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NSG 232 > Oxygenation > Flashcards

Oxygenation Flashcards

1
Q

Characteristics of the Trachea

A

-4 – 5 inches long
-Extends from the larynx to the primary bronchi

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2
Q

What is the primary function of the lungs?

A

transfer oxygen from the atmosphere into the alveoli and carbon dioxide out of the body as a waste product

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3
Q

What is the function of the alveolar capillary membrane?

A

oxygen transfers to the blood, and carbon dioxide transfers from the blood to the alveoli.

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4
Q

Alveoli

A

Where o2 is exchanged for co2

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5
Q

Name and explain the steps of oxygenation

A

Ventilation: The process of moving gases into and out of the lungs

Perfusion: The ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs

Diffusion: Exchange of respiratory gases in the alveoli and capillaries

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6
Q

Inspiration/Expiration

A

An active process stimulated by chemical receptors in the aorta; a passive process for expiration

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7
Q

Pulmonary Circulation

A

Moves blood to and from the alveolar capillary membranes for gas exchange

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8
Q

Carbon dioxide transport

A

Diffuses into red blood cells and is hydrated into carbonic acid

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9
Q

How are normal lung values determined?

A

Age
Gender
Height

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10
Q

Tidal Volume

A

Amount of air exhaled after normal inspiration

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11
Q

Residual Volume

A

The amount of air left in the alveoli after a full expiration

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12
Q

Forced Vital Capacity (FVC)

A

Maximum amount of air that can be removed from the lungs during forced expiration

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13
Q

Spirometry

A

Measures the volume of air entering or leaving the lun

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14
Q

What are two types of respiratory regulation?

A

Neural Regulation (CNS)
-rate, depth and rhythm

Chemical Regulation
-Maintain rate and depth of respirations based on changes of CO2 and O2, and in hydrogen ion concentration (pH) in blood

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15
Q

Why is respiratory regulation necessary?

A

To ensure sufficient oxygen intake and carbon dioxide elimination to meet the demands of the body (e.g., during exercise, infection, or pregnancy

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16
Q

What is diffusion in the respiratory system?

A

Process for exchange of respiratory gases in the alveoli and capillaries of the body tissues. Takes place at alveolar capillary membrane

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17
Q

What can affect the thickness of the alveolar membrane and why does that matter?

A

Increased thickness of the membrane impedes diffusion because gases take longer to transfer across the membrane. Patients with pulmonary edema, pulmonary infiltrates, or pulmonary effusion have a thickened membrane, resulting in slow diffusion, slow exchange of respiratory gases, and decreased delivery of oxygen to tissues. Chronic diseases (e.g., emphysema), acute diseases (e.g.,

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18
Q

What is hemoglobin?

A

Carrier for oxygen and carbon dioxide, transports most oxygen (approximately 97%)

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19
Q

Cardiac Output

A

Amount of blood ejected from the left ventricle each minute
Normal: 4-6 L/m

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20
Q

Stroke Volume

A

Amount of blood ejected from the left ventricle with each contraction

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21
Q

Cardiac output (CO) =

A

Stroke volume (SV) × Heart rate (HR)

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22
Q

Preload

A

End-diastolic pressure

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23
Q

Afterload

A

Resistance to left ventricular ejection

24
Q

What are some examples of physiological factors that affect oxygenation?

A

Decreased oxygen-carrying capacity
Hypovolemia
Decreased inspired oxygen concentration
Increased metabolic rate

25
Q

What are some conditions that affect chest wall movement?

A

Pregnancy, obesity, neuromuscular disease, musculoskeletal abnormalities, trauma, CNS alterations
Chronic Diease

26
Q

Respirtory Assessment

A
27
Q

Hyperventilation

A

Ventilation in excess of that required to eliminate carbon dioxide produced by cellular metabolism

28
Q

Hypoventilation

A

Alveolar ventilation inadequate to meet the body’s oxygen demand or to eliminate sufficient carbon dioxide

29
Q

What can cause hyperventilation?

