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Fundamentals Exam 2 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

oxygenation concept

A

mechanism that facilitates (or impairs) the body’s ability to supply O2 to cells of the body

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2
Q

function of respiratory system (oxygenation)

A

bring in atmospheric air….transport to respiratory tract…into the alveoli…O2 diffuses into capillaries….carried by blood to all cells of the body

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3
Q

function of the respiratory system in achieved through…

A

respiration (processes of inspiration and expiration)

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4
Q

O2 is brought to alveoli with is then…

A

exchanged for CO2 and then expelled from the body

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5
Q

ventilation

A

actual exchange of O2 & CO2

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6
Q

acid-base balance

A

respiratory acidosis

increase CO2—> vasodilation—>increase ICP and pulse

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7
Q

ICP

A

intracranial pressure

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8
Q

nursing implications of acid-base balance

A
  • c/o headache
  • irritability
  • decrease LOC
  • flushed skin
  • important to chest trauma, aspiration, pneumonia, OD
  • be alert with problems r/t airway clearance, limited ambulation, anxiety, or signs/symptoms of decrease O2
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9
Q

cellular regulation

A

-anemias (blood loss, G6PD, aplastic)

decrease in O2—>increase in systemic workload and shunts blood from periphery to vital organs

  • be alert to S/Sx of fatigue, palor, jaundice, tachycardia
  • anticipate need for vitamin supplements, blood transfusions, dietary changes,
  • consider activity tolerance
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10
Q

cognition

A

decrease O2 to brain —> changes in cognition

  • assess mentation
  • rule out acute brain trauma before considering other causes
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11
Q

comfort

A

pain from ischemic events

  • cerebral
  • cardiac
  • shock states
  • pulmonary

decrease in O2 to tissues —> manifestations of pain

  • assess for high pulse, respirations, BP, restlessness, anxiety, diaphoresis, client reporting discomfort
  • anticipate need for additional assessments, medications for pain relief, diversional therapies
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12
Q

diaphoresis

A

sweating

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13
Q

perfusion

A

decrease tissue perfusion —> O2 deficit to organs

  • assess pulses, nail beds, color, body position for comfort, orientation
  • administer oxygen
  • anticipate need for pharmacotherapy to improve CO surgery to correct defect
  • monitor arterial blood gases
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14
Q

assessment interview (respiratory)

A
  • current respiratory problems
  • hx of respiratory dz
  • lifestyle
  • presence of cough
  • description of sputum
  • presence of chest pain
  • presence of risk factors
  • med hx
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15
Q

sputum

A

mix of saliva and mucus coughed up from respiratory tract

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16
Q

types of respiratory assessments

A
  • nasal assessment
  • respiratory assessment
  • thoracic cavity inspection
  • muscles of breathing
  • thoracic wall
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17
Q

nasal assessment

A
  • midline & symmetrical
  • nares mucosa is pink and moist
  • no drainage
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18
Q

respiratory assessment

A
  • regular
  • depth
  • effort
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19
Q

thoracic cavity inspection

A

-AP diameter is 1/2 the transverse diameter

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20
Q

muscles of breathing

A
  • chest wall gently rises & falls
  • neck muscles are relaxed
  • inspect intercostal muscles
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21
Q

thoracic wall

A

-symmetrical hand placement shows symmetrical movement of the hands

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22
Q

types of breath sounds

A
  • vesicular
  • bronchovesicular
  • bronchial
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23
Q

normal vesicular breath sounds

A
  • “gently sighing” sounds

- air moving through smaller airways (alveoli and bronchioles)

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24
Q

normal bronchovesicular breath sounds

A

-moderate pitched “blowing” sounds as air moves through larger airways (bronchi)

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25
Q

normal bronchial breath sounds

A

-high-pitched, loud, “harsh” sounds as air moves through the trachea

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26
Q

color of skin, nail beds, and mucous membranes

A
  • normal
  • dusky hue
  • cyanosis
27
Q

normal color (skin/nail beds/MM)

A

pink color - well oxygenated blood

28
Q

dusky hue (skin/nail beds/MM)

A

poorly oxygenated blood

29
Q

cyanosis (skin/nail beds/MM)

