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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
Rhonchi
loud, bubbling sounds primarily heard over the trachea and bronchi
26
Wheezes
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
Pleural friction rub
dry, grating sound usually heard over the anterior lateral fields
28
Assessment: diagnostic testing
Pulse oximetry
29
Sputum studies
``` Instruct pt to rinse mouth, cough deeply, Use early morning specimen, sterile container Examples: culture and sensitivity, gram stain, cytology ```
30
X rays and nursing responsibilities
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
Thoracentesis
``` Obtain consent Obtain thoracentesis tray Gather collection bottles Position patient in upright position Monitor patient during and after procedure ```
32
Implementation
Health promotion Vaccinations Smoking cessation Regular exercise Environmental pollutants
33
Promote proper breathing
Deep breathing Using incentive spirometry Pursed-lip breathing Abdominal or diaphragmatic breathing
34
Promote and control coughing
Voluntary and Involuntary coughing Use of cough medications Suppressants Expectorants Lozenges
35
Promote comfort
Positioning Maintaining adequate fluid intake Providing humidified air Performing chest physiotherapy Maintaining good nutrition
36
Admin meds
Bronchodilators Mucolytic agents Corticosteroids
37
Bronchodilators
—open narrowed airways
38
Mucolytic
---liquefy or loosen thick secretions
39
Corticosteroids
—reduce inflammation in airways
40
Administer inhaled medications
Nebulizers Metered dose inhalers Dry powder inhalers
41
Nebulizers
disperse fine particles of medication into deeper passages of respiratory tract where absorption occurs
42
Metered dose inhalers
deliver controlled dose of medication with each compression of the canister. Use of spacer recommended
43
Dry powder inhalers
activated by the patient’s inspiration
44
Administer Oxygen
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
Nasal cannula
``` 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
Types of oxygen masks
Simple partial nonrebreather non rebreather venturi
47
Simple face mask
Must fit snugly Inhibits eating Used when increased delivery of oxygen is needed for short periods (< 12 hours). May cause skin breakdown
48
Parital rebreather mask
Similar to simple face mask, but has a reservoir bag. Permits conservation of oxygen. Tight seal necessary. Eating and talking are difficult.
49
Nonrebreather mask
Highest concentration of oxygen. One way valves prevent rebreathing exhaled air.
50
Venturi mask
Permits precise delivery of oxygen concentration
51
nasal catheter
Infrequently used May cause discomfort Catheter must be changed every 8 hours.
52
Oxygen tent
Light, portable, plastic devise. Delivers cool, humidified oxygen. Patient’s clothing and linens may become wet. Difficult to deliver precise oxygen flow.
53
Suctioning techniques
``` Oropharyngeal and Nasopharyngeal Considered clean procedures Nose preferred route Use lubricant for nasal route Last no longer than 15 seconds ```
54
Suctioning complications
Hypoxemia Bleeding Mucosal tears Bronchospasm Cardiac arrhythmias Atelectasis
55
Chest tube drainage system
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
Managing chest tubes
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
Pt education for chest tube
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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