Oxygenation Flashcards
1
Q
When is atelectasis most common?
A
most commonly observed in the setting of thoracic or abdominal surgery
2
Q
What is the amount of air that can be expelled from the lungs in 1 second during forced expiration?
A
forced vital capacity
3
Q
What is maximum amount of air that is expelled after maximal inspiration?
A
vital capacity
4
Q
What valves close during systole
A
mitral and tricuspid
5
Q
What valves open during systole
A
aortic and pulmonic
6
Q
when the mitral and tricuspid valves open and blood flows to the ventricles, the aorta, and the pulmonary artery, what sound is it?
A
S1
7
Q
what sound is heard when pressure in the ventricles decreases as they empty, the aortic and pulmonic valves close,
A
S2
8
Q
what is a normal adult’s CO?
A
4 to 6 L/min.
9
Q
Factors that affect stroke volume (3)
A
preload
afterload, contractility
10
Q
The _____the ventricle stretches with the end-diastolic volume, the ____the contraction and the ___the stroke volume are
A
more stronger greater
11
Q
What is the order of electrical conduction of the heart?
A
SA node
(AV) node
bundle of His
right and left bundle branches
Purkinje fibers
12
Q
What are cardiopulmonary risk factors? (5)
A
diet, exercise, smoking,, environmental factors and stress
13
Q
What are two diets to lower BP?
A
DASH (Dietary Approaches to Stop Hypertension) diet and the Mediterranean diet
14
Q
How much should you exercise to improve blood circulation and strengthen the heart?
A
30 to 60 minutes
15
Q
During the health history, the nurse should ask what questions about smoking? (3)
A
the nurse should ask if the client smokes
if so, how many packs per day
how many years they have been smoking.
16
Q
What kind of environmental factors can affect cardiopulmonary function?
A
air particles such as coal dust, gold dust, grain, construction dust, and chemical vapors emitted by cleaning agents and gas fumes.
17
Q
client’s social history should include information about what?
A
alcohol or tobacco use
employment history
home environment
any recent travel history
18
Q
When is the ideal time to weigh a patient?
A
The client should be weighed in the morning after urinating
19
Q
Any excessive weight gain over a short span of time could indicate what?
A
heart failure
20
Q
What are signs of COPD?
A
clubbing, and edema
21
Q
What things should be observed for cardiopulmonary
A
clubbing
JVD
edema
tripod
22
Q
How much should you recline a patient to check for JVD?
A
30-45 degrees
23
Q
What should you palpate the thorax for? (7)
A
carotid and apical pulses
tenderness
respiratory excursion
tactile fremitus
edema
skin turgor, temperature
cap refil
24
Q
What is the vibration felt in the chest wall during palpation while the client is speaking
A
Tactile fremitus
25
What can decrease tactile fremitus?
pleural effusion
26
What are the grades for edema?
2mm=1+
4mm=2+
6mm=3+
8mm=4+
27
What is pleural effusion?
A buildup of fluid in the pleural space.
28
What is a pneumothorax?
Air in the pleural space causing the lung to completely or partially collapse.
29
What areas should be palpated for rate and quality?
Palpate the radial
brachial
femoral
popliteal
dorsalis pedis
posterior tibialis pulses
30
When will the lung field sound dull?
normally resonant, but dull if areas of excess fluid are present, such as a pleural effusion
31
what causes fluid filling the air sacs; they sound like popping and crackling. Clients with pneumonia or an infection may have crackles.
Crackles
32
what is a musical noise that is heard on exhalation.
Wheezing ior a whistling
33
what sound may be heard in clients with asthma and COPD.
Wheezing is a whistling and rhonchi
34
what sounds much like wheezing but is caused by constriction in the upper airways and is heard on inhalation.
stridor
35
what type of breathing is a medical emergency
stridor
36
What heart sound is often benign, but in adults it can be an indication of heart failure.
S3 gallop
37
What heart sound can indicate aortic stenosis, hypertension, or a history of myocardial infarction?
S4 gallop
38
If you locate a heart murmur, what should you note?
location, quality, intensity, and pitch
39
__occurs when there is a decreased amount of oxygen in the blood and can lead to ___
Hypoxemia, hypoxia
40
Manifestations of hypoxemia and hypoxia include (5)
confusion, irritability, and restlessness
tachycardia, hypertension
41
Why is an intercostal retraction an emergency?
pressure inside the chest is reduced and can indicate an airway blockage
42
Alkalosis may cause (6)
weakness
dizziness
headache, anxiety
increased heart rate
difficulty breathing
numbness and tingling in the fingers.
