Oxygenatio And Gatric Intubation Flashcards

(62 cards)

1
Q

How much oxygen are we administering on room air/ various mask

A

Room air= RA=21%
Nasal cannula=NC= 1-6 liters. 24%-44%
Face mask= 5-8 liters
Venturi mask=4-10 liters 24%- 55% incorporates room air, not used w/cannula Can dial FiO2
Non- rebreather=6-15 liters 70%-100% high quality O2

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2
Q

If Tracy tube is dislodged

A

Grab retention sutures, spread the opening

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3
Q

How often should we check nares and cannula prongs

A

Observe nares and cannula prongs at least once per shift for irritation and breakage

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4
Q

What type of lubricant to use on nares

A

Water soluble

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5
Q

Oxygen administration

A
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6
Q

Timing for suctioning

A

10 seconds or less/ oxygenate for 30 seconds beforehand

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7
Q

Oral suctioning w/Yankauer catherer

A

Used for cleaning the mouth
One time usage
Don clean gloves
Gently and search tip of the suction catheter into one side of the mouth and glide it toward The oropharynx without suction move the catheter around the mouth until secretions are cleared
Encourage the patient to cough
Rinse tip until connecting tube is cleared of secretions
Repeat as necessary

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8
Q

Nasopharyngeal suctioning

A

Be sure nose is unobstructed
Open suction catheter kit don
Mark correct length for insertion
Lubricate catheter w/water soluble jelly or dip tip into sterile saline
Gently insert catheter into one side of nasal passages
Limit suctioning to 10-15 seconds

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9
Q

Endotracheal intubation

A

Tube inserted thru pt mouth and into upper airway to provide a patent airway
O2 given thru this tube via O2 setup/ventilator
Suctioning can be done thru ET tube
ET tubes are usd for short term management of airway
Used for pt undergoing anesthesia
Used in emergency situation to provide an airway
Replaced by tracheotomy if artificial airway is needed for more than 2 weeks
If more than 14 days pt may experience tissue damage/vocal cord damage

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10
Q

Tracheostomy

A

Artificial opening/ surgical incision
For pts experiencing apnea/some form of Respiratory obstruction
Can also be used to prevent aspirations of secretions and blood

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11
Q

Nursing responsibilities for tracheostomy

A

Keep the airway clear
Keep the inner cannula clean
Prevent impairment of surrounding tissue
Provide the patient with a means of communication

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12
Q

Tracheostomy suctioning and care (1)

A
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13
Q

Tracheostomy

A
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14
Q

Tracheostomy suctioning and care (2)

A
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15
Q

Tracheostomy suctioning and care (3)

A
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16
Q

Tracheostomy suctioning and care (4)

A
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17
Q

Tracheostomy suctioning frequency

A

Suction as often as necessary
Pt can indicate a need for suctioning

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18
Q

Cuffed tracheostomy

A

Used for mechanical ventilation

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19
Q

Care of cuffed tracheostomy

A
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20
Q

T tube/ tracheostomy collar

A
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21
Q

Ch 15 elimination n gastric intubation standard steps before and after

A
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22
Q

Simple straight catheter

A

Drain bladder And remove

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23
Q

Bladder training

A

Voluntary control over voiding
Kegel exercise-tightening the muscles of the perineum
Muscle control develops gradually (4 to 6 wks)
Habit training q 1.5 to 2 hours
 schedule avoiding times to correlate with patients activities
Typical voiding times are upon rising before each meal and at bedtime

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24
Q

Stress Incontinence

A

Small leakage of urine win the person laughs coughs or lifts something heavy
Usually caused by a weak sphincter

