Oxygenation Flashcards by Bianca Helfrich

What is room air

21% O2

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What is O2 considered

A medication

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What should you do if your in an O2 emergency

Just give it and get an ORDER later

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What are the two low flow systems

NC, SIMPLE face mask
VARIBLE performance

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What are the high-slow systems

Rebreather masks, venturi
FIXED performance

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Tell me about the flow meter

Attaches to the WALL, CHRISTMAS TREE, TIP goes DOWN, read the ball from the MIDDLE

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Which way should NC prongs go

Point DOWN

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What is the flow rate of NC

1-6

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What do you need for 4L or more on NC

Humidifier

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What do you hook up the O2 to

GREEN not yellow

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What are the pros to NC

Pt can TALK and EAT, SAFE, SIMPLE, 85-90% O2, LONG-TERM use

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What are the disadvangetes of NC

Can’t use with nasal obstruction, DISLODGE, DRYNESS

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What is the flow rate for simple face mask

6-10

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Tell me about the simple face mask

AIR holes, lets OUTSIDE air inWha

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t to use a simple face mask

80%, not is distress, 2-3hrs

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What are the advantages of simple face mask

EXHALE air, still TALK

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What are the cons of the simple face mask

Can’t EAT, STRAP can cause irritation

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What is the flow rate of the partial rebreather

6-15

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Tell me about the ratial rebreather

TWO way VALVES, reservoir BAG

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What are the pros of a partial rebreather

Inhale room air

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What are the cons of a partial rebreather

Claustrophobia, can’t TALK or EAT

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What is the flow rate of a non-rebreather

10-15, 100% O2

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Tell me about the non-rebreather

ONE way valves, reservoir BAG

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What are the advantages of a non-rebreather

Highest concentration of O2

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What are the cons of a non-rebreather

Claustrophobia, can't EAT or TALK, malfunction can cause CO2 BUILDUP

What is the flow rate of the venturi mask

4-12

Tell me about the ventrui mask

ACCURATE O2 concentration

What are the pros of the venturi mask

COPD, doesn't DRY

What are the cons of the venturi mask

Uncomfy, skin IRRITATION

What is the difference between a BIPAP and CPAP

BIPAP- 2 pressure settings CPAP- Same amount of pressure

What do you use for COPD, SEVERE sleep apnea, more SERIOUS episodes, trying to prevent INTUABATION

BIPAP

What do you use for obstructive sleep apnea, newborns, everynight use

CPAP

Should you place a PAP on a pt complaining of nausea

What is O2 toxicity

Lung damage from breathing too much O2

What are the symptoms of O2 toxicity

Coughing, dyspnea, chest APIN, substernal HEAVINESS

How can you prevent O2 toxicity

Correct O2 DEVICE, TITRATING O2

What is intubation

Endotracheal tube (ETT, ET)

What is the most common typr of artficial airway

ETT

When do you use ETT

General anestesia, REST the respiraory muscles, MECHANICAL ventilation

What are the nursing responsibilites for ETT

SUCTIONING PRN, ORAL care Q2hrs, HOB>30

How do you measure an oropharyngeal

Corner of mouth to angle of jaw. Too big- blocked Too small- does not open

When to use an oropharyngeal

UNCONSCIOUS (gag reflex), prevent TONGUE from covering epiglottis

What is a nasal trumpet

Nasophryngeal

How do you measure a nasopharyngeal

Tip of nose to tragus

What is nasopharyngeal good for

SUCTIONING

When to use a nasopharyngeal

Better over mouth one, Obstruction of UPPER airway, MOUTH trauma

When to not use a nose airway

Severe HEAD or FACIAL injury

Are tracheostomies perment or tempoarary

Both

When is a tracheostomy placed

When a patient can't keep thier own airway open

What are the two most common reasons why a trach is used

Proonged dependence on a VENTILATOR (chronic), bypass an OBSTRUCTED upper airway (acute illness)

What are some examples of why a pt would have prolonged dependence on a vent

Fuilian-Barre syndrome, Multiple sclerosis, COPD

What are the examples of why a pt may need a trach to bypass an obstructed upper airway

Prevent vent DEPENDENCY, FACIAL truama

What is the nurses job of trachs

Cleaning and replacement

What can a trach be

Cuffed or uncuffed, fenestrated or non-fenestrated

Tell me about a cuffed trach

SHORT term, OCCLIDES, PRESSURE, NECROSIS

What can the flange do

Skin breakdown

Tell me about the inner cannula

Disposable or non-disposable

What does an obturtator do

Helps INSERT

What is the top nursing priority with a new trach

Maintaining a patent aiway 72 hours POSTOP

At minimum what should you assess every shift

Trach site and patency

What are you observing for the trach site

Inflammation, edema, ulceration, signs of infection

What to know about trach care

DAILY, STERILE, clean TIES with STERILE saline, pre-cut gauze, OPENING facing UP

Tell me about trach suctioning

STERILE, don't suction going IN, no longer than 10 SECD, 30-60 IN-BETWEEN, INTERMITTENT suction, CIRCULAR going OUT, 100% O2 IN-BETWEEN

What do you need at the bedside for trach care

BVM, Trach tube SAME and SMALLER size, insertion TRAY, OBTURATOR, STERILE OCCLUSIVE dressings

What do you do if your pts trach comes out

STAY, call for HELP, SEMI-FOWLERS, STERILE OCCLUZIVE dressing on STOMA, BVM over NOSE and MOUTH

What is a chest tube

Through RIB cage, into the PLEURAL space, connected to a drainage SYSTEM

What is a chest tube used for

REMOVE AIR, FLUIDS, or BLOOD from the pleural space, reestablish intrapleural PRESSURE

What is a pneumothorax, hemothorax, and pleural effusion

AIR, BLOOD, FLUID

What is the brainage chamber

Fluid is collected EXECPT for a pneumothorax

What is the water-seal chamber for

Allows air to be removed without OUTSIDE air entering

What is tidaling

GOOD, the ball goes up and down with each breathe, lung has NOT re-expanded

What can it mean if tidaling has stopped

Lung HAS re-expanded, KINK (CHECK)

What can excessive coutinuous bubbling in the water seal chamber mean

Air LEAK

What is suction-control usally set to

-20

Where do you keep the chest tube drainage system

BELOW the patient's chest

What do you never do with a chest tube

STRIP or CLAMP the tubing

What can clamping the chest tube do

Cause a TENSION pneumothorax

What do you do when the doc is taking the chest tube out

VALSALVA maneuver, BEAR down

What are you monitoring with chest tubes

CACO (every HOUR), sounds, site

What must you report

BRIGHT red blood (dark is expected), >100mL/hr

What do you do if the chest tube disconnects from the drainage system

Put the END in STERILE water

What do you do if the chest tube is pulled out from the pt

Cover site with THREE sided STERILE gauze

When do you use an occlusive dressing for chest tubes

When it's pulled by the doc