43
Causes of hypoventilation include:(4)
Neuromuscular disorders such as muscular dystrophy and Guillain-Barré syndrome
Medications such as barbiturates, narcotics, and benzodiazepines
Neurologic disorders
Trauma
44
s/s of hypoventilation
anxiety
dyspnea with exertion
confusion
disturbed sleep patterns, weakness
an impaired cough.
45
what conditions may cause hypoxia (5)
Smoke inhalation
High altitudes
Lung diseases such as COPD, pneumonia, and asthma
Medications that decrease the respiratory rate
Anemia
46
xamples of contractility disorders include
heart failure, valvular diseases, and arrythmias; examples of perfusion include hypertension, myocardial infarction, and CAD.
47
What are s/s of bradycardia?
lightheadedness, fatigue, chest pain, confusion, fainting (syncope), shortness of breath, and tiring easily with physical activity
48
What are causes of bradycardia?
age-related damage to the heart tissue, damage caused by heart attack or heart disease, and certain medications,
49
What are s/s of tachycardia?
lightheadedness, fatigue, chest pain, heart palpitations, syncope, SOB
50
What are some lifestyle changes for tachycardia?
drinking less caffeine, reducing the amount of alcohol consumed
51
How is atrial fibrillation caused?
triggered by signals coming from outside of the SA node.
52
Why does a- fib cause blood clots?
AV node becomes overwhelmed, start to quiver, and blood pools in the atria
53
When does Ventricular dysrhythmias occur?
electrical impulses begin in the ventricle instead of the atria
54
what-sided heart failure include hypoxia, crackles in the lungs, and shortness of breath.
left-sided
55
dema commonly occurs where
lower extremities, genitals, organs, and abdomen
56
Three factors contribute to tissue perfusion
preload, contractility, and afterload
57
s/s of angina
pain that radiates to the arms, neck area, jaw, shoulder, or back.
Sweating (diaphoresis)
dizziness,
fatigue,
SOB
58
What is the difference between angina and MI pain?
nitro and rest can relieve angina
59
Advantage of Nasal cannula
safe, simple, and inexpensive
comfortable
60
NC concentration
concentrations of 1 to 6 L/min (24% to 44% of oxygen)
61
disadvantage of Nasal cannula
dermatitis
dry mucous/headaches for flow rat 4L+
less accurate in terms of what percentage of O2
62
Simple face mask advantages
Inexpensive
Can be used on mouth breathers
63
What condition is a simple face mask not recommended for a respiratory reason?
co2 retension
those with nausea and vomiting
64
Partial and nonrebreather masks should be used for?
Short term use with clients having acute illness and trauma
65
flow rate for partial and NRB
(60% to 75%; 80% to 95%) at flow rates of 10 to 15 L/min
66
What are some considerations for partial and nonrebreather masks?
Not to be used with humidification.
good seal needed
risk of atelactasis and oxygen toxicity
bag inflated 1/3 for setup
67
Venturi mask disadvantages
noisy
claustrophobic
interferes with eating, drinking, and talking
68
Simple face mask O2 flow
5 to 8 L/min (40% to 60% oxygen concentration)
69
NRB is not recommended to who?
COPD or respiratory failure for long-term use due to a risk of oxygen toxicity.
70
Venturi mask flow rates
flow rates in the range of 4 to 10 L/min (24% to 50%).
71
What patients should have a CPAP?
OSA, premature infants, and clients with cardiopulmonary diseases such as stroke, hypertension, and CAD.
72
OSA s/s
morning headache, extreme daytime drowsiness, loud snoring, and restlessness.
73
OSA can be associated with
heart failure, hypertension, injury, atrial fibrillation, and other arrhythmias
74
How is bilevel positive airway pressure (BiPAP) is different from CPAP?
pressures are higher when inhaling and lower when exhaling, whereas CPAP delivers a single pressure.
75
Who should use BiPAP?
cients whose airway collapses while they are sleeping,
clients with COPD, heart failure, and sleep apnea
76
Oxygen toxicity s/s
twitching of the hand muscles
prolonged exposure can lead to nausea
generalized convulsions
dysphoria
tinnitus
77
chronic oxygen toxicity s/s
atelectasis
coughing
dyspnea
pleuritic chest pain
heaviness substernally. However, once oxygen is discontinued, symptoms lessen within 4 hours
78
how to avoid oxygen toxicity
stress, cold, and increased carbon dioxide in the blood
79
Any heat source should be kept how many feet away from the oxygen system,
five feet
80
Oxygen concentrators should be kept how far away from curtains or walls.
several inches
81
Oxygen tubing should not be longer than how many feet to avoid tripping.
50
82
how many psi for oxygen tank?
2K
83
how much sputum is needed for sample?
