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IM1 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

What is poor oxygenation?

A

A decreased level of oxygen in the blood

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2
Q

What is SpO2

A

measure of how saturated hemoglobin are w/ oxygen (measured w/ pulse ox)

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3
Q

What is the normal range for O2

A

95-10% or often see orders to keep O2 above 92

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4
Q

What are signs/sympts of poor oxygenation?

A

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

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5
Q

What happen when o2 delivery is inadequate?

A

tissue ischemia & cell death

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6
Q

What is hypoxia?

A

low O2 in tissues & when blood doesn’t carry enough oxygen to the tissues to meet body’s needs

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7
Q

How is the chance of having a lung disease increased?

A

Exposure to environmental
Occupational
Personal
& social habits

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8
Q

What makes up the lung (anatomy)?

A

trachea (wind pipe)
bronchioles
Lung lobes
interstitium
alveoli (air sacs)
bronchi
lung
diaphragm

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9
Q

What are pulmonary diseases (definition)?

A

Classified as acute or chronic, obstructive or restrictive, infectious or noninfectious & is caused by alterations in lungs or heart

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10
Q

Example of an acute pulmonary disease?

A

Bronchitis

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11
Q

Ex. of a chronic pulmonary disease?

A

asthma

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12
Q

Ex. of an obstructive pulmonary disease?

A

Chronic obstructive pulmonary disease COPD

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13
Q

Ex of a Restrictive disease?

A

pulmonary fibrosis, sarcoidosis

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14
Q

Ex. of an infectious pulmonary disease?

A

pneumonia

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15
Q

Ex. of a noninfectious pulmonary disease?

A

asthma, COPD, pulmonary fibrosis

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16
Q

What is hemoptysis?

A

coughing up blood

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17
Q

what are altered breathing patterns?

A

tachypnea, bradypnea, use of accessory muscles

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18
Q

what is cyanosis?

A

bluish discoloration of skin & mucus membranes

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19
Q

what is dyspnea?

A

SOB, or not able to get goof air

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20
Q

What are clinical manifestations of respiratory alteraltions?

A

Cough - acute or chronic
Dyspnea - SOB, or not able to get good air
Chest pain
Abnormal sputum
Hemoptysis - coughing up blood
Altered breathing patterns - tachypnea, bradypnea, use of accessory muscles
Cyanosis - bluish discoloration of skin & mucus membranes
Fever

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21
Q

What is orthopnea?

A

dyspnea when laying down

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22
Q

How can we help those w/ orthopnea

A

pts can breath better when propped up slightly

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23
Q

When does clubbing occur?

A

often occurs in heart & lung diseases that reduce the amount of O2 in the blood

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24
Q

What is hypoxemia?

A

low level of oxygen in the blood

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25
Q

What is hypoxia?

A

low levels of oxygen in the tissues in organs

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26
Q

What are symps of hypoxia?

A

Restlessness
Anxiety
Tachycardia/Tachypnea
Bradycardia
Extrem Restlessness
Dyspnea (severe)

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27
Q

What are sypms of hypoxia in Peds?

A

Feeding Difficulty
Inspiratory Stridor
Nares Flare
Expiratory Grunting
Sternal Retractions

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28
Q

What is hypoventilation?

A

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

29
Q

What is hyperventilation?

A

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

30
Q

What is atelectasis?

A

collapsed air sacs (alveoli)

31
Q

How can we prevent atelectasis?

A

Early ambulation
Turn, Cough, Deep breathe
Incentive Spirometry

32
Q

What is aspriration?

A

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

33
Q

What can aspiration cause?

A

aspiration pneumonia

34
Q

How can we prevent aspiration?

A

Assess pt’s ability to swallow
Keep HOB elevated w/ tube feedings
Thorough lung assessment

35
Q

How do we assess the respiratory sys?

A

RR
Use of accessory muscles
Cyanosis
O2 Sat
Adventitous Breath sounds (crackles, wheezes, bronchi, stridor, rubs)
Clubbing
Dyspnea w/ activity

36
Q

What are diagnostic tests we can run for respiratory issues?

A

Chest x-ray
arterial blood gases
sputum culture & sensitivity
CT scan
MRI
Bronchoscopy
Thoarcentesis

37
Q

What are interventions we can use prior to use of O2 to promote lung expansion

A

Change position of pt every 2 hrs
Keep upright
Increase daily activities; insure hydration
Coughing exercises
Deep breathing (IS)

38
Q

What are interventions we can use prior to use of O2 post operative?

A

IS
TCDB
Splinting incision

39
Q

What is albuterol (proair) MDI used for?

