Oxygenation Key Points Flashcards
Adventitious
abnormal breath sound heard over the lungs
Alveoli
small air sacs at end of terminal bronchioles that are the site of gas exchange
Angina
temporary imbalance between the amount of oxygen needed by the heart and the amount delivered to heart muscles
Arterial Blood Gas
diagnostic test examining arterial blood
used to determine the pressure exerted by oxygen and CO2 in blood
Atelectasis
incomplete expansion or collapse of a part of the lungs
Atria
upper chambers of the heart
Atrioventricular Bundle
bundle of modified heart muscle that transmits the cardiac impulse from atrioventricular node to the ventricles, causing them to contract
Atrioventricular node
node of specialized heart muscle located in septal wall of right atrium
receives impulses from sinoatrial node and transmits them to the atrioventricular bundle
Bronchial
heard over larynx and trachea
are HIGH-PITCHED, harsh blowing sounds, with sound on expiration being longer than inspiration
Bronchodilator
medication that relaxes contractions of smooth muscles of the bronchioles
Bronchovesicular
normal breath sounds heard over mainstem bronchus
LOW PITCHED, HOLLOW moderate blowing sounds with inspiration and expiration
Capnography
method to monitor ventilation and indirectly blood flow through the lungs
Cardiopulmonary
relating to the heart and the lungs
Cardiovascular
relating to the heart and blood vessels
Cilia
microscopic, hair-like projections that move mucous toward upper airway so that it can be expectorated
Crackles
fine, crackling sounds made as air moves through wet secretions in the lungs
Endotracheal Tube
polyvinyl-chloride airway that is inserted through the nose or mouth into trachea using larynogoscope
Hyperventilation
more than normal amount of air entering and leaving lungs
Hypoventilation
decreased rate and depth of air movement into lungs
Hypoxemia
deficient oxygenation of blood
Hypoxia
inadequate amount of oxygen available to the cells
Internal Respiration
exchange of O2 and CO2 between circulating blood and tissue
Ischemia
deficiency of blood in a particular area
Oxygenation
process of providing cells life-sustaining oxygen
Perfusion
oxygenated capillary blood passes through the tissues of the body
Pleural Friction Rub
HARSH, grating, LEATHERY sound
caused by inflamed pleura
Pulmonary Ventilation
movement of air into and out of lungs
Pulse Oximetry
noninvasive technology that measures O2 Sat (SaO2) of arterial blood
Respiration
gas exchange between alveoli and blood in capillaries
Rhonchi
low pitched, RUMBLE, SNORING sound
narrow airway in trachea or bronchi
clears w/ coughing
Sinoatrial node
mass of tissue in upper right atrium, below opening of superior vena cava, that initiates transmission of electrical impulses, causing heart contractions
AKA PACEMAKER
Spirometer
instrument used to measure lung capacity and volume
Sputum
respiratory secretion expelled by coughing or clearing throat
Stridor
high pitched, WHEEZING
mostly heard on inspiration
disrupted airflow in larynx or trachea
Surfactant
detergent-like phospholipid that reduces surface tension of fluid lining alveoli
Tracheal
harsh hollow sounds heard over trachea (NORMAL)
Tracheostomy
artificial opening made in trachea through which tracheostomy tube is inserted
Ventricles
lower chambers of the heart
Vesicular
normal sound of respirations heard on auscultation over peripheral lung areas
LOW-PITCHED BLOWING
Wheezes
continuous, high-pitched squeak or MUSICAL sound made as air moves through NARROWED or partially obstructed airway passages
If a problem exists in ventilation, respiration, or perfusion, what might occur?
hypoxia
What are the most common symptoms of hypoxia? (9)
dyspnea
increase BP w/ small pulse pressure
increase RR and pulse rates
pallor
cyanosis
anxiety
restlessness
confusion
drowsiness
What other condition could cause hypoxia?
hypoventilation
Can hypoxia be a chronic condition?
yes
What are the signs and symptoms of chronic hypoxia? (9)
altered though processes
headaches
chest pain
enlarged heart
decreased urinary output
clubbing of fingers and toes
decreased libido (sex drive)
weakness of extremity muscles
muscle pain
What does the amount of blood flowing through the lungs depend on?
the amount of oxygen and other gases that are exchanged
Where is perfusion greater in the lungs?
dependent areas; lowest area of the lungs
How is the majority of oxygen carried through the blood?
