Supporting Ventilation Key Points Flashcards
Breathing Exercises
Pursed-lip breathing and diaphragmatic breathing help increase lung inflation, prevent air trapping, and slow the respiratory rate
Airway Clearance Techniques
Help patients clear the airways of secretions. Includes huff coughing, chest physical therapy, postural drainage, percussion, vibration, commercially available airway clearance devices, and high frequency chest oscillation.
O2
Most important drug a nurse can administer to a patient
Fraction of Inspired Oxygen
FIO2
Dose of oxygen
Dose of Oxygen
Tailored to each patient’s condition and circumstances
O2 Administration
Low-flow or High-flow O2 delivery devices
O2 Admin Considerations
Always administer O2 at the lowest possible flow rate while maintaining acceptable SpO2 and SaO2 targets
Complications of O2 Therapy
include combustion, O2 toxicity, absorption atelectasis, CO2 narcosis, and, rarely, infection
O2 Therapy Management
Evaluating the patient’s level of consciousness (LOC), hemodynamic stability, auscultation of lung sounds, SpO2, and arterial blood gasses (ABGs)
Artificial Airways
Help provide a route for ventilation
Common Artificial Airways
Nasopharyngeal, oropharyngeal, endotracheal tube, nasotracheal tube, and tracheostomy
Nasopharyngeal Airway
For conscious patients
Oropharyngeal Airway
For unconscious patients
ET Tube and Nasotracheal Tube
For patients who require invasive mechanical ventilation
Tracheostomy
Invasive mechanical ventilation and long-term ventilator support
Bronchoscopy and Thoracentesis Purpose
Help facilitate diagnosis of conditions and enhance ventilation
Chest Tubes and Pleural Drainage Systems Purpose
Drain blood or air from the chest cavity
Insertion Priorities
Explain the procedure, position the patient, analgesia, and provide emotional support
Chest Drainage Unit
CDU
Three chambers: Collection, water-seal, and suction control
Suction Control
Can be wet AND dry
Post-Chest Tube Insertion Management
Monitoring vital signs and chest tube drainage, performing dressing changes, ensuring integrity of the CDU (tidaling, bubbling, all connections securely taped), and troubleshooting
Chest Tube Removal
Apply a petroleum gauze dressing over the site, monitoring vital signs, assessing lung sounds, chest x-ray and providing pain relief
Thoracotomy
Incision into the chest Drainage Unit
Commonly encountered respiratory surgical procedure
Video-Assisted Thoracic Surgery
Minimally invasive procedure to diagnose, treat, and biopsy
Commonly encountered respiratory surgical procedure
Noninvasive Ventilation
NIV
Application of an interface (nasal or full-face mask) to support ventilation
Most Common Form of NIV
Bi-Level Positive Airway Pressure
Bi-PAP
Bi-PAP
2 levels of pressure: IPAP and EPAP
Inspiratory Positive Airway Pressure
IPAP
Helps with CO2 removal
Expiration Positive Airway Pressure
EPAP
Helps with Oxygenation
NIV Patient
Must be awake, alert, spontaneously breathing, and able to cough/ clear secretions
NIV Patient Care
Monitoring LOC, vital signs, elevating the HOB, providing eye/mouth/skin/nare care, and observing patient response
Most Common Mechanical Ventilation
Positive Pressure Ventilation
Positive Pressure Ventilation
Air is pushed into the patient’s lungs
Mechanical Ventilation Patients
Those with acute respiratory failure, apnea, cannot protect their own airway, and hypoxemia
Tidal Volume
A certain amount of air is given with each breath
Pressure
A certain amount of air is delivered to the patient until a peak inspiratory pressure is reached
Intubation
The process of placing the ET tube or Nasotracheal tube into the patient’s airway/ trachea
Pre Intubation
Explain the procedure, position the patient, provide analgesia and sedation, help hyper-oxygenate with bag-valve mask, and have FIO2 at 100%
Bag-Valve Mask
BVM
Rapid Sequence Intubation
Provide analgesia, sedation, and a paralytic drug so that we can rapidly secure the airway
Post Intubation
Confirm the placement of the tube
Tracheostomy
A surgical procedure that involves placing a small plastic tube in the trachea of a patient who cannot be successfully extubated or those patients who will require long-term mechanical ventilation
Tracheostomy Patient Care
Changing the tracheostomy dressing, observing site for signs/symptoms of infection, keeping the tracheostomy patent, suctioning using closed/open technique, and changing tracheostomy ties.
Accidental Decannulation
Emergency!
Unintentional removal of the tracheostomy tube from the patient’s airway
Passy-Muir Valve
A device that will help permit speech with a tracheostomy tube
