oxygenation

Question 1

What is hypoventilation

Answer 1

• occurs when alveolar ventilation is inadequate to meet the oxygen demand of the body or eliminate enough carbon dioxide. Alveolar ventilation decreases so body retains CO2.
  Example: atelectasis when alveoli collapse, the normal O2 and CO2 exchange can not occur. Less ventilation
  *patients with COPD given too much oxygen are at risk for hypoventilation. (can lead to respiratory acidosis, or resp. arrest)

Question 2

What is hyperventilation

Answer 2

• lungs remove CO2 faster than it is produced by cellular metabolism
• produced by severe anxiety, infection, drugs, or acid-base imbalance
• fever increases metabolic rate, which increases CO2 production
• pateints with metabolic acidosis are at risk

Question 3

Nasal Cannula advantages

Answer 3

• safe, simple
• easily tolerated
• delivers low concentrations while allowing patients to eat, speak, drink
• doesnt impede talking
• disposable

Question 4

Nasal Cannula disadvantages

Answer 4

• unable to use with nasal obstruction
• drying to mucous membranes
• a flow greater than 4L/min must be humidified
• can dislodge from nares easily
• skin irritation or breakdown on nares

Question 5

Face Mask advantages

Answer 5

• provides humidifed oxygen

Question 6

Face Mask disadvantages

Answer 6

• Exact FIO2 level is difficult to determine
• Requires high FIO2 levels at 5 L/min or more to prevent rebreathing of CO2
• patient inhales room air though side holes in mask
• difficult to eat, speak, drink

Question 7

Procedure for suctioning

Answer 7

• always hyperoxygenate before suctioning–> it provides some protection from suction induced decline in oygenation. Most effective is client takes deep breath (hyperinflation of lungs) or increase ventilator tidal volume.

Question 8

Contraindications to nasal suctioning

Answer 8

• occluded nasal passages
• nasal bleeding
• epiglottis or croup
• acute head, facial, neck injury
• coagulopathy or bleeding disorder
• irritable airway
• bronchospasms
• myocardial infarction

Question 9

Use chest tubes and drainage systems with?

Answer 9

• pneumothorax (air collects in pleural space)

- hemothorax (blood or fluid collects in pleural space)

Question 10

how can you maintain lung expansion?

Answer 10

• Frequent turning
• chest tubes
• incentive spirometer

Question 11

how can you reduce oxygen demands?

Answer 11

• reduce activity
• relieve anxiety
• alleviate pain
• lower body temp

Question 12

How can you mobilize pulmonary secretions?

Answer 12

• Frequent turning
• humidification
• hydration
• Nebulizer
• coughing techniques
• chest physiotherapy–> percussion, vibration, postural drainage

Question 13

What can you do to train respiratory muscles?

Answer 13

• incentive spirometer
• pursed lip breathing exercises
• Diaphragmatic breathing