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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
What is hypoxia?
low levels of oxygen in the tissues in organs
26
What are symps of hypoxia?
Restlessness Anxiety Tachycardia/Tachypnea Bradycardia Extrem Restlessness Dyspnea (severe)
27
What are sypms of hypoxia in Peds?
Feeding Difficulty Inspiratory Stridor Nares Flare Expiratory Grunting Sternal Retractions
28
What is hypoventilation?
breathing too shallow or too slow to meet the body's needs for oxygen
29
What is hyperventilation?
breathing that is too rapid or too deep. Breathing exceeds the body's metabolic demands
30
What is atelectasis?
collapsed air sacs (alveoli)
31
How can we prevent atelectasis?
Early ambulation Turn, Cough, Deep breathe Incentive Spirometry
32
What is aspriration?
passage of gastric contents (fluid or solid) into the lungs
33
What can aspiration cause?
aspiration pneumonia
34
How can we prevent aspiration?
Assess pt's ability to swallow Keep HOB elevated w/ tube feedings Thorough lung assessment
35
How do we assess the respiratory sys?
RR Use of accessory muscles Cyanosis O2 Sat Adventitous Breath sounds (crackles, wheezes, bronchi, stridor, rubs) Clubbing Dyspnea w/ activity
36
What are diagnostic tests we can run for respiratory issues?
Chest x-ray arterial blood gases sputum culture & sensitivity CT scan MRI Bronchoscopy Thoarcentesis
37
What are interventions we can use prior to use of O2 to promote lung expansion
Change position of pt every 2 hrs Keep upright Increase daily activities; insure hydration Coughing exercises Deep breathing (IS)
38
What are interventions we can use prior to use of O2 post operative?
IS TCDB Splinting incision
39
What is albuterol (proair) MDI used for?
Bronchodilator Rescue inhaler for acute difficulty breathing (asthma, COPD)
40
What does Beta 2 (SABAs) Short-Acting Beta Agonist do?
Stimulates beta-2 adrenergic receptors, relaxing airway smooth muscle
41
How do we need educate the pt to take the inhaler?
Two puffs inhaled every 4 to 6 hrs PRN bronchospasm/difficulty breathing May take 2 puffs 5-30 mins before exercise
42
What are common reactions to albuterol?
Nervousness tachycardia headache throat irritation
43
What is Symbicort (Budesonide/Formeterol Inhaled)
Corticosteroid/Bronchodilator Beta 2 agonist (LABA) Log-Acting Beta Agonist
44
How do we educate pt's to take the Symbicort inhaler?
Two puffs bid (2 x's/day)
45
What do we use Symbicort to treat?
Prevention of asthma attacks & exercise-induced bronchospasm & COPD
46
What are common reactions to Symbicort?
Tachycardia, nervousness, palpitations, & candidiasis Rinse mouth & spit it out after inhaling
47
How do we assess pt's on oxygen therapy?
Equipment Correct O2 delivery device Flow rate correct Respiratory assessment - vtal signs - o2 sat - level of consciousness, any s/s of hypoxia - skin
48
What is Fraction of Inspired Oxygen (FIO2)
FIO2 is percent of oxygen a person is inhaling Room air FIO2 is 21% W/ supplemental o2, FIO2 can reach 100%
49
How much oxygen can be delivered via nasal cannula & what is the FIO2 rate on this?
up to 6L/min (usually no more than 4) FIO2 24%-44%
50
What are the advantages of nasal cannula?
safe & simple, easily tolerated increased mobility
51
What are disadvantages?
dries membrane; skin breakdown
52
What are the functions for the Non-rebreather mask?
Delivers higher concentrations of o2 Trat hypoxia Lowers workload of breathing
53
What does the non-rebreather look like?
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
What range should the non-rebreather be?
FIO2 of 60-100% Set flow meter @ 10-15 L for 100%
55
What is the FIO2 & flow rate for the Venti mask?
delivers FIO2 of 24-60% flow rates from 4-12L/min
56
What are the advantages of Venturi mask (venti mask)?
controls exact concentration of oxygen
57
What are the disadvantages of a Venturi mask?
Hot & confining Interferes w/ eating & talking Commonly used in COPD pt's
58
What is the FIO2 & flow rate for a face tent
delivers 28-100% w/ flow rate of 8-12L/min
59
What are the advantages of a face tent?
delivers 28-100% w/ flow rate of 8-12L/min alternative for claustrophobia
60
What are the disadvantages of a face tent?
difficult to control concentration of oxygen
61
What do we document for oxygneation?
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
What are physical factors that alter accuracy of pulse ox?
motion/incorrect placement BP monitoring device bright lights, polish, acrylics
63
What are physiological factors that alter accuracy pf pulse ox?
poor arterial flow or edema cold hands; poor capillary refill anemia
64
What is the purpose for Incentive Spirometry (IS)?
helps prevent post-op pulmonary complications (atelectasis) provides voluntary deep breathing gives visual feedback
65
What is the technique for Incentive Spirometry (IS)?
explain procedure positioning
66
What do we need to know for oxygen safety?
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
When can oxygen toxicity develop?
can develop when a person breaths 100% o2 for > than 12 hrs Results from effects on CNS & Pulmonary systems
68
What are s/s of oxygen toxicity?
pallor, sweating, nausea & vomiting seizures, vertigo, muscle twitching hallucinations, visual changes, anxiety chest pain, dyspnea

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