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NURS 1245 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

…. is the passage of fluid through the circulatory system or lymphatic system to an organ or a tissue, usually referring to the delivery of blood to a capillary bed in tissue.

A

Perfusion

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2
Q

Occurs via diffusion movement of oxygen and carbon dioxide between the air and blood

A

Gas exchange

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3
Q

Gas Exchange

Inspiration & Expiration

Are collectively known as

A

Ventilation

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4
Q

Respiration occurs between

( ______ –> ______)

A

Alveolar —> Capillary

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5
Q

Gas Exchange

Perfusion is between these two parts of the body

A

(Capillary –> Tissues)

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6
Q

Organs of the Respitory Tract

Flash Game Review

A

Think about poor little Andy

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7
Q

Chemoreceptors

Found in the medulla respond to these 2 chemical changes

A

Hydrogen ion (H+)

partial pressure of Carbon Dioxide (PaCO²)

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8
Q

Mechanical Receptors

Found in the conducting upper airways

Do these two things

A

Initiate cough reflex

Aid in control of respiration

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9
Q

Infant- short airways

Risk for

A

Aspiration

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10
Q

ABC

Is always the priority

A

Airway

Breathing

Circulation

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11
Q

Hypoxia is defined as

PO² <

A

80 mm Hg

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12
Q

Condition in which inadequate oxygen is available to the cells

A

Hypoxia

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13
Q

Common signs

Decreased energy

Restlessness (Early)

Rapid, Shallow breathing

Sitting up to breath

A

Hypoxia

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14
Q

Noninvasive Diagnositic Methods

Hypoxia

A

SpO² (Pulse Oximetry)

Pulmonary Function Studies

Peak expiratory flow

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15
Q

Measures SaO²
95 - 99% normal
Treat if <92%
COPD 88%
Must know Hgb

A

Pulse Oximetry

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16
Q

Noninvasive Studies for Hypoxia that require an order

(2)

A

Chest X ray

Sputum for analysis

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17
Q

Peak expiratory flow rate

Over 80% of personal best means
All Good, no further action

50 - 70%

Less than 50%

A

50 - 70%
Take “green zone medications & inhaled bronchodilator, inhaled Anti-inflammatory.

After 20 - 60 minutes if not feeling better or peak flow is less than 70% of personal best, Get Immediate Help

Take Yellow Zone Meds, oral corticosteroids (prednisone)

Get Immediate Help

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18
Q

palpable or audible popping, crackling, grating, or crunching sensation that can occur when air is pushed through the soft tissue in the chest

A

Crepitus

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19
Q

Brief, discontinuous sounds heard during inspiration or expiration. They can be fine (high-pitched) or coarse (low-pitched), indicating conditions like pneu

A

Crackles (Rales)

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20
Q

Continuous, musical sounds heard mainly during expiration. Suggests narrowed airways, common in asthma or chronic obstructive pulmonary disease (COPD).

A

Wheezes (Rhonici)

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21
Q

High-pitched, crowing sound often heard during inspiration, indicating upper airway obstruction, such as in croup.

A

Stridor

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22
Q

Grating or rubbing sound heard during inspiration and expiration, indicating inflammation of the pleural surfaces, often seen in conditions like pleurisy.

A

Pleural friction rub

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23
Q

Decreased / absent lung sounds indicate….

A

Indicates reduced airflow and can be due to conditions like pneumothorax or pleural effusion.

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24
Q

Normal lung sounds are referred to as ____ breath sounds.

Abnormal lung sounds fall into the category of ____ sounds, which include crackles (rales), wheezes (rhonchi), stridor, pleural friction rub, and decreased or absent

A

vesicular= normal

adventitious= abnormal

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25
Q

Rapid, Shallow breathing
Rapid heart rate
Sitting up to breathe
Nasal flaring
Use accessory muscles
Hypertension
Cyanosis

Are all signs of

A

Hypoxia

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26
Q

Peak flow meter use

Blow as hard as possible

How many time?

Which reading do you take

A

3

Highest

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27
Q

Invasive test

ABG

PO²
PCO²

NORMS

A

80-100 mm Hg (PO²)
35-45 mm Hg (PCO²)

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28
Q

Invasive test

Bronchopscopy HIGH RISK

Function

Before and After TEACHINGS

A

Visualize structures & remove substances

NPO Before

NPO until gag reflex returns

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29
Q

Invasive test

CT scan

Contradictions

A

Iodine allergy

Metformin

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30
Q

ABG

PH

A

7.35- 7.45

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31
Q

ABG

bicarbonate HCO3

____ mEq/L

A

22 - 26

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32
Q

Thoracentesis is a procedure….

A

to remove fluid or air from around the lungs

A needle is put through the chest wall into the pleural space.