A

Bronchodilator
Rescue inhaler for acute difficulty breathing (asthma, COPD)

40
Q

What does Beta 2 (SABAs) Short-Acting Beta Agonist do?

A

Stimulates beta-2 adrenergic receptors, relaxing airway smooth muscle

41
Q

How do we need educate the pt to take the inhaler?

A

Two puffs inhaled every 4 to 6 hrs PRN bronchospasm/difficulty breathing
May take 2 puffs 5-30 mins before exercise

42
Q

What are common reactions to albuterol?

A

Nervousness
tachycardia
headache
throat irritation

43
Q

What is Symbicort (Budesonide/Formeterol Inhaled)

A

Corticosteroid/Bronchodilator
Beta 2 agonist (LABA) Log-Acting Beta Agonist

44
Q

How do we educate pt’s to take the Symbicort inhaler?

A

Two puffs bid (2 x’s/day)

45
Q

What do we use Symbicort to treat?

A

Prevention of asthma attacks & exercise-induced bronchospasm & COPD

46
Q

What are common reactions to Symbicort?

A

Tachycardia, nervousness, palpitations, & candidiasis
Rinse mouth & spit it out after inhaling

47
Q

How do we assess pt’s on oxygen therapy?

A

Equipment
Correct O2 delivery device
Flow rate correct
Respiratory assessment
- vtal signs
- o2 sat
- level of consciousness, any s/s of hypoxia
- skin

48
Q

What is Fraction of Inspired Oxygen (FIO2)

A

FIO2 is percent of oxygen a person is inhaling
Room air FIO2 is 21%
W/ supplemental o2, FIO2 can reach 100%

49
Q

How much oxygen can be delivered via nasal cannula & what is the FIO2 rate on this?

A

up to 6L/min (usually no more than 4)
FIO2 24%-44%

50
Q

What are the advantages of nasal cannula?

A

safe & simple, easily tolerated
increased mobility

51
Q

What are disadvantages?

A

dries membrane; skin breakdown

52
Q

What are the functions for the Non-rebreather mask?

A

Delivers higher concentrations of o2
Trat hypoxia
Lowers workload of breathing

53
Q

What does the non-rebreather look like?

A

face mask w/ reservoir bag
has one way valves that open during expiration & close during inhalation to prevent decrease in FIO2 or build up of CO2

54
Q

What range should the non-rebreather be?

A

FIO2 of 60-100%
Set flow meter
@ 10-15 L for 100%

55
Q

What is the FIO2 & flow rate for the Venti mask?

A

delivers FIO2 of 24-60% flow rates from 4-12L/min

56
Q

What are the advantages of Venturi mask (venti mask)?

A

controls exact concentration of oxygen

57
Q

What are the disadvantages of a Venturi mask?

A

Hot & confining
Interferes w/ eating & talking
Commonly used in COPD pt’s

58
Q

What is the FIO2 & flow rate for a face tent

A

delivers 28-100% w/ flow rate of 8-12L/min

59
Q

What are the advantages of a face tent?

A

delivers 28-100% w/ flow rate of 8-12L/min
alternative for claustrophobia

60
Q

What are the disadvantages of a face tent?

A

difficult to control concentration of oxygen

61
Q

What do we document for oxygneation?

A

Date & time oxygen indicated
Method of delivery
Flow rate in L per min
Pt response to o2
Condition of pt’s skin where devices rest
Respiratory assessment
Pt/family teaching

62
Q

What are physical factors that alter accuracy of pulse ox?

A

motion/incorrect placement
BP monitoring device
bright lights, polish, acrylics

63
Q

What are physiological factors that alter accuracy pf pulse ox?

A

poor arterial flow or edema
cold hands; poor capillary refill
anemia

64
Q

What is the purpose for Incentive Spirometry (IS)?

A

helps prevent post-op pulmonary complications (atelectasis)
provides voluntary deep breathing
gives visual feedback

65
Q

What is the technique for Incentive Spirometry (IS)?

A

explain procedure
positioning

66
Q

What do we need to know for oxygen safety?

A

Do not smoke
Do not use aerosol sprays
Do not use any petroleum products
Should be administered to pt via dr order or judgement of RN in emergencies

67
Q

When can oxygen toxicity develop?

A

can develop when a person breaths 100% o2 for > than 12 hrs
Results from effects on CNS & Pulmonary systems

68
Q

What are s/s of oxygen toxicity?

A

pallor, sweating, nausea & vomiting
seizures, vertigo, muscle twitching
hallucinations, visual changes, anxiety
chest pain, dyspnea

IM1 (18 decks)

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