Oxygenation Flashcards
Signs and symptoms of poor oxygenation?
- RESTLESSNESS/ Confusion
- Low BP
- Cool Limbs
- Pale or blue color
- Slow Capillary
Ischemia
Bad blood flow
Lungs have large _________
Surface Area
What factors can influence lung disease?
- Environment
- Occupational
- Personal
- Social Habits
Types of Pulmonary Disease?
-Acute (Bronchitis) or Chronic (Asthma)
- Obstructive (COPD) or Restrictive (Pulmonary Fibrosis/Sarcoidosis)
- Infectious (Pneumonia) or Noninfectious (Asthma/COPD/Pulm. Fibrosis)
Symptoms of Respiratory. Alterations?
- Cough
- Dyspnea
- Chest Pain
- Abnormal Sputum
- Hemoptysis
- Altered breath patterns
- Cyanosis
- Fever
Orthopnea, and what’s one thing that can cause it?
Dyspnea while laying down, can be caused by COPD
What does clubbing insinuate?
Heart or lung disease that reduces O2 in blood
Difference between Hypoxia and Hypoxemia?
- Hypoxemia = Low O2 in blood
- Hypoxia = Low O2 in tissues/organs (Tough to measure)
2 Pnuemonics to remember hypoxia symptoms RAT and BED
Early RAT
- Restlessness
- Anxiety
- Tachycardic/pneic
Late to BED
- Bradycardia
- Extreme Restlessness
- Dyspnea
Where is O2 exchange taken place at?
Alveoli sacs in the lungs
What can Hypoventilation cause and what is it called?
What can Hyperventilation cause and what can it cause?
- Too much CO2, called Hypercapnea
- Too low CO2, called Hypocapnea
Atelectasis and how to prevent?
Collapsed air sacs
Prevention:
- Early Ambulation
- Turn Cough Deep Breath
- Incentive Spiometry
What color do you want to see in an X-ray of the lungs?
- Black, it shows that there is air
How often should you listen to lung sounds?
Roughly every 4 hours
Aspiration and how to prevent?
Passage of food into the lungs, can lead to aspiration pneumonia
Prevention
- Assess pt’s swallowing ability
- Keep head of bed elevated with tubes
- Lung assessments
What is included in a complete respiratory assessment?
- Rate
- Use of Accessory muscles
- Cyanosis
- SpO2
- Clubbing
- Dyspnea
- Adventitious breath sounds (Crackles, Wheezes, rhonchi, stridor, rubs)
Diagnostic tests for respirations?
- X ray
- Arterial Blood Gasses (Draw Blood)
- Sputum Culture and sensitivity
- CT
- MRI
- Bronchoscopy
- Thoracentesis
What can we try to do before putting someone on O2?
- Promote lung expansion
- Change positions
- Sit up
- Daily activities
- Cough
- IS device
Post Op.
- IS
- TCDB (Turn, Cough, Deep, Breath)
- Splinting
What does a thoracentesis allow?
Gets a sample of fluid in lungs and allows testing directly
What is a SABA and its prefix?
- Short Acting Beta Agonist
- -erol
What is Albuterol commonly used as? What are its common reactions?
- Bronchodilator in an inhaler to use as needed or just before needed
- Nervousness, tachycardia, headache, throat irritation
What is the main use of corticosteroid?
Reduce inflammation
What is Symbicort commonly used for? Common Symptoms?
- LABA inhaler
- Used twice a day to precent asthma attacks
- Rinse and spit out after inhaling
Common Symptoms:
- Tachycardia
- Nervous
- Palpitations
- Oral Candaidiasis
Proper assessment of pt’s on O2 therapy
- Equipment/ Correct device
- Flow rate is correct
- Check vitals, LOC, and hypoxia
What is the fraction of inspired oxygen?
- FIO2
- The % of oxygen being inhaled
What is room air’s FIO2?
21%
On an oxygen flow meter, what is a safe number to start with?
2-3
How much air can a nasal cannula give and what is its FIO2?
- Up to 6L/min FIO2 of 24%-44%
Advantages and Disadvantages of Nasal Cannula
Advantages:
- Least invasive
- Allows for mobility and even eating
Disadvantages:
- Dries membranes
- Can cause skin breakdown
When is a Venturi mask optimal over other devices?
- When pt is mouth breathing due to nasal issues
Advantages and disadvantages of Venturi mask?
Advantages:
- Controls exact concentration of O2 with different colored nossels
- FIO2 of 24%-60% and flow rate of 4-12L/min
Disadvantages:
- Hot and confining
- Interferes with eating/talking
- Mainly used on COPD patients
Advantages and Disadvantages of of Nonrebreather masks?
Advantages:
- Highest concentrations of O2 that can reach up to 100%
- Treats hypoxia
- Lessens workload of breathing
- Has oneway valves to prevent loss in FIO2 or build up of CO2
Disadvantages:
Only used on very sick pt’s that need that high amount of O2
When do you typically see a face tent?
After surgery
Advantages and disadvantages of Face tents?
Advantages:
- Alternative mask for claustrophobia
- 28%-100% with flow of 8-12L/min
Disadvantages:
- Difficult to control concentration of O2
What to document for O2 situations?
- Date and time of initiation
- Method of delivery
-LPM - Pt response
- Skin condition
- respiratory assessment
- Any pt/family teaching
Physical and Physiological factors that can alter Pulse Ox accuracy?
Physical:
- Movement/Placement
- BP devices
- Lights, and nail augmentations
Physiological:
- Poor arterial flow/edema
- Cold hands and poor capillary filling
- Anemia
Purpose of an Incentive Spirometer (IS)
- Helps prevent post-op complications, like atelectasis
- Encourages long and deep breaths
- Gives visual feedback
How often should and IS be used by pt?
At least 10 breaths every 2 hours (You can tell pt to take some every time there’s a commercial on tv for example)
Some safety facts on Oxygen Safety?
- Cannot smoke when on O2, O2 is flammable
- No aerosol sprays like fabreeze
- No petroleum products like many lip balms, some hospitals will carry petroleum free lip balm
When does O2 toxicity occur?
When someone breaths 100% O2 for >12 hours
How do we properly get someone off of O2?
Slowly ween them off little by little
Signs of oxygen toxicity?
- Pallor
- Sweating
- Nausea and vomiting
- Seizures
- Vertigo
- Nausea or vomiting-
- Hallucinations or visual changes
- Anxiety
- Chest pain or dyspnea
Some respiratory allergic symptoms?
- Runny nose
- Cough
- Red eyes
- Edema
- Vomiting
- Rash
- Redness
- Sneezing
- Lacrimation (Teary eyes)
Anaphylaxis implications in the skin?
- Hives
- Swelling
- Itching
- Warmth and redness
Anaphylaxis implications in respiration?
- Coughing and wheezing
- Shortness of breath
- Chest pain
- Throat tightness
- Swallowing issues
- Hoarse voice
- Nasal congestion or hay fever-like symptoms
Anaphylaxis implications in GI tract?
- Nausea
- Stomach pain/cramps
- Vomiting and diarrhea
Anaphylaxis Implications in Cardiovascular system?
- Dizziness/Lightheadedness
- Pale/Cyanosis
- Weak pulse
- fainting
- Shock
- Loss of consciousness
Anaphylaxis implications in Neuro system?
- Anxiety
- “Impeding doom” feeling
- Headache
Most common symptoms of Anaphylaxis?
- Loss of consciousness
- Hives
- Swelling of tongue and inability to swallow
- Rapid swelling of throat tissue
