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NS371—Fundamentals of Nursing > Oxygenation > Flashcards

Oxygenation Flashcards

(105 cards)

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1
Q

why does older age affect resp function?

A

chest becomes less elastic
air exchange decreases
cough reflex decreases
mucous membranes become drier
immune system weakens
more GI reflux disease, more at risk for aspiration

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2
Q

stone blasters can get…

A

silicosis

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3
Q

coal miners can get…

A

black lung disease, anthracosis

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4
Q

sedentary pts lungs have…

A

lack of expansion

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5
Q

drugs c effects on resp

A

sedatives or hypnotics
antianxiety drugs

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6
Q

how does stress affect resp

A

can cause hyperventilation - causes arterial blood O2 to rise and CO2 to fall - tingling, numbness, lightheadedness

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7
Q

when hyperventilating, tell pt…

A

breathe into your hands to keep more CO2

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8
Q

respiratory center

A

pons
medulla oblongata

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9
Q

chemoreceptors respond to…

A

blood H+ concentration

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10
Q

Increased ___ most strongly affects stimulation of respiration

A

CO2

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11
Q

hypoxic drive

A

lack of O2 affects respiration more stongly than CO2

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12
Q

4 ways respiration can be altered

A

Patency
Movement of air into & out of lungs
Diffusion of resp. gases
Transport of resp. gases to and from tissues via blood

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13
Q

extreme inspiratory effort c no chest movement

A

completely obstructed airway

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14
Q

potential causes of completely obstructed airway

A

anaphylaxis
burned airway

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15
Q

hypoxemia compensated for by…

A

increased HR & cardiac output

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16
Q

s/s hypoxia

A

rapid HR; rapid shallow respirations; dyspnea; restlessness or lightheadedness; flaring of nares; substernal of intercostal retractions

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17
Q

interventions for cyanosis

A

put nasal cannula c oxygen on s order - then call physician

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18
Q

elements of physical respiratory assessment

A

Rate, depth, quality, rhythm of respirations
Inspect variations of shape of thorax

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19
Q

examples of resp diagnostics

A

Sputum specimens
Throat cultures
Visualization procedures (imaging)
Venous & arterial blood specimens
Pulmonary function tests

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20
Q

pt risks/problems with breathing problems

A

skin and tissue breakdown
syncope
acid-base imbalances
feeling of hopelessness
social isolation

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21
Q

implementations for nurses - resp problems

A

promoting oxygenation
educating pt about coughing/respiration
encouraging deep breathing/coughing
pt hydration
medications

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22
Q

how to promote oxygenation

A

position pt for maximum chest expansion
encourage or provide frequent position changes
encourage deep breathing & coughing
encourage ambulation
implement comfort meastures

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23
Q

how does ambulation help breathing?

