Oxygenation Flashcards
What is room air
21% O2
What is O2 considered
A medication
What should you do if your in an O2 emergency
Just give it and get an ORDER later
What are the two low flow systems
NC, SIMPLE face mask
VARIBLE performance
What are the high-slow systems
Rebreather masks, venturi
FIXED performance
Tell me about the flow meter
Attaches to the WALL, CHRISTMAS TREE, TIP goes DOWN, read the ball from the MIDDLE
Which way should NC prongs go
Point DOWN
What is the flow rate of NC
1-6
What do you need for 4L or more on NC
Humidifier
What do you hook up the O2 to
GREEN not yellow
What are the pros to NC
Pt can TALK and EAT, SAFE, SIMPLE, 85-90% O2, LONG-TERM use
What are the disadvangetes of NC
Can’t use with nasal obstruction, DISLODGE, DRYNESS
What is the flow rate for simple face mask
6-10
Tell me about the simple face mask
AIR holes, lets OUTSIDE air inWha
t to use a simple face mask
80%, not is distress, 2-3hrs
What are the advantages of simple face mask
EXHALE air, still TALK
What are the cons of the simple face mask
Can’t EAT, STRAP can cause irritation
What is the flow rate of the partial rebreather
6-15
Tell me about the ratial rebreather
TWO way VALVES, reservoir BAG
What are the pros of a partial rebreather
Inhale room air
What are the cons of a partial rebreather
Claustrophobia, can’t TALK or EAT
What is the flow rate of a non-rebreather
10-15, 100% O2
Tell me about the non-rebreather
ONE way valves, reservoir BAG
What are the advantages of a non-rebreather
Highest concentration of O2
What are the cons of a non-rebreather
Claustrophobia, can’t EAT or TALK, malfunction can cause CO2 BUILDUP
What is the flow rate of the venturi mask
4-12
Tell me about the ventrui mask
ACCURATE O2 concentration
What are the pros of the venturi mask
COPD, doesn’t DRY
What are the cons of the venturi mask
Uncomfy, skin IRRITATION
What is the difference between a BIPAP and CPAP
BIPAP- 2 pressure settings
CPAP- Same amount of pressure
What do you use for COPD, SEVERE sleep apnea, more SERIOUS episodes, trying to prevent INTUABATION
BIPAP
What do you use for obstructive sleep apnea, newborns, everynight use
CPAP
Should you place a PAP on a pt complaining of nausea
NO
What is O2 toxicity
Lung damage from breathing too much O2
What are the symptoms of O2 toxicity
Coughing, dyspnea, chest APIN, substernal HEAVINESS
How can you prevent O2 toxicity
Correct O2 DEVICE, TITRATING O2
What is intubation
Endotracheal tube (ETT, ET)
What is the most common typr of artficial airway
ETT
When do you use ETT
General anestesia, REST the respiraory muscles, MECHANICAL ventilation
What are the nursing responsibilites for ETT
SUCTIONING PRN, ORAL care Q2hrs, HOB>30
How do you measure an oropharyngeal
Corner of mouth to angle of jaw.
Too big- blocked
Too small- does not open
When to use an oropharyngeal
UNCONSCIOUS (gag reflex), prevent TONGUE from covering epiglottis
What is a nasal trumpet
Nasophryngeal
How do you measure a nasopharyngeal
Tip of nose to tragus
What is nasopharyngeal good for
SUCTIONING
When to use a nasopharyngeal
Better over mouth one, Obstruction of UPPER airway, MOUTH trauma
When to not use a nose airway
Severe HEAD or FACIAL injury
Are tracheostomies perment or tempoarary
Both
When is a tracheostomy placed
When a patient can’t keep thier own airway open
What are the two most common reasons why a trach is used
Proonged dependence on a VENTILATOR (chronic), bypass an OBSTRUCTED upper airway (acute illness)
What are some examples of why a pt would have prolonged dependence on a vent
Fuilian-Barre syndrome, Multiple sclerosis, COPD
What are the examples of why a pt may need a trach to bypass an obstructed upper airway
Prevent vent DEPENDENCY, FACIAL truama
What is the nurses job of trachs
Cleaning and replacement
What can a trach be
Cuffed or uncuffed, fenestrated or non-fenestrated
Tell me about a cuffed trach
SHORT term, OCCLIDES, PRESSURE, NECROSIS
What can the flange do
Skin breakdown
Tell me about the inner cannula
Disposable or non-disposable
What does an obturtator do
Helps INSERT
What is the top nursing priority with a new trach
Maintaining a patent aiway 72 hours POSTOP
At minimum what should you assess every shift
Trach site and patency
What are you observing for the trach site
Inflammation, edema, ulceration, signs of infection
What to know about trach care
DAILY, STERILE, clean TIES with STERILE saline, pre-cut gauze, OPENING facing UP
Tell me about trach suctioning
STERILE, don’t suction going IN, no longer than 10 SECD, 30-60 IN-BETWEEN, INTERMITTENT suction, CIRCULAR going OUT, 100% O2 IN-BETWEEN
What do you need at the bedside for trach care
BVM, Trach tube SAME and SMALLER size, insertion TRAY, OBTURATOR, STERILE OCCLUSIVE dressings
What do you do if your pts trach comes out
STAY, call for HELP, SEMI-FOWLERS, STERILE OCCLUZIVE dressing on STOMA, BVM over NOSE and MOUTH
What is a chest tube
Through RIB cage, into the PLEURAL space, connected to a drainage SYSTEM
What is a chest tube used for
REMOVE AIR, FLUIDS, or BLOOD from the pleural space, reestablish intrapleural PRESSURE
What is a pneumothorax, hemothorax, and pleural effusion
AIR, BLOOD, FLUID
What is the brainage chamber
Fluid is collected EXECPT for a pneumothorax
What is the water-seal chamber for
Allows air to be removed without OUTSIDE air entering
What is tidaling
GOOD, the ball goes up and down with each breathe, lung has NOT re-expanded
What can it mean if tidaling has stopped
Lung HAS re-expanded, KINK (CHECK)
What can excessive coutinuous bubbling in the water seal chamber mean
Air LEAK
What is suction-control usally set to
-20
Where do you keep the chest tube drainage system
BELOW the patient’s chest
What do you never do with a chest tube
STRIP or CLAMP the tubing
What can clamping the chest tube do
Cause a TENSION pneumothorax
What do you do when the doc is taking the chest tube out
VALSALVA maneuver, BEAR down
What are you monitoring with chest tubes
CACO (every HOUR), sounds, site
What must you report
BRIGHT red blood (dark is expected), >100mL/hr
What do you do if the chest tube disconnects from the drainage system
Put the END in STERILE water
What do you do if the chest tube is pulled out from the pt
Cover site with THREE sided STERILE gauze
When do you use an occlusive dressing for chest tubes
When it’s pulled by the doc