Exam 4: Chapter 39 Airway Management Flashcards by Kevin Avelino

Factors Essential to Normal Functioning of the Respiratory System: Integrity

Integrity of the airway system to transport air to and from lungs

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Factors Essential to Normal Functioning of the Respiratory System: Properly

Properly functioning alveolar system in lungs. Oxygenates venous blood and removes CO2 from blood

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Factors Essential to Normal Functioning of the Respiratory System: Properly functioning cardiovascular and hematologic systems

Carry nutrients and wastes to and from body cells

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Upper Airway Functions

Warm, Filter, Humidify Inspired Air

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Upper Airway omponents

Nose, Pharynx, Larynx, Epiglottis

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Lower Airway Functions

Conduction of air , mucociliary clearance, production of pulmonary surfactant

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Lower Airway Components

Trachea
Right and Left Mainstem Bronchi
SEgmental Bronchi
Terminal Bronchioles

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Lower Airway Cilia Function

Line and help clean out foreign matter to ensure that it does not go into the lungs

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Anatomy of Lungs: Extend from

the base of the diaphragm to the apex above the first rib

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The right side has how many lobes?

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Left side has how many lobes?

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Lungs composed of?

Elastic tissue (alveoli, surfactant, pleura)

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Lung Listening: Be sure to listen to

front and back on both sides

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What is inspiration?

The active phase of ventilation

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What does Inspiration involve?

Involves movement of muscles and the thorax to bring air into the lungs

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What is Expiration?

THe passive phase of ventilation

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What does Expiration involve?

The movement of fair out of the lungs

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What events occcur during inspiration?

Diaphragm contacts and descends, lengthening the thoracic cavityl the external intercostal muscles contact, lifting the ribs upward and outwward

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Gas Exchange (REspiration) refers to

the intake of oxygen adn release of carbon dioxide

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Gas Exchange mad possible by

respiration and perfusion

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Gas Exchanges occurs via

Diffusion

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Gas Exchange occurs in

Alveoli so O2 diffuses into blood and CO2 diffusees from blood to exhaled air

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Transport of Repiratory Gases: Oxygen is carried

in the body via plasma and red blood cells

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Transport of Repiratory Gases: Most oxygen (97%) is

carried by red blood cells in teh form ox oxyhemoglobin

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Transport of Repiratory Gases: Hemoglobin also carries

CO2 in the form of Carboxyhemoglobin

Alterations in REspiraotry Functions: Hypoxia

Inadequate amount of oxygen available to cells (Low O2)

Alterations in REspiraotry Functions: Dyspnea

Difficulty breathing

Alterations in REspiraotry Functions: Hypoventilation

Decreased rate or depth of air movement into the lungs

Alterations in REspiraotry Functions: What can cause Hypoventilation?

Narcotics

Factors Affecting CArdiopulmonary Functioning and Oxygenation: Level of Health Examples

COPD, Asthma, Pheumonia

Factors Affecting Cardiopulmonary Functioning and Oxygenation: Developmental COnsiderations

Infant will be much higher than a adult

Factors Affecting Cardiopulmonary Functioning and Oxygenation: Medication Considerations

Nacrotics decrease respiration and breathing while increasing heart rate

Factors Affecting Cardiopulmonary Functioning and Oxygenation: Physchological Health Considerations

Stress, Anxiety

Respiratory Functioning in the Older Adult

Decreased gas excchange and increased work in breathing. | Decreased ventilation and ineffective cough

Respiratory Functioning in the Older Adult: Deep breathe, should use

spirometer

Respiratory Functioning in the Older Adult: Head of Bed

Head of bed should be elevated

Physical Assessment: Inspection

LOC, Orientation, General Appearance, Respiratory Rate, Any Distress, Skin Color Are they using accessory muscles? Hunched over?

Physical Assessment: Palpation

Skin Temperature, Capillary Refill, Pulses

Physical Assessment: Auscultation

Bilateral Lungs, Anterior and Posterior

What do crackles sound like?

High Pitched Heard During Inspirration Not Cleared By Cough

What do Rhonchi sound like?

RUmbling Course Sounds Like a Snore May Clear with Coughing

What does Wheeze sound like?

Muscial Noise During Inspiration/Expiration | Usually Louder During Expiration

What does Aterial Blood Gas measure?

