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Fundamentals of Nursing > Oxygenation and Perfusion > Flashcards

Oxygenation and Perfusion Flashcards

1
Q

what is the number 1 preventable cause of lung disease and death

A

smoking

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2
Q

oxygenation

A

properly functioning alveolar capillary membrane

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3
Q

oxygenation does what to venous blood

A

oxygneates

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4
Q

oxygenation removes what from the blood

A

carbon dioxide

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5
Q

COPD is an oxygenation or ventilation issue

A

oxygenation

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6
Q

oxygenation is basically

A

diffusion

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7
Q

ventilation

A

ability to transport air to and from lungs

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8
Q

asthma would be a oxygenation or ventilation issue

A

Ventilation

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9
Q

obstructions would be an oxygenation or ventilation issue

A

ventilation

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10
Q

what two things need to occur to get proper levels of O2 to the tissues

A

oxygenation and ventilation

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11
Q

upper airway function

A

warm, filter, humidify

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12
Q

lower airway function

A

conduction of air, mucocillary clearance

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13
Q

alveolar capillary membrane function

A

gas diffusion

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14
Q

factors affecting pulmonary functioning

A

levels of health
medications
lifestyle
environment

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15
Q

how would left sided heart failure affect the lungs

A

buildup and back flow into lungs

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16
Q

how would deficiency in nutrition affect pulmonary functioning

A

leads to muscle wasting which leads to the diaphragm not being able to work as good as possible which leads to increased workload

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17
Q

how would anemia affect oxygenation

A

not enough hemoglobin to pick up oxygen

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18
Q

how do opioids affect pulmonary function

A

depresses respiratory function

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19
Q

how does obesity affect pulmonary function

A

more effort
normally hypo ventilators

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20
Q

what are some environment related things that can affect pulmonary function

A

pollution
secondary smoke
fumes

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21
Q

increased work of breathing would cause decreased oxygenation or decreased ventilation

A

decreased oxygenation

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22
Q

decreased gas exchange would cause decreased oxygenation or decreased ventilation

A

decreased oxygenation

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23
Q

why is increased work of breathing bad

A

expiration becomes active

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24
Q

why is decreased gas exchange bad

A

decreased number of capillaries
and/or
decreased inspiratory lung volumes

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25
Q

would an ineffective cough cause cause decreased oxygenation or decreased ventilation

A

decreased ventilation

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26
Q

would drier mucous membranes cause decreased oxygenation or decreased ventilation

A

decreased ventilation

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27
Q

increased risk for aspiration due to decreased gastric mobility would cause decreased oxygenation or decreased ventilation

A

decreased ventilation

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28
Q

would impaired mobility cause decreased oxygenation or decreased ventilation

A

decreased ventilation

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29
Q

medications that decreased ventilation cause decreased oxygenation or decreased ventilation

A

decreased ventilation

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30
Q

why would impaired mobility cause decreased ventilation

A

pooling of secretions

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31
Q

is tissue and airways becoming more rigid cause decreased oxygenation or decreased ventilation

A

decreased ventilation

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32
Q

why would airways becoming more rigid cause decreased ventilation

A

diaphragm moves less efficiently which leads to less air exchange

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33
Q

what is included in a focused pulmonary interview

A

how is your breathing
do you smoke
do you have any pets
have you travelled recently
do you experience difficulty breathing or fatigue? if so what causes this
where do you sleep?
who does the shopping?
do you vacuum?
what type of work do you or did you do?
any chest pain?
do you have a cough
- if yes= how long? Is anything coming up?
- if yes= what color?
have you ever been exposed to fumes
is there a position in which your breathing is most comfortable?
do you have any allergies?

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34
Q

why would we ask
- how is your breathing?

A
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35
Q

why would we ask
- how is your breathing?

A

so we know patient normal

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36
Q

how do we measure smoking and years

A

PACK YEAR

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37
Q

how do we measure pack years

A

number of packs you smoke a day x years you’ve been smoking

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38
Q

say you smoke 3 packs a day for 5 years, what’s the pack years

A

15 pack years

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39
Q

why would we ask
- do you have any pets

A

any allergies or possible allergies

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40
Q

why would we ask
- have you traveled recently

A

travel to any countries with an increase in respiratory diseases

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41
Q

why would we ask
- where do you sleep

A

tells us if the patient is able to get to the bedroom especially if it is a two story home

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42
Q

why would we ask
- who does the shopping

A

know activity level

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43
Q

why would we ask
- do you vacuum

A

vacuuming requires the lung accessory muscles so we get a firm understanding if the accessory muscles are being used for breathing

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44
Q

why would we ask
- what type of work do you do or did you do?

A

pollutions and fume exposure
ex: farmers are exposed to fertilizers and pollutions

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45
Q

why would we ask
- have you ever been exposed to fumes

A

restrictive diseases could come from fume exposure

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46
Q

pulmonary ventilation inspection

A

respiratory rate
depth
pattern
work of breathing
using accessory muscles
chest symmetry
skin color
surgical scars

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47
Q

why should we inspect for scars on the back

A

incase part of or whole part of the lung was removed

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48
Q

what can we auscultate for the lungs

A

adventitious sounds

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49
Q

what are the 3 adevtnious sounds

A
  • wheezes
  • crackles
  • rhonchi
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50
Q

what are wheezes frequency

A

high pitch

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51
Q

when would you hear wheezes
inhale or exhale or both

A

both

52
Q

wheezes is caused by a ____________ airway

A

narrow

53
Q

wheezes is a ventilation or oxygenation issue

A

ventilation issue

54
Q

what is an example of wheezes

A

asthma, obstruction, tumor

55
Q

what is the treatment for wheezes

A

bronchodilator

56
Q

what distinguishes between crackles and rhonci

A

crackles are discontinous
rhonchi are continous

57
Q

crackles can be

A

course or fine

58
Q

what are examples of crackles

A

Collapsed alveoli

59
Q

rhonchi are

A

secretions in larger airways

60
Q

with you patient with rhonci and they cannot cough what intervention are you going to do

