Oxygenation

Question 1

What is poor oxygenation?

Answer 1

A decreased oxygen level in the blood

Question 2

What does SpO2 measure?

Answer 2

How saturated hemoglobin are with oxygen
Measured with pulse oximetry (95-100%)

Question 3

Signs and symptoms of poor oxygenation:

Answer 3

Restlessness/confusion
Decreased blood pressure
Cool extremities
Pallor or cyanosis of extremities
Slow capillary refill

Question 4

When oxygen delivery is inadequate to meet metabolic demands of the body =

Answer 4

Tissue ischemia and cell death

Question 5

Hypoxia:

Answer 5

Low oxygen in the tissues

Question 6

What is the first/early symptom of poor oxygenation?

Answer 6

Restlessness

Question 7

Where does oxygen exchange take place?

Answer 7

Alveoli

Question 8

Lung disease is greatly influenced by what a patient is exposed to. What are some examples?

Answer 8

Environmental
Occupational
Personal
Social habits

Question 9

What are some pulmonary diseases?

Answer 9

Acute- bronchitis
Chronic- asthma
Obstructive- COPD
Restrictive- pulmonary fibrosis, sarcoidosis
Infectious- pneumonia
Noninfectious- asthma, COPD, pulmonary fibrosis

Question 10

What type of disease includes difficulty exhaling?

Answer 10

Obstructive

Question 11

What type of disease includes difficulty inhaling?

Answer 11

Restrictive

Question 12

Clinical manifestations of respiratory alterations:

Answer 12

Cough
Dyspnea
Chest pain
Abnormal sputum
Hemoptysis
Altered breathing patterns
Cyanosis
Fever

Question 13

What is cyanosis? Where are common places to see cyanosis on the body?

Answer 13

Cyanosis is bluish discoloration of skin and mucus membranes.
Seen on the ends of extremities (fingers, toes), mucous membrane, tip of nose, inside nares, earlobes.

Question 14

Orthopnea

Answer 14

Dyspnea (shortness of breath) when laying down

Question 15

What nursing intervention can be implemented for a patient experiencing orthopnea?

Answer 15

Prop the patient up slightly to promote better lung expansion

Question 16

When does clubbing occur?

Answer 16

Occurs when a person has been chronically low on oxygen. Indicates low oxygen in the blood.

Question 17

Hypoxemia

Answer 17

Low level of oxygen in the blood

Question 18

What device can we use to measure oxygen of blood? What is the normal range?

Answer 18

Oxygen saturation (SpO2)
95-100%

Question 19

Hypoxia

Answer 19

Low levels of oxygen in the tissues and organs

Question 20

We can assume a patient with hypoxemia for an extended amount of time as…

Answer 20

Hypoxia

Question 21

Early symptoms of hypoxia include:

Answer 21

Restlessness
Anxiety
Tachycardia/Tachypnea

Question 22

Later symptoms of hypoxia include:

Answer 22

Bradycardia
Extreme restlessness
Dyspnea (severe)

Question 23

Hypoventilation

Answer 23

Breathing too shallow or too slow to meet the body’s needs for oxygen

Question 24

Hyperventilation

Answer 24

Breathing that is too rapid or too deep; breathing exceeds the body’s metabolic demands

Question 25

Atelectasis

Answer 25

Collapsed air sacs (alveoli)

Question 26

What are ways to prevent atelectasis?

Answer 26

Early ambulation Turn, cough, deep breathe Incentive spirometry

Question 27

What does black indicate on an X-ray?

Answer 27

Air

Question 28

What does white indicate on an X-ray?

Answer 28

Fluid or tissue

Question 29

Aspiration

Answer 29

Passage of gastric contents (fluid or solid) into the lungs

Question 30

What can aspiration cause?

Answer 30

Aspiration pneumonia

Question 31

What are ways to prevent aspiration?