Measures the acidity (pH) and the levels of oxygen and CO2 in the blood from the artery

Arterial Blood Gas test is used to check how

well the lungs are able to move oxygen into the blood and remove CO2 from the blood

Normal pH range?

7.35 - 7.45

If pH higher than 7.45, whats it called

Alkalosis

If pH lower than 7.35, whats it called

Acidic

What happens if PO2 is low?

O2 is low

What does PCO2 represent?

partial pressure of CO2 in blood

What does HCO3 represent?

Bicarb-Matabolic Acidosis/Alkalosis

Normal PO2 range?

80-100

Normal PCO2 range?

35-45

Normal HCO3 range?

22-28

What is Pulse Oximetry?

Measurs the arterial oxyhemoglobin saturation of arterial blood

Normal range for Pulse Oximetry?

95-100%

Pulse Oximetry: What does a value less than 90% indicate?

oxygenation to the tissues is inadequate and requires immediate intervention

Promoting Proper Breathing: DEep breathing used for

Surgery Pts

Promoting Proper Breathing: Position

High Fowler is position of choice. Increase of fluids can help thin secretions

Promoting Proper Breathing: Using Incentive Spirometry Goal

Goal is to breathe deep enough to get dial to raise up to goal

Promoting Proper Breathing: Pursed Lip Breathing

This is slow and prolonged and results in improve air exchange and decreased dyspnea

Promoting Proper Breathing: Diaphragmatic Breathing

Useful for those with COPD. THis reduces the respiratiory rat, increases alveolar ventilation, and sometimes helps expel as much air as possible during expiration

Chest Physiotherapy: Percussion

CUpped hands over back to break up

Chest Physiotherapy: Vibration

Helps get secretions moving

Chest Physiotherapy: Postural Drainage

Change position to facilitate drainage

Chest Physiotherapy: Used for

Loosening secretions

Chest Physiotherapy: When should this be done

1 hour before or after meal. Vomiting and Aspiration can occur. Can also be done at bedtime

What is a nasal cannula?

Most commonly used oxygen delivery device. Plastic device with two protruding prongs that are inserted into the nostrils

What is a simple face mask?

Connected to oxygen tubing, a humidifer, and a flow meter. Has vents on its side that allow room air to leak in at many places, therby diluting the source oxygen

When is a simple face mask used?

Used when an increased delivery of oxygen is needed for short periods (less than 12 hours)

Flow rate for simple face mask?

Less thran 5 L/min

What is a Partial Re-breather Mask?

Like a simple face mask, but is equuipped wiht a reservoir bag for the collection of the first part of the patietns exhaled air . CAn inhale oxygen from teh room

What is a Nonrebreather mask

Deliverys the highest concentration of oxygen via a mask to a spontaneously breathing patient. Similar to the parital rebreather mask except that two one way valves prevent the patient from rebreathing exhaled air

What is a Venturi Mask

allows the mask to delivery the most precise concentration of oxygen. Mask has large tube with oxygen inlet. As the tube narrows, the pressure drops

Precautions for Oxygen Administration: Avoid open

flames in patients room

Precautions for Oxygen Administration: Place

"no smoking" signs in conspicous places

Precautions for Oxygen Administration: Check

to see that electrical equipment in the room is in good working order

Precautions for Oxygen Administration: Avoid wearing

and using synthetic fabrics (build up static electricity)

Precautions for Oxygen Administration: Avoid using

oils in the ara (oils ignite spontaneously in oxygen

What is a Oropharyngeal Airway?

Semicircular tube of plastic or rubber inserted into the back of the pharynx. Used to keep tongue clear fo airway

What is a nasopharyngeal airway?

Inserted through the naris and protrudes into teh back of the pharynx.

What is a tracheostomy?

An artificial opening made into the trachea, usually at the level of the second or third cartilaginous ring

Suctioning Key Points: Assess

For pain prior

Suctioning Key Points: Position

Semi-Fowlers position if patietn can tolerate it

Suctioning Key Points: Adjust

Suction to appropriate pressure

Suctioning Key Points: Suction

On teh way out for no more than 10-15 seconds at a time

Suctioning Key Points: Allow

at least 30 seconds before additional attempt, no more than two passes

Suctioning Key Points: Oxygenate

between suction passes. Maintain patient airway

Exam 4: Chapter 39 Airway Management Flashcards

(87 cards)