Skills Flashcards (Oxygenation PowerPoint)
Soft-intensity, low-pitched, “gentle sighing” sounds made by air moving through smaller airways (bronchioles and alveoli).
What breathing sound would you call this?
Vesicular Breathing Sounds
Moderate-intensity and moderate-pitched “blowing” sounds created by air moving through larger airway (bronchi).
What breathing sound would you call this?
Bronchovesicular Breathing Sounds
High-pitched, loud, “harsh” sounds created by air moving through trachea.
What breathing sound would you call this?
Bronchial (Tubular) Breathing Sounds
Name off a buncha normal breathing sounds:
Vesicular Breathing Sounds
Bronchovesicular Breathing Sounds
Bronchial (Tubular) Breathing Sounds
Give a description of Rales:
Crackle Breathing Sounds.
Best heard on inspiration.
May not be cleared with coughing.
Give a description of Rhonchi:
Gurgle Breathing Sounds.
Low-pitched, moaning or snoring sounds.
Best heard on expiration.
May be altered with cough.
Give a description of Friction Rub Breathing Sounds:
Grating / Creaking Sounds.
Heard with both inspiration + expiration.
Give a description about what a Wheeze is:
High-pitched musical sounds.
Best heard on expiration.
Not usually altered by cough.
What is the cause of Rales?
Air passing through fluid or mucous
What is the cause of Rhonchi?
Air passing through narrowed air passages
What is the cause of Friction Rub?
Rubbing together of inflamed pleural surfaces
What is the cause of Wheezing?
Air passing through constricted bronchus
At what location is it possible to auscultate Rales?
Bases of Lower Lungs
At what location is it possible to auscultate Rhonchi?
Predominate Over Trachea + Bronchi
At what location is it possible to auscultate a Friction Rub?
Lower Anterior + Lateral Chest
At what location is it possible to auscultate a Wheeze?
All Lung Fields
What kind’s of people is oxygen therapy prescribed for?
Pt’s with Hypoxemia, Hyper-Ventilation, Loss of Lung Tissue, Anemia, Blood Loss
What are some things that the Primary Care Provider should specify when giving Oxygen Therapy?
Concentration, Method of Delivery, Liter Flow per Minute (LPM).
May prescribe for titration to achieve therapeutic level.
When giving oxygen therapy, what flow should the humidifier be set to in order to prevent drying?
High Flow (Over 4 LPM)
It is common to titrate 02 in order to-
Keep sats above a certain level (Like > 92%)
How much humidity do humidifiers add?
20-40%
What do Humidifiers prevent?
The drying of mucous membranes and therefore decrease risk of irritation and nose bleeds
What may help to loosen secretions for easier expectoration?
Humidifiers
Is oxygen addictive?
Nah
What % oxygen is room air?
21% Oxygen
Most people are only ordered how much oxygen?
28% Oxygen Concentration at 2 LPM
What can excessive amount of oxygen intake lead to?
Pulmonary tissue damage, increase in ventilator time, and longer hospitals stays
You should always use the highest concentration needed to achieve desired blood oxygen saturation.
True or false?
False, always use the lowest.
List the different types of oxygen delivery devices:
Cannula
Tracheal Mask
Face Masks:
Simple
Partial Rebreather
Non Rebreather
Venti Mask
Oxygen Face Tent
What should you never use in the nose for dryness when using oxygen because it causes burning?
Vaseline / Petroleum Jelly
How many LPM is Low Flow?
1-6 LPM
What oxygen concentration is given with 1 LPM via a Nasal Cannula?
1 LPM would have 24% Oxygen
What oxygen concentration is given at 2 LPM via a Nasal Cannula?
What about 3 LPM?
2 LPM would have 28% Oxygen.
3 LPM would have 32% Oxygen.
4 would be 36%, etc.
Give me a description about the Nasal Cannula:
It’s used for clients with chronic airflow limitations or for long term use. Most commonly used oxygen therapy device. Inexpensive. Doesn’t interfere with eating or talking
What do you need to watch out for with pt’s who are on a Nasal Cannula?
Watch for skin irritation and breakdown in the nares, around ears, neck, and face
When should Humidification be used for pt’s on a Nasal Cannula?
When giving them 4 LPM or higher
What are the interventions needed for a pt who needs a Nasal Cannula?
Place prongs in nostrils with openings facing the client.
Add humidification as prescribed (should be used when using liter flows above 4 LPM for client comfort).
Check water levels and change humidification PRN.
Provide water soluble jelly to nares PRN.
What are some things that you’d need to assess for a pt who has a Nasal Cannula?
Assess client for changes in respiratory rate and depth.
Assess mucosa for drying/irritation.
Assess skin integrity; oxygen tubing may irritate especially around the ears can cause Pressure Wounds.
How much oxygen should a Simple Oxygen Mask deliver?
40-60% Oxygen Concentration at 5-8 LPM.
A Simple Mask should be over 6 LPM to wash out the exhaled CO2.
How much oxygen should a Simple Rebreather Oxygen Mask deliver?
40-60% Oxygen Concentration at 6-10 LPM
The bag must not deflate for a Partial Rebreather Oxygen Mask, if it does, what should you do?
Increase the LPM
What are some interventions for a Simple Oxygen Mask?
Make sure mask fits properly over nose and mouth.
Assess skin and provide skin care to area covered by the mask.
Monitor for aspiration; mask may limit client’s ability to clear mouth.
Provide emotional support (may feel claustrophobic).
Switch to nasal cannula during meals after consultation with HCP to approve switch.
What are some interventions for a Partial Rebreather Oxygen Mask?
Make sure reservoir doesn’t twist or kink (bag will deflate).
Adjust flow rate to keep bag 2/3 full during inspiration.
How much oxygen should a Nonrebreather Oxygen Mask deliver?
95-100% Oxygen Concentration at 10-15 LPM
How much oxygen should a Venturi Oxygen Mask deliver?
LPM Varies Per Manufacturer (Oxygen Concentration is 24% to 40-50 %)
If your pt has a non-rebreather mask, then you should make sure that it-
Doesn’t Deflate
A Venturi Mask will have a dial to set the percentage of oxygen if it has an LPM of-
4-10
What type of oxygen masks are used in clients who are deteriorating and might require intubation?
Nonrebreather Oxygen Masks
What are some interventions for Nonrebreather Oxygen Masks?
Remove mucus or saliva from mask.
Assess and monitor client’s respiratory status closely.
Ensure flaps are intact and functional.
Monitor for suffocation if reservoir kinks or oxygen source disconnects.
What kind’ve masks provide high flow oxygen delivery?
Venturi Oxygen Masks
What kind’ve interventions are there for pt’s with Venturi Oxygen Masks?
Monitor client to ensure accurate flow rate of oxygen concentration.
Keep orifice of adapter open/uncovered for proper delivery.
Ensure mask fits snugly.
Ensure tubing free of kinks.
Assess client for dry mucous membranes.