Week 2 - Respiratory Health 1 Flashcards

Question

Metabolic Alkalosis

Answer 1

- Caused by loss of acid or increase in HCO3 -. Most common cause is vomiting. Also due to diuretic therapy, K+ deficit, excess NaHCO3 intake - H+ decreases, HCO3 increases - Increased pH - Compensatory response of CO2; retention by lungs

Answer 2

- Process by which compensatory mechanisms (respiratory/metabolic systems) return pH toward normal without correcting underlying problem * Respiratory system compensates for disorders in metabolic system * Metabolic system compensates for disorders in respiratory system

Answer 3

Uncompensated: - pH abnormal - 1 other measure abnormal - 1 measure normal Partially compensated: - pH abnormal - other measures abnormal + opposite Fully compensated: - pH normal - other measures abnormal + opposite

Answer 4

- Assess ABG (only way to detect imbalance, pH) - Assess vitals - RR, heart rate/rhythm (remember impact on potassium) ○ Acid-base imbalance causes K imbalance - Assess electrolyte, BUN, creatinine, hematocrit (fluid status) - Electrolyte, fluid replacement as needed - O2 if required (if a resp problem) - Look for underlying cause and treat (ie. Vomiting, diarrhea)

Answer 5

- Fits into nose - Delivers up to 6L/minute (4%/L) Advantages ○ Can eat/drink while wearing ○ More comfortable Limitations ○ Easily dislodged ○ Drying to nose ○ Not effective for mouth breathing

Answer 6

- Look at diagnosis/case of resp dysfunction - General rule: lower the SpO2 and/or more difficulty breathing, the more supplemented oxygen required - Oxygen is not a cure ○ Treat underlying condition causing hypoxia to manage and improve patient outcomes

Answer 7

- Disturbance in resp function (respiration, gas exchange) - Dyspnea, abnormal rate, rhytmn, effort, inability to maintain normal SpO2, abnormal acid-base imbalance Causes - Infection (pneumonia, TB, etc) - Trauma (pneumothorax) - Pathological (COPD, ASTHMA, CANCER) - Genetic (cystic fibrosis)

Answer 8

- Elevate head of bed, tripod position - Breathing techniques ○ Deep breathing and coughing (mobilizes secretions) ○ Sit up, breathe in through nose, hold for 10 seconds, breathe out through their mouth, repeat 4x, on 5th one, breathe in and cough out □ If can not cough, try huffing (say huff and breath out) ○ Huffing - for clients who are in pain and can not deep breath - Maintain fluids - loosens secretions - Asses SPO2, resp rate - Auscultate lungs - Apply oxygen PRN - Suction PRN (to remove secretions) - Consider meds to enhance breathing - Rest between activities - Manage anxiety - Consider other causes of dyspnea

Answer 9

- Conditions where ventilation of all areas of lung is impaired - Conditions in which has exchange is impaired - Conditions in which oxygen delivery to tissue is decreased - - Conditions in which cells are unable to use oxygen efficiently

Answer 10

- Mask fits over nose and mouth - Ventilation holes to allow cO2 to be exhaled - Delivers up to 60% Advantages ○ Provides moderate oxygen concentrations ○ Efficiency depends on how well mask fits and patients resp demands Disadvantages ○ Confining feeling ○ Difficult to eat/drink while wearing

Answer 11

- Simple mask with small reservoir bag attached to oxygen tubing connecting to flow meter - Series of 1 way valves between the mask and the bag and covers on exhalation ports - On inspiration, the patient only breathes in from the reservoir bag - On exhalation, gases are directed out through the exhalation ports Advantages ○ High flow ○ Delivers 60-80% Disadvantages ○ Short-term use only ○ Risk of suffocation (if bag is not full of air) ○ Requires tight seal

Answer 12

- High flow system with mask, corrugated tubing - Delivers up to 50% Advantages ○ Delivers more precise flow Disadvantages ○ Mask may be hot and confining ○ Interferes with talking and eating ○ Need a properly fitted mask

Answer 13

- Check flow rate and equipment at BEGINNING of every shift and whenever entering room for care ○ Oxygen is considered a medication - Assess resp rate frequency (q1-4 hours), depending on patient status - SpO2 may be assessed continually or intermittently ○ Check skin integrity if probe on finger continuously, change location frequently to prevent skin breakdown - Adjust oxygen delivery rate based on SpO2 changes in breathing - Oxygen is drying - frequent oral care (q1-2 hours) - Keep hydrated to loosen secretions (1500-2000mL/day) - Monitor for nosebleeds (common for ppl with nasal prongs) ○ Check if someone is on anti-coagulants - Monitor for skin breakdown around mask, nares, chin, ears, head - Tubing is a safety hazard - keep off floor, keep clean, check for proper positioning to avoid choking - Significant decreases to O2 saturation levels or large increases to maintain O2 saturation should be reported to healthcare provider - Changes in oxygen flow rates should be in 5%-10% increments - Changes in L flow should be in 1 - 2 L increments - Consider changing O2 delivery device if O2 saturation levels are not maintained at target range - Do not pause oxygen therapy to transfer/ assist a patient out of bed ○ Mobility increases oxygen demand - Do not withhold oxygen in emergency situation if there is no order. Apply O2 THEN obtain the order - Typical order for oxygen: titrate oxygen to keep SpO2 at or greater than 95% (may vary). Use clinical judgement

Week 2 - Respiratory Health 1 Flashcards

(37 cards)