Oxygenation and Perfusion Flashcards
1
Q
what is the number 1 preventable cause of lung disease and death
A
smoking
2
Q
oxygenation
A
properly functioning alveolar capillary membrane
3
Q
oxygenation does what to venous blood
A
oxygneates
4
Q
oxygenation removes what from the blood
A
carbon dioxide
5
Q
COPD is an oxygenation or ventilation issue
A
oxygenation
6
Q
oxygenation is basically
A
diffusion
7
Q
ventilation
A
ability to transport air to and from lungs
8
Q
asthma would be a oxygenation or ventilation issue
A
Ventilation
9
Q
obstructions would be an oxygenation or ventilation issue
A
ventilation
10
Q
what two things need to occur to get proper levels of O2 to the tissues
A
oxygenation and ventilation
11
Q
upper airway function
A
warm, filter, humidify
12
Q
lower airway function
A
conduction of air, mucocillary clearance
13
Q
alveolar capillary membrane function
A
gas diffusion
14
Q
factors affecting pulmonary functioning
A
levels of health
medications
lifestyle
environment
15
Q
how would left sided heart failure affect the lungs
A
buildup and back flow into lungs
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
17
Q
how would anemia affect oxygenation
A
not enough hemoglobin to pick up oxygen
18
Q
how do opioids affect pulmonary function
A
depresses respiratory function
19
Q
how does obesity affect pulmonary function
A
more effort
normally hypo ventilators
20
Q
what are some environment related things that can affect pulmonary function
A
pollution
secondary smoke
fumes
21
Q
increased work of breathing would cause decreased oxygenation or decreased ventilation
A
decreased oxygenation
22
Q
decreased gas exchange would cause decreased oxygenation or decreased ventilation
A
decreased oxygenation
23
Q
why is increased work of breathing bad
A
expiration becomes active
24
Q
why is decreased gas exchange bad
A
decreased number of capillaries
and/or
decreased inspiratory lung volumes
25
would an ineffective cough cause cause decreased oxygenation or decreased ventilation
decreased ventilation
26
would drier mucous membranes cause decreased oxygenation or decreased ventilation
decreased ventilation
27
increased risk for aspiration due to decreased gastric mobility would cause decreased oxygenation or decreased ventilation
decreased ventilation
28
would impaired mobility cause decreased oxygenation or decreased ventilation
decreased ventilation
29
medications that decreased ventilation cause decreased oxygenation or decreased ventilation
decreased ventilation
30
why would impaired mobility cause decreased ventilation
pooling of secretions
31
is tissue and airways becoming more rigid cause decreased oxygenation or decreased ventilation
decreased ventilation
32
why would airways becoming more rigid cause decreased ventilation
diaphragm moves less efficiently which leads to less air exchange
33
what is included in a focused pulmonary interview
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?
34
why would we ask
- how is your breathing?
35
why would we ask
- how is your breathing?
so we know patient normal
36
how do we measure smoking and years
PACK YEAR
37
how do we measure pack years
number of packs you smoke a day x years you've been smoking
38
say you smoke 3 packs a day for 5 years, what's the pack years
15 pack years
39
why would we ask
- do you have any pets
any allergies or possible allergies
40
why would we ask
- have you traveled recently
travel to any countries with an increase in respiratory diseases
41
why would we ask
- where do you sleep
tells us if the patient is able to get to the bedroom especially if it is a two story home
42
why would we ask
- who does the shopping
know activity level
43
why would we ask
- do you vacuum
vacuuming requires the lung accessory muscles so we get a firm understanding if the accessory muscles are being used for breathing
44
why would we ask
- what type of work do you do or did you do?
