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Nur 333 Fun 2 > Oxygenation (Exam 1) (Sub with JD's FCs) > Flashcards

Oxygenation (Exam 1) (Sub with JD's FCs) Flashcards

1
Q

Breathing is what kind of process?

A

Passive. It is regulated by O2 CO2 and pH of the blood.

-When CO2 increases the body knows to increase rate and depth of breaking to help remove CO2

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2
Q

Lung Volumes depend on

A

Age, Gender, Height

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3
Q

Tidal Volume

A

-Amount of air exhaled following normal inspiration

-Tidal volume can vary based on health status, activity, pregnancy, exercise, obesity, and etc

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4
Q

Alveoli Function

A

Promote gas exchange

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5
Q

Respiration assessment

A

-Is measuring ventilations. Normal 12-20.

-Watch the depth and rhythm of breathing

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6
Q

Who’s respiration is higher?

A

Kids and Males. They are abdominal breathers where as females are thoracic breathers

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7
Q

Crackles

A

Fine to coarse bubbly sounds associated with air passing through fluid or collapsed small airways

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8
Q

Wheezes

A

High pitched whistling, narrow obstructed airways. Musical

Asthma or allergic reaction

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9
Q

Rhonchi

A

-Loud low pitch rumbling, rattling, can resolve with coughing

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10
Q

Stridor

A

Chocking and in children

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11
Q

Pleural friction rub

A

Inflamed pleural friction rub

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12
Q

Oxygen Saturation Assess

A

Diffusion and perfusion

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13
Q

Work of Breathing

A

-Determine by rate and depth. Evaluate accessory muscle use.

-Effort to expand and contract lungs

-COPD (Effort to breath)

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14
Q

Compliance

A

Ability of lungs to distend or expand in response to pressure changes

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15
Q

Decreased compliance, increased airway resistance, and/or increased accessory muscle use ____________ work of breathing

A

increases

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16
Q

Factors Affecting Oxygenations: 4 main factors

A
  1. Physiological
  2. Developmental
  3. Lifestyle
  4. Environmental
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17
Q

Factors Affecting Oxygenation: Chest wall movement

A

-Pregnancy, obesity, musculoskeletal diseases, trauma, neuromuscular disease, CNS alterations

-Damage to the Medulla Oblongata

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18
Q

Goal of Ventilations

A

Normal Arterial carbon dioxide tension and normal arterial oxygenations tension

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19
Q

Labs:

A

PaO2 = 80-100

PaCO2 = 34-45

EtCO2 = 35-45

O2 sat (SpO2) = > 95%

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20
Q

Hypoventilation Causes and S/S

A

Medications and Atelectasis

Mental status changes and heart dysrthythmias

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20
Q

Hypoventilation

A

Inadequate alveolar ventilation to meet demand

Not enough O2 or too much CO2

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21
Q

Hyperventilation

A

-Removing CO2 faster than it is produced by cellular metabolism

-Anxiety attacks (severe), infection, drugs, pH imbalance, aspirin poisoning, amphetamine use

Numbness/tingling, hands feet, light-headedness, loc

INCREASE WOB

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22
Q

Hypoxia

A

In adequate tissue oxygenation at the cellular level

Can lead to cardiac problems because the heart needs O2 to function

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23
Q

Hypoxia Causes

A

-Decreased hemoglobin levels/low O2 carrying capability (Decrease Hemo)

-Diminished O2 concentration of inspired O2 (Altitude)

-Inability of tissues to get O2 from the blood (Cyanide poison)

-Decreased diffusion of O2 from alveoli to blood-infections/pneumonia

-Poor perfusion with oxygenated blood (shock)

-Impaired ventilations from trauma (rib fracture)

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24
Q

Which Cyanosis do we worry about hypoxia

A

Central Cyanosis.

25
Q

Chronic Hypoxia

A

-Chronic Lung conditions (COPD)

-Cyanotic nail beds
-Clubbed nail
-Sluggish Cap refill
-Barrel chest

26
Q

Important when it comes to coughing

A

Control the patients pain

27
Q

Sputum collection

A

-Collect early morning

-Collect 1-2 hours after patient eats

-Sterile procedure

-Teach patient to cough into the container and get as much expectorate sputum as possible

-May require suctioning if they cant cough anything up

28
Q

Negative sputum collections means

A

It was normal and they did not have anything

29
Q

Sputum for acid-fast bacillus (AFB)

A

-Screens for presence of AFB for detection of tuberculosis by early morning specimens on 3 consecutive days

30
Q

Sputum for cytology

A

-Obtained to identify lung cancer

-Differentiate type of cancer cells

31
Q

Pulmonary Function Test

A

-Basic ventilation studies. How well you are breathing

-Determines ability of the lungs to efficiently exchange O2 and CO2.

-Used to differentiate pulmonary obstructive from restrictive disease

32
Q

Peak Expiratory Flow Rate (PEFR)

A

-Airway resistance. Asthma and progression of asthma

33
Q

Bronchoscopy

A

Checking for normal airways without massess, pus, or foreign bodies

34
Q

Lung scan

A

-Nuclear scanning test used to identify abnormal masses by size and location. Used to find blood clots preventing normal perfusion or ventilation

35
Q

Thick secretions : Nursing Diagnoses

A

-Ineffective airway clearance

36
Q

Weak cough : Nursing Diagnosis

A

Risk for Aspiration

37
Q

Atelectasis and Chronic lung disease and Infections: Nursing diagnoses

A

Impaired Gas Exchange

38
Q

Head position airway maintenance

A

head title and chin lift

Jaw Thrust (Spinal Cord injury)

38
Q

Long Term Preventative Measures

A

-Vaccinations

-Healthy Lifestyle

-Environmental and Occupational exposures

39
Q

CPR order

A

Compression

Airway

Breathing

C_A_B

40
Q

Managing Pulmonary Secretions

A

-Mobilize

-Hydrate

-Humidification

-Medicaitons

41
Q

Chest Physiotherapy Contraindications

A

-pregnant
-Rib/chest
-Increased intracranial pressure
-Recent abdominal surgery
-Bleeding disorders
-Osteropororsis

42
Q

When is suctioning indicated

A

-When patients cannot clear secretions on their own through coughing or CPT

-Orotracheal and Nasotracheal NT

43
Q

Which type of suctioning is most common

A

-Nasotracheal (NT)

44
Q

Incentive Spirometer

A

-Promotes lung expansion through deep breathing

45
Q

Nasal Cannule

A

FiO2: 1-6L/min: 24-44%

Use humidification if greater than 4L of flow or more than 24 hours

46
Q

Simple face mask

A

FiO2: 6-12 L/min: 35-50%

Short Transportation

Can worsen CO2

47
Q

Non-Rebreather Mask

A

Highest non evasive O2

Critical patients

Use before intubation

48
Q

Pharyngeal airways

A

Through the mouth or nose and for people still breathing on their own. They may have a decrease in breathing which calls for it

loss of muscle or need suctioning

49
Q

Tracheal Airways

A

Unable to breathing effectively on their own

50
Q

Endotracheal Tube

A

Ventilator. Tube goes all the way down

51
Q

Percutaneous

A

The normal trach

52
Q

Accidental Decannulation

A

-Keep orburator at bedside

-Insert orburator into outer cannula

-Extend neck and open tissue. Insert cannula

-Remover obturator

-Check breath sounds

-Secure trach

53
Q

Signs and symptoms indicating need for suctioning

A
  1. Increase restlessness
  2. Increase WOB
  3. Noisy congestion when encouraged to cough
  4. Noisy breath sounds upon ausculation
53
Q

What is at bedside at all times

A

Spare inner cannula, spare trach, ambu bag, and obturator

54
Q

Hyper-oxygentation

A

With 100% O2 set at 10/15 L/min with 100% humidity for at least 30 seconds. Deep breathe 3/4 times to facilitate hyper-oxygenation

55
Q

Only suction the patient on the way out

A
56
Q

Sucitoning

A

Allow 1 min between suctioning passes. Limit suctioning pass to no more than 2-3x in one setting.

57
Q

Inner cannula goes into what solution

A

1/2 NS

1/2 peroxide

58
Q

Clean faceplate with

A

Only NS

59
Q

Fenestrated vs Non-fenestrated trach

A

Non-fenestrated patient are very ill and need all the air forced into lungs

Fenestrated is patient we are trying to wean off incubator

Nur 333 Fun 2 (12 decks)

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