A

anxiety, infection, drugs, acid-base imbalance, fever, aspirin poisoning, or amphetamine use.

30
Q

What can cause hypoventilation?

A

atelectasis and collapsed alveoli

31
Q

What are some causes of hypoxia?

A

anemia, carbon monoxide poisoning, septic shock, cyanide poisoning, pneumonia atelectasis, cardiomyopathy, spinal cord injury, and head trauma

32
Q

What are causes of cyanosis?

A

Late stages of hypoxia

33
Q

What are examples of life threatening arrhythmias?

A

Ventricular tachycardia is a life-threatening dysrhythmia caused by decreased cardiac output with the potential to deteriorate into ventricular fibrillation or sudden cardiac death.

34
Q

What causes backflow of blood and what assessment supports that diagnosis?

A

Valvular dysfunction

On assessment, pt. would present with murmur or whooshing sound

35
Q

What are some developmental factors that affect oxygenation in infants and toddlers?

A

upper respiratory infections (URIs), nasal congestion

36
Q

What are some developmental factors that affect oxygenation in school aged children and adolescents?

A

exposed to respiratory infections and secondhand smoke; plus danger of starting cigarette smoking

37
Q

What are some developmental factors that affect oxygenation in young to middle aged adults?

A

exposed to cardiopulmonary factors, unhealthy diet, lack of exercise, stress, cigarette smoking, illegal substances; over-the-counter (OTC) and prescription drugs not used as intended

38
Q

What are some developmental factors that affect oxygenation in older adults?

A

calcification of valves, SA node, and costal cartilages; osteoporosis; atherosclerosis; enlarged alveoli, trachea, and bronchi

39
Q

What are things to include during the cardiopulmonary assessment of a pt?

A

Past impairments in circulatory/respiratory function
Oxygenation uses
Physical exams
Lab/diagnostic tests

40
Q

What do we inspect during the physical exam?

A

Skin and mucous membranes, level of consciousness (LOC), breathing patterns, chest wall movement

41
Q

What do we palpate during a physical exam?

A

Chest, feet, legs, pulses

42
Q

What does percussion asses?

A

Presence of abnormal fluid or air; diaphragmatic excursion

43
Q

What do we listen for during auscultation?

A

Normal and abnormal heart and lung sounds

44
Q

How can nurses promote lung expansion?

A

mobility, positioning, incentive spirometry, and chest tube insertion

45
Q

What position promotes lung expansion and why?

A

45 degree semi-fowlers uses gravity to assist in lung expansion and reduces pressure from the abdomen on the diaphragm

46
Q

What does the incentive spirometer treat/prevent?

A

Prevent/treats atelectasis

47
Q

How do we instruct patients when using the incentive spirometer?

A

A patient inhales slowly and with an even flow to elevate the balls and keep them floating as long as possible to ensure a maximally sustained inhalation.

48
Q

What pts. does the CPAP treat?

A

obstructive sleep apnea, those with congestive heart failure, and preterm infants with underdeveloped lungs

49
Q

What is orthopnea Posture and why is it seen in pts with respiratory problems?

A

Pt. sits upright with hands/elbows resting upon some support. It is easier to breathe while sitting upright and give space for the lung to expand greater

50
Q

True/False
Oxygen is a drug

A

True

51
Q

What is important to assess with pts. on oxygen?

A

Skin integrity of the ears, nares, and bridge of the nose

52
Q

What is Fio2

A

Percentage of oxygen-inspired concentration

53
Q

What is the highest flow on the nasal cannula?

A

up to 6L

54
Q

When is a humidfer indicated for pts on o2?

A

Any flow rate above 4Ls and if as pt complains of dry nares

55
Q

What is the highest flow rate of a high-flow nasal cannula? What color should the tubing be?

A

Up to 60L
Green

56
Q

Fio2 percentage for 1-6L on the nasal cannula?

A

1L/minute = 24%
2L/minute = 28%
4L/minute = 36%
6L/minute = 44%

NSG 232 (6 decks)

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