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Fundamentals > Class 4-Oxygenation > Flashcards

Class 4-Oxygenation Flashcards

1
Q

Highest single preventable factor for lung disease

A

Cigarettes/tobacco

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2
Q

second hand smoke=

A

heart disease

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3
Q

Oxygenation

A

-properly functioning alveolar capillary membrane (gases can’t diffuse)
-oxygenate venous blood
-remove carbon dioxide from blood

Essential to normal functioning of the pulmonary system

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4
Q

Ventilation

A

-ability to transport air to and from lungs (can’t bring air in)

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5
Q

What do ABG’s measure?

A

oxygenation & ventilation

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6
Q

Functional units of the respiratory system

A

-upper airway: warm, filter, humidify (nose/mouth)

-lower airway function: conduction of air, mucocilliary clearance..help to move things up (trachea/lungs)

-alveolar capillary membrane: gas diffusion (terminal airway)

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7
Q

Factors affecting pulmonary functioning

A

-levels of health
-medications
-lifestyle
-environment

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8
Q

Levels of health

A

-mobility, decreased nutrition, anemia, lung disease, weakness, muscle wasting of diaphragm

-anemias: carrying capacity of RBCs
-immobile: decreased respiratory rate

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9
Q

Medications

A

narcotics; analgesics

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10
Q

Lifestyle

A

sedentary, stasis of secretions, smoking, working environment

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11
Q

Environment

A

pets, toxins, pollutants

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12
Q

How age effects respiratory function

A

-Decreased oxygenation
-decreased ventilation

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13
Q

Decreased oxygenation

A

-INCREASED work of breathing (expiration becomes active)

-DECREASED gas exchange due to decreased number of capillaries & decreased inspiratory lung volumes

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14
Q

Decreased ventilation

A

-ineffective cough
-drier mucous membranes
-INCREASED risk for aspiration due to decreased gastric motility
-impaired mobility
-meds that decrease ventilation
-tissues and airways become more rigid; diaphragm moves less efficiently –> less air exchange

**things get stiff; harder to move; have to actively exhale (increased work of breathing); thicker secretions

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15
Q

Pack year

A

packs per day x years smoking

2 pack a day for 20 years= 40 years

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16
Q

Focused pulmonary interview

A

-how is your breathing?
-do you smoke? (how much?)
-do you have any pets?
-have you traveled recently? (cryptoplasmosis)
-do you experience difficulty breathing or fatigue? if so what causes this?
-where do you sleep?
-who does the shopping?
-do you vacuum?
-what type of work do you or did you do?
-any chest pain?
-do you have a cough? (is it productive? what color? how much volume?)
-have you ever been exposed to fumes? (inhalation effects years later)
-is there a position in which your breathing is most comfortable?
-do you have allergies?

17
Q

Pulmonary ventilation acute care shift assessment

A

-inspection
-auscultation

18
Q

inspection

A

-respiratory rate
-depth
-pattern
-work of breathing
-using accessory muscles
-chest symmetry
-skin color
-surgical scars

-lights on; look at work of breathing, both sides symmetrically rising; surgical scars; hyperventilation
-watch rate, depth, & pattern of breathing

19
Q

Auscultation

A

-adventitious sounds
-wheezes
-crackles
-rhonchi

-on skin (L –> R or R –> L), upper upper, middle middle, lower lower
-listen to front first
-leads you to know what intervention

20
Q

What term do we not use?

A

RALES

21
Q

wheezes

A

-narrowing of an airway (shrill)
-do something to open it

22
Q

crackles

A

-popping; pneumonia; fluid overload; CHF
-cough, rebreathe, if fluid need diuretic
-discontinuous

23
Q

rhonchi

A

-secretions in the large airway
-continuous
-make them productive cough

24
Q

Diagnostic methods for assessing pulmonary function

A

-Non-invasive
-pulse oximetry (gives oxygenation info only)
-spot check (if normal take off)
-continuous (leave on if abnormal & get instructor)
-CXR (show outline of lung)
-pulmonary function tests (PFTs) (measure depth of respiration; for ventilation)

-Invasive
-Arterial blood gas analysis (going into artery for blood sample; gives idea of ventilation)
-bronchoscopy

25
Q

How SPO2 correlates to PAO2

A

-normal pao2 60-80

Pao2= 40%. 50%. 60%. 80%
spo2= 70%. 80%. 90%. 95%

** see slide 18
-want over 95 but over 92 really

26
Q

Nursing interventions promoting adequate pulmonary functioning

A

-smoking cessation
-positioning (fowlers: 45-60)
-chest physiotherapy (cup hands & pat back loosens fluid then have them cough, take 3 shallow huffing breaths then have them cough)
-control anxiety
-medications
-guided imagery
-pursed lip breathing (inhale through nose 2 seconds; exhale through pursed lips 4 seconds; COPD to prolong expiratory phase; helps air trapping; get barrel chest)
-adequate fluid intake (2-3L; thin secretions)
-humidified oxygen
-adequate nutrition
-respiratory medications
-coughing and deep breathing
-incentive spirometry

27
Q

Types of respiratory medications

A

-cough suppressants (dry cough)
-expectorants (productive)
-bronchodilators (open narrowed airways)
-corticosteroids (reduce inflammation in airways)

28
Q

Delivery mechanisms for pulmonary medications

A

-nebulizers: disperse fine particles of medication into deeper passages of respiratory tract where absorption occurs (delivered by inhalation)

-metered dose inhalers: delivers controlled dose of medication with each compression of the canister (rinse after use)

-dry powder inhaler: activated by the patient’s inspiration

29
Q

MDI

A

-spacers for MDIs
-rinse after steroid mdi’s (or develop thrush)
-wait 1-5 minutes between sprays
-know the difference between your rescue inhaler and your maintenance inhaler (Saba vs laba)

30
Q

oxygen delivery systems and fio2 (fraction of inspired oxygen)

A

Nasal Cannula 1L/NC – 6 L/NC (24%-44% FiO2)

RA=21%
Liters=fio2
1L/NC=24%
2L/NC=28%
3L/NC=32%
4L/NC=36%
5L/NC=40%
6L/NC=44%

Venturi Mask 24% - 40% FiO2
Non Re-Breather 80% - 100 % FiO2
Trach Shield, T-Mist, T-Mask, T-Pieces
CPAP
BiPAP

31
Q

look at slides for pictures

A
32
Q

***look at slide 42 very important!

A

Fundamentals (13 decks)

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