Oxygenation Exam 2 Flashcards
What is hypoxemia?
Low oxygen levels within the blood
mia-blood
Common causes include respiratory conditions like COPD, pneumonia, asthma, as well as old age, smoking, and high altitude.
What is hypoxia?
Low oxygen levels in the tissues of the body
xia-tissue
Hypoxia is sometimes associated with hypoxemia but not always.
What is the average tidal volume in adults?
400-500 ml
Tidal volume is the volume of air inspired and expired with each breath.
What does FiO2 stand for?
Fraction of inspired oxygen
FiO2 increases with nasal cannula, masks, BiPAP, or mechanical ventilation.
What is the oxygenation percentage of room air?
21% oxygenation
What is the oxygen delivery percentage from a 2 liters nasal cannula?
28% oxygen
What nursing intervention can help clients receiving high levels of oxygen through a nasal cannula?
Comfort measures
This may include humidification or adjusting the flow rate.
True or False: Oxygen administration will fix carbon dioxide levels.
False
Clients with decreased lung compliance may still retain CO2 despite oxygen administration.
What therapy benefits clients with decreased lung compliance?
BiPAP therapy
BiPAP provides both oxygen and positive airway pressure to help exhale CO2.
What is the purpose of BiPAP?
To provide oxygen and positive airway pressure
It also helps with exhalation of carbon dioxide.
What should a nurse monitor for in a client with elevated CO2 levels due to COPD?
Assessment findings such as confusion or shortness of air (SOA)
What oxygen saturation level is realistic for a client with a history of COPD?
Lower than normal saturation levels
Specific levels may vary based on individual conditions.
Fill in the blank: A client admitted with sleep apnea may show _______ as symptoms.
[Common symptoms such as loud snoring, daytime sleepiness, etc.]
What cues would indicate the client’s current regimen isn’t working?
Signs of increased respiratory distress or worsening symptoms
What nursing interventions should be taken for a client with suspected sleep apnea?
Monitor sleep patterns, assess respiratory status, educate on lifestyle changes
Additional interventions may include weight management and CPAP use.
What questions may the nurse want to ask the family of a client with confusion?
About the client’s recent health changes, medication adherence, and any known triggers
What labs would the nurse analyze to validate confusion in a client with COPD?
Arterial blood gas levels
Fill in the blank: _______ will help lower CO2 and increase oxygen levels.
[Oxygen therapy]
What are some nursing interventions for those with pulmonary disorders?
Encourage pulmonary toilet, assess lung sounds, position in Semi to High Fowler’s, monitor oxygen saturation
Additional interventions include monitoring skin color and respiratory effort.
What lung sound indicates an emergency?
Wheezing or stridor
What discharge considerations should be taken into account for a client going home with oxygen?
Oxygen needs and follow-up care
What education should be provided to a client going home with BiPAP?
How to properly use and maintain the BiPAP machine
This includes troubleshooting common issues and understanding therapy goals.
Bipap vs cpap?
Bipap for COPD Different air pressure levels for inhale and exhale
CPAP for SLEEP APNEA- only oxygen 1 way valve. Same pressure on inhale and exhale
What s/s would the nurse expect to see in a client in respiratory distress?
anxiety
What are some other observations you might note r/t oxygenation?
When is a nasal cannula not appropriate?
Mouth breathers, broken nose, burns
When clients are receiving high levels of O2 through a nasal cannula what is a nursing intervention to help with comfort?
Humidify
Will oxygen administration fix carbon dioxide levels?
No, bipap will fix Co2
Nursing intervention to promote oxygen.
Dont smoke
No petroleum products
hard breathing, labor- sit up.
Might see blue skin-COPD
If CO2 rises- look at level if patient is confused and lethargic
N/A
If bibpap is not working, what will the nurse do?
intubate/ vent patient
Transporting a client on oxygen
Do not put oxy on bed.
Educate on replacement oxy.
What assessment findings would the nurse expect in someone with elevated carbon dioxide levels due to COPD?
Lethargic, blue
What oxygen saturation is realistic for a client with a history of COPD?
88%
If the client is receiving biPap therapy, what are some assessment findings the nurse would expect if therapy is effective? What if it isn’t?
Alert, orientated, less RR
Scenarios both sides
Client admitted with sleep apnea.
S/S: Snoring, big neck
Risk factors: Big neck, overweight
Treatment: Cpap
What cues would indicate the client’s current regimen isn’t working? Tired, snoring. If it is working, less headaches and less tired
Currently on biPap therapy due to elevated carbon dioxide levels secondary to COPD.
S/S: Blue?
Risk factors: smoking, enviroment
Treatment: bipap
What cues would indicate the client needs more aggressive therapy?
lethargic, confused
65 yo, retired, Filipino female admitted for sleep study after she reports waking up several times each night
Her wife states the client’s snoring keeps her up all night.
Height: 52 inches Weight: 195 pounds
Client reports feeling sleepy throughout the day.
Client reports moodiness and irritability.
What do you suspect the client is experiencing?
Sleep apnea
Name 3 nursing interventions for a client with the suspected condition.
How would the nurse evaluate the interventions?
-Cpap
-more exercise
-position, pulmonary toilet, incentive spirodomer
55 yo, male, white, truck driver with history of COPD and smoking presents to ER with confusion and SOA.
What are questions the nurse may want to ask the family?
Why is the client confused?
What labs would the nurse analyze to validate their analysis?
Do they smoke? Use oxygen?
confused because co2 in increased.
What labs would the nurse analyze? ABG blood gas
Arterial blood gas shows the client has elevated CO2 levels. The nurse understands _______ will help lower CO2 and increase oxygen levels.
BIPAP
What other nursing interventions are appropriate when initiating this type of oxygen therapy?
Lung sounds, incentive spirometer
Nursing Interventions for those with Pulmonary Disorders
Encourage pulmonary toilet.
Assess lung sounds. What lung sound indicates an emergency?
Position in Semi to High Fowler’s position.
Monitor oxygen saturation, skin color, breathing effort, RR
Monitor for s/s of irritation and irritability, especially in clients who cannot verbalizesoa.
Monitor lab values.
Administer medications as ordered and PRN (as needed).
Perform suctioning, if needed.
Provide Yankauerto low wall suction at bedside
Oxygen home safety (Exam)
Oxygen needs
Follow up
Education – What would you teach the client going home with oxygen?
What would you teach the client going home with biPap?
No smoking,
no fire, how to change oxy.