Answer 31

Assess patient's ability to swallow Keep head of bed elevated Thorough lung assessment

Question 32

Assessment of the respiratory system includes:

Answer 32

Respiratory rate Use of accessory muscles Cyanosis Oxygen saturation Adventitious breath sounds Clubbing Dyspnea with activity

Question 33

Diagnostic tests include:

Answer 33

Chest X-ray ABGs Sputum culture and sensitivity CT scans MRI Bronchoscopy Thoracentesis

Question 34

Interventions prior to oxygen use include:

Answer 34

Promotion of lung expansion Post operative

Question 35

What can promote of lung expansion?

Answer 35

Position changes frequently (every 2 hours) Keep upright Increase daily activities Ensure adequate hydration Coughing exercises Splinting incision

Question 36

Forms of post operative interventions:

Answer 36

Incentive spirometer TCDB Splinting incisions

Question 37

Albuterol (proair) Bronchodilator

Answer 37

A rescue inhaler for acute difficulty breathing (asthma, COPA)

Question 38

What are common reactions to bronchodilator?

Answer 38

Nervousness, tachycardia, headache, throat irritation

Question 39

Corticosteroid/Bronchiolar

Answer 39

Long acting drug that is taken on a regularly scheduled basis to prevent shortness of breath

Question 40

What should you do after using a corticosteroid/bronchiolar?

Answer 40

Rinse mouth out to prevent thrush

Question 41

What do you assess on patients on oxygen therapy?

Answer 41

Equipment Correct oxygen delivery device Flow rate Respiration assessment

Question 42

What is included in a respiration assessment for patients on oxygen therapy?

Answer 42

Vitals Level of consciousness/ any signs or symptoms of hypoxia Oxygen saturation Skin

Question 43

What is FIO2

Answer 43

Fraction of inspired oxygen The percent of oxygen a person is inhaling

Question 44

What is the percentage of room air FIO2?

Answer 44

21%

Question 45

Methods of oxygen delivery include:

Answer 45

Nasal cannula Non-rebreather mask Venturi mask

Question 46

What is the first (and least invasive) choice for delivering oxygen?

Answer 46

Nasal cannula

Question 47

What is the flow rate of oxygen for a nasal cannula?

Answer 47

Up to 6L/min (usually no more than 4)

Question 48

What are advantages of using a nasal cannula?

Answer 48

Safe and simple Easily tolerated Increased mobility

Question 49

What are disadvantages of using a nasal cannula?

Answer 49

Dries membrane Skin breakdown

Question 50

What does a non-rebreather mask do?

Answer 50

Delivers high concentrations of oxygen Treat hypoxia Lowers workload of breathing

Question 51

What is the flow rate for a non-rebreather mask?

Answer 51

10-15 L for 100% FIO2

Question 52

What are advantages of a Venturi mask?

Answer 52

Controls exact concentration Delivers FIO2 of 24-60% flow rates from 4-12L/min

Question 53

What are disadvantages of a Venturi mask?

Answer 53

Hot and confining Interferes with eating and talking

Question 54

What do you document for oxygen use?

Answer 54

Date and time oxygen initiated Method of delivery Flow rate in L/min Patient response to oxygen Condition of patient's skin where oxygen rests Respiratory assessment Patient/family teaching

Question 55

What are some physical factors that alter accuracy of a pulse ox?

Answer 55

Motion/incorrect placement BP monitoring device Bright lights, polish, acrylics

Question 56

What are some physiological factors that alter accuracy of a pulse ox?

Answer 56

Poor atrial flow or edema Cold hands; poor capillary refilling Anemia

Question 57

What is the purpose of an incentive spirometer?

Answer 57

To help prevent post-op pulmonary complications (atelectasis)

Question 58

What are things to consider for oxygen safety?

Answer 58

Do not smoke Do not use aerosol products Do not use any petroleum products Should be administered to patient by physicians order or in judgement of RN in emergency situations

Question 59

When can oxygen toxicity develop?

Answer 59

When a person breathes 100% oxygen for more than 12 hours

Question 60

What are signs/symptoms of oxygen toxicity?

Answer 60

Pallor, sweating, nausea, vomiting Seizures, vertigo, muscle twitching Hallucinations, visual changes, anxiety Chest pain, dyspnea