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oxygen needs
oxygen lecture
| Question | Answer |
|---|---|
| upper respiratory system | pharynx, larynx, trachea |
| lower respiratory system | lungs, bronchi branching throughout lungs |
| 3 functions of the respiratory system | gas exchange, fluid balance, acid-base balance (pH) |
| phases of oxygen needs | ventilation, diffusion, perfussion |
| 4 requirements essential for adequate ventilation | adequate atmospheric oxygen, clear air passages, adequate stretch ability and recoil, intact CNS center |
| RBC normal blood values | men= 4.2-5.4 million/mm3 women=3.6-5 million/mm3 |
| Hct normal blood values | men= 40-54% women=37-50% |
| Hgb normal blood values | men= 14-16 gm/dl women= 12-15 gm/dl |
| highly responsive to inc. in blood CO2 | medulla oblongata |
| hypoxia | O2 dec. in cells/body |
| hypoxia can be related to what parts of respiration | ventilation, diffusion, transport of gases by blood |
| early manifestations of hypoxia | restlessness, anxiety, tachycardia, tachypnea |
| late manifestations of hypoxia | bradycardia, extreme restlessness, dyspnea, cyanosis |
| chronic hypoxia | fatigue, clubbing of fingernails |
| how to get a sample of sputum | have patient cough from deep lungs into sterile container hydrate patient before and take deep breaths |
| hand held nebulizer | aerosol mist, mobilization and expectoration of thick secretions, inc. perfusion ration, treatment of post-op atelectasis and hypostatic pneumonia |
| altered breathing pattern | loss of adequate ventilation due to altered breathing patterns |
| nursing order of ineffective breathing patterns r/t anxiety AMB tachypnea, resp30/min | stay calm, give short clear directions, orthopneic position, breath into paper bag |
| what is the rational for the orthopneic position | maximize lung expansion |
| inspirometer | measure amount of inspiration |
| assessments prior to and during oxygen therapy | assess VS, breathing, airway, circulation |
| reasons for oxygen therapy | low O2 in blood and air, trauma, blood loss, ischemic tissues |
| pulse ox | measures oxygen saturation of hemoglobin. should be 92% and over |
| arterial blood gases | measurements obtained to assess adequacy of oxygenation and ventilation, evaluate acid-base balance and to monitor effectiveness of therapy |
| oxygen is a drug that is... | regulated, humidified, and signs are posted for caution |
| nursing responsibilities for oxygen | patient body image changes, compliances, dryness and discomfort |
| nasal cannula maximum O2 % and liter flow | 24-44% 1-6L |
| simple face mask maximum O2 % and liter flow | 40-60% 5-10L |
| venturi mask maximum O2 % and liter flow | 24-60% 4-12L |
| nursing action for patient with venturi mask | ensure correct mask to meet doctors order, order needs to specify the fraction of inspired oxygen desired NOT the liter flow |
| non-rebreather mask maximum O2 % and liter flow | 60-100% 6-15L |
| non-rebreather mask is used for... | short term (1-2 days), delivers highest concentration possible |
| complications of oxygen therapy | respiratory and circulatory depression, atelectasis, trachea-bronchitis, oxygen toxicity |
| activity intolerance | state which patient experiences an inability, physiologically and psychologically, to tolerate activity |
| most activity intolerance is r/t... | generalized weakness and debilitation secondary to acute or chronic illness and disease |
| defining characteristics for altered response to activity | dyspnea, shortness of breath, abnormal HR and BP response to activity, failure for VS to return to resting rate after 3minutes, weakness, fatigue |
| risk factors for peripheral vascular disease: Arterial | obesity, smoking, stress, family history |
| chronic arterial peripheral vascular disease | atherosclerotic plaque which can lead to amputation, gangrene foot and poor healing |
| acute arterial peripheral vascular disease | occlusive or complete obstruction > clot formed in arterial system |
| arteries | distribute oxygenated blood to body |
| arterioles | smaller arteries>these go to capillaries |
| capillaries | smallest vessels, connector between arterioles and venules |
| venule | smallest of veins>then turn into veins and carry blood back to heart |
| vein valves | prevented backward flow of blood |
| acute venous peripheral vascular disease | thrombus, thrombophlebitis |
| chronic venous peripheral vascular disease | incompetent valves, stasis ulcers, varicose veins |
