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Fundamentals NUR 220 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

what is the highest single preventable factor in decreasing lung disease?

A

cigarette smoking

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2
Q

smoking has been historically ____?

A

embedded in culture

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3
Q

more smokers in rural or urban cities?

A

urban

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4
Q

what does smoking do to lungs?

A

breaks down and destroys alveolar capillaries and tissue- decreases life expectancy

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5
Q

what is EVALI?

A

e-cig product use associated with lung injury

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6
Q

what is oxygenation?

A

properly functioning alveolar capillary membrane

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7
Q

what blood does oxygenation oxygenate?

A

venous

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8
Q

what does oxygenation remove from blood?

A

carbon dioxide

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9
Q

what is ventilation?

A

ability to transport air to and from lungs
*can’t bring air in

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10
Q

COPD oxy or vent issue?

A

oxygenation issue

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11
Q

asthma oxy or vent issue?

A

ventilation issue

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12
Q

obstructions vent or oxy issue?

A

ventilation issue

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13
Q

which is required to get proper levels of O2 to the tissues?

A

both oxygenation and ventilation

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14
Q

function of upper airway?

A

warm, filter, humidify air
*not actually a function, has to be provided

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15
Q

function of lower airway?

A

conduction of air, mucocilliary clearance
*helps clear airways

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16
Q

what impairs mucocilliary fibers moving air?

A

anesthesia

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17
Q

function of alveolar capillary membrane?

A

gas diffusion

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18
Q

factors affecting pulmonary functioning?

A

-levels of health
-medications (like analgesics)
-lifestyle
-environment

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19
Q

examples of lifestyle factors?

A

sedentary- stasis of secretions
pollution
smoking
work environment
obesity- hypoventilators
pets

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20
Q

what issue do cardiac and lung problems cause?

A

respiratory

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21
Q

affect of chronic resp issue?

A

muscle wasting - includes diaphragm (not working as well) leads to increased workload

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22
Q

anemia affect?

A

low RBC=low oxygen (hemoglobin carries oxygen) resp rate increases to compensate

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23
Q

how would left sided heart failure affect the lungs?

A

build up and back flow into lungs

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24
Q

opioid effect?

A

depressed respiratory system

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25
Q

how does age affect oxygenation function?

A

decreased oxy
-increased work of breathing:
expiration becomes active, should be passive (have to work harder to breath)
-decreased gas exchange due to:
decreased capillaries (where gas exchange takes place)
decreased inspiratory lung volumes

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26
Q

how does age affect ventilation function?

A

decreased vent
-ineffective cough (thicker secretions)
-drier mucous membrane
-delayed gastric emptying= increase aspiration risk
-impaired mobility- impacts resp system
-meds that decrease vent
-tissues and airways more rigid/stiff; diaphragm moves less efficient=less air exchange

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27
Q

increased work of breathing causes?

A

decreased oxygenation

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28
Q

decreased gas exchange causes?

A

decreased oxygenation

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29
Q

what’s included in a focused pulmonary interview?

A

-how is your breathing?
-do you smoke?
-what kind of house? (asbestos, older, stairs/levels, pets)
-who does the cleaning? shopping?
-what type of work?
-chest pain?
-cough? how long? productive? what color?
-fume/smoke exposure? (pulmonary fibrosis)
-most comfy position for breathing?
-allergies?
-travelled? (cryptoplasmosis encounters)

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30
Q

what does using accessory breathing muscles cause?

A

increased work to breathe

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31
Q

what are PACK years?

A

packs per day x years smoking
ex. 1 pack per day for 30 years = 30 pack year hx
*significant lung probs after 35 years

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32
Q

productive cough colors?

A

red - TB
green - infection, bacterial pneumonia
yellow - not so bad
how much?

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33
Q

what term do you NOT use?

A

rales

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34
Q

involved in pulmonary assessment?

A

inspection
auscultation

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35
Q

involved in inspection?

A

-resp rate
-depth
-pattern
-work of breath
-accessory muscle use
-chest symmetry
-skin color
-surgical scars

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36
Q

adventitious sounds in ausculation?

A

wheezing
crackles
rhonchi

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37
Q

what do wheezes sound like?

A

continuous high pitched squeak or musical continuous sound
*air moving through narrow or partially obstructed airway passages
*heard on inhale and exhale
VENTILATION ISSUE
ex. asthma, obstruction, tumor

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38
Q

treatment for wheezes?

A

bronchodilator

39
Q

what do crackles sound like?

A

fine, popping/crackling discontinuous sounds
*air moving through wet secretions
*causes alveolar collapse (pneumonia, fluid overload)
*can be coarse or fine!

40
Q

what does rhonchi sound like?

A

low pitched coarse continuous snoring quality
*secretions in larger airways
need to clear secretions through coughing or suction

41
Q

how to cough for rhonchi?

A
  • breathe in
  • 3 small coughs (work secretions up closer to exit)
  • breathe in
  • one big cough
42
Q

noninvasive ways to check pulmonary function?