The pleural space is the thin gap between the pleura of the lung and of the inner chest wall

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33
Q

During thoracentesis if chest tube becomes dislodged

A

Cover with gauze and call physician

If Dr. Doesn’t arrive quick, Call Code

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34
Q

Proper breathing techniques

(5)

A

Deep breathing
Cough
Incentive spirometer
Pursed Lips breathing
Abdominal breathing

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35
Q

When would you use a Antitussive Cough syrup

Give examples

A

Suppression of cough

Codine
Dextromethorphan (Robitussin DM)

Post operative, Pain Management, Sleep Disturbance

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36
Q

To promote cough give this type of syrup

A

Expectorant

Guaifenesin (Robitussin)

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37
Q

Reinforce deep breathing
Promote cough
Max lung inflation
Reduce Atelectasis
Optial gas exchange

A

Incentive spirometer

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38
Q

Percuss lungs to loosen secretions

How long & Often

A

30 - 60 seconds

3x daily

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39
Q

How know patient isn’t tolerating suctioning

A

Respiratory Distress
Hypoxia/ cyanosis
Change in heart rate

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40
Q

In situations of acute respiratory distress, such as an asthma attack or exacerbation of COPD, ________ can help relieve symptoms and improve airflow.

A

bronchodilators

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41
Q

Albuterol (Proventil)

A

Bronchodilator

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42
Q

Montelukast (Singulair)

A

Bronchodilator

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43
Q

Theophylline (Slo-bid)

A

Bronchodilator

44
Q

Tiotropium (Spiriva)

A

Bronchodilator

45
Q

Purpose: They are primarily used for Acute relief of narrowing of the airways.

They quickly improve airflow and alleviate symptoms like wheezing and shortness of breath.

A

Bronchodilators

46
Q

Purpose: They are used to manage chronic inflammatory conditions and prevent exacerbations.

They have a slower onset of action

A

Steroids - Anti-inflammatory
Budesonide (Pulmicort)
Prednisone

47
Q

In summary, ________ provide rapid relief by relaxing airway muscles,

while ____ address underlying inflammation and are often used for long-term management and prevention of exacerbations in chronic respiratory conditions.

A

bronchodilators

steroids (prednisolone)

48
Q

Antihistamines are commonly used to manage allergic reactions, but they may also have a role in certain respiratory conditions.

rhinitis (hay fever)

Name 3

A

Benadryl (Diphenhydramine)
Claritin (Loratadine)
Zyrtec (Cetrizine)

49
Q

Supp Oxygen

Therapeutic Goal

Arterial PO² & PCO²

A

Po² 80 - 100

PCO² <45

50
Q

Nasal Cannula

Room air = ___ %

A

21

51
Q

Nasal Cannula

1L = ___ %
2L
3L
4L
5L
6L

A

1L = 24%
2L = 28%
3L = 32%
4L = 36%
5L = 40%
6L = 44%

52
Q

Nasal Cannula rate no higher than __ LPM

A

6

53
Q

Nasal Cannula/ High Flow

Who is it best tolerated by

A

10L - 15L 65 - 90%

Children

54
Q

Simple Face Mask

Delivers __ - __ L/min
Never less than 6 lpm
. A minimum of 6 L/minute of oxygen flow is needed to prevent rebreathing of exhaled carbon dioxide.

Hypercapnic

Shorter periods
___ - ___ hrs

A

6 - 10

12 - 24hr

55
Q

This device is used when an increase of oxygen is needed for a short period of time.

Flow rate 5 - 10 lpm 40% - 60%

A

Simple face Mask

56
Q

_______ Masks are used for individuals who are still able to breathe on their own but require additional oxygen (e.g., traumatic injury to the lungs; smoke inhalation; carbon monoxide poisoning; any chronic disorder of the airways that limits the amount of oxygen reaching the lungs, such as chronic obstructive pulmonary disease [COPD], cystic fibrosis, pulmonary fibrosis, and sarcoidosis).

A

Non-rebreather

57
Q

The main difference between the two masks is in how much recycled air you rebreathe. A ______ mask has two-way valves instead of one-way valves. This means you rebreathe a small amount of outside air. With a ________, the one-way valve doesn’t allow you to breathe in any outside air.

A

partial rebreather

non-rebreather mask

58
Q

Partial rebreather mask

Flow: 6 - ____ LPM

70% - 90%

How much should the bag deflate?