A

use suction

61
Q

what order do we have patients cough up rhonchi

A

breathe in
3 small coughs
breathe in
one big cough

62
Q

why do we tell patients with rhonchi to have 3 small coughs

A

to work the secretions up closer to the exit

63
Q

what term do we NOT use

A

rales

64
Q

what are some non invasive ways to check pulmonary function

A

pulse ox
chest Xray
pulmonary function tests

65
Q

when is it not appropriate to have a pulse ox on

A

when in a code
peripheral obstruction

66
Q

what does a pulse ox measure

A

arterial hemoglobin saturation of oxygen

67
Q

when would we leave a pulse ox on for continuous measurement

A

if abnormal
less than 90

68
Q

what are invasive ways to check for pulmonary function

A

arterial blood gas
bronchoscopy

69
Q

when do we take a ABG

A

when in code
or ordered

70
Q

what does an ABG tell us

A

O2, PaO2, bicarb, CO2

71
Q

ABG tells us about what
oxygenation, ventilation or both

A

both

72
Q

bronchoscopy is a

A

tube into the lungs to look

73
Q

if the SpO2 is 95 what is the PaO2

A

80

74
Q

if the SpO2 is 90 what is the PaO2

A

60

75
Q

if the SpO2 is 80 what is the PaO2

A

50

76
Q

if the SpO2 is 70 what is the PaO2

A

40

77
Q

tumors are

A

vascular

78
Q

if we have a patient after a biopsy of lung tumor was completed what do we need to do and what interventions

A

we need to watch for blood since tumors are vascular and we need to position them up

79
Q

what are some nursing interventions promoting adequate pulmonary functioning?

A

smoking cessation
positioning
chest physiotherapy
control anxieties
- meds
- guided imagery
pursed lip breathing
adequate fluid intake
humidified oxygen
adequate nutrition
respiratory medications
coughing and deep breathing
incentive spirometry

80
Q

how would we postion a patient who is having difficulty breathing

A

up

81
Q

pursed lip breathing promotes prolonged

A

expiration

82
Q

how does pursed lip breathing promote prolonged expiration

A

creating resistance at lips

83
Q

what is the recommended amount of fluid required for people

A

2-3L

84
Q

why do we want adequate hydration in patients with secretions

A

this thins and loosens secretions

85
Q

incentive spirometry promotes

A

deep breathing

86
Q

SMILE incentive spirometry

A

sustained maximum inspiratory lung expander

87
Q

when would we want to give a cough suppressants

A

a dry non productive cough

88
Q

when would we want to give cough expectants

A

productive cough

89
Q

bronchodilators

A

open narrowed airway

90
Q

corticosteriods

A

reduce inflammation in airways

91
Q

bronchodilators could cause

A

tachycardia

92
Q

nebulizers

A

disperse fine particles of medication into deeper passages of respiratory tract where absorption occurs

93
Q

metered dose inhalers

A

delivers controlled dose of medication with each compression of the canister

94
Q

dry powder inhaler

A

activated by patients inspiration

95
Q

what do we want when we use a metered dose inhalers

A

spacer

96
Q

what do we want to do after we give a steroid metered dose inhaler

A

rinse

97
Q

if we do not rinse after a metered dose inhaler with steroids we could develop

A

thrush

98
Q

nasal cannula only goes up to how many liters

A

6L

99
Q

room air is what % o2

A

21%

100
Q

nasal cannula can only do FiO2 of

A

24-44%

101
Q

what is different about o2 reporting between nasal cannula, Venturi mask, and nonrebrether

A

nasal cannula is reported in liters, the other are reported in FiO2 percent

102
Q

if I have a patient on 1L nasal cannula what % is that

A

24%

103
Q

2L %

A

28%

104
Q

3L %

A

32%

105
Q

4L %

A

36%

106
Q

5L %

A

40%

107
Q

6L %

A

44%

108
Q

if I have a patient on 32% FiO2 what liter is that

A

3L

109
Q

venturi mask devlivers what %

A

24-40% FiO2

110
Q

nonrebreather delivers what %

A

80-100%

111
Q

the nonrebreather mask is set ti 80-100% so what does the range actually depend on

A

rate and depth of breathing

112
Q

CPAP is for OSA

A

obstructive sleep apnea

113
Q

CPAP is for

A

sleep onlt

114
Q

BiPAP

A

biphasic positive air pressure

115
Q

BiPAP only delivers pressure

A

on inhalation and pressure stops on exhalation

116
Q

what color is oxygen

A

GREEN

117
Q

where do we read the liters of O2

A

middle of ball

118
Q

what color is air

A

yellow

119
Q

when we apply a humidifier what part do we need to take off

A

Christmas tree/nipple

120
Q

what is special about a nonrebreather mask

A

exhaled air cannot be rebreathed

121
Q

high flow nasal cannula will deliver

A

higher FiO2 amounts

122
Q

when do we not give a pulmonary toilet

A

fractured ribs
brittle bones

123
Q

on the high flow oxygen how much FiO2 is in 10L

A

60%

124
Q

on the high flow oxygen how much FiO2 is in 15L

A

80%

125
Q

on the high flow oxygen how much FiO2 is in 20L

A

90%

126
Q

on the high flow oxygen how much FiO2 is in 30L

A

98%

127
Q

above how many liters do we humidify the oxygen

A

2L nasal cannula

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