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Nurs300 Exam 2 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

Ventilation

A

cyclical movement of gas into and out of the lungs.

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2
Q

Distribution

A

process of air traveling to areas within the lungs

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3
Q

Diffusion

A

Movement of gases between alveoli and blood (gas exchange).

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4
Q

Perfusion

A

the process of oxygenated blood passing through the tissues of the body.

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5
Q

Oxygen is carried in the body via

A

plasma and red blood cells

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6
Q

Most oxygen (97%) is carried by red blood cells in the form of

A

oxyhemoglobin

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7
Q

_____ also carries carbon dioxide in form of carboxyhemoglobin

A

Hemoglobin

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8
Q

Developmental factors affecting oxygen: Infant

A

Lungs are transformed from fluid-filled structures to air-filled organs

The infant’s chest is small, airways are short, and aspiration is a potential problem

Respiratory rate is rapid and respiratory activity is primarily abdominal

Synthetic surfactant can be given to the infant to reopen alveoli

Crackles heard at the end of deep respiration are normal

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9
Q

Developmental Factors affecting Oxygenation: Child

A

Some subcutaneous fat is deposited on the chest wall making landmarks less prominent

Eustachian tubes, bronchi, and bronchioles are elongated and less angular

The average number of routine colds and infections decreases until children enter day care or school

Good hand hygiene and tissue etiquette are encouraged

By end of late childhood, immune system protects from most infections

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10
Q

Developmental Factors affecting Oxygenation: Older Adult (65+ years)

A

Bony landmarks are more prominent due to loss of subcutaneous fat

Kyphosis contributes to appearance of leaning forward

Barrel chest deformity may result in increased anteroposterior diameter

Tissues and airways become more rigid; diaphragm moves less efficiently

Older adults have an increased risk for disease, especially pneumonia

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11
Q

Lifestyle Risk Factors affecting Oxygenation

A

Obesity

Smoking

Lack of exercise

Lack of regular health care provider visits

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12
Q

Environmental Factors affecting Oxygenation

A

Residence

Workplace

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13
Q

Assessment: nursing history

A

Pain

Fatigue

Smoking

Dyspnea

Cough

Sputum production
Exposures

Respiratory conditions and infections

Allergies

Health risks

Medications

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14
Q

Assessment: Physical examination

A 
Inspection
Head-to-toe
Skin
Mucus membranes
Level of consciousness
Nail beds
AP diameter
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15
Q

AP diameter

A

Anterior to posterior
Transverse from left to right side
1:2 ratio

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16
Q

Palpation

A

Excursion

Tenderness

Lumps or masses

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17
Q

Percussion

A 
resonance
hyperresonance
flatness
dullness
tympany
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18
Q

Resonance

A

loud, hollow low-pitched sound heard over normal lungs

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19
Q

Hyperresonance

A

loud, low booming sound heard over emphysematous lungs

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20
Q

flatness

A

detected over bone or heavy muscle

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21
Q

dullness

A

with medium pitch and intensity heard over the liver

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22
Q

Tympany

A

high-pitched, loud, drum-like sound produced over the stomach

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23
Q

Auscultation

A

crackles
rhonchi
wheezes
pleural friction rub

24
Q

crackles

A

sounds occurring when air moves through airways that contain fluid
Classified as fine, medium, or coarse

25
Q

Rhonchi

A

loud, bubbling sounds primarily heard over the trachea and bronchi

26
Q

Wheezes

A

continuous sounds heard on expiration and sometimes on inspiration as air passes through airways constricted by swelling, secretions, or tumors
Classified as sibilant or sonorous

27
Q

Pleural friction rub

A

dry, grating sound usually heard over the anterior lateral fields

28
Q

Assessment: diagnostic testing

A

Pulse oximetry

29
Q

Sputum studies

A 
Instruct pt to rinse mouth,
cough deeply,
Use early morning specimen,
sterile container
Examples: culture and sensitivity, gram stain, cytology
30
Q

X rays and nursing responsibilities

A

X Rays:

Chest

Computerized Tomography (CT)

Magnetic Resonance Imaging (MRI)

Nursing Responsibilities:
Remove metal

Same, check allergies

Same, Implanted objects? Tattoos? Very loud noise.

