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201B Exam 4 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

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

A

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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2
Q

what is ventilation?

A

pressure and volume changes in chest involving inspiration and expiration

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3
Q

what is involved in inspiration?

A

diaphragm and
intercostals contract

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4
Q

what is involved in expiration?

A

muscles relax

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5
Q

what is an acceptable inspiration/expiration ratio?

A

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

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6
Q

O2 and CO2 are exchanged by __________

A

diffusion

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7
Q

most O2 is carried by _________

A

hemoglobin molecule on RBCs

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8
Q

explain diffusion

A

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

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9
Q

the respiratory center of the brain is located where?

A

the medulla, pons

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10
Q

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

A

chemoreceptors

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11
Q

in normal respiration what is the “driver” ?

A

CO2 levels

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

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12
Q

O2 is the ______________ of normal respiration

A

secondary driver

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

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13
Q

give examples of disorders that chronically retain CO2

A

COPD
bronchitis
emphysema

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14
Q

in patients that chronically retain CO2 they develop a __________

A

CO2 tolerance

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15
Q

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

A

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

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16
Q

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

A

depress; requires careful monitoring

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17
Q

what is looked at in a respiratory assessment?

A

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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18
Q

what is a normal tidal volume for adults?

A

500mL/breath av.

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19
Q

a barrel chest appearance is sign of what?

A

excessive use of accessory muscles

20
Q

does oxygen require an MD order?

A

yes, considered a drug

21
Q

can you apply O2 PRN in an emergency?

A

yes

22
Q

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

A

> 94%
87-92%

23
Q

what are some safety implication for O2?

A

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

24
Q

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

A

decreased ciliary action

decreased strength of cough

decrease muscle strength

decreased rib cage mobility

25
Q

what are some lifestyle considerations related to Oxygenation?

A

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

26
Q

what is the purpose of the incentive spirometer?

A

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

27
Q

what are IS instructions?

A

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

28
Q

what are 4 oxygen delivery devices?

A

nasal cannula
high flow nasal cannula
simple mask
nonrebreather

29
Q

a regular nasal cannula can give between_________and ________LPM and FiO2

A

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

30
Q

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

A

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

31
Q

what is a problem with a high flow nasal cannula?

A

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

32
Q

a simple mask can deliver between ________and _________ LPM and FiO2

A

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

33
Q

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

A

dangerous can deprive pt. of O2

34
Q

non-rebreather mask info

A

up to 100% FiO2 with proper fit

reservoir bag must remain inflated

35
Q

BIPAP machine info

A

“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

36
Q

who should use a BIPAP machine?

A

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

37
Q

what are the nursing implications for the BIPAP machine?

A

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

38
Q

what are some signs and symptoms of respiratory disfunction?

A

adventitious breath sound

accessory muscle use

cough and sputum production

pain (infection or inflammation)

cyanosis

dyspnea

39
Q

what are s/s of hypoxia?

A

mental status changes (anxiety, restless, confusion, coma, drowsy)

vital signs (↑RR, ↑HR)

late change (skin, GI, Renal)

40
Q

what is end tidal CO2 monitoring?

A

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

41
Q

who should we use end tidal monitoring on?

A

post op patients, pt. receiving strong opioid meds

42
Q

what are normal tidal CO2 levels?

A

35-45

higher values indicate CO2 retention and potential respiratory depression

43
Q

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

A

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

44
Q

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

A

Assess
TCBD q2hr
IS
activity
hydration
mobilize asap

45
Q

what is TCDB?

A

turn cough deep breathe

46
Q

what is the nurses role with the hypoventilating pt?

A

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

47
Q

what does nalaxone do?

A

counteracts any opioids to fix respiratory depression

201B Exam 4 (3 decks)

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