A

pulse ox
chest x ray (lung outline)
pulmonary function test (volume in 1 second, max expiratory pressure: blow as fast and hard as you can to measure volumes, also for vent)

43
Q

what does pulse ox measure?

A

arterial hemoglobin, saturation of oxygen

44
Q

when to do continuous pulse ox measurement?

A

if abnormal- less than 90

45
Q

what is a pulse ox spot check?

A

on during vital reading then taken back off

46
Q

what are the invasive way to assess pulmonary function?

A

arterial blood gas analysis (go into artery for sample: gives oxy, bicarb, ph, and co2= oxy and vent)
bronchoscopy (tube into lungs)

47
Q

what is SpO2? PaO2?

A

SpO2: saturation
PaO2: partial pressure of oxygen (from invasive monitoring in ABG)

48
Q

if spo2 is 70%, what is pao2?

A

40%

49
Q

if spo2 is 80%, what is pao2?

A

50%

50
Q

if spo2 is 90%, what is pao2?

A

60%

51
Q

if spo2 is 95%, what is pao2?

A

80%

52
Q

what is normal pao2?

A

60-80

53
Q

tumors are?

A

vascular

54
Q

what to do after lung tumor biopsy?

A

watch for blood, position them upright

55
Q

interventions for adequate pulmonary functioning?

A

-smoking cessation
-positioning (Fowler’s is best [45-60])
-chest physiotherapy (cut hands and repeatedly tap area to loosen fluid= easier to cough up, several shallow huffing breaths then final forceful cough)
-anxiety control
-pursed lip breathing (for COPD- prolongs expiratory phase, inhale 2 exhale 4)
-adequate fluid intake (hydrations thin secretions)
-humidified oxygen
-nutrition
-resp meds
-coughing and deep breathing
-incentive spirometry

56
Q

what is ARDS?

A

adult respiratory depressed syndrome (put in prone position for better breathing)

57
Q

what is a yankauer?

A

suction tube for aspiration precautions

58
Q

what are cough suppressants for?

A

dry cough

59
Q

what are expectorants for?

A

productive cough- get secretions out

60
Q

what do bronchodilators do?

A

open narrowed airways

61
Q

what do corticosteroids do?

A

reduce airway inflammation

62
Q

recommended fluid intake?

A

2-3L

63
Q

what is SMILE incentive spirometry?

A

sustained maximum inspiratory lung expander

64
Q

what does a nebulizer do?

A

disperse fine particles of med into deeper passages of respiratory tract where absorption occurs

65
Q

metered dose inhalers

A

delivers controlled dose of med with each compression of canister
(regular inhaler)

66
Q

dry powder inhaler

A

activated by patients inspiration

67
Q

needed for metered dose inhaler to work properly?

A

spacer, wait 1-5 mins between sprays

68
Q

what do you have to do after using a steroid metered dose inhaler?

A

rinse, possible thrush (fungal infection) if you don’t

69
Q

rescue inhaler duration?

A

short acting beta agonists (SABA)

70
Q

maintenance inhaler duration?

A

long acting beta agonist (LABA)

71
Q

nasal cannula goes to how many liters? fio2 %?

A

6L
24-44%

72
Q

room air is?

A

21% fio2

73
Q

1L/NC?

A

24% Fio2

74
Q

2L/NC?

A

28% fio2

75
Q

3L/NC?

A

32% fio2

76
Q

4L/NC?

A

36% fio2

77
Q

5L/NC?

A

40% fi02

78
Q

6L/NC?

A

44% fio2

79
Q

what is the “christmas tree”?

A

measures fio2

80
Q

nasal cannula injury?

A

behind ears and in nose bc pressure from tubing and drying skin
*can use surgilube

81
Q

how does a non rebreather mask work?

A

oxygen fills reservoir and exhaled air goes out the sides (not re-breathing air they brought in)
*delivers a lot of oxygen
*80%-100% fio2

82
Q

how much fio2 in venturi mask?

A

24%-40%
can dial in precisely how much oxygen is titrated in mask

83
Q

what is CPAP (continuous positive airway pressure) for?

A

obstructive sleep apnea
*can be oxygen delivery or just pressure

84
Q

when is CPAP used?

A

only during sleep

85
Q

how does a BIPAP (biphasic positive airway pressure) work?

A

decreases pressure so you are not exhaling against restistance
*only delivers pressure on inhalation

86
Q

what color is oxygen?

A

GREEN

87
Q

what color is air?

A

YELLOW

88
Q

where do you read O2 liters?

A

middle of little ball

89
Q

what kind of oxygen for highflow nasal cannula?

A

humidified

90
Q

10LPM?

A

60% fio2

91
Q

15LPM?

A

80% fio2

92
Q

20LPM?

A

90% fio2

93
Q

30LPM?

A

98% fio2

Fundamentals NUR 220 (21 decks)

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