Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

IM1 Exam 2 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

poor oxygenation

A

a decreased oxygen level in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

oxygen saturation

A
  • can be used to assess oxygen level
  • SpO2: measure of how saturated hemoglobin are with oxygen (measured with pulse oximetry)
    – 95-100%
    – often see orders to “keep O2 sats above 92%”
    – SpO2 aka SaO2
    (blood is meant to carry oxygen, oxygen attaches to hemoglobin and is carried around)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

signs / symptoms of poor oxygenation

A
  • restlessness / confusion (panicky, anxious)
  • decreased blood pressure
  • cool extremities
  • pallor or cyanosis of extremities (pale or purple blue color)
  • slow capillary refill: normal is less than 3 seconds, pushing nail down and releasing or if nails are painted pushing down on back of finger
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

when oxygen delivery is inadequate to meet metabolic demands of the body, there is ____

A

tissue ischemia and cell death
(when we don’t have enough oxygen to meet the demands of our body = tissues start to die off)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

hypoxia (low oxygen in your tissues) occurs when

A

your blood doesn’t carry enough oxygen to the tissues to meet the body’s needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

lung disease

A
  • the lungs have a large surface area that is constantly exposed to the external environment
  • greatly influenced by what a patient is exposed to:
    – environmental: is it dusty or many trees? ex: pollen allergies
    – occupational: coal miners or painters
    – personal
    – social habits: smoking
  • alveoli are air sacs and that is where air exchange takes place
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

pulmonary diseases

A

are often classified as either acute or chronic, obstructive or restrictive, infectious or noninfectious and is caused by alterations in the lungs or heart
- acute: bronchitis
- chronic: long-term like asthma
- obstructive: difficulty exhaling air, more common than restrictive, chronic obstructive pulmonary disease (COPD)
- restrictive: difficulty inhaling air, pulmonary fibrosis, sarcoidosis
- infectious: pneumonia (fluid in lungs that becomes infected)
- noninfectious: asthma, COPD, pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

acute

A

short term, ex: bronchitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

chronic

A

long term, ex: asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

obstructive

A
  • difficulty exhaling air
  • much more common than restrictive
  • ex: chronic obstructive pulmonary disease (COPD)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

restrictive

A
  • difficulty inhaling air
  • ex: pulmonary fibrosis, sarcoidosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

infectious

A

ex: pneumonia - fluid in lungs that becomes infected

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

noninfectious

A

ex: asthma, COPD, pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

clinical manifestations of respiratory alterations

A
  • cough: acute or chronic
  • dyspnea: shortness of breath, feeling of inability to get a good breath
  • chest pain
  • abnormal sputum
  • hemoptysis: coughing up blood
  • altered breathing patterns: tachypnea, bradypnea, use of accessory muscles
  • cyanosis: bluish discoloration of skin and mucus membranes
  • fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

cyanosis

A

bluish-purple discoloration of skin
- at ends of extremities (fingers and toes)
- mouth, mucus membranes, tip of nose and inside our nares (nostrils), earlobes
- in people of color, have to rely on mucus membranes and pale capillary refill

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

orthopnea

A

dyspnea (shortness of breath) when laying down
(laying down = less lung expansion, or fluid in lungs makes it harder when laying down)
- patients can breath better when propped up slightly
- people with chronic lung disorders may sleep better sitting up in a recliner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

clubbing

A

often occurs in heart and lung diseases that reduce the amount of oxygen in the blood
- when person is chronically low on oxygen
- strange angle on nail and fingers get wide at the end
- to check for this in clinical, ask patient to press fingernails together like making a heart with hands and they won’t be able to meet exactly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

hypoxemia

A

low level of oxygen in the blood (emia = blood)
- pulse ox is used to measure this
- SpO2: oxygen saturation
- 95-100%
- often see orders to “keep O2 sats above 92%”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

hypoxia

A

low levels of oxygen in the tissues and organs
- can be difficult to measure: can tell through head to toe assessment or if patient says they have symptoms of it
- we can assume that a patient with hypoxemia for an extended amount of time has hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

symptoms of hypoxia

A

early:
R - restlessness
A - anxiety
T - tachycardia/tachypnea: fast heart rate and breathing
late:
B - bradycardia: low heart rate
E - extreme restlessness
D - dyspnea (severe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

hypoventilation

A

breathing too shallow or too slow to meet the body’s needs for oxygen
- narcotics (opioid pain medications), sleep can cause this
- below normal rate of 12-20 respirations
- person holds onto CO2 = hypercapnia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

hyperventilation

A

breathing that is too rapid or too deep, breathing exceeds the body’s metabolic demands
- caused by anxiety, exercise (overexertion), pain
- getting rid of too much CO2 = hypocapnia, = breathing into paper bag

