MedSurg Mod 6: Oxygen Therapy Modalities and Pulmonary Embolism Flashcards Preview

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Flashcards in MedSurg Mod 6: Oxygen Therapy Modalities and Pulmonary Embolism Deck (67)
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1

What is oxygen therapy

administration of O2 at a concentration greater than Room air

2

What is Room air at sea level

21%

3

RA (room air) decreases with ___

elevation

4

Goal of Oxygen therapy

increase O2 availability to the lungs and tissues in order to reduce effort of breathing and cardiac stress

5

Low Flow Oxygen Therapy

Room Air AND Supplemental oxygen - oxygen is not meeting complete need as RA is involved to help

Inconsistent or unknown O2 concentration

Delivery options: Nasal cannula, simple mask, partial rebreather, non rebreather

6

High Flow oxygen therapy

TOTAL inspired air

precise O2 concentration

delivery options - Venturi mask, mechanical ventilation

7

Why can we know exact high flow concentrations but not low flow

We do not have total control over low flow since something like a nasal cannula may give air but some of it is given via RA - so we cannot find exactly what is breathed in and it changes due to lack of control

with high flow we are meeting or exceeding needs and we know exactly what they are getting

8

Nurses can apply __ flow systems without an order like...

low flow systems like nasal cannula, simple mask, partial rebreather, non rebreather

9

O2 is considered a ___

medication

10

In order for emergency use of O2 by the nurse, the nurse should know...

1. the clinical indicators for applying each type of low flow system

2. how to correctly apply each of the systems

3. the appropriate oxygen regulation for each system

11

With a venti/venturi mask what controls flow

A Rate Valve

they come in different colors and give precise oxygen percentages

they take into account room air and give precise amounts so we know exactly what someone gets

12

What is the difference between Partial Rebreather and Nonrebreather masks

partial has a bag capturing exhalation which some is rebreathed back in but a nonrebreather always has fresh air coming in due to a valve

13

What treatment is given to someone with O2 sat of 95-100%

no treatment

14

What treatment is given to someone with O2 sat 91-94 % (Mild hypoxemia)

Nasal cannula or simple mask

15

What treatment is given to someone with O2 sat of 86% to 91% (moderate hypoxemia)

partial rebreather or non rebreather or venturi mask

16

What treatment is given to someone with O2 sat < or equal to 85% (severe hypoxemia)

partial rebreather or a nonrebreather mask as a temporary measure until they are intubated

17

Oxygen Toxicity

case where someone is getting too much O2

there are very vague responses that can be similar looking to hypoxia

not common but must be assessed for

18

What are s/s of Oxygen toxicity

HA

substernal discomfort

dyspnea

alveolar atelectasis

paresthesia

restlessness, anxiety

fatigue, malaise, confusion

progressive respiratory difficulties

refractory hypoxemia

19

Assessments for O2 toxicity

chest tightness

respiratory rate

breath sounds

O2 saturation

numbness and tingling of extremities

activity level

general attitude

change in mentation

20

Interventions for O2 toxicity

monitor O2 flow setting

monitor total therapy time

assess before therapy

assess with changes in therapy

ensure therapy is initiated/maintained at correct "dose"

recommend therapy changes based on assessments

treat other symptoms

21

What to educate the patient about regarding O2 use at home

maintaining therapy at prescribed settings as ordered

when to notify the provider

safety precautions like discouragement of smoking and danger of o2 to facilitate combustion

22

When should someone on O2 at home notify a physician

frequent HA

increased anxiety

blue tinge to lips and nail beds

drowsiness

confusion

restlessness

slow, shallow, difficult, irregular or significant change in established breathing pattern

23

Positive End Expiratory Pressure / Continuous Positive Airway Pressure / Bilevel Positive Airway pressure (PEEP/CPAP/BiPAP)

Gives an extra boost in pressure to help prevent micro atelectasis / keep alveoli open

BiPAP and CPAP are more common

24

What are the benefits of PEEP/CPAP/BiPAP

it maintains a slight positive lung pressure and maintains slightly expanded lung tissue to prevent micro atelectasis

it also allows a lower percentage of O2 to be effective

25

BiPAP is more commonly used when?

for sleep apnea to prevent times of no gas exchange

26

PEEP is more commonly used when?

for those with spontaneous or mostly mechanical ventilation

27

PEEP

positive end expiratory pressure

maintains airway pressure above atmospheric airway pressure at the END OF EXPIRATION

may be used with either spontaneous or mechanical ventilation

28

CPAP

continuous positive airway pressure

maintains a positive airway pressure throughout THE WHOLE RESPIRATORY CYCLE

used with spontaneous ventilation NO MECHANICAL

29

BiPAP

bilevel positive airway pressure

similar to CPAP, still noninvasive

delivers 2 levels of pressure with the higher one DURING INHALATION

can be used for a variety of situations including COPD< sleep apnea, pneumonia, etc

30

What are some safety precautions to educate patients using O2 about

No open flames

No combustible products

exercise care with electrical devices

use explosion proof plugs

storage precautions like cart/collar cylinders, avoid bumping cylinders together/at all, keep in well ventilated area, post no smoking signs around