Oxygenation Flashcards
Mechanics of ventilation?
Moving air in and out of lungs
Mechanics of perfusion?
CV system pumping oxygenated blood & oxygen to the tissues then returns deoxygenated blood to lungs
Mechanics of diffusion?
Exchange of gases (O2 and CO2) across membranes in alveola and alveoli membranes
How to assess ventilation?
depth of breathing, RR, chest rise/fall
How to assess perfusion?
capillary refill, O2 sat, skin color
How to assess diffusion?
ABG’s
What is Hyperkapnia?
High level of CO2
What triggers a COPD patient to breath?
Low level of O2
Is oxygen therapy good for COPD patients?
No, O2 levels are elevated, trigger to breath is removed
What do crackles sound like?
Popping sound
Heard during inspiration
Not cleared by coughing
What do wheezes sound like?
Singing, High Pitched during inspiration and expiration
Not cleared by coughing
What does rhonchi sound like?
Low pitched, snoring
Cleared by coughing
What does Pleural friction rub sound like?
Squeaky saddle, low pitch
not cleared by coughing
What do oxygen orders include?
Flow rate, delivery system, duration, instructions
What does delivery include?
Flow meter, supply, tubing, device, Humidifier if over 4L/min
Nasal cannula FiO2 and rates
26-44% FiO2 on rates of 1-6 L/min
Vapotherm/High-flow nasal cannula FiO2 and rates
35-100% FiO2, 1-40 L/min
O2 is warm and humidified
Simple face mask FiO2 and rates
35-50% FiO2, 6-12L/min must be at least 5 L/min
Non rebreather mask FiO2 and rates
60-90% FiO2, 10-15L/min. Reservoir bag must be inflated 2/3 full, 1-way valve to prevent rebreathing of CO2
What is FiO2?
Fraction of inspired oxygen
What is FiO2% of Room Air? How much % does oxygen therapy add per L?
21% FiO2 Room Air
Oxygen Therapy adds 3% per L
Describe a rebreather mask
Inhale some of CO2 from reservoir bag, for hyperventilation/alkalosis
Describe a Venturi Mask
Specific volume of O2 for accurate low concentrations. 24-60% delivery
Who are face tents used for?
Claustrophobic patients
Describe a Trach mask
Gives humidified air to trachea
List purposes of chest tubes
- Remove air or fluid from pleural space for negative pressure
- Reestablish intrapleural and intrapulmonary pressure
- Reexpand the lungs
- Post-op
Care for patient tubes
- Dislodged tube: cover site with gauze and tape 3 sides. NOTIFY HCP
- Broken drainage system: insert tube 1 inch in bottle of sterile water and get replacement
- DO NOT CLAMP WITHOUT HCP ORDER (only for tubing changing, air leaks, or before tube removal)
- NOT RECOMMENDED TO MILK TUBING
What culture is taken for TB test?
Sputum culture
If more than one inhaler is used what order do you give them in?
Use bronchodilator(Albuterol) first, then Corticosteroid(Advair) next
What is a fast way to get medication into respiratory tract?
Nebulizers
What structures are found in the Upper Respiratory Tract? Functions?
Nasal Cavity, Pharynx, Larynx
Nose humidifies air
Epiglottis protects aspirations into lower respiratory tract
What structures are found in the Lower Respiratory Tract?
Trachea, Carina. Primary Bronchi, Bronchioles, Alveoli
Name the 2 layers of the lung
Chest Wall (parietal Pleura) Lung Tissue (Visceral Pleura)
What is surfactant?
Maintains surface tension and prevents collapse
What is Atelactasis?
Collapse of Alveoli
How do accessory muscles help with oxygenation?
Can increase lung volume, prolonged use will result in fatigue
Where does does diffusion occur?
Alveolar capillary membrane
What influences the capacity of blood to carry O2?
- Amount of HGB (RBCs)- transports O2 from lungs to tissues and binds some CO2 to return to lungs
- Iron Availability
- Ability of HGB to bind with CO2
- Amount of O2 dissolved in plasma
What regulates breathing?
Cerebral Cortex- voluntary control of breathing
Medulla Oblongota-sends signals to muscles that control respirations
Where is deoxygenated blood transported to?
To right side of heart then flows to lungs. Oxygenated blood travels from lungs to left side of heart then to the tissues.