23
Q

atelectasis

A

collapsed air sacs = alveoli
prevention:
- early ambulation
- turn, cough, deep breathe
- incentive spirometry

24
Q

aspiration

A

passage of gastric contents (fluid or solid) into the lungs
can cause aspiration pneumonia
prevention:
- assess patient’s ability to swallow
- keep head of bed elevated with tube feedings
- thorough lung assessment

25
Q

assessment of respiratory system

A
  • respiratory rate
  • use of accessory muscles
  • cyanosis
  • oxygen saturation (SpO2)
  • adventitious breath sounds (crackles, wheezes, rhonchi, stridor, rubs)
  • clubbing
  • dyspnea with activity
26
Q

vesicular lung sounds

A

(listening with stethoscope)
normal breath sounds, no extra crackle or wheeze

27
Q

bronchial lung sounds

A

(listening with stethoscope)
normal breath sounds, heard when stethoscope placed over trachea

28
Q

fine crackles lung sounds

A

(listening with stethoscope)
most common abnormal lung sound you will hear, little popping sounds - if little bit of fluid in lungs, may hear fine crackles, same as rubbing hair together by ear

29
Q

coarse crackles lung sounds

A

(listening with stethoscope)
lots of fluid in lung, encourage patient to cough
crackles are more common on inspiration

30
Q

wheeze lung sounds

A

(listening with stethoscope)
more common on expiration, like snoring, encourage patient to cough

31
Q

rhonchi lung sounds

A

(listening with stethoscope)
really bad wheezes, with a lot of fluid, on expiration

32
Q

list of diagnostic tests

A
  • chest x-ray
  • arterial blood gases
  • sputum culture and sensitivity
  • CT scans
  • Magnetic Resonance Imaging (MRI)
  • Bronchoscopy
  • Thoracentesis
33
Q

chest x-ray

A
  • black is good bc that is air
  • white in lungs means collapsed air sacs (alveoli) which is atelectasis
  • flip right and left so that the left lung is the picture on the right
34
Q

sputum culture and sensitivity

A
  • culture: patients spit what they coughed up into the little cup thing and the sputum is examined to see what organism is growing in the sputum
  • sensitivity: see what antibiotics will kill that organism, expose organism to antibiotics to see what will kill it
35
Q

CT scan

A
  • shows cross section of body
  • with or without IV contrast or dye
  • arrows on picture on slide point to blood clots in lungs
  • more sophisticated than a chest x-ray
36
Q

MRI

A
  • magnetic resonance imaging
  • even more sophisticated than CT scan
  • can really see details
  • no metal on patients in here: no implantable devices (pacemaker), some tattoos may have metal
37
Q

bronchoscopy

A

go to endoscopy lab and run a flexible tube down bronchus down respiratory tract and look at what the tissue looks like (view the airways and check for any abnormalities)
- can get gunk out, and take biopsies
- can be done at the bedside in critical care

38
Q

thoracentesis

A
  • use a long needle to aspirate fluid out of the lungs
  • done in respiratory lab
  • use an ultrasound to see where the needle should go
  • patient is leaning over the table to increase space between the ribs, poke needle in and pull fluid out
  • getting fluid out helps them breathe (relieve pressure), open up the lung space, and a culture and sensitivity can be done on that fluid
39
Q

interventions prior to oxygen use

A

promotion of lung expansion:
- position changes frequently: every 2 hours
- keep upright
- increase daily activities; ensure adequate hydration
- coughing exercises
- deep breathing (Incentive spirometry aka IS)
post operative:
- IS
- TCDB, turn cough deep breath
- splinting incision

40
Q

albuterol (proair) MDI

A

bronchodilator (generic: albuterol, brand: proair)
- rescue inhaler for acute difficulty breathing (asthma, COPD)
- Beta 2 agonist (SABAs) Short-Acting Beta Agonist
– stimulates beta-2 adrenergic receptors, relaxing airway smooth muscle
– 2 puffs inhaled every 4 to 6 hours prn bronchospasm / difficulty breathing
– may take 2 puffs 5-30 minutes before exercise
– common reactions: nervousness, tachycardia, headache, throat irritation
(rescue inhaler used only when short of breath, not regularly)
(beta cells have to do with fight or flight, when activated everything starts to speed up so nervousness and tachycardia are common reactions)

41
Q

symbicort (budenoside/formeterol inhaled)

A

corticosteriod / bronchodilator
- beta 2 agonist (LABA) Long-Acting Beta Agonist
- MDI: 80 mcg/ 4.5 mcg, 160/4.5 mcg
– 2 puffs bid (2x day)
– treatment for prevention of asthma attacks and exercise-induced bronchospasm and COPD
– common reactions: tachycardia, nervousness, palpitations, oral candidiasis,
- rinse mouth and spit it out after inhalation
(long-acting drug, used on regular scheduled basis to prevent shortness of breath)
(has a steroid in it, so it is important to rinse mouth and spit it out after inhalation)

