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NP Ch 28 CCC 105

NP Ch 28 Respiration and Oxygen CCC PN105

Lobes in L lung 2 lobes
Lobes in R lung 3 lobes
Function of upper airways carry air to and from lungs
Function of cilia/mucous membranes trap and remove foreign particles in respiratory tract
Function of alveoli contain microphages that phagocytize inhaled bacteria
Hypoxemia decreased amount of oxygen in the blood (at a cellular level)
Main causes of hypoxemia obstruction of airway and restriction of thoracic cage
Obstructions of airway tongue, mucous, foreign body, aspiration, vomitus, burns, COPD, drowning
Restriction of thoracic cage chest injury, flail chest, pneumothorax, extreme obesity, diseases
Central cyanosis blue tongue/mucous membranes; very serious
Signs of hypoxemia, early confusion, restlessness, irritable, dyspnea, tachypnea, stridor
Signs of hypoxemia, late cyanosis, muscle retractions, dysrhythmias, hypotension, acid-base disturbance, decreased O2 sat
Pulse ox measures hgb in blood
Normal range for pulse ox above 90%
Pulse ox rotation q4h or disposable change q24h
Nasal cannula plastic tube with curved pronges that is held in place by looping it over the ears and cinching under the chin
Benefits of nasal cannula patient can still talk, move, and eat with receiving oxygen
Oxygen colorless, tasteless, odorless gas present in the air
Oxygen administration used to supplement oxygen in inspired air
Inspired air is _____% oxygen 21%
Delivery systems for oxygen administration nasal cannula, mask, tent, croupette, catheter
Administered oxygen requires humidification
Common oxygen flow rate 4-6L, prescribed by physician
COPD oxygen flow rate 2-3L to prevent respiratory arrest
Oxygen mask used for oxygen concentrations ranging from 24%-55% at flows 3-7L/min
Oxygen concentration above 60% rarely used because danger of toxicity
Oxygen artificial airways, nasopharyngeal and oropharyngeal keeps the tongue from falling back into the throat
Before giving oxygen, you must check flow meter check for oxygen passing through delivery system
Tracheostomy, temporary or permanent surgical opening intot he trachea to facilitate insertion of a cuffed tube
To clean tracheostomy 1/2 strength peroxide and saline to wash; saline to rinse; clean prior to deflating cuff
How often to clean tracheostomy q8h or more if secretions blocking airway
Aseptic suctioning for patients unable to clear secretions from their own airway effectively
Types of aseptic suctioning nasopharyngeal and oral
Instrument to perform aseptic suctioning 14-16 Fr suction catheter or Yankauer suction tip
Negative pressure setting for aseptic suctioning 80-120mm/Hg
Nasopharyngeal aseptic suctioning used most often for infants, gravely debilitated, or unconscious patients, and patients with an ineffective cough
Tracheobronchial sterile suctioning most often performed on intubated patients or patients with tracheostomy
Directions for tracheobronchial sterile suctioning Preoxygenation for patients, short period of time, hold with dominant hand using sterile gloves
Time for tracheobronchial sterile suctioning no longer than 10 seconda at a time with oxygenation in between
Chest drainage tubes used to remove air from patient with a pneumothorax or hemothorax or after chest surgery
Nursing Role in airway support maintain airway; turn patients; encourage cough/deep breathe q2h when in bed; splilnt wiht pillow to help deep breathe/cough; encourage use of incentive spirometer
Incentive spirometer ball moves upward when patient takes deep breath, amount of air is measured so results are visible to user
First signs of hypoxia restlessness, irritability, confusion
How to use incentive spirometer patient strives to reach certain colume of air and hold it for 3 seconds, taking 10 slow deep breaths every hour when awak
Huff coughing deep breath through nose, hold 3-5 sec, exhale pursed lips, another deep breath and short segmented forcible exhaled open mouth coughs for 1/3 expiratory volume with each cough
Heimlich maneuver can person speak, place hands halfway between xiphoid process and umbilicus with thimb of fist inward, forcefully thrust hands into abdomen using upward rotating motion, repeat until clear or unconscious
Types of oxygen masks simple, partial rebreathing, non-rebreathing, venturi
Simple mask low to medium oxygen concentrations 40-60%, liter flow above 5L/min
Partial rebreathing mask higher concetrations oxygen 60-80%, reservoir bag must stay inflated at all times
Non-rebreathing mask higest concentration of oxygen 80-95%, reservoir bag must stay inflated at all times
Venturi mask constant flow of oxygen regardless of breathing pattern, concentration marked on apparatus, 24-50% available
Nasal prongs (nasal cannula) low concetraion of oxygen, dependent on rate and depth of person breathing, 24-44%
Tracheostomy collar and T-bar (Briggs adapter) oxygen and humidification delivery, must be connected to nebulizer, flow set on nebulizer
Drainage systems drain air or fluid from pleural space and prevents being sucked back into chest
Water-seal drainage system there should be constant bubbling in suction chamber
Normal respiratory rate 12-20 breaths/min
Created by: cmp12345