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Fundamentals of Nursing > Gas Exchange > Flashcards

Gas Exchange Flashcards

1
Q

What is oxygenation ?

A

the mechanisms that facilitate or impair the body’s ability to supply oxygen to all cells of the body

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2
Q

What is ventilation ?

A

process of moving gases into and out of the lungs

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3
Q

What is perfusion ?

A

ability of the CV system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs

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4
Q

What is diffusion ?

A

exchange of respiratory gases in the alveoli and capillaries

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5
Q

What component of blood carries O2 and CO2 ?

A

hemoglobin

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6
Q

What body systems support oxygen transport ?

A

lungs and cardiovascular (CV) system

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7
Q

What side of the heart does oxygenated blood go to ?

A

Left side

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8
Q

What side of the heart does deoxygenated blood go to ?

A

Right side

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9
Q

What is cardiac output ?

A

amount of blood ejected from the left ventricle each minute

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10
Q

What is stroke volume ?

A

amount of blood ejected from the left ventricle with each contraction

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11
Q

What is preload ?

A

amount of blood in the LV at the end of diastole

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12
Q

What is afterload ?

A

resistance to left ventricular ejection

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13
Q

What components are part of cardiac output ?

A

Stroke volume (SV) x heart rate (HR)

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14
Q

How does stress affect oxygenation ?

A

a continuous state of stress or severe anxiety increases the metabolic rate and oxygen demand of the body

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15
Q

Why would anemia affect your oxygenation ?

A

if you don’t have enough RBCs then you won’t be able to carry enough O2

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16
Q

What is hyperventilation ?

A

ventilation in excess of that required
- rate and depth of respirations increases

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17
Q

What are some signs and symptoms of hyperventilation ?

A
  • rapid respirations
  • sighing breaths
  • numbness and tingling of hands/feet
  • lightheadedness
  • loss of consciousness
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18
Q

What is hypoventilation ?

A

alveolar ventilation inadequate to meet the body’s oxygen demand
- respiratory rate and depth is low

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19
Q

What are some signs and symptoms of hypoventilation ?

A
  • mental status changes
  • dysrhythmias
  • convulsions
  • unconscious
  • death
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20
Q

What are some causes of hypoventilation ?

A
  • neuromuscular disorders
  • atelectasis
  • drugs (respiratory depression)
  • trauma
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21
Q

What are some causes of hyperventilation ?

A
  • severe anxiety
  • infection
  • COPD/Asthma
  • DKA
  • brain injury
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22
Q

What is hypoxia ?

A

inadequate tissue oxygenation at the cellular level, late sign cyanosis

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23
Q

What are some causes of hypoxia ?

A
  • decreased in Hgb and lowered O2-carrying capacity of blood
  • diminished inspired O2
  • decreased in diffusion of O2 from the alveoli to the blood
  • impaired ventilation
  • poor tissue perfusion
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24
Q

What are some signs and symptoms of hypoxia ?

A
  • decreased LOC
  • increased RR and HR
  • dizziness
  • restlessness, inability to concentrate
  • apprehensive
25
Q

What are some late signs of hypoxia ?

A
  • decreased RR and HR
  • cyanosis
26
Q

What is pneumonia ?

A

acute inflammation of the lung that is most frequently caused by a microorganism
- fluid and exudate in the alveoli

27
Q

How does HOB up Semi-Fowlers help with respiration ?

A

helps to drain secretions from specific segments of the lungs and bronchi into the trachea

28
Q

What are some additional interventions for respirations ?

A
  • deep breathing and coughing
  • pursed lip breathing
  • flutter valve (clearing secretions)
  • encourage fluids
  • hydration
  • humidification
  • nebulization
29
Q

What are some oxygenation safety info ?

A
  • O2 must be prescribed and adjusted only with an order
  • can prescribe O2 if pt is unstable but need to request order
  • electrical equipment must be functioning and grounded
  • no smoking/open flames
  • secure O2 cylinders and store them upright and chained or secured in a holder
  • check O2 level of portable tanks before transporting pt
30
Q

What is the max amount of O2 per L/min does the nasal cannula use ?

A

6 L/min
- 24 to 44% O2

31
Q

What % of O2 is in room air ?

