OXYGENATION Flashcards
poor oxygenation
decreased oxygen level in the blood
can be used to assess oxygen level
oxygen saturation
SpO2 or SAO2 measures what
how saturated hemoglobin are with oxygen (pulse oximetry)
hemoglobin is ___
molecule in blood that carries oxygen
normal oxygen saturation level
95% to 100%, but may see orders for keep O2 Sats above 92%
signs/symptoms of poor oxygenation
restlessness/confusion, decreased blood pressure, cool extremities, pallor or cyanosis of extremities, and slow capillary refill
when oxygen is inadequate to meet metabolic demands of the body we start to get ____ or ____
tissue ischemia or cell death
tissue ischemia
struggling for oxygen
cell death is called
necrosis
hypoxia
low oxygen in tissues
main clinical manifestation for early and late hypoxia
restlessness
alveoli are
air sacs where oxygen is exchanged
lung disease is influenced by
environmental, occupational, and personal
the ____ needs to be able to move freely
diaphragm
pulmonary diseases:
acute, chronic, obstructive, infectious, noninfectious, and restrictive
acute pulmonary disease
sudden onset, short period- bronchitis
chronic
asthma
obstructive
COPD
restrictive
pulmonary fibrosis, sarcoidosis
infectious
pneumonia
noninfectious
asthma, copd, pulmonary fibrosis
clinical manifestations of respiratory alterations:
cough (acute/chronic), dyspnea, chest pain, hemoptysis, altered breathing patterns, cyanosis, fever
hemoptysis is ___
cough up blood
cyanosis is best assessed
around fingertips and around mucus membrane of face
orthopnea
dyspnea when laying down
often occurs in heart and lung diseases that reduce amount of oxygen in the blood
clubbing in fingers
low levels of oxygen in the tissues and organs, hard to measure
hypoxia
low level of oxygen in the blood
hypoxemia
measure for hypoxemia with
pulse ox
symptoms of hypoxia
early: restlessness, anxiety, tachycardia/tachypnea
late: bradypnea, extreme restlessness, dyspnea
ventilation
act of exchanging oxygen for carbon dioxide
hypoventilation
breathing too shallow or too deep
causes of hypoventilation
anxiety, respiratory depression, mediations (opioids), sleep (normal process), decreased level of conciousness
if you are hypo-ventilating you are ____
hypercapnic
hypercapnia
building/holding on to CO2
hyperventilation
breathing that is too rapid or too deep
causes of hyperventilation
exercise, anxiety, and pain
hypocapnia
low on CO2
what color is good to see on an x-ray of lungs?
black = air
atelectasis
collapsed air sacs (alveoli)
prevention of atelectasis:
early ambulation, TCDB, incentive spirometry
aspiration
passage of gastric contents (solid or fluid) into lungs, can cause aspiration pneumonia
prevention of aspiration
assess patients ability to swallow, keep head of bed elevated with tube feedings, thorough lung assessment (minimum every 8 hours)
assessment of respiratory rate
respiratory rate, use of accessory muscles, cyanosis, oxygen saturation, adventitious breath sounds, clubbing, dyspnea with activity
crackles in lungs
fine crackles are very common, fluid in lungs, and coarse crackles
wheezes
due to fluid or blockage, high pitch squeaking sounds. heard on expiration than inspiration
rhonchi is
severe wheezes
types of diagnostic testing
x-ray, sputum culture and sensitivity, MRI, CT scan, arterial blood gases, bronchoscopy, and thoracentesis
what is thoracentesis?
needle that aspirates fluid out
two things from doing a thoracentesis
remove fluid and send fluid off for testing
promotion of lung expansion
position change (every 2 hours), keep upright, increase daily activities & ensure hydration, coughing exercises, and deep breathing (IS)
post operative of lung expansion
IS, TCDB, splinting incision (abdominal incision)
-erol
SABAs- short-acting beta agonist, stimulates beta- 2 adrenergic receptors, relaxing airway smooth muscle
common reactions of albuterol
nervousness, tachycardia, headache, and throat irritation
budesonide
LABA - long- acting beta agonist
common reactions of budesonide
tachycardia, nervousness, palpations, oral candidiasis
assessing patients on oxygen therapy
equipment, correct oxygen delivery device, flow rate is correct, respiratory assessment
respiratory assessment for patients on oxygen therapy
vital signs, oxygen saturation, LOC and any signs or symptoms of hypoxia, and skin
oxygen is a ____
medication and needs doctor orders
flow meter
normal flowing is around 2L
fraction of inspired oxygen
is percent of oxygen a person is inhaling
room air FIO 2 is
21%
with supplemental oxygen, FIO2 can reach
100%
oxygen delivery for nasal cannula
usually no more than 4 LPM, up to 6 LPM. (2-3 lpm good starting point)
FIO2 for nasal cannula is ___
24% to 44%
disadvantage of a nasal cannula:
dries membrane and skin breakdown
oxygen delivery for venturi mask
4 to 12 lpm
FIO2 for venturi mask
24% to 60%
advantage of a venturi mask
controls exact concentration of oxygen
venturi mask is commonly used in ___
COPD patients
FIO2 for non-breather mask
60-100% at 10-15 L for 100%
non-breather masks has valves that ____
open during expiration and close during inhalation
non-breather delivers ____ and treats
higher concentrations of oxygen and treat hypoxia
face tent delivers ____%
28-100%
flow rate of face tent
8-12 lpm
documentation
date and time of oxygen initiated, method of delivery, flow rate in liters per minute, patient response to oxygen, condition of patient’s skin where device rests, respiratory assessment, and patient/family teaching
oxygen toxicity can develop when a person breathes ____ % oxygen for > 12 hours
100%
signs and symptoms of oxygen toxicity
pallor, sweating, nausea and vomiting, seizures, vertigo, muscle twitching, hallucinations, anxiety, chest pain, and dyspnea
respiratory implications of allergic reactions
lacrimation, running nose, cough, red eyes, edema, vomiting, rash, redness, and sneezing
respiratory implications of anaphylaxis
skin, respiratory, gastrointestinal, cardiovascular, neurological
oxygen may be titrated from ____ via nasal cannula
0-5 lpm
all nasal cannula’s above 4 lpm will be ____
humidified
oxygen may be titrated up to ____% for venturi mask
40%
patient will be re-evaluated every ___ hours
24 hours
oxygen therapy will be titrated and weaned for patients that are able to maintain a SpO2 of ____
90%