Resipratory/Airway management Flashcards
Cheyne Stokes
Cycles of progressively deeper, quicker breathing followed by a gradual decrease leading to temporary apnea
Tachypnea
Abnormally rapid breathing
Apnea
Temporary cessation of breathing lasting more than 20 second
Kussmaul
Rapid, deep labored breathing (to blow off CO2-often seen in DKA)
Nasal Canula
1-6 LPM
24-44%
COPD appearances
Clubbing of fingers
Barrel chest
SpO2 may be low or normal
Simple Mask
6-12 LPM
35-50%
Partial Non-rebreather
6-11 LPM
60-75%
Bag inflated 1/3-1/2 full
Non-rebreather
10-15 LPM
80-95%
Bag inflated 2/3 full
Venturi Mask
4-12 LPM
24-50%
Allows for a specific amount of air to mix with O2
Tracheostomy Collar
at least 10 LPM
24-100%
Requires constant humidifacation (we have bypassed the body’s natural humidifiers)
High flow respiratory oxygen source
non-rebreather
remember the bag should be inflated, if not something is wrong and the pt is breathing in their own CO2. The O2 flow is probably not high enough if the bag is collapsed.
We want 12-15 LPM
Internal Respirations
Bloodstream and cells
External Respirations
Alvioli and Capllaries
Tracheostomy care and suction
q8h
if visibly soiled or sputum collection observed at the trach opening
SpO2 dropping
C/O SOB
Adventitious breath sounds
S/Sx of respiratory depression
Decreased RR
Decreasing SpO2
Decreasing HR
Difficulty to arouse
Lung sounds of Asthmatics
Wheezing
Early S/Sx of Hypoxia
Tachypnea
Tachycardia
Restlesness/Anxiety/Confusion
Pale skin/mucous membranes
Elevated BP
Use of accessory muscles
Nasal flaring
Adventitious breath sounds
Late S/Sx of Hypoxia
Stupor
Cyanotic skin/musous membranes
Bradypnea
Bradycardia
Hypotension
Cardiac dysrhythmias
Chest tubes
Drainage containers should always be below chest level and upright.
Connections should be taped to avoid air leakage.
Tubing should be pinned to pt.
All dressings should be kept intact.
If tubing of chest tube disconnects to keep air lock what do we do?
Place tube in sterile water
If tubing of chest tube is pulled out what do we cover the “sucking chest wound with”?
occlusive dressing taped on 3 sides so air can come out but not be sucked back in.
How do we treat bacterial pneumonia?
Antibiotics
Expectorant
Bronchiodilators
O2
Analgesics
How do we treat viral pneumonia?
Likely to resolve with rest and Sx management. However some providers may perscribe anti-virals to lessen the duration and severity of Sx.
Coughing and deep breathing education.
Take a deep breath and hold it for a few seconds.
Exhale slowly
Repeat 5 times
Brace incision with pillow, try to cough deeply
Repeat q1h while awake
Bracing/splinting the incsion when coughing can help minimize pain.
Coughing and deep breathing expands the lungs.
Sitting upright promotes optimal lung expansion.
How is pneumonia diagnosed?
Chest X-ray and sputum samples
Compliations of prolonged O2 therapy?
Drying and Cracking of mucous membranes.
Prevention of complications from prolonged O2 therapy?
Good oral care
Possible humidifacation
Use of moisturizors on mucous membranes (water based only, NO patroleum products)
Crackles/Rales
Fine to coarse bubbly sounds (not cleared with coughing) as air passes through fluid or re-expands callapsed small airways.
Fluid in the lungs
Stridor
Upper airway narrowing or obstruction
Rhonchi
Coarse, loud, low-pitched rumbling sounds during either inspiration or expiration resulting from fluid or mucous (can clear with coughing) Blockages in bronchi
Wheezing
High pitched whistling, musical sounds when air is moving through narrowed airways, usually louder on ecpiration. (fairy muscial)
Pleural friction rub
Dry, grating or rubbing sound as the inflamed visceral and parietal pleura rub against eachother during inspiration and/or experiation.
What do we do first if a NEW trach tube becomes dislodged?
Call for help! Activate the emergent responce team. Then we assess the pt airway needs. Typically bag them til help arrives.
ABC’s
Airway
Breathing
Circulation
If someone is airway compromised or SOB they take priority!!!
Always evaluate and assess for pt needs then choose appropriate intervention.
Hydration in relation to airway managment
Helps to thin secretions to allow for expulsion.
Then build on that with the deep reathing and coughing to assist with the expansion of the lungs to prevent atelectasis, and movement of the secretions to be expelled from the airways.
Atelectasis
Complete or partial collapse of a lung or lobe of a lung.