A

bluish discoloration=severe O2 deprivation

30
Q

diagnostic tests

A
  • chest radiograph
  • CT, MRI
  • Arterial blood gas
  • pulmonary function tests
  • bronchoscopy
  • thoracentesis
  • sputum specimen
31
Q

chest radiograph

A

to see fluid, air, or masses

32
Q

CT, MRI

A

more detail

33
Q

Arterial blood gas

A

provides direct indication of O2 & CO2 exchange and acid-base balance

34
Q

pulmonary function tests

A

info about ventilation airflow, lung volumes, lung capacity, diffusion of gas

35
Q

bronchoscopy

A

direct visualization of the lungs via bronchoscope

36
Q

thoracentesis

A

drain excessive pleural fluid and the fluid is analyzed

37
Q

sputum specimen

A
  • collect in AM
  • identify microbes, inflammation, immunoglobulins
  • culture for ab choice
38
Q

Non-modifiable risk factors

A
  • genetic effect of hemoglobin and hematocrit
  • women have lower concentrations of hemoglobin & hematocrit
  • low hemoglobin/hematocrit = anemia —> low O2 carrying capacity
39
Q

prevention for risk factors

A

-management of environmental air quality (less smoking in population, workplace, smog…)

-vaccination:
older adults: influenza and pneumonia
children: pertussis

40
Q

Modifiable risk factors

A
  • HTN
  • Atherosclerosis
  • obesity
  • type 2 diabetes
  • smoking
  • stress
  • anxiety
41
Q

Independent interventions used to improve respiratory function

A
  • positioning
  • encourage smoking cessation
  • monitor activity tolerance/ADLs
  • promoting secretion clearance
  • deep breathing and coughing
  • breathing exercises
  • turning
  • slow diaphragmatic breathing
  • forceful exhalation
42
Q

semi-fowlers

A

30-45 degrees

-tube feeds = decrease aspiration

43
Q

fowler’s

A

45-60 degrees

-increase comfort during eating

44
Q

high fowler’s

A

80-90 degrees

-feeding, breathing treatment

45
Q

orthopneic

A

head and arms over bed table to facilitate lung expanision

46
Q

commonly employed breathing exercise

A

abdominal (diaphragmatic) and pursed lip breathing

47
Q

collaborative interventions used to improve respiratory function

A
  • improving nutrition
  • pharmacologic therapy
  • oxygen therapy
48
Q

pharmacologic therapy meds

A
  • bronchodilator
  • anti-inflammatory
  • expectorants
49
Q

nasal cannula

A

-oxygen therapy

  • does NOT provide exact concentration
  • cheap
  • do NOT use with more than 6L/min
  • better tolerated by patients
  • check q8hrs for flow, patency, trauma to ears and nose
  • need humidifier if >2L/min to prevent drying of nose or mouth
50
Q

room air is…

A

~21%

51
Q

1L/min

A

~24%

52
Q

2L/min

A

~28%

53
Q

3L/min

A

~32%

54
Q

4L/min

A

~36%

55
Q

5L/min

A

~40%

56
Q

6L/min

A

~44%

57
Q

simple face mask

A
  • provides O2 at 5-8L/min

- gives 30-60% O2

58
Q

partial rebreather mask

A
  • delivers O2 from 60-95% at liter flows of 6-10 L/min
  • O2 reservoir bag holds first 1/3 of exhaled air
  • must not totally deflate during inspiration to avoid CO2 build up
59
Q

non-rebreather mask

A
  • delivers highest O2 concentration possible with mask
  • 95%-100% at liter flows of 10-15 L/min
  • one way valve prevents intake of room air
  • no expired air in bag
  • bag must not totally deflate during inspiration to prevent CO2 build up
60
Q

venturi mask

A
  • high flow system
  • delivers 02 concentrations varying from 24% to 40% to 60% at liter flows at 4-12 L/min
  • color-coded jet adapters correspond to precise O2 concentration & liter flow
  • can administer low, constant O2 concentrations to patients with COPD
61
Q

techniques to mobilize secretions:

A

-often done by Respiratory therapists or techs

  • chest physiotherapy
  • postural drainage
  • chest percussion (CPT)
  • vibration
  • suctioning
62
Q

incentive spirometer

A
  • device that stimulates the patient to achieve maximum voluntary lung expansion
  • prevents atelectasis (lung collapse)
  • inhale, pause, exhale
  • pt encouraged to cough and expectorate any secretions loosened by deep breathing
  • patient should perform 10x per hour while awake
63
Q

pulse oximetry

A
  • noninvasive procedure that helps measure client’s arterial O2 saturation to detect hypoxemia
  • sensor on finger, ear lobe, nose, or forehead
  • normal=95%-100%;

Fundamentals Exam 2 (5 decks)

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