| arterial assessment | pain, cold temp., pallor, absent pulse, paresthesia |
| pitting edema +3 | deep pit, puffy appearance |
| pitting edema +4 | deep pit, trankly swollen |
| 5 methods of heat transfer | conduction, convection, radiation, evaporation, diathermy |
| body's control of heat and cold | hypothalamus, ANS |
| local application of heat... | inc. blood flow, dec. blood viscosity, inc. capillary permeability, perspiration, dec. venous congestion, inc. tissue metabolism, dec. muscle tension |
| local application of cold... | dec. skin sensation, blood flow, capillary permeability, lymph flow, metabolic needs, and inc. muscle tension, blood viscosity |
| factors which will modify both local and systemic application of heat and cold | integrity of skin, ability to feel, diabetes, scar, peripheral vascular disease, LOC, spinal cord injury, malignancy |
| Hypoxia occurs if... | the amount of oxygen delivered to tissues is too low |
| primary functions of the heart | deliver deoxygenated blood to the lungs for oxygenation and oxygen and nutrients to the tissues |
| The nursing history includes information about the patient’s... | cough, dyspnea, fatigue, wheezing, chest pain, environmental exposures, respiratory infection, cardiopulmonary risk factors, and use of medications |
| Nursing assessment include | respiratory pattern, thoracic inspection, palpation, and auscultation for deviations from normal |
| what completes the database for a patient with decreased oxygenation | Diagnostic and laboratory tests |
| Health promotion include | vaccinations against flu and pneumonia, exercise programs, nutrition support, smoking cessation, and environmental assessment for pollutants and air quality |
| Airway maintenance requires mobilization of secretions by... | increased fluid intake, humidification, or nebulization |
| Breathing exercises improve... | ventilation, oxygenation, and sensations of dyspnea |
| Chest physiotherapy include | postural drainage, percussion, and vibration to mobilize pulmonary secretions |
| Promotion of lung expansion can be achieved by... | mobility, positioning, incentive spirometry, and chest tube insertion |
| Nasal cannulas and oxygen masks deliver oxygen therapy, which improve... | tissue oxygenation |
| what actions benefit patients with chronic pulmonary diseases | breathing exercises such as pursed-lip breathing and diaphragmatic breathing |
| why does hypoxia occur | decreased circulating blood volume, which leads to decreased oxygen to muscles, causing fatigue, decreased activity tolerance, and a feeling of shortness of breath |
| Decreased effective contraction of left side of heart leads to | back up of fluid in the lungs, increasing hydrostatic pressure and causing pulmonary edema, resulting in crackles in lung bases |
| what happens when the lung collapses? | the thoracic space fills with air on each inspiration, and the atmospheric air irritates the parietal pleura, causing pain |
| an incentive spirometer is used to | encourage deep breathing to inflate alveoli and open pores of Kohn |
| A nasal cannula delivers | precise, high-flow rates of oxygen |
| atelectasis | collapse of alveoli ta prevents normal exchange of O2 and CO2 |
| patient with COPD lose... | elastic recoil of the lungs and thorax |
| surfactant | chemical produced in the lungs to maintain surface tension of alveoli and keep them from collapsing |
| hypoventilation | occurs when alveolar ventilation is inadequate to meet O2 demand of the body or eliminate sufficient CO2 |
| patients with COPD the administration of excessive oxygen results in... | hypoventilation |
| S&S of hypoventilation | mental status changes, dysrhythmias, cardiac arrest |
| hyperventilation | ventilation which lungs remove CO2 faster than it is produced by cellular metabolism |
| myocardial ischemia | results when supply of blood to myocardium from coronary arteries is insufficient to meet myocardial oxygen demands |
| impaired gas exchange r/t dec. lung expansion AMB... | confusion, fatigue, restlessness, dyspnea, pallor, cyanosis, tachypnea |
| humidification | process of adding water to gas. keeps air moist and loosens and mobilizes pulmonary secretions |
| incentive spirometry | promotes deep breathing and prevents or treats atelectasis in the postoperative patient |
| pneumothorax | collection of air in pleural space as a result of chest trauma |
Created by:
kamia2010
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