Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nur 333 fundamentals 2 > WK 1: oxygenation and trachs > Flashcards

WK 1: oxygenation and trachs Flashcards

1
Q

Factors that affect oxygenation
(and examples of each)

A

-decreased oxygen-carrying capacity
(Hemoglobin level, carbon monoxide)
-hypovolemia
-decreased inspired O2 concentration
(Increased altitude)
-chest wall movement
(pregnancy, obesity, trauma)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

thorough respiratory assessment consists of what

A

-RR
-pattern, depth and rhythm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Hypoventilation
-def
-S/Sx

A

not enough oxygenation
inadequate alveolar ventilation
causes: medications, lung Dz
S/Sx: AMS, dysrhythmias, somnolent
can lead to: cardiac arrest, Sz, LOC, death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

atelectasis
-def

A

collapsed alveoli which prevents nml gas exchange
VERY preventable by nurse
Conditions associated: immobility, obesity, sleep apnea, chronic Lung Dz
Can lead to: lung collapse, PNA, Resp failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Chronic hypoxia

A

Chronic: assoc. with chronic lung Dz
common assessment findings: cyanotic nail beds, slow cap refill, clubbing, barrel chest

We do not treat for chronic hypoxia, while acute hypoxia is requires immediate intervention

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hypoxia
-def
-S/Sx (rat/bed)

A

inadequate tissue oxygenation at cellular level, can be related to hypovolemia
Causes: low hemoglobin, low O2 concentration, pH imbalance, decreased diffusion, poor perfusion, impaired ventilation from traumas
S/Sx:
Early: RAT (restlessness, anxiety, tachycardia/tachypnea)
Late: BED (bradycardia, extreme restlessness, dyspnea)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Why do we encourage coughing?

A

helps maintain airway patency
most effective way to move secretions through airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

components of dyspnea

A

-associated with hypoxia
-SUBJECTIVE, difficult breathing, related to SOB
-S/Sx: accessory muscles, nasal flaring, increased RR and depth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Nursing interventions to improve oxygenation
(Include long/shirt term measures)

A

Long-term: vaccinations, healthy lifestyle, environmental and occupational exposures

Short-term: coughing, deep breathing, supplemental O2 (has to be ordered)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Ventilation
-what is it
-the goal of it

A

movement of gas in and out of lungs
Goal: nml arterial CO2 and O2 tension
ventilation = respirations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Diffusion

A

oxygen and CO2 exchange in alveoli and red blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

perfusion

A

distribution of newly oxygenated red blood cells to tissues in the body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When CO2 increases (hypercarbia) the body knows to increase __1__ and ___2__ of breathing

A

rate
depth

Why? to remove CO2 quicker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Tidal volume
What is it? What is it impacted by?

A

amount of air exhaled following normal inspiration

Tidal volume impacted by: health status, activity, pregnancy, exercise, obesity, lung Dz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the function of alveoli?

A

to promote gas exchange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are three expected and normal breath sounds? where are they heard?
what do they sound like?

A
  1. bronchial: heard over tracheal area
    -high pitched/loud
  2. Bronchovesicular: heard over mainstream bronchi
    -medium pitch
  3. vesicular: heard laterally
    -soft/low pitch/sounds like snoring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Crackles/rales

A

COARSE bubbly sounds, low pitched

associated with air passing through fluids
Course vs. fine?

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Wheezing

A

high pitched whistling
narrow airways
asthma/inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Rhonchi

A

low pitched rumbling
fluid/mucus in airway
can resolve with coughing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

stridor

A

choking/ gasping sound
something is obstructing upper airway

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

pleural friction rub

A

inflamed pleural space
low pitched, harsh/grating sound with I/E

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Bradypnea

A

abnormally slow respirations (< 12 breathes/min)

23
Q

Tachypnea

A

abnormally rapid respirations ( > 20 breathes/min)

24
Q

Apnea

A

respirations stop for several seconds
-if this happens persistently then respiratory arrest could occur

25
Q

Hyperventilation

A

Rate and depth of respirations increases. Hypocarbia sometimes occurs

26
Q

Hypoventilation

A

RR abnormally low and depth of ventilation is depressed. hypocarbia sometimes occurs

27
Q

Oxygen Saturation

A

-measures diffusion and perfusion
-Peripheral oxygenation
-normal: 95-100%
-goal is: 95-98%
-Chronic lung Dz: 88% is nml, why wouldn’t you apply O2?
-SPO2 is measured with light transmission, impaired with: jaundice, nail polish, intravascular dyes, PVD, hypothermia, excessive edema

28
Q

Compliance of lungs

A

ability of lungs to distend and expand, relies on inter-thoracic pressure changes

