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Health and Illness Exam #2 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

Three Main Elements of Respiration?

A
  1. Ventilation
  2. Transport
  3. Perfusion
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2
Q

Age Related factors: For Babies
( Born before 36 weeks )

A
  • Insufficient surfactant to keep alveoli from collapsing
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3
Q

Age Related factors: For Babies
( Newborn - 3 mon )

A
  • Breath through nose, sneeze a lot, irregular respiratory patterns
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4
Q

Age Related factors: For Older Adults

A
  • Diminished muscle strength
  • Reduced inspiratory / expiratory effort
  • Less RBC’s
  • Less alveolar elasticity
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5
Q

Oxygenation Impairment

A

Mild Impairment: Compensation; fatigue, increased HR, RR
Moderate Impairment: Less O2 to cells- Cellular injury, More CO2 in cells: Resp Acidosis

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6
Q

Consequences of Impairment of Oxygen

A

Hypoxemia –> Hypoxia —> Anoxia —> Cell death

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7
Q

Risk factors for impaired oxygen

A
  • Age
  • Smoking
  • COPD, CF presence
  • Anemia
  • Brain injury
  • Prolonged immobility
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8
Q

Ventilation

A

The process of inhaling oxygen into the lungs
Impaired –>
High altitude
Disorders
Rib fractures
Narrowed airways ( COPD, CF )
Poor gas diffusion ( PE, pneumonia )

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9
Q

Transport

A

Refers to the availability and ability of hemoglobin to carry oxygen from the alveoli into the cells
Impaired –>
Not enough erythrocytes or hemoglobin = anemia

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10
Q

Perfusion

A

Refers to the ability of the blood to transport oxygen containing hemoglobin to the cells
Impaired —>
Decreased CO, thrombi, emboli, vessel narrowing

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11
Q

Unexpected finding Assessment for Breathing:

A
  • Use of accessory muscles, asymmetrical, barrel chested
  • HR over 100 bPM
  • Wheezing, stridor, rhonchi, dull
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12
Q

Diagnostic Tests

A

ABG, complete blood count, sputum, biopsy
Chest X ray
Endoscopy: Stent to see blockage
Pulm function ( FVC ) : Max air you can blow out in 1 min

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13
Q

What is a pneumothorax?

A

Presence of air or gas in the pleural space which causes lung collapse

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14
Q

Air vs Liquid

A

Pneumothorax: Air in pleural cavity
Hemothorax: Blood
Pleural Effusion: Fluid

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15
Q

Pneumothorax traumatic vs spontaneous

A

Traumatic:
- Air enters space due to trauma
- Blunt force ( broken rib )
- Penetrating trauma ( stabbing, shooting )

Spontaneous:
- Small sac of air called bleb in lung tissue ruptures
- Weak lung tissue
- High pressure pushing into lungs
- No trauma
- COPD, old age –> Fragile lung tissue , lung infection

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16
Q

Risk factors for pneumothorax

A
  • Blunt chest trauma
  • Penetrating chest wound
  • COPD
  • Older adults: decreased lung elasticity = more fragile lung tissue
17
Q

Tension Pneumothorax

A
  • Air enters during inspiration but not able to leave
  • Hypotension
  • *** Mediastinal shift; r/t pressure rise
  • JVD
  • More likely after trauma
  • ** Emergent Situation
18
Q

S/S of pneumothorax

A
  • Anxiety, pain, inability to take breath
  • Sudden onset
  • Sharp, severe chest pain felt on same side as the pneumothrorax ( ipsilateral )
  • Usually unilateral
19
Q

Pneumothorax physical assessment

A
  • Resp distress
  • *** Tracheal Deviation
    -Reduced breath sounds on affected side
  • Asymmetrical chest wall movement ( 1 side functioning normal )
  • Hyperrsonance ( Drum ) = trapped air
  • Hemothorax ( Dull )
  • Subq emphysema ( air )
20
Q

Diagnostic tests for pneumothorax

A
  • ABG’s: PaO2 less than 80 mmHg
  • Chest X ray: Confirmation of pneumothorax or hemo
  • Thoracentesis: Temp fix, large bore needle into chest wall and pleural space, if tension = emergent!
21
Q

Oxygenation Nursing Care

A
  • Admin oxygen, meds
  • Listen to heart and lungs
  • Vital signs
  • Position to high fowlers
  • Monitor for; chest tube drainage, s/s of infection
22
Q

Patient Centered Care: Meds

A
  • Benzodiazepines ( Lorezepam )
  • Decrease anxiety = sedatives
  • Decreases anxiety
  • Vital signs: watch for hypotension, amnesiac effects, monitor for euphoria/ rage, drowsiness, memory loss
23
Q

Patient Centered Care: Meds

A

Opiod agonists
- For severe pain
- Morphine, sulfate, fentanyl
- Monitor for respiratory depression
- Pain Q4hrs
- Hypotension, N/V, constipation

24
Q

Therapeutic Procedures

A
  • Chest tube insertion
    : Drain blood, fluid, air
  • Re establish negative pressure
  • Facilitate lung expansion
  • Restore normal intrapleural pressure
25
Q

Therapeutic Procedures
Nursing actions:

A
  • Witness informed consent
  • Gather supplies
  • Admin pain meds
    Monitor: Vital signs, response, placement
26
Q

Therapeutic Procedures
Education:

A
  • Deep breathing
  • Rest
  • Immunizations
  • Smoking cessation
  • Report URI
  • Importance of support
27
Q

Complications

A

Decreased CO:
- Hypotension
- IV fluids

Resp Failure: Inadequate gas exchange d/t lung collapsing
- Mechanical ventilation

28
Q

Chest tube Care

A

-Keep all tubing free of kinks and occlusions; for instance, check for tubing beneath the patient or pinched between bed rails.
- Take steps to prevent fluid-filled dependent loops, which can impede drainage.
- To promote drainage, keep the CDU below the level of the patient’s chest.

Health and Illness Exam #2 (3 decks)

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