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Assessment > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

Evaluating Oxygenation / Nursing Assessment

A 
Color
Respiratory rate, depth
Use of accessory muscles
Patient Complaints (SOB)
LOC
Pulse Oximeter
Breath Sounds
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2
Q

Clinical Signs of Hypoxemia

A 
Tachypnea
Tachycardia
Restlessness, anxiety
Use of Accessory Muscles
Nasal Flaring
Dyspnea
Drowsiness --> Confusion
Pale skin & mucous membranes --> cyanosis
Adventitious Lung sounds
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3
Q

Tests, Diagnostic studies

A 
Arterial blood gasses (pH, PaO2, PaCO2)
Pulmonary Function Tests
         Peak Expiratory Flow Rate (PEFR)
Chest X ray
Lung Scan
Bronchoscopy
Thoracentesis
Sputum Culture
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4
Q

Oxygen Therapy

A

-Indications: hypoxemia / decreased SpO2 level
-Caution:
-patients with COPD
-Hypoxia –> drive to breath
-If overcorrected –> suppress drive
to breath
-Neonates - premature infants
- High Fio2 –> lung injury
- High arterial O2 –> retinopathy
-Beneficial: hyperbaric chamber

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5
Q

Oxygen therapy, 2

A
  • Written as an order unless emergency
  • Concentration
  • Method of Delivery
  • Liter flow per minute (L / m)
  • May also include titration order (SpO2)
  • Humidification
  • Skin care and oral hygiene
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6
Q

Oxygen Delivery

A
  • Oxygen gauge flow meter
  • (Liters/minute)
  • FiO2 (ratio of oxygen in blood to oxygen breathed in)
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7
Q

Oxygen Therapy equip

A

Combustible, SAFETY, transportation

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8
Q

Oxygen Delivery method depends on

A

Oxygen needs, comfort, age and developmental stage, equipment available

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9
Q

Method of O2 Delivery, Oxygen Therapy

A
  • Nasal Cannula
  • Face Mask
  • Venturi Mask
  • Partial rebreather mask
  • Non-rebreather Mask
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10
Q

Nasal Cannula

A
  • Deliver low concentration of oxygen (22-44%)
  • At flow rates of 2-6 L/min
  • Each L/min adds approx. 4% more O2
  • Humidification / Alternate: Reservoir nasal cannula
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11
Q

Face Mask

A

Delivers O2 concentrations from 40-60%, at 5-8L/min

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12
Q

Partial Rebreather Mask

A

-Delivers O2 concentration of 40-60%
-At liter flows of 6-10 L/min
-Oxygen reservoir bag is attached
-allows client to rebreathe about 1/3 of
the exhaled air in conjunction with O2
-Thus it increases the FiO2 by recycling
expired O2
-Rebreather bag must not deflate during inspiration to avoid CO2 buildup
-If it happens, increase liter flow so the
bag remains 1/3 to 1/2 full

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13
Q

Non-rebreather mask

A

-Delivers the highest O2 concentration possible
-60-100% by means other than
mechanical ventilation, at liter flows
6-15 L/min
-ONE WAY VALVES ON THE MASK
-Between reservoir bag and mask;
-only oxygen enters mask
-Flaps on exhalation ports prevent
room air and client’s expired air from
entering the bag; so only O2 in the
bag
-To prevent CO2 buildup, the bag must not totally deflate during inspiration; if deflates, increase liter flow of O2

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14
Q

Venturi Mask

A
  • Delivers oxygen concentration from 24-60%
  • Liter flows 4-12 L/min
  • Allows specific amounts of air to mix with oxygen
  • Large bore tubing with color-coded adapters
    - Or dials
    - 24% concentration at 4L/min
    - 35% concentration at 8L/min
    - Color / concentration vary by Mfgr
  • Often used for patients with chronic lung disease
  • COPD
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15
Q

Face Tent

A
  • Provide varying concentration of O2
  • 30-50%
  • 4-8 L/min
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16
Q

Nursing Considerations

A

-Respiratory Assessment
-VS, O2Sat, color, anxiety, respiratory
effect
-Skin assessment
-Hydration (mucous membranes)
-Breakdown
-Chafing, irritation

17
Q

Infants / Children

A
  • Oxygen Tent

- Oxygen Hood

18
Q

CPAP

A
  • Continuous Positive Airway Pressure (CPAP)
  • Bilevel (BiPAP)
  • Purpose: provides air under pressure during inhalation and exhalation to keep airway open; prevent collapse
  • Indications: obstructive sleep apnea
19
Q

Incentive Spirometer

A

-Designed to mimic natural sighing or yawning
-Objectives:
-Increases transpulmonary pressure
and inspiratory volumes
-Improve inspiratory muscle
performance
-Re-establish or stimulate the normal
pattern of pulmonary hyperinflation
-Encourage patient to take long, slow, deep breaths - 10 x / hour
-When the procedure is repeated on a regular basis, airway patency may be maintained and lung atelectasis prevented and reversed
EVALUATION!!

20
Q

Peak Flow Meter

A

-Peak Expiratory Flow Rate
-Measure amount of exhaled air
-Based on age, size
-Peak zones: Traffic light (red, yellow,
green)
-Anticipate early changes in condition
-COPD, Asthma
EVALUATE MEDICATION EFFECTIVENESS

21
Q

When a patient has respiratory trouble…

A
  • Use your assessment skills

- Determine what the problem is…

22
Q

Nursing Assessment / Respiratory

A
  • Respiratory rate, depth
  • Breath sounds
  • Use of accessory muscles
  • Color
  • Patient complaints (SOB)
  • Pulse Oximeter
  • LOC
23
Q

Nursing Diagnosis

A

-Ineffective breathing pattern
-Inspiration and expiration do not
provide adequate ventilation
-Ineffective airway clearance
-Inability to clear secretions or
obstructions from respiratory tract to
maintain clear airway
-Impaired Gas Exchange
-Excess or deficit in oxygenation and or
CO2 elimination

24
Q

Nursing Interventions

A
  • Positioning
  • Incentive Spirometer
  • Turn, cough, and deep breathe
  • Hydration
  • Chest physiotherapy
  • Suctioning
  • Medication admin
  • Oxygen Therapy
  • Activity as tolerated
25
Q

Discharge Teaching

A
  • Maintenance & promotion of oxygenation: oxygen therapy
  • Home O2
  • Safety precautions
  • Oxygen supply / supplier
  • Methods of oxygen delivery
  • Comfort tips
  • Medication education
26
Q

Health Promotion & Patient Teaching

A
  • Weight
  • Exercise
  • Stress reduction
  • Occupational safety
  • Smoking / Smoke free environment
  • Regular physical exams / screening
  • Immunizations
  • Medications
27
Q

The last attempt before intubation

A

Nonrebreather mask

28
Q

The reservoir bag must remain 1/2 to 1/3 full

A

partial rebreather mask

29
Q

Allows specific amounts of air to mix with o2

A

Venturi mask

30
Q

Is comprised of one way valves

A

non rebreather mask

31
Q

Delivers low conc of O2

A

nasal cannula

Assessment (8 decks)

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