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Adult Health I > T2: Airway and O2 Mgmt (1) > Flashcards

T2: Airway and O2 Mgmt (1) Flashcards

1
Q

Oxygen therapy improves what 2 things?

A
  • oxygenation

- tissue perfusion

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2
Q

6 signs that someone may need supplemental oxygen:

A

(Just remember these are normal signs of respiratory distress!)

1) dyspnea
2) nasal flaring
3) use accessory muscles
4) pursed-lip or diaphragmatic breathing
5) decreased endurance
6) skin, mucous membrane changes (pallor, cyanosis)

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3
Q

What do we evaluate in a respiratory assessment?

A
  • nose and sinuses
  • pharynx, trachea, larynx
  • lungs and thorax
  • general appearance
  • skin and mucous membranes
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4
Q

Oxygen therapy relieves _____.

A

hypoxEMIA

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5
Q 
\_\_\_\_\_ = decreased O2 in the BLOOD
\_\_\_\_\_ =  decreased O2 in the TISSUES
A 
hypoxemia = blood
hypoxia = tissues
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6
Q

What is the GOAL of oxygen therapy?

A

Use lowest FiO2 for acceptable blood oxygen level WITHOUT causing harmful side effects

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7
Q

How does the body compensate for hypoxia?

A
  • increased heart rate

- increased RBCs/Hbg

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8
Q

What is the best lab to determine the need for O2 therapy?

A

Arterial blood gas (ABG)

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9
Q

ABGs:

Normal pH

A

7.35 - 7.45

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10
Q

ABGs:

Normal PaCO2

A

35 - 45

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11
Q

ABGs:

Normal PO2

A

75 - 100

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12
Q

ABGs:

Normal HCO3

A

22 - 26

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13
Q

Hazards and complications of O2 therapy:

A
  • combustion
  • oxygen-induced hypoventilation
  • oxygen toxicity
  • absorption atelectasis
  • drying of mucous membranes
  • infection
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14
Q

What factors are taken into account when deciding the oxygen delivery system?

A
  • O2 concentration desired
  • Importance of accuracy and control of O2 concentration
  • Pt comfort
  • Importance of humidity
  • Pt mobility
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15
Q

Low-flow O2 delivery:

What 2 devices can be used?

A
  • nasal cannula

- facemask

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16
Q

What are the 3 types of facemasks?

A
  • simple
  • partial rebreather
  • non-rebreather
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17
Q

Nasal cannula:

Flow rates and concentration

A

1 - 6 L/min

24% - 44%

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18
Q

Simple facemask:

Flow rates and concentration

A

6 - 10 L/min

40% - 60%

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19
Q

Partial rebreather mask:

Flow rates and concentration

A

6 - 11 L/min

60% - 75%

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20
Q

Partial rebreather mask:

How much exhaled tidal volume with each breath?

A

1/3

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21
Q

Partial rebreather mask:

Should reservoir bag be inflated or deflated during use?

A

inflated

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22
Q

Non-rebreather mask:

Flow rates and concentration

A

12-15 L/min

80% - 100%

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23
Q

Non-rebreather mask:

Who is this used for?

A

unstable pts requiring intubation

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24
Q

Non-rebreather mask:

Nursing responsibility when applying this mask

A

ensure valves are patent and functional

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25
Q

What happens if the non-rebreather mask does not function properly?

A

CO2 buildup, the pt can’t breathe room air

26
Q

What are 5 types of high-flow O2 devices?

A
  • Venturi mask
  • Face tent
  • Aerosol mask
  • Tracheostomy collar
  • T-piece
27
Q

Venturi mask:

Used for _____ O2 delivery.

A

precise

28
Q

Venturi mask:

The best for ____ ____ ____.

A

chronic lung disease

29
Q

T-piece:

Delivers desired FiO2 for what type of pts?

A

those with tracheostomy, laryngectomy, ET tubes

30
Q

T-piece:

If we see mist during inspiration or expiration, what should we do?