A

15LPM

Only partially

59
Q

This mask provides the highest concentration of O²

Up to 100%

A

Nonrebreather Mask

60
Q

Provides most precise level of Oxygen

Usually from 4 - 10L

A

Venturi Masks

61
Q

Used in unconscious persons

Prevents the tongue from blocking the airway

A

nasopharyngeal airway (NPA)

Oropharyngeal airway

62
Q

deliver oxygen to the lungs if you’re unable to breathe normally after an injury or accident, or because your muscles are very weak

allow you to breathe if your throat is blocked – for example, by a swelling, tumour or something stuck in the throat

reduce the risk of food or fluid entering the lungs (aspiration) if you find coughing difficult

Uses of what

A

Tracheostomy

63
Q

Tracheostomy

Palpate around stoma for ______, which occurs if air leaks out into muscle planes from tracheal wall erosion or dislodged tube.

What does it feel like

A

subcutaneous Emphysema

Rice krispies

64
Q

These devices blow humidified, heated oxygen into the nostrils. They can deliver up to 60 liters of oxygen per minute.

A

High Flow nasal cannula

65
Q

surgically created hole _____ in your windpipe (trachea) that provides an alternative airway for breathing

Tracheostomy

A

(stoma)

66
Q

Difference in appearance from an Oral / Nasopharyngeal Tube

A

Oral: Pirate Hook shaped

Nasal: longer / curved type tube

67
Q

An _____ is a thin, curved piece of hard plastic or rubber that is inserted into the tracheostomy tube (cannula) to help with placing the tube into the trachea.

The ____ provides a smooth surface to guide the tube into the airway without damaging the inner lining of the trachea

A

obturator

68
Q

Tumors or bronchial cancer.

Airway blockage (obstruction)

Narrowed areas in airways (strictures)

Inflammation and infections such as tuberculosis (TB), pneumonia, and fungal or parasitic lung infections.

Interstitial pulmonary disease.

Indicated for…

A

Bronchoscopy

69
Q

How do you know patient can tolerate suctioning

How do you know they can’t tolerate it

A

Cough = Tolerate

Pulse Ox Drops = Not tolerate

70
Q

Patients with good coordination and inhalation abilities often prefer ( MDIs, DPI, Nebulizer);

( MDIs, DPI, Nebulizer) inhalers are suitable for those who may struggle with the hand-lung coordination.

( MDIs, DPI, Nebulizer) are typically used for patients, especially young children or those with severe respiratory conditions, who may find it challenging to use inhalers effectively.

A

( MDIs, DPI, Nebulizer)

71
Q

Turn up oxygen when giving a Nebulizer treatment

True or False

A

True

72
Q

This type of mask is most commonly used post surgery and delivers 6 - 10L.

Short term use only 12 - 24 hrs

A

Simple Mask

73
Q

This type of mask is used to maintain CO² Levels

A

Partial rebreather

74
Q

Highest concentration of O² & Fastest release of CO²

A

Non Rebreather

75
Q

Occlusion or closure of the one-way valves in a _____ mask can lead to an increase in oxygen concentration, potentially exceeding safe levels.

A

partial rebreather

76
Q

Air comes in but doesn’t come out describes

A

COPD

77
Q

Concerns with tracheostomy (4)

A

Airway Management: Ensuring the patency of the tracheostomy tube and assessing for any signs of obstruction or dislodgment.

Infection Control:

Suctioning: Regular suctioning

Humidification:

78
Q

Suctioning a tracheostomy is sterile procedure

True or False

A

True

79
Q

When do you suction

Going in or Pulling out

A

Pulling out

80
Q

Passy-Muir valve….

A

Helps patients with a tracheostomy talk better

81
Q

Too much oxygen can be dangerous for patients with … (2)

A

COPD

chronic obstructive pulmonary disease (COPD)

Hypercapnia (partial pressure of carbon dioxide in arterial blood greater than 45 mm Hg).

82
Q

_____, or “crepitation,” are short, high-pitched sounds.

______ are a lower pitch and last longer.

A

Fine crackles

Coarse crackles

83
Q

The sound of a _____ is a high-pitched, continuous whistle-like, musical sound. This is caused by air passing through an obstructed, narrow airway.

A

classic wheeze: Sibilant wheeze

84
Q

Deep, low-pitched rumbling or coarse sound, as air moves through tracheal/bronchial passages in the presence of mucus or respiratory secretions.

Refered to as (2)

A

Rhonchi: Sonorous wheeze

85
Q

Commonly heard in the bases of the lung lobes during inspiration.

Crackles can be further categorised as coarse or fine.

_____ crackles sound quality is low-pitched and moist; it may be heard in pulmonary oedema and bronchitis.

____ crackles sound quality is like hair rubbing near the ear and may be heard in congestive heart failure and pulmonary fibrosis.

