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foundations > oxygenation > Flashcards

oxygenation Flashcards

1
Q

respiratory system includes

A

upper airways, lungs, lower airways, and alveolar air sacs (base of lungs)

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2
Q

the lungs aid the body

A

in oxygenation and tissue perfusion

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3
Q

noninvasive procesures

A
  • chest x-ray (CXR): use lead sheild for adults who are childbearing age
  • pulse oximetry
  • pulmonary function tests
  • sputum culture
  • ct scan
  • mri
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4
Q

hypoxemia

A

when there is a limited amount of oxyegen in the blood

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5
Q

retractions

A
  • when the muscles are pulled inward and occur between the ribs when inspiration occurs
  • intercostal retractions are a sign that the airway is blocked
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6
Q

Hypoxia

A

lack of oxygen at the cellular level

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7
Q

clinical manifestation of hypoxia and hypoemia

A 
tachypnea
tachycardia
restlessness
pale skin and mucous membranes 
elevated blood pressure
use of accessory muscles, nasal flaring, adventitious lung sounds
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8
Q

nursing actions for hypoxia and hypoxemia

A
  • monitor respiratory rate and pattern, level of consciousness
  • provide oxygen therapy at the lowest liter flow that will correct hypoxia
  • make sure the mask creates a secure seal over the nose and mouth
  • assess/monitor restlessness, hypertension, and headache
  • wheezing because of inflammation on inhaling or exhale
  • auscultate the lungs for breath sounds and adventitious sounds (crackles and wheezes)
  • assess/ monitor oxygenation status with pulse oximetry
  • promote oral hygiene
  • encourage turning, coughing, deep breathing, and the use of incentive spirometry and suctioning
  • promote rest and decrease environmental stimuli
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9
Q

oxygen therapy

A
  • a therapeutic gas that treats hypoxemia (low levels of arterial oxygen)
  • administering and adjusting oxygen requires a prescription
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10
Q

oxygen delivery devices

A
  • nasal cannula
  • simple face mask
  • partial rebreather mask
  • non-rebreather mask
  • venturi mask
  • aerosol mask, face tent
  • t-piece
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11
Q

nasal cannula

A

tubing with two small prongs for insertion into the nares

- fraction of inspired oxygen: delivers an Fio2 of 24% to 44% at a flow rate of 1-6 l/min

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12
Q

nasal cannula advantages

A
  • safe, simple, easy to apply method
  • cannula is comfortable and well tolerates
  • client is able to eat, talk, and ambulate
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13
Q

nasal cannula disadvantages

A
  • FiO2 varies with flow rate, and the rate and depth of the clients breathing
  • extended use can lead to skin breakdown and dry mucous membranes
  • tuning is easily dislodged
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14
Q

nasal cannula nursing actions

A
  • assess the patency of the nares
  • ensure that the prongs fit in the nares properly
  • use water-soluble gel to prevent dry nares
  • provider humidication for flow rates of 4l/min and greater **
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15
Q

simple face mask

A
  • covers the client’s nose and mouth
  • delivers an Fi02 of 35% to 50% at flow rates of 6 to 12 l/min
  • minimum flow rate is 6l/min to ensure flushing of CO2 from the mask
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16
Q

simple face mask advantages

A
  • face mask is easy to apply and can be more comfortable than a nsal cannula
  • provides humidified oxygen
17
Q

simple face mask disadvantages

A
  • flow rates less than 6L/min can result in rebreathing of co2
  • clients who have anixety or claustrophobia do not tolerate it well
  • eating, drinking, and talking are impaires. mositure and pressure can collect under mask and cause skin breakdown
  • face mask pose a greater risk of aspiration
18
Q

simple face mask nursing actions

A
  • assess proper fit to ensure a secure seal over the nose and mouth
  • make sure the client wears a nasal cannula during meals
  • use with caution for clients who have a high risk of aspiration or airway obsutrction
  • monitor for skin breakdown
19
Q

non-rebreather mask fraction of inspired oxygen

A
  • delivers an FiO2 of 80% to 95% at flow rates of 10-15 l/min to keep the reservoir bag 2/3 full during inspiration and expiration
20
Q

non-rebreather mask advantages

A
  • it delivers the highest 02 concentration possible
  • a one-way valve situated between the mask and reservoir allows the client to inhale maximum 02 from the reservoir bag
  • the two exhalation ports have flaps covering them that prevent room air from entering the mask
21
Q

non-rebreather mask disadvantage

A
  • the valve and flap on the mask must be intact and functional during each breath
  • it is poorly tolerated by clients who have anxiety or claustrophobia
  • eating drinking and talking are impaired
  • use with caution for clients who have high risk of aspiration or airway obstruction
22
Q

non-rebreather mask nursing actions

A
  • perform and hourly assessment of the valve and flap
  • assess proper fit to ensure a secure seal over the nose and mouth
  • assess for skin breakdown beneath the edges of the mask and bride of the nose. make sure the client uses a nasal cannula during meals
23
Q

oxygen complications

A
  • oxygen toxicity can result from high concentrations of oxygen (typically greater than 50%)
  • long duration of oxygen therapy (typically more than 24 to 48 hours) and the severity of lung disease
24
Q

oxygen toxicity manifsations

A
  • nonproductive cough
  • substernal pain
  • nausea
  • vomiting
  • fatigue
  • dyspnea
  • restlessness
  • paresthesias
25
Q

oxygen toxicity nursing actions

A
  • use the lowest level of oxygen necessay to maintain an adequate spo2
  • monitor abg and notify the provider if sp02 levels are outside the expected reference range
  • decrease the fio2 as the clients spo2 imrpoves
26
Q

combustion nursing actions

A
  • post “no smoking” or “oxygen in use” signs to alert others of the fire hazard. known where to find the closest fire extinguisher
  • educate about the fire hazard of smoking with oxygen use
  • have clients wear a cotton gown because synthetic or wool fabrics can generate static electricity
27
Q

combustion

A
  • ensure that all electric devices (razors, hearing aids, radios) are working well
  • make sure all electric machinery (monitors, suction machines is grounded
  • do not sure volatile, flammable materials (alcohol, acetone) near clients receiving oxygen
28
Q

specimen collection and airway clearance

A
  • mucoasl secretion buildup or aspiration of emeis can obstruct a clients airway
  • adequate hydration and coughing help the client maintain airway patency
  • these interventions promote adequate gas exchange and lung expansion
29
Q

specimen collection and airway clearance nursing actions that mobilize secretions and maintain airway patency include:

A
  • assistance with coughing
  • hydration
  • positioning
  • humidification
  • nebulizer therapy
  • chest phsiotherapy
  • suctioning
30
Q

suctioning

A

don the required personal protective equitment

  • assist the client to high-fowelers or fowlers position for suctioning if possible
  • encourage the client to breathe deeply and cough in a an attempt to clear secretions without artifical suction
31
Q

suctioning nursing actions

A
  • obtain baseline breath sounds and vital signs, including sao2 by a pulse oximeter
  • can monitor sao2 continually during the procedure
  • oropharyngeal suctioning use a yankauer or tonsil tipped rigid suction catheter and move the catheter around the mouth, gum line, and pharynx

foundations (21 decks)

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