1-2 tspn or 2-10 mL
84
What should you document when collecting sputum?
document the time the sample was collected and transport i
85
chest physiotherapy (CPT) consists of what?
chest percussion, vibration, and postural drainage
86
how many times would chest physiotherapy be done a day?
no more than four
87
Percussion is not done over what areas?
the ribs, the sides of the chest, or the lower back, breastbone, lower back and spine
88
When is an IS used?
device is utilized postoperatively to restore functioning of the lungs following a surgical procedure.
89
how often should an IS be used?
10 repetitions per hour with each breath held for 3 to 5 seconds
90
Purse-Lipped Breathing can be used for what situations?
stressful situations, during exercise, and during labor-intensive activities
91
What type of breathing is beneficial for those with emphysema, COPD, and pulmonary fibrosis
stressful situations, during exercise, and during labor-intensive activities
92
How should a purse-lip breathing
breathe in two and exhale 4
93
Coughing and Deep Breathing can aim to
expand lung and clearing secretios
94
When is Coughing and Deep Breathing tecnhique used?
lear the lungs of mucus and pus, and to prevent atelectasis and pneumonia
95
When is Coughing and Deep Breathing tecnhique used?
lear the lungs of mucus and pus, and to prevent atelectasis and pneumonia
96
Coughing and Deep Breathing should be done how often?
five times a day every 1-2 hours
97
Huff Coughing is not as strong as what?
regular coughing because it it just breathing out air forcefully
98
What type of technique should be used for tracheal suctioning?
sterile
99
How should the tracheostomy client be suctioned?
sterile and suction while going up for 10 to 15
100
What shoudl nurses look out for with a chest drainage system
vital signs, breath sounds, oxygenation, and respiratory effort
ensure they are functioning appropriately.
site for edness, swelling, pain, and signs of subcutaneous emphysema
101
nurse is teaching a client how to perform the purse-lipped breathing technique. What is the correct order of steps in purse-lipped breathing?
Purse-lipped breathing is performed by relaxing the neck and shoulders. The client takes a deep breath, inhaling through the nostrils slowly; purses the lips; and exhales through the mouth slowly. This helps ease the struggle of breathing.
102
What should be assessed when documenting drainage chamber?
amount, color, and consistency of drainage
103
What type of water is used to clean a tracheostomysite?
Sterile water or 0.9% sodium chloride
104
How long should you hyperoxygenate a patient for?
Hyperoxygenate the client using 100% oxygen for at least 30 seconds or by having the client take five to six deep breaths.
105
What is the amount of additional air that can be inspired after a regular inspiration.
inspiratory reserve
106
What waist circumference increases the risk for heart disease?
102 cm (40 in) or greater for men and 89 cm (35 in) or greater for women
107
At what level should a chest tube drainage system be at?
below the client's chest to reduce the risk of drainage flowing back into the client's pleural space.
108
Why should you not clamp chest tube tubin for a drain?
The nurse should not clamp the chest tube tubing because this can cause a tension pneumothorax.
109
The nurse should identify that continuous bubbling in the water seal chamber indicates what?
that there is an air leak in the chest tube system.
110
pneumonia s/s
tachypnea
increased temp
111
What allows the lungs to stetch?
surfactant
112
hypoxia is caused by what?
low anemia
pulmonary disease
hypoxemia
113
Why is it more difficult for older people to breathe?
lungs get stiffer and less elastic
muscles are weaker
expiration and inspiration is decreased
alveoli is stiffer
114
early signs of hypoxia
Restlessness
Anxiety
Tachycardia/tachypnea
115
late signs of hypoxia
Bradycardia
Extreme restlessness
Dyspnea
116
How to facilitate oxygen
postition
maintain fluid intake
provide humidified air
chest physiotherapy (except osteoporosis
117
what are benefits of the incentive spirometer?
fully exapnds lungs, prevents atelectasis and infections like pneumonia
118
What do many antitussives contain?
codeine, which causes respiratory distress
119
What drugs reduce inflammation of the airways?
corticosteroids?
120
What drugs opens the airways?
bronchodilators
121
What does smoking do to the lungs?
increases airway resistance
reduces ciliary action
increases mucus
thickens alveolar membrane
causes bronchial wall thickening and loss of elasticity
reduces circulation be narrowing blood vessels-MAJOR vasoconstrictor
122
Where would you hear bronchial sounds and what does it sound like?
loud, high-pitched, hollow quality, expiration longer than inspiration over trachea
123
What are bronchovesicular sounds and where are they heard?
medium pitch, blowing sounds and intensity with equal inspiration and expiration times over the larger airways
124
What are the vescicular sounds?
soft low-pitched over perpheral areas of lungs
