PROMOTING OXYGEN

Question 1

What is a chest tube?

Answer 1

drain that is inserted between ribs into the plueal cavity, rids pleural cavity of blood, fluid, or air

Question 2

Why would a doctor insert a chest tube?

Answer 2

after a lung collapse/trauma/lung surgery, to restore negative pressure in lungs for re-expansion

Question 3

Could a chest tube have suction?

Answer 3

Yes..it could also not have suction

Question 4

Hemothorax vs Pneumothorax

Answer 4

Hemothorax: blood accumulating in pleural cavity
Pnuemothorax: air accumulation in pleural cavity

Question 5

spontaneous pneumothorax vs tension pneumothorax

Answer 5

spontaneous: idiopathically occurs more in tall, thin young men

pneumothorax: pressure build-up in pleural space, mediastinum opposite side of chest

Question 6

pleural effusion

Answer 6

abnormal accumulation of fluid around lung; due to cancer, pneumonia, C.H.F.

Question 7

What is a thoracotomy?

Answer 7

Open chest surgery

Question 8

What is a simple face mask and it’s requirements?

Answer 8

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

Question 9

Venturi mask vs partial rebreather mask

Answer 9

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

Question 10

Face tent mask vs aerosol mask

Answer 10

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

Question 11

What the procedure for controlled coughing/ Huff cough (CPT)

Answer 11

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

Question 12

Define the Nasal Cannula’s function and pros/cons

Answer 12

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

Question 13

What is an Endotracheal Tube (aka ETT)?

Answer 13

Breathing tube that goes in the throat to the trachea for the PT who can’t breathe independently (I.e. during thoracotomy)

Question 14

Characteristics of an ETT

Answer 14

Maintains patent airway, used with vent, 10-14 PRN, 20-30 cm H2O is normal range

Question 15

What is a tracheostomy?

Answer 15

Surgical incisions into trachea to establish an airway; temporary or permanent

Question 16

Orotracheal vs nasotracheal

Answer 16

Oro: ETT in mouth
Nasal: ETT in nose

Question 17

What is the nasotracheal suctioning method?

Answer 17

1. Reassure patient
2. Sterile technique
3. Lube Trach
4. Deep breaths
5. Insert cath. 6-8 inches into nose until resistance/ patient coughs
6. Apply suction
7. No longer than 10-15 seconds

Question 18

What is the Trach Care method?

Answer 18

1. Hyperoxygenate
2. Suction
3. Remove old dressing
4. Hand hygiene
5. Open the Trach kit/cannula
6. Pour NSS
7. Sterile gloves
8. Remove/replace cannula
9. Cleanse around stoma
10. New dressing

Question 19

What is Ventilator Assisted Pneumonia and it’s prevention methods?

Answer 19

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

Question 20

What are some short-acting Beta 2 antagonists?

Answer 20

Albuterol, metaproterenol, levalbuterol, pirbuterol, albuterol/ipratropium combo (i.e. duo neb which is MOST COMMON)

Question 21

what is oxygen therapy? Give an example

Answer 21

administering O2 to prevent or reverse hypoxia, treat arterial hypoxemia, insufficient oxygen for tissues and cell metabolism) i.e. nebulizer, nasal cannula, masks, etc.

Question 22

What are characteristics of oxygen therapy?

Answer 22

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

Question 23

Hypoxia vs Hypoxemia

Answer 23

hypoxemia: decreased O2 in arterial blood; a reason why O2 therapy is used
hypoxia: insufficient O2 in tissues as a result of hypoxemia

Question 24

True or False: O2 therapy has no complications

Answer 24

false; O2 therapy can cause blindness in children and COPD PTs should be on low liters because of slow respirations resulting from damaged chemoreceptors

Question 25

Define the goals of O2 therapy?

Answer 25

reverse hypoxia, treat hypoxemia, decrease work/cost of breathing, decrease myocardial work

Question 26

What are the pros and cons of a neb treatment?

Answer 26

pros: loosens secretions, improves coughing, bronchodilates»better breathing
cons: can increase heart rate and cause restlessness

Question 27

what are muscles of the respiratory system?

Answer 27

diaphragm (dome-shape, separates thoracic & abdominal cavities) and intercostals (between the ribs, enlarges thorax during inspiration)

Question 28

what are characteristics of the respiratory system?

Answer 28

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

Question 29

What are the stages of respiration

Answer 29

internal and external

Question 30

Define the organs of the respiratory system

Answer 30

trachea, pharynx, larynx, nose, bronchi, lungs

Question 31

What should the O2 of a normal PT be?

Answer 31

95-100%

Question 32

what should the expected highest O2 of a COPD PT be?

Answer 32

92%

Question 33

What are complications of tension pnuemothorax?

Answer 33

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.