Oxygenation Flashcards
0
Q
Cardiopulmonary physiology
A
Provides oxygen to tissues and removes Co2 and waste products from the body
1
Q
Oxygenation
A
Process by which oxygen is transported to the cells and carbon dioxide is transported from the cells
2
Q
Ventilation
A
Movement of air in and out of the lungs
3
Q
Diffusion
A
Movement of gases between air spaces and the bloodstream
4
Q
Respiration
A
Exchange of oxygen and carbon dioxide during cellular metabolism
5
Q
Movement of blood into and out of the lungs to the organs and tissues of the body and supported by the heart Ventilation Diffusion Respiration Perfusion
A
Perfusion
6
Q
Need to get oxygen across
A
Alveolar membrane
7
Q
Need to get oxygen into
A
Rbcs
8
Q
Need to get oxygen into
A
Body cells
9
Q
Inadequate tissue oxygenation with a deficiency in oxygen delivery at cellular level
Hypoxia
Hypoxemia
A
Hypoxia
10
Q
Hypoxemia
A
Abnormal deficiency in concentration of oxygen in arterial blood. Low partial pressure of oxygen
11
Q
Ventilation which is inadequate to meet demands of the body and results in hypercapnea. Respiratory acidosis
A
Hypo ventilation
12
Q
Increase in respiratory rate which results in excess co2 elimination. Respiratory alkalosis
A
Hyperventilation
13
Q
Clinical signs of hypoxemia
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Dyspnea Tachypnea Restlessness motor function Anxiety mental status change Hyper or hypotension Pallor or cyanosis Blurred or tunnel vision Nausea and vomiting
14
Q
The angle of Louis is at the junction between
A
The Manubrium and the body of the sternum
15
Q
The Lower lobes project
A
Laterally and anteriorly
16
Q
Posteriorly the tip or inferior margin of the scapula lies approximately at the level of the
Eighth
Seventh
Ninth
A
Seventh rib
17
Q
Breathlessness
A
Dyspnea
18
Q
Risk factors for HIV or TB
A
Persistent cough, hemoptysis, unexplained weight loss, fatigue, anorexia, night sweats and fever.
19
Q
Normal chest contour
A
Ap diameter 1/3to 1/2 of the size of the transverse or side to side diameter
20
Q
Barrel shaped chest characterizes
A
Chronic lung dx
21
Q
Patients with breathing problems may do this
A
Lean over a table or splint the side of the chest
22
Q
When breathing bulging or retraction indicates
A
Patient using great effort to breathe
23
Q
Normal resp rate
A
12 to 20
24
Bronchi vesicular and vesicular sounds are normally heard over
Anterior
Posterior
Posterior thorax
25
Medium pitched blowing sounds normally heard
Between the scapulae
26
Where are vesicular sounds normally heard over
Periphery of the lungs
27
Vesicular sounds are
Soft
Breezy
Low pitched
And insp phase is three times longer than exp phase
28
Stress
Hyperventilation
29
Anxiety
Bronchospasm
30
Four things you do during physical assessment
Inspection
Palpation
Percussion
Auscultation
31
Inspection
```
Shape and symmetry
Trachea
Color
Resp rate
Sputum
Distress
Fingernail clubbing
```
32
Palpating
```
Bulges
Tenderness
Abnormal movements
Temp
Tactile fremitus 99
Presence or absence of crepitation
```
33
Percussion
Compare one side with other
34
Resonant
Lungs
35
Hyperressonant
Emphysematous lungs
36
Flat
Bone
37
Dull
Organs
| Consolidation
38
Tympanic
Stomach
39
Heard over large airways
Caused by spasm
Mucous secretions
Wheezes
Crackles
Rhonchi
Pleural friction rub
Rhonchi
40
```
Heard over lung fields
Cause is increase in interstitial lung water or deflated alveoli
High pitched
Static like
Discontinuous
```
Rhonchi
Pleural friction rub
Crackles
Wheezes
Crackles (rales)
41
Heard over lung fields and airways
Caused by narrow airways
Pleural friction rub
Wheezes
Rhonchi
Wheezes
42
Dry grating due to inflammation
Wheezes
Rhonchi
Pleural friction rub
Pleural friction rub
43
Peak flow meter
Estimate volume of air that can be forcibly exhaled
44
Measures oxygen saturation of arterial blood
Pulse ox
45
Abnormal pulse ox
90
85
80
Below 85
46
Procedure of entering pleural cavity and aspirating fluid usually done at bedside
Thoracentesis
47
Used to diagnose and treat airway and lung disorders
