Oxygenation Flashcards
Ventilation
Process of moving gases in and out of the lungs
What is ventilation affected by?
- Rate and depth of breathing
- Condition of the airway
- Condition of the lungs
Respiration external
Exchange of respiratory gases at the alveoli
External respirations affected by
- Thickness of alveolar membrane
- Lung surface
Respiration internal
Exchange of respiratory gases at the capillary level into organs and tissues
what alveoli are and what is happening in and around them constantly (in a healthy client).
They are tiny air sacs surrounded by a network of capillaries. Oxygen and carbon dioxide flow back and forth between the two
how inhalation occurs.
Expansion of lungs and chest cavity due to the negative pressure in the lungs causes air to be drawn in.
Respiration
the exchange of carbon dioxide and oxygen in the lungs
chemoreceptors
- HIGH CO2 LEVELS STIMULATE BREATHING TO ELIMINATE THE EXCESS CO2
- A SECONDARY, THOUGH IMPORTANT, DRIVE TO BREATHE IS HYPOXEMIA. LOW BLOOD O2 LEVELS STIMULATE BREATHING TO GET MORE OXYGEN INTO THE LUNGS
Eupnea
normal breathing, about 12-20 bpm
Tachypnea
fast, shallow breathing, more than 24 bpm. Caused by hypoxemia or increased oxygen demand and can cause hypoventilation
Bradypnea
slow respirations, fewer than 10 bpm and may cause poor gas exchange and can be caused by sedative and opioid meds and neuromuscular dysfunction
Kussmaul’s
regular but increased rate and abnormally deep respirations and can be caused by fear, anxiety or panic
Biot’s
irregular respirations (usually shallow), alternating with periods of apnea and usually associated with brain injury
Cheyne-Stokes
gradual increase in depth followed by gradual decrease in depth then a period of apnea. Often associated w brain injury
Apnea
absence of breathing. Requires immediate cardiopulmonary resuscitation
Paroxysmal nocturnal dyspnea (PND)
sudden awakening caused by shortness of breath during sleep
Conversational dyspnea
cant speak complete sentences without pausing to breathe
Stridor
high-pitched, harsh, crowing inspiratory sound caused by partial obstruction. Partial can become complete so get immediate care
WHITE OR CLEAR sputum means
usually in viral infection (common cold)
YELLOW OR GREEN sputum means
sign of infection
Black sputum means
caused by coal dust, smoke, or soot
Rust colored sputum
usually associated w pneumococcal pneumonia, TB and possibly blood presence
HEMOPTYSIS
the coughing up of blood
PINK FROTHY SPUTUM
is associated w pulmonary edema
FOUL ODOR sputum
bacterial infection (pneumonia or lung abscesses)
What are two methods nurses use to collect sputum specimens?
- EXPORATED have patient breathe a few times to stimulate a cough and spit the specimen into a cup
- SUCTIONED
What are several ways you can confirm that you are getting accurate pulse ox readings?
Choose a site w proper circulation, free or artificial nails and contains no moisture, make sure site is clean, dim the lights or cover probe w bed covers
The nurse assesses that several clients have low oxygen saturation levels. Which client will benefit the most from receiving oxygen via a nasal cannula?
The client who has dry oral mucous membranes from mouth breathing
The client who has a nasogastric tube in place for gastric decompression
The client who has many visitors and spends much time sitting in a chair
The client who has an upper respiratory infection and spends much time sleeping
The client who has many visitors and spends much time sitting in a chair
The nurse is caring for a client with severe dyspnea who is receiving oxygen via a Venturi mask. Which action would the nurse take when caring for this client?
Assess frequently for nasal drying.
Keep the mask tight against the face.
Monitor oxygen saturation levels when the client is eating.
Set the oxygen flow at the highest setting that the client can tolerate.
Monitor oxygen saturation levels when the client is eating.
Because the mask cannot be worn when eating, the client may become hypoxic. A nasal cannula may be needed to deliver oxygen while the client is eating. Nasal drying usually is not a problem with the use of a Venturi mask.
When the oxygen saturation of a client with pneumonia is at 89% to 90% while using a nonrebreather mask, which collaborative action would the nurse anticipate?
Administration of oxygen using a simple face mask
Use of a Venturi mask for administration of high-flow oxygen
Continued oxygen administration with the nonrebreather mask
Oxygen administration with bi-level positive airway pressure (BiPAP)
Oxygen administration with bi-level positive airway pressure (BiPAP
The client’s oxygen saturation is low even with the fraction of inspired oxygen (FiO2) levels of up to 95% that can be administered with a nonrebreather mask, and another method of oxygen administration is needed. BiPAP adds positive pressure during inspiration to oxygen administration, decreasing some of the work of breathing and improving tidal volumes and gas exchange without some of the risks that are associated with intubation and mechanical ventilation.
The nurse is preparing to perform endotracheal suctioning on a client. Before beginning the procedure, which intervention would the nurse do?
Ask the client to take several deep breaths.
Instruct the client to cough before suctioning.
Administer 100% oxygen to the client.
Administer 100% oxygen to the client.
Before suctioning, regardless of the means, oxygen should be administered, because the suctioning procedure depletes oxygen from the respiratory tract, causing a potential drop in oxygen saturation levels. In a client with an endotracheal tube, manually bagging with 100% oxygen will hyperoxygenate the lungs.
When suctioning a client with a tracheostomy, which nursing intervention is correct?
Hyperventilate the client with room air before suctioning.
Apply suction only as the catheter is being withdrawn.
Insert the catheter until the cough reflex is stimulated.
Apply suction only as the catheter is being withdrawn.
Which nursing action is appropriate when suctioning the secretions of a client with a tracheostomy?
Use a new sterile catheter with each insertion.
Initiate suction as the catheter is being withdrawn.
Insert the catheter until the cough reflex is stimulated
Initiate suction as the catheter is being withdrawn.
The nurse is suctioning a client’s airway. Which nursing action will limit hypoxia?
Limit suctioning with catheter to 30 seconds.
Apply suction only after the catheter is inserted.
Lubricate the catheter with saline before insertion.
Apply suction only after the catheter is inserted.
The nurse teaches a postoperative client how to use an incentive spirometer. Which client behavior indicates to the nurse that the spirometer is being used correctly?
Inhales deeply through the mouthpiece, relaxes, and then exhales
Inhales deeply, seals the lips around the mouthpiece, and exhales
Uses the incentive spirometer for 10 consecutive breaths per hour
Inhales deeply through the mouthpiece, relaxes, and then exhales