A

breaks up mucus

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24
Q

huff coughing

A

pt leans forward and exhales sharply with huff sound during mid-exhalation

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25
pursed lip coughing
pt breathes normally through nose, then exhale with pursed lips slowly while tightening abdominal muscles to assist c exhalation
26
how much fluid for resp issues?
as much as pt can tolerate
27
why is hydration important for resp issues?
thins secretions when dehydrated, secretions become tenacious
28
pt use this med first, and then this
bronchodilator anti-inflammatory inhaler
29
break up mucus, making it easier to expectorate sputum
expectorants
30
expectorant example
gauifenesin
31
postural drainage position
prone - pillows under abdomen
32
pt spends ____ in postural drainage
20 mins
33
exercises used on pts in postural drainage
percussion vibration
34
cupped hands - tap pt’s back quickly, firmly
percussion technique
35
hands like in CPR - send fine vibrations on pt’s back - when pt exhales, not inhales - give pt commands of when to inhale/exhale
vibration technique
36
nurse may initiate O2 s an order when?
emergency - then call PCP
37
usually low-liter, low flow - no humidifier
portable wall unit
38
when using O2, pts should wear...
cotton
39
Delivers low concentration - 25% to 45% O2 - flow rate from 2-6 L/min
nasal cannula
40
pts with nasal cannula may need ___ to prevent skin breakdown
padding behind ears
41
Stores O2 & delivers 100% O2 Humidification not necessary
reservoir cannula
42
Covers nose & mouth Delivers 35% to 65% O2 - flow rate 8-12 L/min Exhalation ports on side of mask
simple face mask
43
Prevents CO2 buildup - prevents RA and expired air from entering bag Delivers highest concentration - 60% to 100%
nonrebreather mask
44
nonrebreather mask must not...
totally deflate during inspiration
45
Wide bore tube c color coded jet adapters corresponding to O2 sat
Venturi mask
46
blue venturi mask
24% @ 4 L/min
47
green venturi mask
35% @ 8 L/min
48
sleep apnea
upper airway obstruction \>10 seconds during sleep
49
Sleep apnea Continuous positive airway pressure
CPAP
50
risk factors sleep apnea
Male Obesity \>40 yo
51
CPAP variation
BIPAP - pressure delivered during exhalation & is less than inhalation
52
Oropharyngeal airway for... Nasopharyngeal airway for...
unconscious pts alert pts c gag reflex
53
Commonly used in surgery & emergency Only inserted by anesthesiologist, CRNA, respiratory therapist, physician Inserted in mouth or nose Pt is unable to speak - tubes pass through epiglottis & glottis
endotracheal tube
54
inserted surgically in neck
tracheotomy tube
55
stoma
surgical opening
56
guide for trach tube
obturator
57
when inflated, provides even pressure against trachea - less pressure causes less necrosis
balloon
58
\_\_\_\_\_\_\_\_ trach tubes allow talking
fenestrated
59
\_\_\_\_\_\_ trach tubes have airtight seal
cuffed
60
initially trachs must be cleaned...
q1-2h
61
heat & moisture exchange device for trach
artifical nose
62
suction for removing thick mucus plugs
open tipped
63
less irritating suction
whistle tipped
64
suctions oral cavity (like at the dentist)
Yankauer
65
reason for trach suctioning
inability to cough up and expectorate secretions
66
during suctioning, always assessing for...
respiratory distress (dyspnea, poor skin color, bubbling or rattling breath sounds, decreased O2 sat)
67
potential complications of trach suction
hypoxemia, trauma to airway, nosocomial infections, cardiac dysrhythmia
68
how to decrease trach suction complications
suctioning only as needed using sterile technique do not instill saline hyperinflation of pt (3-6 breaths) before and after suctioning hyperoxygenation gently rotating catheter, withdraw while suctioning, suctioning for 5-10 seconds only
69
positions for trach suction
Fowler's when pt conscious lateral when pt unconscious
70
after suction let pt recover for at least...
30 seconds
71
full respiratory before & after...
trach care trach suction
72
T/F once the inner cannula is back in the pt after cleaning, you don't have to use sterile technique anymore
true
73
when tying trach knot, do not tie over...
carotid artery
74
be able to fit ____ fingers beneath trach ties
1-2
75
accumulation of air in pleural space
pneumothorax
76
blood in pleural space
hemothorax
77
excessive fluid in pleural space
pleural effusion
78
location difference between pneumothorax tube and hemothorax tube
Pneumothorax tube - upper chest Hemothorax tube - lower chest
79
function of disposable drainage system
drains fluid from thorax
80
controls amt of suction according to amt of water in chamber
suction control chamber
81
keeps air from moving backwards through system
water seal chamber
82
collects fluids from pt's chest
closed collection system
83
disposable drainage system has to be kept lower than...
pt's chest
84
One way flutter valve - air can escape from chest cavity, but not back in
Heimlich chest drain valve
85
chest drain for ambulatory pts
Heimlich chest drain valve
86
check chest drain dressings every... resposition pt every...
4 hr 2 hr
87
what should nurse do for chest drain pts to maintain ROM?
Assist c ROM on affected shoulder 3x/day
88
if chest drainage tube is disconnected...
submerge end in 1 inch of water/saline
89
if chest drainage tube comes out...
cover c dry sterile dressing
90
prior to chest tube removal...
give pt pain meds as ordered - it is brief but painful
91
nasal cannula
92
reservoir cannula
93
simple face mask
94
nonrebreather mask
95
venturi mask
96
CPAP
97
endotracheal tube
98
tracheostomy tube
99
disposable drainage system
100
Heimlich chest drain valve
101
improve ventilation; counteract effects of anesthetia or hypoventilation; loosen secretions; facilitate gas exchange; expand collapsed alveoli
incentive spirometers
102
spirometers mimic...
natural sighing/yawning
103
spirometers encourage pt to take...
long, slow, deep breaths
104
2 types of incentive spirometers
Flow-oriented - uses plastic balls that rise as pt inhales Volume-oriented - measures inhalation volume
105
spirometer instructions for patients
Take in a slow, deep breath - hold for 2 seconds at first, and work up to 6 Try to make the balls rise as slowly as possible Exhale after removing mouthpiece Cough to expel loosened secretions Take several normal breaths between spirometer use Repeat process 4-5 times hourly

NS371—Fundamentals of Nursing (12 decks)

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