A

Nothing! This is what you want to happen.

31
Q

2 Types of noninvasive positive-pressure ventilation (NPPV):

A
  • BiPAP

- CPAP

32
Q

How do NPPV systems deliver oxygen?

A

uses positive pressure to keep alveoli open

33
Q

CPAP:

When does it deliver the set positive airway pressure?

A

Throughout the breathing cycle…during both inhalation and exhalation

34
Q

CPAP:

Opens collapsed _____.

A

alveoli

35
Q

CPAP:

When is it used?

A
  • atelectasis after surgery
  • cardiac-induced pulmonary edema
  • sleep apnea
36
Q

T/F: Transtacheal Oxygen Delivery (TTO) is used for LONG-term delivery of O2 directly into the lungs.

A

True

37
Q

TTO:

What is the benefit?

A
  • avoids irritation that can be caused by nasal prongs

- more comfortable

38
Q

3 types of O2 “tanks” for home use:

A
  • compressed gas in tank
  • liquid O2 in reservoir
  • O2 concentrator
39
Q

How do we reposition patient to open the airway?

A
  • head tilt-chin lift (normal)

- jaw thrust method (spinal injury)

40
Q

How do we clear the airway?

A

suction

41
Q

What is the rate when using a bag-mask-valve (BMV)?

A

8 - 12 squeezes per min

42
Q

Who can we use an oropharyngeal airway on? Why?

A

Only for unconcious/semiconcious pts

will stimulate gag reflex

43
Q

How do we place an oropharyngeal airway?

A
  • Place along the outside of the jaw with one end of the airway at the bottom tip of the ear
  • Close mouth and bring tip of the airway toward the corner of the mouth
44
Q

Proper placement of the oropharyngeal airway:

A

tip of the airway lies above the epiglottis at the base of the tongue

45
Q

Why is it important to use the correct size oropharyngeal airway?

A

can cause airway obstruction

46
Q

What do we do before placing a nasopharyngeal airway?

A
  • LUBRICATE!

- Hold the airway against the side of the face and ensure it extends from the tip of the nose to the earlobe

47
Q

Proper placement of the nasopharyngeal airway:

A

the tip of the airway lies above the epiglottis at the base of the tongue

48
Q

Short-term airway: ___ or ___

Long-term airway: ____ (how long?)

A

Short-term: oral or nasal

Long-term: tracheotomy (for greater than 21 days)

49
Q

3 ways to check for correct ETT placement:

A
  • auscultate
  • inspect chest expansion
  • end-tidal CO2 detector
50
Q

Where do you auscultate first when checking ETT placement?

A

epigastric area

51
Q

What test is used to validate the depth of the ETT?

A

CXR

52
Q

What is correct placement of ETT?

A

3-4 cm above carina

53
Q

What 6 things do you assess with ETT?

A

1) tube TYPE
2) SIZE of airway
3) LOCATION at teeth/gums
4) pilot BALLOON
5) check for mucosal DAMAGE
6) check for STABILITY

54
Q

If ETT balloon pressure is too high:

If too low:

A

Too high = tracheal damage

Too low = aspiration around cuff leak

55
Q

What tool is used to measure cuff pressure?

A

aneroid pressure manometer

56
Q

Why do we suction ETT?

A

maintains patent airway, promotes gas exchange

57
Q

Where is the HOB when suctioning?

A

elevated

58
Q

How long should we suction each time?

A

10-15 sec

59
Q

5 complications of suctioning:

A

1) hypoxia
2) tissue (mucosal) trauma
3) infection
4) vagal stimulation, bronchospasm
5) cardiac dysrhythmias

60
Q

What should we do if vagal stimulation occurs during suctioning? How do we know when it happens?

A

back off quickly

slows down heartrate

61
Q

What cardiac dysrhythmia can occur from induced hypoxia during ETT?

A

PVCs from lack of oxygen

Adult Health I (10 decks)

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