A

21%

32
Q

What % of O2 is 1L/min ?

A

24%

33
Q

What is the rule for nasal cannula O2 concentrations ?

A

Starting at 1 L/min, increasing the oxygen flow by 1 L/min will increase the inspired oxygen concentration by about four percentage point

34
Q

What is the max amount of O2 per L/min with a simple face mask ?

A

5-10L/min
- 35 to 60%

35
Q

What is the max amount of O2 per L/min with a partial O2 mask ?

A

10-15L/min
- 60 to 90%
- reservoir bag must be inflated

36
Q

What is the max amount of O2 per L/min with a non-rebreather O2 mask ?

A

10-15L/min
- 80 to 98%
- reservoir bag must be inflated

37
Q

What is a venturi mask ?

A

delivers higher O2 concentration depending on the flow-control meter selected
- 4 to 15L/min
- 24 to 60%

38
Q

What is the difference between BiPAP and CPAP ?

A
  • BiPAP: gives 2 different pressure settings for inhale and exhale & set rate of breaths per min
  • CPAP: stays at one single pressure setting and is to keep their airway open without being hooked up to O2
39
Q

Why is suctioning important ?

A

with pt’s that are unable to clear respiratory secretions from the airways by coughing or other less invasive procedures

40
Q

What is the max amount of time to suction ?

A

do not suction longer than 10-15 secs at a time
- allow 60 secs between passes

41
Q

For continuous open suctioning up to what amount of mmHg is used ?

A

120 mmHg

42
Q

For continuous closed suctioning up to what amount of mmHg is used ?

A

160 mmHg

43
Q

How often is trach care for ?

A

minimum of every 24 hrs/daily

44
Q

When doing trach care what do you change ?

A
  • inner cannula
  • site cleaning
  • dressing change
    (suctioning is not “daily trach care”)
45
Q

For what situations would trach care and inner cannula changes be more often ?

A

new tracheostomies or pulmonary infections

46
Q

What would you asses and document for trach care ?

A

q4hrs
- any trach care done
- type and size of trach
- stoma assessment
- all safety measures in place
- trach ties assessed (2 fingers underneath/skin assess)

47
Q

When are Passy-Muir Speaking valves used and why ?

A

used with tracheostomy and ventilator patients
- helps them with speaking and communicating better

48
Q

What is a chest tube ?

A

catheter placed through the thorax to remove air and fluids from the pleural space

49
Q

What is the purpose of chest tubes ?

A
  • remove air and fluids from the pleural space
  • prevent air or fluid from reentering the pleural space
  • re-establish normal intra-pleural and intra-pulmonary pressures
50
Q

Where is a chest tube inserted ?

A

between the ribs into the chest (pleural space) and is connected to a closed water or dry seal

51
Q

What is used to keep a chest tube in place ?

A

stitch (suture) and adhesive tape

52
Q

What are some signs and symptoms of a hemo- or pneumothorax ?

A
  • acute chest pain
  • labored breathing
  • dyspnea
  • increased BP, HR, RR
  • decreased O2 sat
  • uneven chest wall movement
  • deviation of airway
  • very anxious
53
Q

What are some chest tube interventions ?

A
  • Maintain: secure and airtight dressing, & underwater seal, & tubing for patency & pt
  • monitor and secure all connections
  • observe for bubbling
  • record output (quantity, characteristics)
  • dressing changes per agency
54
Q

Is bubbling in a chest tube canister normal ?

A
  • bubbling in suction canister is normal
  • continuous bubbling in the water seal is a sign of an air leak
55
Q

What is the purpose of the incentive spirometer ?

A

to increase inspiratory volume, strengthen lungs and to help clear out secretions

56
Q

For what L/min of O2 do we administer a humidifier ?

A

4L/min or greater

57
Q

What is the purpose of a Venturi mask ?

A

for pt’s who need a very specific % of O2
- most accurate form of O2 delivery

58
Q

What is the purpose of a face tent ?

A

fits loosely around the face and is often used for pt’s that feel claustrophobic

59
Q

How are the simple face mask and non-breather face mask different ?

A
  • simple face mask has holes at the end to allow for expiration
  • non breather has valves that close during expiration

Fundamentals of Nursing (14 decks)

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