Bronchoscopy
48
Nursing diagnosis
| Impaired gas exchange related to pulmonary infection
Dyspnea
Sp02 82 percent
Rr 36 breaths
Coarse lung sounds
49
Interventions
02 at 1 liter min to maintain sp02 greater than 92 percent
High fowler position
Monitor lung sounds
Monitor results of chest X-ray
50
Nursing diagnosis
| Fatigue related to decreased oxygen
Sp02 82%
Decrease in activity level
Inability to perform ADL's
51
Interventions
Alternate rest and activity periods
Limit enviromental stimuli to promote relaxation
Monitor nutritional intake to include high nutrient intake
52
Nursing diagnosis
| Acute pain related to frequent cough
Complaints of chest pain
Pulse rate of 120 beats per min
Patients hold chest when coughing
53
Intervention
Administer analgesics
Explore factors that improve or worsen pain
Teach pain management
Teach effective coughing techniques
54
Nursing diagnosis
| Ineffective airway clearance related to pulmonary secretions
Temp 102
Thick yellow sputum
Dyspnea
55
Intervention
Cough and deep breathe every two hours
Increase fluids to 2800 ml for 24 hours
Administer antipyretic
Administer analgesics as needed before coughing
56
Is suctioning a sterile procedure
How long should procedure last
How long in between
Yes
10 to 15 seconds
20 to 30 seconds
57
Right lung is made up of how many lungs
3
58
Essential for normal lung function. Without adequate amts, the alveoli would collapse on expiration leading to impaired gas exchange
Surfactant
59
Successful ventilation depends on
Neuro and chemo receptors
60
Tissues most sensitive to hypoxia are the
Brain
Heart
Pulmonary vessels
Liver
61
Signs and symptoms of hypoxia include
Tachycardia
Peripheral vasoconstriction
Dizziness
Mental confusion
62
Causes of hypoxia
```
Anemia
Monoxide poisoning
High altitudes
Airway obstruction
Septic shock
Cyanide poisoning
COPD
impaired ventilation from rib fractures, chest trauma, spinal cord injury
Left shifted oxyhemoglobin dissociation curve
```
63
Causes of hypoxemia
```
Decreased diffusion as in pneumonia and atelectasis
Decreased alveolar oxygen tension
Cardiac arrhythmia
Ventricular fibrillation
A Systole
```
64
Treatment of hypoxemia
Oxygen
| Correction of underlying cause
65
Treatment of hypoxia
Cardiac and resp stimulant drugs
Oxygen
Mechanical ventilation
Frequent analysis of blood gases
66
As ventilation decreases, what increases
Pac02
67
Signs and symptoms of hypoventillation
```
Dizziness
Occipital headache on awakening
Lethargy
Disorientation
Decreased ability to follow instructions
Cardiac dysrhythmias
Electrolyte embalance
Convulsions
Possible coma
Cardiac arrest
```
68
Chronically elevated pac02 and copd
Inappropriate administration of excessive oxygen may result in hypo ventilation
69
Hypercapnea
High carbon dioxide
70
Patients with COPD and hypercapnea adapt better to higher or lower carbon dioxide level
Higher
| 24 to 28%
71
Treatment for hypo ventilation
Treating underlined cause
Improving tissue oxygenation
Restoring ventilation
Achieving acid-base balance
72
Causes of hyperventilation
```
Severe anxiety
Infection
Head injury
Meds
Acid based imbalance
```
73
Hyperventilation signs and symptoms
```
Tachycardia
SNOB
chest pain
Dizziness
Lightheadedness
Decreased concentration
Paresthesia
Extremity numbness
Tinnitus
Blurred vision
Tetany
```
74
Treatment for hyperventilation
```
Treating underlined cause
Improving tissue oxygenation
Restoring ventilation
Reducing resp rate
Achieving acid base balance
```
75
Early clinical signs and symptoms of hypoxemia
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Anxiety
Change in level of consciousness
Restlessness
Increased hr
Increases rr and bp
Cardiac dysrhythmias such as PAC's, PVC's, and sinus tachycardia
```
76
Pulmonary patients are at risk for
Hypoxemia and hypercapnea
77
Cervical trauma at c3 to c5 results in
Paralysis of phrenic nerve
78
Cardiac pain radiates into where in males
Left arm and jaw
79
Cardiac pain in women symptoms
```
Epi gastric pain
Complaints of indigestion
Nav
