the acidosis: IV sodium bicarbonate
Respiratory alkalosis
caused by an excessive loss of CO2 through hyperventilation
conditions that result in respiratory alkalosis
fear, anxiety, mechanical ventilation, salicylate toxicity, high altitudes, shock, early stage acute pulmonary problems
treatment for respiratory alkalosis
correct the underlying cause; if due to hyperventilation/anxiety and panic attack- instruct breathing exercises.
metabolic alkalosis
caused by either an increase of bases (base excess) or a decrease of acids (acid deficit)
conditions that result in metabolic alkalosis
increase of base components (oral ingestion of antacids, blood transfusion, sodium bicarbonate, TPN)
treatment of metabolic alkalosis
correct underlying cause
non invasive positive airway pressure
uses positive pressure to keep alveoli open and improve gas exchange
uses a tightly fitting mask around nose or nose and mouth
can be with or without oxygen
indications for non invasive positive airway pressure
sleep apnea
hypercarbia (increase of CO2 in blood stream)
acute COPD
manage acute dyspnea
pulmonary edema
CPAP
continuous positive airway pressure
one set pressure or volume is delivered with each cycle of inhalation/exhalation
BiPAP
bi-level positive airway pressure
different pressure is set for inhalation and exhalation
Nursing consideration for non invasive positive airway pressure
ensure mask has an adequate seal, monitor for skin breakdown, monitor for vomiting/aspiration
transtracheal oxygen
oxygen delivered through a small flexible catheter that is places in the trachea through a small incision
used for patients with long term O2 needs
avoids irritation that nasal prongs cause
typically require less O2 when delivered in this method
tracheotomy
surgical incision into trachea for purpose of establishing an airway
tracheostomy
stoma that results from tracheotomy
may be temporary or permanent