Unit 5: Oxygenation Flashcards
What diagnostic study measures the arterial blood level of oxygen, carbon dioxide, and pH?
Aterial Blood Levels
The nurse explains to the patient that ABG labs are obtained from a(n) _______ because_________________.
Artery -because- arterial blood is oxygenated.
What arteries are used to obtain ABG’s?
Radial, Brachial, Femoral
How long is pressure applied to the puncture site after obtaining the ABG’s?
Radial/Brachial- 5 minutes.
Femoral- 10 minutes.
What is the function of HCO3?
Maintain normal acid-base balance of the blood.
Where is HCO3 produced? Stored?
Produced & Stored in the Kidneys.
What diagnostic study measures the oxygen saturation of arterial blood non-invasively?
Pulse Oximetry
What does pulse oximetry measure?
Percentage of hemoglobin that combines with oxygen.
What can affect sensor accuracy when performing pulse oximetry?
Patient motion, cigarette smoking, fingernail polish, cold extremities.
What diagnostic study measures lung volume, lung capacities, volume/time relationships, and diffusion/perfusion measurements?
Pulmonary function studies.
What is the best time of day for a sputum specimen?
Morning, before eating.
How are sputum specimens obtained?
1) Having the patient couching up the specimen,
2) Suctioning,
3) Bronchoscopy.
What is defined as the inadequate oxygen at the cellular level?
Hypoxia
What are the S/S of hypoxia?
Tachycardia, hypertension, peripheral vasoconstriction, dizziness, mental confusion.
Severe hypoxia can be identified by what S/S?
Irregular Respirations (Apnea, Cheyne-Stokes, Respiratory Failure)
Define: Atelactasis
Collapse of alveoli, preventing the normal respiratory exchange of oxygen and carbon dioxide.
Alternating periods of apnea and deep rapid breathing is termed:
Cheyne-Stokes
Respirations in which the abdomen moves out while the diaphragm descends on inspiration is termed:
Diaphragmatic Breathing
The presence of free air or gas in the subcutaneous tissues, may produce a crackling or popping sound as air moves under the skin is termed:
Subcutaneous Emphysema
What level should chest tube systems be placed and kept?
Below the chest level.
The nurse assessing the chest tube system notes tidaling of fluid in the water seal chamber. She identifies this as (NORMAL -or- ABNORMAL)
Normal.
The nurse assessing the chest tube system notes bubbling of fluid in the water seal chamber. She identifies this as (NORMAL -or- ABNORMAL)
Abnormal.
What does bubbling in the water seal chamber suggest?
Suggests a leak in the drainage system.
The nurse assessing the chest tube system notes an absence of tidaling in the water seal chamber. What does this suggest?
System is not patent, or lung may have re-expanded.
What should the nurse assess for a patient with a chest tube?
Color, amount, and consistency of drainage in the drainage tube.
Vital Signs, Breath Sounds, SpO2,
Insertion site for drainage and subcutaneous emphysema.
What should the nurse encourage the patient who has a chest tube to do?
Perform deep breathing, coughing, incentive spirometry.
What should be done immediately following the removal of a chest tube?
Apply a sterile occlusive petroleum gauze dressing over the site to prevent air from entering the pleural space.
What is the single most effective method of controlling respiratory secretions?
Coughing
Post operative patients without lung disease should be encourage to do what? Why?
Cough deeply to help mobilize secretions and to open collapsed alveoli.
What are the 5 uses of an incentive spirometer?
1) Improve pulmonary ventilation
2) Counteract the effects of anesthesia
3) Loosen respiratory secretions
4) Facilitate respiratory gas exchange
5) Expand collapsed alveoli.
What position should the patient be placed when using the incentive spirometer? Why?
Sitting up right, Facilitates maximum ventilation.
How does the nurse instruct a post-operative patient without lung disease to use the incentive spirometer?
Place lips over mouthpiece. Inhale slowly and steadily. When maximum inhalation has occured, instruct patient to hold breath for 2-3 seconds, then slowly exhale.