Choking feeling
Dyspnea
```
80
Is pericardial pain radiating or no radiating
Nonradiating and occurs with inspiration or when leaning forward
81
Pleuritic chest pain is
Peripheral
Usually radiates to scapular area
Knifelike
82
Muskoskelatal pain is often confused with what kind of chest pain
Pleuritic chest pain
83
Orthpnea
Difficulty breathing when lying and uses mult pillows
84
Hemoptysis
Bloody sputum
85
What herb should cv patients not take
Ma hung
86
Patients with asthma should not take
Ephedrine containing products such as bronchodilators because they cause increased bronchospasm and resp arrest
87
Is the mouth considered clean or dirty
Clean thus oral and nasopharyngeal suctioning requires only clean technique
88
Most effective position for CP dx is in the
90 degree fowler
45 degree semi fowler
45 degree semi fowler position
89
How do you position a patient with unilateral lung dx such as pneumothorax or atelectasis
Healthy lung up or down
Down
90
Pneumothorax
Collection or air or gas in the pleural space
91
Accumulation of air in the pleural space usually as a result of trauma
Hemothorax
92
What is the usual CPAP setting
5 to 20 cm
93
Affects person oxygenation by binding strongly with hemoglobin preventing the formation of oxyhemoglobin
Carbon monoxide
94
Low concentration carbon monoxide causes
Nausea
Dizziness
Headache
Fatigue
95
High concentration carbon monoxide causes
Are fatal
96
Persons comfort zone is between
40 to 90 C
18 to 23
18 to 23 or 65 and 75 F
97
High pitched continuous musical sounds bilateral over lung fields
Wheezes
98
Fine bubbling sounds heard on auscultation
Crackles
99
Clinical findings indicate central cyanosis
Bluish discoloration of lips and mouth and conjunctivae
| Heart dx
100
Clinical signs of peripheral cyanosis
Blue lips, earlobes, and nail beds
| Indicates peripheral vasoconstriction
101
Bulging of of the tissues of nail base
Clubbing
102
Primary reason for giving morphine for patient experiencing MI
Decreased oxygen demand on heart
103
Mental status changes, agitation, and falls early signs of
Worsening cardiac status
104
Resistance of ejection of blood from the left ventricle
Afterload
105
Increased risk of developing ventilator associated pneumonia
Pooling of secretions in the oropharynx
106
Associated with VAP
Fever
| Progressive infiltrates on chest X-ray 3 days after on mechanical vent
107
VAP is associated with colonization of the
Resp and digestive systems
108
Accumulation of blood and fluid in the pleural cavity between the
Parietal and visceral pleurae
Hemothorax
109
Shortness of breath or difficulty in breathing caused by certain heart or lung conditions or strenuous exercise
Dyspnea
110
A collapse of alveoli preventing the normal respiratory exchange of oxygen and carbon dioxide
Atelectasis
111
What do bibasilar crackles and diminished breath sounds indicate
Fluid from heart failure or bilateral pneumonia
112
In assessing breath sounds, where should the nurse listen first
Lung bases
Lung Apices
Lung Apices
113
The nurse auscultation vesicular breath sounds in the periphery lung field. Is this a normal finding
Yes
114
```
Tenacious means
Odor
Color
Frequency
Consistency
```
Consistency
115
After determining the priority nursing diagnoses, what step should the nurse take next in developing the plan of care
Establish goals and outcomes
116
What is an early sign of hypoxia
Restlessness
117
When applying a nasal cannula it is most important for the nurse to provide which instructions
Remind client and family that oxygen is combustible and must be kept 10 feet away from open flames
118
What is the best technique for the nurse to assess respirations accurately
Place a hand on chest and count the hand motion
119
Early signs of hypoxemia include
Anxiety
Change in level of consciousness
Restlessness
120
Are patients with pulmonary diseases at greater risk for
| Hypoxemia or hypoxia
Hypoxemia
121
What are examples of NS diseases that result in hypoventillation
Myasthenia gravis
Gillian Barre dx
Poliomyelitis