red blood cells as part of hemoglobin
Factors that affect oxygenation (6)
level of health
developmental considerations
medication considerations
lifestyle considerations
environmental considerations
psychological health considerations
Healthy lifestyles that promote optimal respiratory functioning (6)
no smoking
regular exercise
limit alcohol intake
healthy diet/weight
monitor cholesterol
vaccinations
Vaccinations that promote optimal respiratory functioning (3)
influenza
COVID-19
pneumonia (pneumococcal)
Reducing anxiety techniques that promote optimal respiratory functioning in patients (3)
create environment that lessens anxiety
use active listening
treat patient w/ empathy and nonjudgmental
Pullutant free environments that promote optimal respiratory functioning (6)
avoid cities (w/ lots of pollution)
avoid second-hand smoke
avoid fires or places likely to have fires (ex: California)
avoid vacuuming/dusting
avoid occupational hazards (mining, farming, painting, cleaners)
Maintaining good nutritional habits that promote optimal respiratory functioning (5)
small frequent meals
plan breathing treatments before eating (1-2 hrs before)
avoid extra added salts
wear oxygen while eating
avoid fats, salts, sugars
Ways to promote comfort for a patient having dyspnea (3)
positioning
providing humidified air
maintaining adequate fluid intake
Positioning for promoting comfort for someone with dyspnea
Fowler’s (promotes chest expansion)
Tripod (increases lung expansion)
Prone (opens up lungs for an acute pt)
Considerations for providing humidified air to promote comfort while breathing
clean the air humidifier
humidifying removes moisture from respiratory passages (which protects against infection and irritation)
Considerations for maintaining adequate fluid intake to promote comfort while breathing
keep secretions thin
recommended 2-3 quarts a day
Techniques that Promote Proper Breathing (4)
deep breathing
incentive spirometer
pursed-lip breathing
diaphragmatic breathing
How does deep breathing promote proper breathing?
used to overcome hypoventilation
in nose, out mouth
move ribs up while breathing in
How does the incentive spirometer help promote proper breathing?
opens up alveoli (atelectasis)
provides a visual
How does pursed-lip breathing help promote proper breathing?
feeling of control = decreased anxiety
prevents collapse of small airways
How does diaphragmatic breathing help promote proper breathing?
decreases RR
increases alveolar ventilation
helps expel as much air as possible
Non productive cough
dry cough
can be fatiguing/irritating
Productive cough
wet cough w/ sputum
Coughing is a
cleansing mechanism for respiratory system
Voluntary Coughing
forced
-combined w/ deep breathing
-give frequent reminders
-have pt cough before bed
Involuntary Coughing
could be caused by:
-respiratory infection
-respiratory secretion
Pharmacological Options for Promoting and Controlling Coughing
expectorants: facilitates removal of secretions by EXPElling it (example: mucinex)
cough suppressants: depress cough reflex (don’t give if a patient has a productive cough)
lozenges: cough drops w/ local anesthetic (numb cough reflex)
Performing Chest Physiotherapy for promoting and controlling coughing
percussion, vibration
Suctioning the Airway to Promote and Control Coughing
suction mouth or internal airways, done in ICU
irritates mucosa and can cause hypoxemia when done in internal airways
FiO2
fraction inspired oxygen
What does typical room air contain?
Oxygen: 21%
Nitrogen: 78%
Methane, Helium, CO2: 3 %
Nasal Cannula
MOST COMMON
basic supplemental oxygen source when pt needs a little extra
1-6 L/min (more than 6L is not effective)
use humidifier for any device greater than 4 L/min (oxygen dries out mucosa)
Simple Mask
no bag on mask
very simple, basic, flexible tubing and mask
can attach nebulizer for meds (breathing treatment)
holes on each side of mask to allow O2 and CO2 out of mask
6-10 L/min
may see in PACU or for mouth breathers
Partial-Rebreather
similar to non-rebreather, but has open holes w/out valves on side (which allows for increased O2 levels)
bag should be 2/3 way full
do NOT let bag collapse
8-11 L/min
requires careful monitoring to verify FiO2 rate
High Flow Nasal Cannula
high flow O2
max 6-10 L/min
green tubing
must be humidified (very drying)
Face Tent/Shield
much like trach O2 supply
comes in and around nose and mouth
at least 10 L/min
fixed FiO2 28%-100%
HUMIDIFY!!!