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NS371—Fundamentals of Nursing > Oxygenation > Flashcards

Oxygenation Flashcards

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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
Q

pursed lip coughing

A

pt breathes normally through nose, then exhale with pursed lips slowly while tightening abdominal muscles to assist c exhalation

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26
Q

how much fluid for resp issues?

A

as much as pt can tolerate

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27
Q

why is hydration important for resp issues?

A

thins secretions
when dehydrated, secretions become tenacious

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28
Q

pt use this med first, and then this

A

bronchodilator
anti-inflammatory inhaler

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29
Q

break up mucus, making it easier to expectorate sputum

A

expectorants

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30
Q

expectorant example

A

gauifenesin

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31
Q

postural drainage position

A

prone - pillows under abdomen

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32
Q

pt spends ____ in postural drainage

A

20 mins

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33
Q

exercises used on pts in postural drainage

A

percussion
vibration

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34
Q

cupped hands - tap pt’s back quickly, firmly

A

percussion technique

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35
Q

hands like in CPR - send fine vibrations on pt’s back - when pt exhales, not inhales - give pt commands of when to inhale/exhale

A

vibration technique

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36
Q

nurse may initiate O2 s an order when?

A

emergency - then call PCP

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37
Q

usually low-liter, low flow - no humidifier

A

portable wall unit

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38
Q

when using O2, pts should wear…

A

cotton

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39
Q

Delivers low concentration - 25% to 45% O2 - flow rate from 2-6 L/min

A

nasal cannula

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40
Q

pts with nasal cannula may need ___ to prevent skin breakdown

A

padding behind ears

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41
Q

Stores O2 & delivers 100% O2
Humidification not necessary

A

reservoir cannula

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42
Q

Covers nose & mouth
Delivers 35% to 65% O2 - flow rate 8-12 L/min
Exhalation ports on side of mask

A

simple face mask

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43
Q

Prevents CO2 buildup - prevents RA and expired air from entering bag
Delivers highest concentration - 60% to 100%

A

nonrebreather mask

44
Q

nonrebreather mask must not…

A

totally deflate during inspiration

45
Q

Wide bore tube c color coded jet adapters corresponding to O2 sat

A

Venturi mask

46
Q

blue venturi mask

A

24% @ 4 L/min

47
Q

green venturi mask

A

35% @ 8 L/min

48
Q

sleep apnea

A

upper airway obstruction >10 seconds during sleep

49
Q

Sleep apnea
Continuous positive airway pressure

A

CPAP

50
Q

risk factors sleep apnea

A

Male
Obesity
>40 yo

51
Q

CPAP variation

A

BIPAP - pressure delivered during exhalation & is less than inhalation

52
Q

Oropharyngeal airway for…
Nasopharyngeal airway for…

A

unconscious pts
alert pts c gag reflex

53
Q

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

A

endotracheal tube

54
Q

inserted surgically in neck

A

tracheotomy tube

55
Q

stoma

A

surgical opening

56
Q

guide for trach tube

A

obturator

57
Q

when inflated, provides even pressure against trachea - less pressure causes less necrosis

A

balloon

58
Q

________ trach tubes allow talking

A

fenestrated

59
Q

______ trach tubes have airtight seal

A

cuffed

60
Q

initially trachs must be cleaned…

A

q1-2h

61
Q

heat & moisture exchange device for trach

A

artifical nose

62
Q

suction for removing thick mucus plugs

A

open tipped

63
Q

less irritating suction

A

whistle tipped

64
Q

suctions oral cavity (like at the dentist)

A

Yankauer

65
Q

reason for trach suctioning

A

inability to cough up and expectorate secretions

66
Q

during suctioning, always assessing for…

A

respiratory distress (dyspnea, poor skin color, bubbling or rattling breath sounds, decreased O2 sat)

67
Q

potential complications of trach suction

A

hypoxemia, trauma to airway, nosocomial infections, cardiac dysrhythmia

68
Q

how to decrease trach suction complications

A

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
Q

positions for trach suction

A

Fowler’s when pt conscious
lateral when pt unconscious

70
Q

after suction let pt recover for at least…

A

30 seconds

71
Q

full respiratory before & after…

A

trach care
trach suction

72
Q

T/F once the inner cannula is back in the pt after cleaning, you don’t have to use sterile technique anymore

A

true

73
Q

when tying trach knot, do not tie over…

A

carotid artery

74
Q

be able to fit ____ fingers beneath trach ties

A

1-2

75
Q

accumulation of air in pleural space

A

pneumothorax

76
Q

blood in pleural space

A

hemothorax

77
Q

excessive fluid in pleural space

A

pleural effusion

78
Q

location difference between pneumothorax tube and hemothorax tube

A

Pneumothorax tube - upper chest
Hemothorax tube - lower chest

79
Q

function of disposable drainage system

A

drains fluid from thorax

80
Q

controls amt of suction according to amt of water in chamber

A

suction control chamber

81
Q

keeps air from moving backwards through system

A

water seal chamber

82
Q

collects fluids from pt’s chest

A

closed collection system

83
Q

disposable drainage system has to be kept lower than…

A

pt’s chest

84
Q

One way flutter valve - air can escape from chest cavity, but not back in

A

Heimlich chest drain valve

85
Q

chest drain for ambulatory pts

A

Heimlich chest drain valve

86
Q

check chest drain dressings every…
resposition pt every…

A

4 hr
2 hr

87
Q

what should nurse do for chest drain pts to maintain ROM?

A

Assist c ROM on affected shoulder 3x/day

88
Q

if chest drainage tube is disconnected…

A

submerge end in 1 inch of water/saline

89
Q

if chest drainage tube comes out…

A

cover c dry sterile dressing

90
Q

prior to chest tube removal…

A

give pt pain meds as ordered - it is brief but painful

91
Q
A

nasal cannula

92
Q
A

reservoir cannula

93
Q
A

simple face mask

94
Q
A

nonrebreather mask

95
Q
A

venturi mask

96
Q
A

CPAP

97
Q
A

endotracheal tube

98
Q
A

tracheostomy tube

99
Q
A

disposable drainage system

100
Q
A

Heimlich chest drain valve

101
Q

improve ventilation; counteract effects of anesthetia or hypoventilation; loosen secretions; facilitate gas exchange; expand collapsed alveoli

A

incentive spirometers

102
Q

spirometers mimic…

A

natural sighing/yawning

103
Q

spirometers encourage pt to take…

A

long, slow, deep breaths

104
Q

2 types of incentive spirometers

A

Flow-oriented - uses plastic balls that rise as pt inhales

Volume-oriented - measures inhalation volume

105
Q

spirometer instructions for patients

A

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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