A

Coarse / Fine

86
Q

Bronchial breath sounds can be auscultated where?
A. Peripheral lung fields
B. Sternal area
C. Mid-scapulae area
D. Tracheal area

A

D. Tracheal area

87
Q

These type of breath sounds are found at the site of the bronchi and are located anteriorly at the 1st and 2nd intercostal space & posteriorly in between the scapulae?
A. Crackles
B. Wheezes
C. Bronchovesicular
D. Vesicular

A

C. Bronchovesicular

88
Q

These breath sounds are found anteriorly and posteriorly throughout the peripheral lung fields?
A. High-pitched wheezes
B. Vesicular
C. Discontinuous
D. Bronchial

A

B. Vesicular

89
Q

While assessing a patient’s lung sounds you note bronchial breath sounds in the peripheral lung fields. What could this finding represent?
A. This is a normal finding.
B. Pulmonary emboli
C. Lung consolidation like with pneumonia
D. Pleuritis

A

The answer is C.

Bronhical breath sounds should only be heard in the trachael area. It is ABNORMAL to hear them in the perpherial lung fields. If this happens, it could represent lung consolidation like with pnemonia.

90
Q

Select all of the following that are considered discontinuous breath sounds:
A. High-pitched wheeze
B. Stridor
C. Pleural friction rub
D. Fine crackles
E. Low-pitched wheeze
F. Coarse Crackles

A

C. Pleural friction rub
D. Fine crackles
F. Coarse Crackles

The answer is C, D, and F. The other options are CONTINUOUS breath sounds.

91
Q

True or False: Low-pitched wheezes are polyphonic sounds that can be cleared when coughing.
True
False

A

The answer is FALSE. Low-pitched wheezes are MONOPHONIC (have one sound quality to them) that are not usually cleared by coughing.

92
Q

This lung sound is continuous, high-pitched with musical instrument sound that is polyphonic and occurs mainly during expiration but can be present with inspiration as well?
A. Stridor
B. Fine crackles
C. High-pitched wheeze
D. High-pitched crackles

A

C. High-pitched wheeze

93
Q

On auscultation of a patient in respiratory distress, you hear a high-pitched, harsh sound that is monophonic and is present only during inspiration. This is known as:
A. Stridor
B. Vesicular
C. Rales
D. Rhonchi

A

A. Stridor

94
Q

You are auscultating a patient’s lung sounds. During your assessment, you note there is a low-pitched harsh, grating sound that sounds like a pleural friction rub. However, you’re not sure if this is a pleural friction rub or pericardial friction rub. What do you do next to determine the difference?
A. Have the patient cough and see if the sound clears
B. Assess the posterior lower lobe only
C. Have the patient hold their breath and note if the sound is still present
D. Place the patient in supine position and reassess for the sound

A

The answer is C. A pleural friction rub can sound similar to a pericardial friction rub. If you are unsure about what you are hearing, have the patient hold their breath which will cause the lungs to stop inflating and deflating. If you still hear the sound, it is possible the patient has a pericardial friction rub rather than pleural friction rub. All the other options are incorrect.

95
Q

True or False: The left lung has 3 lobes: left upper lobe, left middle lobe, and left lower lobe.
True
False

A

The answer is FALSE. The right lung has THREE lobes and the left lung has TWO lobes.

96
Q

During auscultation, the anterior part of the chest mainly provides an assessment of the upper lobes of the right and left lungs, while the posterior part of the chest provides mainly provides an assessment of the lower lobes of the right and left lungs.
True
False

A

The answer is TRUE.

97
Q

When auscultating the anterior part of the chest, specifically the apex of the lungs, it is best to auscultate where with the stethoscope?
A. Slightly above the clavicle
B. 2nd intercostal space mid-clavicular
C. 4th intercostal space mid-clavicular
D. 6th intercostal space mid-axillary line

A

A. Slightly above the clavicle

98
Q

When auscultating the posterior part of the chest the upper lobes are found?

A. Between C9 to T10

B. Between T3 to T10

C. Between C7 to T3

D. Directly over the scapulae

A

The answer is C.

C. Between C7 to T3

99
Q

Thoracentesis treats _____ or excess fluid in the space between your lungs and your chest wall.

It helps relieve symptoms and figure out what might be causing the fluid, so that your provider can treat it appropriately

A

pleural effusion

100
Q

Venturi mask is most likely used in which type of patient

A

COPD

101
Q

Aerosolized

10L - 15L

Best tolerated by children

A

Nasal Cannula/ High Flow

102
Q

6 - 15L

Deflation of bag w/ inspiration (less than 2/3)

Hypercapnia

A

Partial rebreather

103
Q

Highest concentration O²

Exhale through side ports

Faster release of Co²

Set at 15 L / min

70 - 100% O²

A

Non-rebreather

104
Q

Occlusion of Venturi mask can cause

A

O² LEVELS TOO HIGH

105
Q

3 types of artificial airways

A

Nasopharyngeal/ Oropharyngeal

Endotracheal Tube

Tracheostomy

NURS 1245 (12 decks)

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