PROMOTING OXYGEN Flashcards
What is a chest tube?
drain that is inserted between ribs into the plueal cavity, rids pleural cavity of blood, fluid, or air
Why would a doctor insert a chest tube?
after a lung collapse/trauma/lung surgery, to restore negative pressure in lungs for re-expansion
Could a chest tube have suction?
Yes..it could also not have suction
Hemothorax vs Pneumothorax
Hemothorax: blood accumulating in pleural cavity
Pnuemothorax: air accumulation in pleural cavity
spontaneous pneumothorax vs tension pneumothorax
spontaneous: idiopathically occurs more in tall, thin young men
pneumothorax: pressure build-up in pleural space, mediastinum opposite side of chest
pleural effusion
abnormal accumulation of fluid around lung; due to cancer, pneumonia, C.H.F.
What is a thoracotomy?
Open chest surgery
What is a simple face mask and it’s requirements?
It’s a short-term or emergency mask that delivers 35-50% of oxygen and requires a minimal flow rate of 6-12 liters/minute to prevent the rebreathing of exhaled air…can cause claustrophobia
Venturi mask vs partial rebreather mask
Venturi: provides specific amt of O2 (24-50%) using room air for most accurate delivery of concentration
Partial Rebreather: mask with bag (needs to be inflated), bag shouldn’t totally deflate, 60-90% of O2; PT rebreathes 1/3 of exhaled
Face tent mask vs aerosol mask
Tent: O2 concentration varies, for facial traumas/burns, pro: humidification, con: no control over O2 concentration, flow rate: 8-12 L/min; flow meter: set to specific liter
Aerosol: for PTs who need high humidity, post-extubation, or thick secretions; can be used w/ RA for neb
What the procedure for controlled coughing/ Huff cough (CPT)
Controlled coughing: Pt sits upright, leans forward slightly, takes 2 slow deep breaths, inhales: nose/exhales: mouth, 2/3 deep coughs
Huff: slight breath in, make “ha” sound with mouth open, repeat 3x
ALWAYS DO OVER CLOTHING/GOWN
Define the Nasal Cannula’s function and pros/cons
Used at 1-6 L/min, provides 24-44% O2; flow meter: sets Ls/min concentrations, for chronic air flow, pros: safe, simple, tolerated more, can eat/talk; cons: dries out nose on 4 or more Ls, skin breakdown
What is an Endotracheal Tube (aka ETT)?
Breathing tube that goes in the throat to the trachea for the PT who can’t breathe independently (I.e. during thoracotomy)
Characteristics of an ETT
Maintains patent airway, used with vent, 10-14 PRN, 20-30 cm H2O is normal range
What is a tracheostomy?
Surgical incisions into trachea to establish an airway; temporary or permanent
Orotracheal vs nasotracheal
Oro: ETT in mouth
Nasal: ETT in nose
What is the nasotracheal suctioning method?
- Reassure patient
- Sterile technique
- Lube Trach
- Deep breaths
- Insert cath. 6-8 inches into nose until resistance/ patient coughs
- Apply suction
- No longer than 10-15 seconds
What is the Trach Care method?
- Hyperoxygenate
- Suction
- Remove old dressing
- Hand hygiene
- Open the Trach kit/cannula
- Pour NSS
- Sterile gloves
- Remove/replace cannula
- Cleanse around stoma
- New dressing
What is Ventilator Assisted Pneumonia and it’s prevention methods?
Pneumonia associated with mechanical ventilation —90% HAI rate
Prevention: HOB 30-45 degrees, good hand washing, oral care Q 8-12 hrs, take PT off vent ASAP, reposition PT
What are some short-acting Beta 2 antagonists?
Albuterol, metaproterenol, levalbuterol, pirbuterol, albuterol/ipratropium combo (i.e. duo neb which is MOST COMMON)
what is oxygen therapy? Give an example
administering O2 to prevent or reverse hypoxia, treat arterial hypoxemia, insufficient oxygen for tissues and cell metabolism) i.e. nebulizer, nasal cannula, masks, etc.
What are characteristics of oxygen therapy?
it (O2) is considered a drug, must be Dr. ordered and given correctly, is combustible, and an assessment (LOC, cough, if any sputum, energy level) should be completed prior to use
Hypoxia vs Hypoxemia
hypoxemia: decreased O2 in arterial blood; a reason why O2 therapy is used
hypoxia: insufficient O2 in tissues as a result of hypoxemia
True or False: O2 therapy has no complications
false; O2 therapy can cause blindness in children and COPD PTs should be on low liters because of slow respirations resulting from damaged chemoreceptors
Define the goals of O2 therapy?
reverse hypoxia, treat hypoxemia, decrease work/cost of breathing, decrease myocardial work
What are the pros and cons of a neb treatment?
pros: loosens secretions, improves coughing, bronchodilates»better breathing
cons: can increase heart rate and cause restlessness
what are muscles of the respiratory system?
diaphragm (dome-shape, separates thoracic & abdominal cavities) and intercostals (between the ribs, enlarges thorax during inspiration)
what are characteristics of the respiratory system?
found in medulla oblongata (tells diaphragm to move down) , gives off CO2, CO2 also stimulates respiration (too much CO2»tachypnea), CO2 and O2 exchange in alveoli, use in tissues
What are the stages of respiration
internal and external
Define the organs of the respiratory system
trachea, pharynx, larynx, nose, bronchi, lungs
What should the O2 of a normal PT be?
95-100%
what should the expected highest O2 of a COPD PT be?
92%
What are complications of tension pnuemothorax?
Build up of pressure in pleural space. Pushes the mediastinum to the opposite side of the chest. The trachea deviates away from the side with tension. Patients experience immediate respiratory problems, hypotension and tachycardia.
