Oxygenation Flashcards by Jenna Hufford

what do we look for in a doorway assessment in regards to oxygenation.

Oxygen on correctly
Oxygen attached to wall port
General appearance of patient
Work of breathing, at rest, during exertion
Lung sounds without stethoscope

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what is ventilation?

pressure and volume changes in chest involving inspiration and expiration

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what is involved in inspiration?

diaphragm and
intercostals contract

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what is involved in expiration?

muscles relax

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what is an acceptable inspiration/expiration ratio?

1:2 w/ normal breathing
1:1 w/ rapid breathing (ok if running but not if at rest)

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O2 and CO2 are exchanged by __________

diffusion

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most O2 is carried by _________

hemoglobin molecule on RBCs

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explain diffusion

O2 moves into blood (inspiration) and CO2 moves from blood to alveoli, then expelled (expiration)

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the respiratory center of the brain is located where?

the medulla, pons

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what evaluates levels of CO2, O2, H+ (acid-base balance)?

chemoreceptors

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in normal respiration what is the “driver” ?

CO2 levels

↑CO2 levels/RR increases
↓CO2 levels/RR decreases

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O2 is the ______________ of normal respiration

secondary driver

↑O2 level/RR decreases
↓O2 level/RR increases

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give examples of disorders that chronically retain CO2

COPD
bronchitis
emphysema

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in patients that chronically retain CO2 they develop a __________

CO2 tolerance

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in patients with CO2 retention disorders the primary driver of respiration is

decrease O2 (different reason to breath if given O2 will decrease RR

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in a patient with COPD >2L/min oxygen will _________ respiratory drive

depress; requires careful monitoring

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what is looked at in a respiratory assessment?

general appearance
respiratory rate
O2 stats
lung sounds
skin, mucus membranes, nail bed color
use of accessory muscles
tripoding
mental state (anxiety ↑ RR)

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what is a normal tidal volume for adults?

500mL/breath av.

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a barrel chest appearance is sign of what?

excessive use of accessory muscles

does oxygen require an MD order?

yes, considered a drug

can you apply O2 PRN in an emergency?

yes

what is a normal O2 range in healthy people? and a normal range in COPD?

> 94%
87-92%

what are some safety implication for O2?

O2 supports combustion
assess devices, connections, transport safely
oral and nasal care
assess skin breakdown

what are some factors related to a geriatric adult in regards to oxygenation?

decreased ciliary action

decreased strength of cough

decrease muscle strength

decreased rib cage mobility

what are some lifestyle considerations related to Oxygenation?

smoking vaping excessive alcohol/drug use poor nutrition lack of exercise

what is the purpose of the incentive spirometer?

to prevent atelectasis (the collapse of the alveoli and the beginning of pneumonia)

what are IS instructions?

exhale (breathe out) normally and then do the following: mouthpiece in inhale slowly and deeply when you cannot inhale any longer remove mouthpiece and hold breath for 3 sec. exhale normally

what are 4 oxygen delivery devices?

nasal cannula high flow nasal cannula simple mask nonrebreather

a regular nasal cannula can give between_________and ________LPM and FiO2

1 (24%) and 6 (44%) LPM

a high flow nasal cannula can give between ________and ____________ LPM and FiO2

6 (44%) and 15 (84%) LPM

what is a problem with a high flow nasal cannula?

prevents eating, talking etc. it is a short term solution

a simple mask can deliver between ________and _________ LPM and FiO2

6 (50%) and 8-10 (80%) LPM

if a simple mask is receiving <6L/minute what can happen?

dangerous can deprive pt. of O2

non-rebreather mask info

up to 100% FiO2 with proper fit reservoir bag must remain inflated

BIPAP machine info

“Bilevel positive airway pressure” positive airway pressure increased tidal volume opens alveoli in the bases improves gas exchange often used at night sealed mask/skin breakdown risk

who should use a BIPAP machine?

respiratory distress pt. CHF, COPD, pulmonary edema meant to be SHORT TERM

what are the nursing implications for the BIPAP machine?

pt. comfort continuous pulse ox resp. assessment oral and skin condition mask fit and leak eye condition

what are some signs and symptoms of respiratory disfunction?

adventitious breath sound accessory muscle use cough and sputum production pain (infection or inflammation) cyanosis dyspnea

what are s/s of hypoxia?

mental status changes (anxiety, restless, confusion, coma, drowsy) vital signs (↑RR, ↑HR) late change (skin, GI, Renal)

what is end tidal CO2 monitoring?

a way to measure the amount of CO2 in a person's exhaled breath it is measured probe on the nasal cannula or the endotracheal tube

who should we use end tidal monitoring on?

post op patients, pt. receiving strong opioid meds

what are normal tidal CO2 levels?

35-45 higher values indicate CO2 retention and potential respiratory depression

what are the nursing interventions for pt. with impaired respiratory function?

IS use encourage turn, cough and deep breathing pain control splint with pillow for cough ↑ambulation/activity hydration (mobilizes secretions) expectorants resp. tx o2 rest periods

how do we care for the post op pt with resp. issues?

Assess TCBD q2hr IS activity hydration mobilize asap

what is TCDB?

turn cough deep breathe

what is the nurses role with the hypoventilating pt?

Assess position for max lung expansion stimulate and encourage deep breathing assess med., O2 STAY W/ PT. rapid response naloxone (last resort)

what does nalaxone do?

counteracts any opioids to fix respiratory depression