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25
Urge incontinencex
Constant leakage whenever the bladder contains urine Overactive bladder
26
Incontinent skin
Urine and feces are very irritating to the skin to help prevent skin impairment make sure to change the undergarments or under pads frequently cleanse the skin thoroughly after each episode of incontinence with warm soapy water and dry completely it is important that the patient is not meant to feel as though they are a burden
27
Indwelling catheter (foley)
Stays in Balloon keeps them in place
28
Nasotracheal suctioning
29
Transtracheal oxygen delivery
A method of oxygen delivery for the patient with a tracheostomy is the tracheal catheter which is inserted directly into the trachea between the second and third tracheal cartilages how much transtracheal catheter does not interfere with drinking eating or talking oxygen is delivered throughout the entire Respitory cycle 1-2 L
30
Obturator
Used when changing inner cannula of trach
31
Ostomy irrigation
Hey colostomy irrigation requires special equipment attach a tone to tubing lubricate the con insert the con into the stoma do a top of sleeve do not force the cone into the stoma. Use gentle pressure to hold a tip and place in stoma why are you hold con in place allow solution to flow slowly into the: patient complains of cramping stop flow without removing a call it’s so cramps subside instruct patient to sit about 15 to 20 minutes while we train solution flows into toilet Patient cannot sit this long it is acceptable to close the end of the irrigation sleeve with a clamp and allow the patient to be up and walking drain sleeve rinse and remove it I was very patient and results of irrigation ash toilet perform colostomy care document. From step 7
32
Performing ostomy care (1)
33
Performing ostomy care (2)
34
Nursing skills
Be organized Teaching Safety Efficiency Standard steps- before during and after
35
Amount of time for suctioning
15 seconds /oxygenate for 30 seconds beforehand
36
Timing for suctioning
15 seconds
37
Trach collar
Mask for someone who has a trach No ventilator
38
Colostomy Care products
Paper tape Barrier paste Basin w/ warm water Bedpan or trash bag Clean gloves measuring guide Pouch clamp. Scissors Skin sealant wipes Washcloth(or disposable)
39
Nasogastric tube. Other types of NG tubes-PEG tube (percutaneous endoscopic gastronomy) or G-tube
Hollow tube passed into stomach via the nasopharynx Used to remove gas fluids or toxic substances from stomach one to administer fluids and nutrients into the stomach Can help to prevent vomiting
40
Gastric Gavage
NG tube can be attached to a feeding pump or feeding can flow in by gravity via bag/ syringe Slow and gradual to prevent dumping syndrome (caused by rapid infusion) Verify placement of tube
41
Gastric lavage
Used in cases of poisoning Room temp meds instilled in stomach and then suctioned out Repeated until ordered amt of solution is used Removed solution must be evaluated and documented
42
Enemas (1)
Can be pre filled and let lubricated Introduction of solution into the colon the defecation of patient with constipation Various reasons cleansing colon before surgery or abdominal surgery or fecal impaction .
43
Enema (2)
44
Hemorrhoids
Swollen inflamed veins in anus and lower rectum Can result from straining during bowel movements/pregnancy Goal is to decrease pain, prevent elimination problems, prevent further damage Maintain high fiber diet adequate fluid intake Use lubricate for any insertion
45
Urostomy care
Bladder removed
46
Flatulence
The presence of air or gas in the intestinal track typically occurs in person consumes Gas producing liquids and food or decreased peristalsis Many cause distention of stomach and abdomen
47
Hypoxic drive
Pts with COPD Respiratory effort driven by hypoxia. Give O2 w/caution (2liters)
48
Signs and symptoms of hypoxia
49
Why ausculatae lung sounds
To verify adequate oxygenation and patency of the airway
50
Oxymizer
Similar to nasal cannula in delivery collects and conserves oxygen allowing higher percent of oxygen to be delivered can be set as high as 15 liters
51
What is tracheostomy
An artificial opening in trachea
52
Primary responsibility for Trach care
Minimize infection risk by evaluating the patient for excess secretions suction as often as necessary provide constant airway humidification change or clean respiratory therapy equipment every eight hours Remove water that condenses in equipment tubing provides frequent mouth care apply moisturizing agents to the dry cracked lips Maintain nutritional levels Patients with a tracheostomy may drink fluids and eat once the initial healing phase of the new tracheostomy has passed
53
Endotracheal tube
Tube inserted thru mouth and into upper airway to provide a patent airway O2 is administered via ET tube via oxygen setup or ventilator Pt with ET tube are allowed nothing by mouth It is necessary to provide parenteral or enteral nourishment Suctioning can be performed thru ET tube Used for emergency/short term
54
T tube/Trach collar
Attached to Trach to deliver to deliver oxygen or moisture It is T shaped the collar covers open end of the tracheostomy tube and has adjustable strap that extends around the neck
55
Urinary catheters
used for treatment and diagnosis used to maintain urinary flow, to divert urine flow to facilitate healing after surgery and to introduce medication to dilate or prevent narrowing of some portions of the urinary track used for intermittent and continuous urinary drainage *****Can be placed in the bladder ureter or the kidney
56
Nursing interventions for a patient with urinary drainage system
Check for infection and trauma follow aseptic technique when inserting a catheter keep collection bag off of the floor Record fluid intake and urinary output check drainage system for proper placement and function regularly encourage patient to drink plenty of fluids to flush the urinary tract do not open drainage system after it is in place unless there is a drs order open irrigation of the catheter as necessary and then only with an order from the doctor
57
Catheter care
Patient with a Catheter iS especially vulnerable to urinary tract infections encourage oral fluid intake of at least 2000 mL a day Have patient ambulate‘s if possible to facilitate urine flow Avoid kinks or compression of the drainage tube to prevent pooling of urine Teach signs and symptoms of urinary track infection which are urgency frequency hesitancy burning sensation bladder spasms Patient should receive routine catheter care and perineal hygiene at least two times per day to prevent urinary track infection
58
Gastric decompression
The purpose of gastric decompression is to remove the air and fluids that build up when gastrointestinal motility is slowed It is used frequently after surgery to help with distention that may occur and to prevent nausea and vomiting
59
Removal of nasogastric tube
Assemble equipment reassure patient that nasogastric tube removal is less distressing than insertion evaluate patient’s abdomen for bowel sounds evaluate patient’s nasal and oral cavity if tube is attached to suction turn off suction and disconnect tubing place towel or waterproof pad across patients chess instruct patient to take deep breath and hold it pinch tube with fingers or clamp place tubing in a plastic bag provide oral and nasal care position patient for comfort dispose of tube and equipment measure drainage and characteristics of drainage inspect condition of nares and oral cavity document any abnormalities
60
Ostomy
An artificial opening The site of the opening is called a stoma Ostomies can be created because of trauma to the intestine, severe inflammation or diseases they can be temporary or permanent is it dependent on the reason they are present
61
Bowel elimination
Elimination of bowel where is defecation is a basic human needs and is essential for normal body function Paul elimination depends on several factors A balanced diet including high fiber foods daily fluid intake 2000 to 3000 mL and activity Every patient should have a bowel movement at least every 1 to 3 days Give patients as much privacy as possible avoid continually checking on the patient
62
Self catheterization
for a patient who has a spinal cord injuries or other neurological disorders that interfere with urinary elimination promote independence for the patient Clean technique can be use rather than sterile technique at home