pollutions and fume exposure
ex: farmers are exposed to fertilizers and pollutions
45
why would we ask
- have you ever been exposed to fumes
restrictive diseases could come from fume exposure
46
pulmonary ventilation inspection
respiratory rate
depth
pattern
work of breathing
using accessory muscles
chest symmetry
skin color
surgical scars
47
why should we inspect for scars on the back
incase part of or whole part of the lung was removed
48
what can we auscultate for the lungs
adventitious sounds
49
what are the 3 adevtnious sounds
- wheezes
- crackles
- rhonchi
50
what are wheezes frequency
high pitch
51
when would you hear wheezes
inhale or exhale or both
both
52
wheezes is caused by a ____________ airway
narrow
53
wheezes is a ventilation or oxygenation issue
ventilation issue
54
what is an example of wheezes
asthma, obstruction, tumor
55
what is the treatment for wheezes
bronchodilator
56
what distinguishes between crackles and rhonci
crackles are discontinous
rhonchi are continous
57
crackles can be
course or fine
58
what are examples of crackles
Collapsed alveoli
59
rhonchi are
secretions in larger airways
60
with you patient with rhonci and they cannot cough what intervention are you going to do
use suction
61
what order do we have patients cough up rhonchi
breathe in
3 small coughs
breathe in
one big cough
62
why do we tell patients with rhonchi to have 3 small coughs
to work the secretions up closer to the exit
63
what term do we NOT use
rales
64
what are some non invasive ways to check pulmonary function
pulse ox
chest Xray
pulmonary function tests
65
when is it not appropriate to have a pulse ox on
when in a code
peripheral obstruction
66
what does a pulse ox measure
arterial hemoglobin saturation of oxygen
67
when would we leave a pulse ox on for continuous measurement
if abnormal
less than 90
68
what are invasive ways to check for pulmonary function
arterial blood gas
bronchoscopy
69
when do we take a ABG
when in code
or ordered
70
what does an ABG tell us
O2, PaO2, bicarb, CO2
71
ABG tells us about what
oxygenation, ventilation or both
both
72
bronchoscopy is a
tube into the lungs to look
73
if the SpO2 is 95 what is the PaO2
80
74
if the SpO2 is 90 what is the PaO2
60
75
if the SpO2 is 80 what is the PaO2
50
76
if the SpO2 is 70 what is the PaO2
40
77
tumors are
vascular
78
if we have a patient after a biopsy of lung tumor was completed what do we need to do and what interventions
we need to watch for blood since tumors are vascular and we need to position them up
79
what are some nursing interventions promoting adequate pulmonary functioning?
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
how would we postion a patient who is having difficulty breathing
up
81
pursed lip breathing promotes prolonged
expiration
82
how does pursed lip breathing promote prolonged expiration
creating resistance at lips
83
what is the recommended amount of fluid required for people
2-3L
84
why do we want adequate hydration in patients with secretions
this thins and loosens secretions
85
incentive spirometry promotes
deep breathing
86
SMILE incentive spirometry
sustained maximum inspiratory lung expander
87
when would we want to give a cough suppressants
a dry non productive cough
88
when would we want to give cough expectants
productive cough
89
bronchodilators
open narrowed airway
90
corticosteriods
reduce inflammation in airways
91
bronchodilators could cause
tachycardia
92
nebulizers
disperse fine particles of medication into deeper passages of respiratory tract where absorption occurs
93
metered dose inhalers
delivers controlled dose of medication with each compression of the canister
94
dry powder inhaler
activated by patients inspiration
95
what do we want when we use a metered dose inhalers
spacer
96
what do we want to do after we give a steroid metered dose inhaler
rinse
97
if we do not rinse after a metered dose inhaler with steroids we could develop
thrush
98
nasal cannula only goes up to how many liters
6L
99
room air is what % o2
21%
100
nasal cannula can only do FiO2 of
24-44%
101
what is different about o2 reporting between nasal cannula, Venturi mask, and nonrebrether
nasal cannula is reported in liters, the other are reported in FiO2 percent
102
if I have a patient on 1L nasal cannula what % is that
24%
103
2L %
28%
104
3L %
32%
105
4L %
36%
106
5L %
40%
107
6L %
44%
108
if I have a patient on 32% FiO2 what liter is that
3L
109
venturi mask devlivers what %
24-40% FiO2
110
nonrebreather delivers what %
80-100%
111
the nonrebreather mask is set ti 80-100% so what does the range actually depend on
rate and depth of breathing
112
CPAP is for OSA
obstructive sleep apnea
113
CPAP is for
sleep onlt
114
BiPAP
biphasic positive air pressure
115
BiPAP only delivers pressure
on inhalation and pressure stops on exhalation
116
what color is oxygen
GREEN
117
where do we read the liters of O2
middle of ball
118
what color is air
yellow
119
when we apply a humidifier what part do we need to take off
Christmas tree/nipple
120
what is special about a nonrebreather mask
exhaled air cannot be rebreathed
121
high flow nasal cannula will deliver
higher FiO2 amounts
122
when do we not give a pulmonary toilet
fractured ribs
brittle bones
123
on the high flow oxygen how much FiO2 is in 10L
60%
124
on the high flow oxygen how much FiO2 is in 15L
80%
125
on the high flow oxygen how much FiO2 is in 20L
90%
126
on the high flow oxygen how much FiO2 is in 30L
98%
127
above how many liters do we humidify the oxygen
2L nasal cannula