31
Q

Thoracentesis

A 
Obtain consent
Obtain thoracentesis tray
Gather collection bottles
Position patient in upright position
Monitor patient during and after procedure
32
Q

Implementation

A

Health promotion
Vaccinations

Smoking cessation

Regular exercise

Environmental pollutants

33
Q

Promote proper breathing

A

Deep breathing

Using incentive spirometry

Pursed-lip breathing

Abdominal or diaphragmatic breathing

34
Q

Promote and control coughing

A

Voluntary and Involuntary coughing

Use of cough medications
Suppressants
Expectorants
Lozenges

35
Q

Promote comfort

A

Positioning

Maintaining adequate fluid intake

Providing humidified air

Performing chest physiotherapy

Maintaining good nutrition

36
Q

Admin meds

A

Bronchodilators

Mucolytic agents

Corticosteroids

37
Q

Bronchodilators

A

—open narrowed airways

38
Q

Mucolytic

A

—liquefy or loosen thick secretions

39
Q

Corticosteroids

A

—reduce inflammation in airways

40
Q

Administer inhaled medications

A

Nebulizers
Metered dose inhalers
Dry powder inhalers

41
Q

Nebulizers

A

disperse fine particles of medication into deeper passages of respiratory tract where absorption occurs

42
Q

Metered dose inhalers

A

deliver controlled dose of medication with each compression of the canister. Use of spacer recommended

43
Q

Dry powder inhalers

A

activated by the patient’s inspiration

44
Q

Administer Oxygen

A

Oxygen is a prescribed treatment.
There are many oxygen delivery systems.
Flow rate of oxygen is measured in liters per minute.
Oxygen delivered at a rate > 2L/M requires humidification.
Transport patients using portable cylinders.
Ensure patient safety.

45
Q

Nasal cannula

A 
Plastic devise with prongs that fit in nostrils.
Patients can eat while wearing.
Can be easily dislodged.
Causes nasal dryness. 
May cause skin breakdown
46
Q

Types of oxygen masks

A

Simple
partial nonrebreather
non rebreather
venturi

47
Q

Simple face mask

A

Must fit snugly
Inhibits eating
Used when increased delivery of oxygen is needed for short periods (< 12 hours).
May cause skin breakdown

48
Q

Parital rebreather mask

A

Similar to simple face mask, but has a reservoir bag.
Permits conservation of oxygen.
Tight seal necessary.
Eating and talking are difficult.

49
Q

Nonrebreather mask

A

Highest concentration of oxygen.

One way valves prevent rebreathing exhaled air.

50
Q

Venturi mask

A

Permits precise delivery of oxygen concentration

51
Q

nasal catheter

A

Infrequently used

May cause discomfort

Catheter must be changed every 8 hours.

52
Q

Oxygen tent

A

Light, portable, plastic devise.
Delivers cool, humidified oxygen.
Patient’s clothing and linens may become wet.
Difficult to deliver precise oxygen flow.

53
Q

Suctioning techniques

A 
Oropharyngeal and Nasopharyngeal
Considered clean procedures
Nose preferred route
Use lubricant for nasal route
Last no longer than 15 seconds
54
Q

Suctioning complications

A

Hypoxemia

Bleeding

Mucosal tears

Bronchospasm

Cardiac arrhythmias

Atelectasis

55
Q

Chest tube drainage system

A

Commonly utilized with chest trauma and indicated if patient has a pneumothorax or hemothorax. Chest tube/drainage permits expulsion of air or fluid while allowing lung tissue to re-expand.

56
Q

Managing chest tubes

A

Assess respiratory status.

Check dressing.

Ensure patent drainage.
No dependent loops

Look at drainage system.

Keep drainage system below the level of the chest.

Never clamp.

57
Q

Pt education for chest tube

A

Range of Motion

Coughing and Deep Breathing – Monitor sputum

Encourage activity – walking (best exercise)

Nutrition and fluids

Avoid crowds and smoking

Flu/pneumonia vaccines

Nurs300 Exam 2 (4 decks)

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