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NP Ch 28 CCC 105
NP Ch 28 Respiration and Oxygen CCC PN105
| Question | Answer |
|---|---|
| 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
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