42
Q

assessing patients on oxygen therapy

A
  • equipment
  • correct oxygen delivery device
  • flow rate is correct
  • respiratory assessment: vital signs, oxygen saturation, level of consciousness, any signs/symptoms of hypoxia, skin (cyanosis)
    (we’re allowed as nurses to place oxygen on a patient to stabilize them, once they are stabilized we have to inform the healthcare provider and get a continuous order)
43
Q

flow meter

A

guide we use to see how much oxygen (liters per minute) a patient receives
- so you would set the flow meter to the correct amount
screw christmas tree on bottom of flow meter, connect tubing to bottom of x-mas tree and turn it on to where the ball is at the correct L/minute

44
Q

fraction of inspired oxygen (FIO2)

A

percent of oxygen a person is inhaling
- room air FIO2 is 21%
- with supplemental oxygen, FIO2 can reach 100%

45
Q

nasal cannula

A

oxygen delivery (least invasive, put it in to follow curve and direction of our nostrils)
- up to 6 L/min. (usually no more than 4)
- FIO2 24%-44%
advantages
- safe and simple, easily tolerated
- increased mobility
disadvantages
- dries membranes; skin breakdown
(skin breakdown could occur inside nose, behind ears, cheek and chins)
(most common starting - 2-3 L, titrate up or down depending on what their oxygen saturation does)
(can use connector and add another section of tube to move around room, or if walking outside room attack nasal cannula to portable tank)
(oxygen is flammable - no smoking, candles, e-cigarettes, nothing that can cause a spark, no petroleum products (vaseline, carmex)
(a humidifier can be added to the oxygen if they are dried out (commonly at 4-5 L))

46
Q

non-rebreather mask

A

most invasive
face mask with reservoir bag
- has one way valves that open during expiration and close during inhalation to prevent decrease in FIO2 or build up of CO2
- delivers higher concentrations of oxygen
- treat hypoxia
- decrease workload of breathing
- FIO2 of 60-100%
- set flow meter at 10-15 L for 100% (can get close to 100%)
(for very very sick people, low O2, have retractions - need to stabilize quickly or going to be intubated)
(no humidification)
(administers highest levels of oxygen without intubation)
(to eat, put them on nasal cannula and then nurse or nurse aide holds the non-rebreather on the patient while they are chewing)

47
Q

venturi mask aka venti mask

A

with the different nozzles for different flow rates and different amounts of oxygen for the patient to get
- controls exact concentration of oxygen
- delivers FIO2 of 24-60%, flow rates from 4-12 L/min
- hot and confining
- interferes with talking and eating: commonly used with COPD patients
(used for mouth breathers bc nasal cannula won’t work for them)
(mask, tube, vent and tubing are all individual pieces)
(skin breakdown on the nose, mouth, cheek and ears)
(can put patient on nasal cannula to eat and then back on venti mask)

48
Q

documentation

A
  • date and time oxygen initiated
  • method of delivery: which mask
  • flow rate in liters per minute
  • patient response to oxygen
  • condition of patient’s skin where device rests
  • respiratory assessment: check O2 saturation, listen to lungs, resp. rate, vital signs
  • patient/family teaching: can live normal lives with oxygen
    (everything is documented)
    (document reason oxygen is initiated)
49
Q

high flow nasal cannula

A

temporary fix, trying to decide whether to intubate
(likely bc ran out of ventilators)

50
Q

factors that affect accuracy of pulse ox

A

physical:
- motion/incorrect placement
- BP monitoring device
- bright lights. polish, acrylics
physiological:
- poor arterial flow or edema (swollen)
- cold hands, poor capillary filling: talk to them while you warm them up
- anemia
can do on fingers, toes, forehead, nose, ear lobe

51
Q

incentive spirometry (IS)

A
  • helps prevent post-op pulmonary complications (atelectasis)
  • provides voluntary deep breathing
  • gives visual feedback
  • technique: explain procedure and positioning
    it is the sucking inspiration motion, not the exhalation blowing motion
    want indicator to dangle bc sustained deep breath (expand lungs)
    want patients to take minumum 10 breaths every 2 hours, usually put it on the table and every time commercial comes on take a breath
52
Q

oxygen safety

A
  • do not smoke
  • do not use aerosol sprays
  • do not use any petroleum products
  • should be administered to patient by physician order or in judgement of RN in emergency situations
53
Q

oxygen toxicity

A

can develop when a person breathes 100% oxygen for greater than 12 hours
- results from effects on CNS and pulmonary systems
signs/symptoms:
- pallor, sweating, nausea and vomiting
- seizures, vertigo, muscle twitching
- hallucinations, visual changes, anxiety
- chest pain, dyspnea

IM1 Exam 2 (4 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions