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PCC > Oxygenation (Exam 2) > Flashcards

Oxygenation (Exam 2) Flashcards

1
Q

Where does the diffusion of gas take place?

A

alveoli

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2
Q

Describe the mechanical process of the pulmonary system

A

VENTILATION!

movement of air into and out of lungs

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3
Q

Describe the chemical process of the pulmonary system?

A

RESPIRATION!

exchange of O2 and CO2
transport in body
exchange of gases between alveoli and capillary membranes

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4
Q

Describe inspiration

A

VENTILATION, ACTIVE PROCESS

diaphragm and intercostal muscles contract

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5
Q

Describe exhalation

A

VENTILATION, PASSIVE PROCESS

Lung pressure increases, forcing air out of

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6
Q

Describe external respiration

A

diffusion of O2 from alveoli into pulmonary circulation across alveoli-capillary membrane

release of CO2 from circulation into alveoli

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7
Q

Describe internal respiration

A

capillary-tissue gas exchange for tissue oxygenation

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8
Q

CO2 is a byproduct of…

A

cellular metabolism

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9
Q

What are 6 factors that affect ventilation?

A

respiratory rate and depth
hyperventilation
hypoventilation
lung compliance
lung elasticity
airway resistance

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10
Q

What is hyperventilation?

A

rapid and deep breathing resulting in excess loss of CO2 (hypocapnia)

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11
Q

What is hypoventilation?

A

the rate and depth of respirations are decreased and CO2 is retained

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12
Q

What is lung compliance?

A

ease of lung inflation

scar tissue, fluid, lower surfactant

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13
Q

What is lung elasticity?

A

tendency for elastic fibers to return to normal

LOSS OF ABILITY TO RECOIL

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14
Q

What is airway resistance?

A

resistance to airflow within the airways

NARROWING AIRWAYS

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15
Q

Developmental factors affecting older adults for oxygenation

A

calcification of heart valves
osteoporosis
changes in size and shape of thorax
declining immune systems
GERD

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16
Q

What are factors affecting pulmonary function?

A

LIFESTYLE (occupation, exercise, nutrition, obesity (sleep apnea), substance abuse, smoking and drugs, pregnancy)
MEDS
COMORBID CONDITIONS (CVD, respiratory conditions)
TRAUMA
ENVIRONMENT (stress, allergies, air quality, high altitudes, pollutants and exposure)

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17
Q

What are some Upper Respiratory Infections that cause alterations in gas exchange?

A

colds and the flu

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18
Q

What are some Lower Respiratory Infections that cause alterations in gas exchange?

A

bronchitis, pneumonia, respiratory syncytial virus (RSV), TB

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19
Q

What does asking about past history also include?

A

use of oxygen and ventilatory assist devices
demonstrating inhaler technique
taking as prescribed

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20
Q

What are some physical examinations for assessing oxygenation status?

A

breathing pattern
respiratory effort
pulse oximetry
IPPA

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21
Q

What are some diagnostic testing for assessing oxygenation status?

A

ABGs (pH, PO2, PCO2)
peak flow monitoring

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22
Q

What are some things to look out for during a physical assessment?

A

mental status/LOC
skin
nose (NASAL FLARING)
lips/mouth (CYANOSIS/PURSED LIP BREATHING)
nail beds (CLUBBING, CYANOSIS)
neck (TRACHEAL DEVIATION, VEIN DISTENTION)
chest (ASYMMETRY, STERNAL RETRACTIONS)
lungs
heart (MURMURS, DISPLACED PMI)

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23
Q

What is a wheeze?

A

high pitched continuous musical sounds, usually heard on expiration

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24
Q

What is rhonchi?

A

low-pitched continuous sound caused by secretions in large airways

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25
Q

What are crackles?

A

discontinuous sounds usually heard on inspiration, and may be high pitched popping sounds or low pitched bubbling sounds

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26
Q

What is stridor?

A

a piercing, high pitched sound heard primarily during inspiration

27
Q

What is stertor?

A

labored breathing that produces a snoring sound

28
Q

What are some common tests to diagnose lung disease?

A

chest radiography (CXR)
sputum cultures
complete blood count
skin tests
pulmonary function tests
ABGs

29
Q

What is oximetry?

A

measures O2 saturation of hemoglobin, stated as a percentage and is less accurate at lower volumes

LIGHT IS REFLECTED OFF HEMOGLOBIN MOLECULES, CALCULATES AMOUNT OF LIGHT ABSORBED

30
Q

What is capnography?

A

measures CO2, often used with oximetry and used during anesthesia and in ICUs (+ABGs)

PROVIDES INFO ABOUT VENTILATION

35-45

31
Q

What is spirometry?

A

measures air in and out of lungs; lung volumes/capacity measurements

varies with body size, age, and exercise

32
Q

Arterial puncture correlates with…

A

ABGs

33
Q

What is a peak flow meter?

A

amount of air forcibly exhaled; ASTHMA PTS

34
Q

What are some nursing interventions to promote oxygenation?

A

positioning for maximum lung excursion
incentive spirometer
mobilizing secretions
pursed lip breathing
emotional support
administer meds

35
Q

What are 4 ways to mobilize secretions?

A

turn, coughing, and deep breathing (TCDB)
hydration! encourage fluids
humidify O2 delivery
postural drainage and chest physiotherapy

36
Q

Supplemental O2

A

REQUIRES ORDER
caution with CO2 retention (COPD, hypoxia)

DRYING, CAN HUMIDIFY

37
Q

Nasal Cannula: Oxygen Delivered (FIO2)

A

MOST COMMON!!

1-6 L/min

1L=24%, 2L=28%, 3L=32%…

38
Q

Nasal Cannula: Patient

A

patient can talk and eat
comfortable
dryness

39
Q

Simple Mask (no reservoir bag): FIO2

A

5-10 L/min
40-60%

40
Q

Simple Mask: Patient

A

need to remove to eat
not tolerated as well
WATCH SKIN BREAKDOWN

41
Q

Partial Rebreather: FIO2

A

6-15 L/min
50-90%

42
Q

Partial Rebreather: Patient

A

Allows higher O2
PT CAN BE VERY ANXIOUS

43
Q

Non-Rebreather: FIO2

A

6-15 L/min
70-100%

44
Q

Non-Rebreather: Patient

A

only mask able to deliver 100% O2 (most effective)
MAKE SURE MASK FITS SNUGLY
KEEP RESERVOIR BAG AT LEAST 1/3-1/2 FULL

45
Q

Venturi Mask (Adapters to control O2): FIO2

A

24-50%

46
Q

Venturi Mask: Patient

A

useful with chronic lung disease
exhalation ports to keep CO2 buildup to a minimum

47
Q

Face Mask: FIO2

A

SECOND MOST COMMON!
8-12 L/min

30-35%

48
Q

Face Tent: Patient

A

more humidification
less reliable than mask

49
Q

Tracheostomy Collar/T-Piece: FIO2

A

4-10 L/min
24-100%

50
Q

Tracheostomy/T-Piece: Patient

A

specialized equipment for advanced airways
humidifies

51
Q

Artificial Airways: Oropharyngeal

A

ONLY WHEN UNCONSCIOUS
opens airway, keeps tongue away

suctioning upper airway

52
Q

Artificial Airways: Nasopharyngeal

A

CONSCIOUS PTS
useful to aid in clearing secretions and suctioning upper airway

53
Q

Artificial Airways: Endotracheal tubes

A

advanced airways usually placed by anesthesiology
SHORT TERM MECHANICAL VENTILATION

suctioning lower airway

54
Q

Artificial Airways: Tracheostomy tube

A

LONG TERM MECHANICAL VENTILATION

suctioning lower airway

55
Q

For all artificial airways tubes…

A

NEED TO MAINTAIN AIRWAY PATENCY

will require suctioning for clear secretions and monitoring

56
Q

Chest Tubes

A

INSERTED IN PLEURAL SPACE
PURPOSE IS TO EVACUATE AIR/FLUID (pneumothorax/hemothorax)
3 chamber system (drainage, water seal, suction)

57
Q

When using chest tubes, assess for…

A

Vitals
SpO2
Pulmonary
Color
Consistency
Amount
Pain

58
Q

How to use an inventive spirometer?

A

encourage patient to take deep breaths

SLOW BREATH IN THEN BALL GOES UP TO DETERMINE PROGRESSION OF IMPROVEMENT

can delegate to LPN/CNA

59
Q

What is postural drainage?

A

the use of various positions to allow secretions to drain by gravity

RESPIRATORY THERAPIST

60
Q

What is chest physiotherapy?

A

percussion and vibration after 10-15 minutes of postural drainage

RESPIRATORY THERAPIST

61
Q

What is pursed lip breathing?

A

slows expiration, good for COPD

breathe in through nose and exhale through pursed lips; teach via straw

62
Q

Yankauer suctioning

A

removing secretions and maintaining airway patency via oral cavity

63
Q

What is a nebulizer?

A

aerosolized medication to open airways
usually takes 5 min. breathing in and out
can be in mouthpiece or mask

PCC (14 decks)

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