-lungs loose compliance -> unable to open/ close effectively

29
Q

Work of breathing

A

effort to expand and contract lungs
determined by rate and depth

30
Q

What is the purpose of an ABG? (arterial blood gas)

A

arterial blood is taken instead of peripheral blood b/c it will tell us how oxygenated the blood is

31
Q

End tidal CO2

A

how much CO2 is present is at the end of exhalation

32
Q

Hyperventilation

A

removing CO2 faster than it is produced by cellular metabolism
Causes: anxiety attack, fever, drugs, pH imbalance, asprin poisoning
S/Sx: high RR, sighing breathing (panting), numb/tinging, LH, LOC

Increased WOB

33
Q

Primary problems/ nursing diagnoses related to oxygenation

A

ineffective airway clearance
risk for aspiration
impaired gas exchange
activity intolerance

34
Q

Coughing techniques (need to know three)

A
  1. Huff cough: deep inhale, hold 2-3 seconds, forceful exhale, open glottis by saying “huff”
  2. Cascade cough: slow deep breath, hold 1-2 sec, then open mouth and perform series of coughs while exhaling
  3. Quad cough: manually assisted, for pt w/o abd muscle control, nurse pushes in/up on abd while pt exhales
35
Q

Chest physiotherapy

A

includes: postural drainage, chest percussion, chest vibration

dependent nursing intervention for Pt with thick secretions w/ goal to mobilize secretions

36
Q

Postural Drainage

EX: there is an infiltration seen in the Rt lower lobe, what position do you use?

A

laying on unaffected side to promote drainage of one particular lobe

lay on Lt side in trendelenburg

37
Q

How to use an Incentive spirometer

A

sit up
deep breath
lips over mouthpiece
breathe in slowly, keeping range indicator at target zone
hold breath 3 seconds
repeat as Rx, usually 10 breathes every hour
cough and deep breathes after

38
Q

Can a nurse delegate applying supplemental O2 to a CNA?

A

Yes
BUT the nurse must do a respiratory assessment along with assessment of pt response, setup, and adjustment responses

39
Q

NC (nasal cannula)

A

1-6 liters
22-44%
use humidification if >4 liters or used over 24 Hrs
usually safe and well tolerated

40
Q

Simple Face Mask

A

6-12 Liters
33-55%
best for short periods/ transportation
assess for fit, watch for aspiration risk/ claustrophobia

41
Q

Partial Rebreather Mask

A

6-11 Liters
60-75%
used for short periods of dyspnea
keep reservoir partially inflated
HOURLY assessment

42
Q

Non-Rebreather Mask

A

10-15 Liters
80-95%
best for critical needs, prior to intubation
HOURLY assessment
Pt is not rebreathing exhaled air d/t flaps covering ports on side of mask

43
Q

Venturi Mask

A

High flow O2
4-12 Liters
24-50%
delivers PRECISE O2 concentration w/ humidity
NOT for long periods of time

44
Q

Complications of O2 therapy

A

drying of mucus membranes
oxygen toxicity
skin breakdown

45
Q

Pharyngeal airways

A

short term use
NPA & OPA’s
Pt still has respiratory drive
used for Pt with decreased LOC or who need frequent suctioning

46
Q

Tracheal airways

A

longterm patency issues
for people who need mechanical ventilation

47
Q

Endotracheal airways Vs. Percutaneous airways

A

ETT is always on a vent
Percutaneous trach is through the skin, bypasses upper airway structure, Pt can breathe independently or through vent

48
Q

Indications for a tracheostomy

A

acute airway obstruction
airway protection
facilitate removal or secretions
prolonged intubation ( > 1 wk)
less damage to airway
more comfortable
allowed to eat
improved mobility

49
Q

Shiley Vs. Jackson Trachs

A

Shiley: disposable inner cannula, plastic, cuff, obturator

Jackson: Reusable inner cannula, no cuff, obturator, metal

*with jackson you ALWAYS use a trach care kit for cleaning, but it should be used for shiley too

50
Q

What is an obturator

A

device used to insert a trach, like a guidewire

51
Q
  1. what is the purpose of a cuff on a trachea?
  2. dangers of prolonged inflation
A
  1. To help create a snug fit for the trachea, precent aspiration, and help ventilator give strong breaths
  2. increased mucosal pressure, causing ischemia, softening cartilage, mucosal erosion

-inflation of cuff has to be ordered by the physician

52
Q

Passy-Muir

A

-speaking valve
-cuff deflated while being used
-cant use if Pt has respiratory distress

53
Q

Nursing problems for a patient with a trach

A

-ineffective airway clearance
-impaired verbal communication
-risk for infection
-impaired swelling
-body image disturbance
-anxiety

54
Q

how often is trach care done?

A

every 12 hours
usually patient dependent

Nur 333 fundamentals 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions