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SOPN FON OXYGENATION
| Question | Answer |
|---|---|
| Circulation of heart to the lungs | Cardiopulmonary Circulation |
| Pumping action of the heart - is essential to deliver oxygen via the blood | Myocardial Pump |
| Decrease pump effectiveness causes: | Decrease oxygen delivery |
| Arteries which directly supply heart with blood and oxygen | Coronary Arteries |
| Amount of blood ejected from left ventricle each minute | Cardiac Output |
| Normal Cardiac Output | 4-6 liters/minutes at rest |
| Amount of blood ejected from left ventricle after each contraction | Stroke Volume |
| Amount of volume to be ejected by left ventricle. | Preload |
| Amount of resistance the left ventricle has to pump against | Afterload |
| Affects blood flow to lungs. | Contractility of heart |
| Affects blood flow to heart and lungs | Heart rate |
| Electrical impulses from part of the Central Nervous System (CNS) | Autonomic Nervous System (ANS) |
| Most often heard at lung bases, high-pitched fine crackling sound during ispiration. Does not clear with cough. | Crackles |
| Course low pitched rumbling sounds, may clear with cough | Rhonchi |
| High-pitched continuous musical like sound, a squeak heard during ispiration or expiration. Doesn't clear with cough. | Wheezes |
| Increase heart rate and blood pressure. | Sympathetic Nervous System |
| Sympathetic Nervous System: Main neurotransmitter | Epinephrine/Adrenaline |
| Decreases heart rate: | Parasympathetic Nervous System |
| Parasympathetic Nervous System: Main neurotransmitter | Acetylcholine |
| Both Sympathetic and Parasympathetic Nervous Systems send impulses to the heart via: | Sinoatrial Node (SA Node) |
| Pacemaker of the heart. Is located in the right atrium of the heart | Sinoatrial Node (SA Node) |
| Nervous System: mediates impulse, transmission between atrial and ventricle | Atrial Ventricular Node (AV node) |
| Nervous System: located in ventricles | Perkinjie Fibers |
| Respiratory: The mechanical process of moving gases in and out of the lungs | Ventilation |
| Respiratory: Amount of elasticity, needed for proper ventilation | Compliance of lungs |
| Respiratory: diseases which cause pulmonary edema ( lungs too full of fluid) | Fibrosis and COPD |
| Respiratory: Amount of blood flow to the lungs | Perfusion of lungs |
| Respiratory: Small air sacs of lung, where oxygen is exchanged from O2 ---lungs and CO2 to air | Alveoli |
| Respiratory: Movement of molecules from an area of high concentration to an area of low concentration. | Diffusion |
| Respiratory: Collapsed lung | Pneumothorax |
| Respiratory: Removal of a lung | Lobectomy |
| Respiratory: Transport 97% of O2 to tissues of the body | Hgb |
| Respiratory: 3% dissolved directly in plasma | Hgb |
| Respiratory: Hgb combines with O2 to form | Oxyhemoglobin |
| Oxygenation: Decreased pumping action = decreased blood circulation to lungs | Cardiac Disorders |
| Oxygenation: Decreased blood volume = decreased O2 from shock, severe dehydration | Hypovolemia |
| Conditions which affect chest wall movement. Affects tissue oxygenation. | Pregnancy, Obesity, Muscle diseases and other abnormalities |
| Conditions which affect chest wall movement | Nervous system diseases, trauma or disease to respiratory center |
| Nervous system diseases: impairs nervous & muscular control: | Myasthenia, Graves disease, Gillian Barre Syndrome, Polio, Multiple Sclerosis (MS) |
| Trauma or diseases to respiratory center in the medulla oblongata affects: | Neural control, and abnormal breathing patterns can develop |
| C3 to C5 fracture of spinal cord causes: | Paralysis of nerves which inervate muscles of respiration |
| Diaphragm does not descend: | Phrenic nerve damage |
| Decreased inspiratory lung volumes | Hypoxemia |
| Lifestyle risks which increase risk of cardiopulmonary problems: | Unhealthy diets, Lack of exercise, Smoking, Substance/ETOH abuse |
| Increased fat, calories, causes obesity, and artherosclerotic disease: | Unhealthy diet |
| Increase work of breathing at rest, | Lack of exercise |
| Increases risk of heart disease, COPD, and lung CA | Smoking |
| Depresses the respiratory center | Substance/ETOH abuse |
| Increase rate and depth to meet body's need for additional oxygen and to rid the body of CO2 | Excercise |
| Pain alters rate and rhythm of respirations, breathing becomes shallow. May inhibit or splint chest wall movement when pain is in area of chest or abdomen | Acute Pain |
| Increases rate and depth as a result of sympathetic stimulation | Anxiety |
| Changes the lung's airways, resulting in increased rate of respirations at rest | Smoking |
| Body positions: A straight errect posture promotes: | Full chest expansion |
| Body positions: A stooped or slumped position impairs: | Ventilatory movement |
| Body positions: Lying flat prevents: | Full lung expansion |
| Medications: Depress rate and depth of respirations: | Narcotic analgesics, general anesthetics, and sedative/hyponotics |
| Medications: May increase rate and depth of respirations | Amphetamines and cocaine |
| Medications: Slow rate of respirations by causing airway dilation | Brochodilators |
| Injury to the brainstem impairs the respiratory center and inhibits respiratory rate and rhythm | Neurological injury |
| Decrease hemoglobin levels reduces oxygen carrying capacity of the blood, which increases respiratory rate | Hemoglobin Function (Anemia) |
| Abnormal blood cell function, reduces the ability of hemoglobin to carry oxygen | Sicke Cell |
| Exposure to environmental hazards: smog, asbestos | Increased risk of respiratory disease |
| Increased CO2 levels: | Hypercapnia |
| Ventilation in excess of body needs, increased respiratory rate | Hyperventilation |
| Causes of Hyperventilation: | Anxiety, infection, drugs, acid base imbalances |
| Lack of O2 at tissue cell level, especially from pulmonary embolus and shock | Hypoxia |
| Signs and symptoms of hyperventilation: | Tachycardia, SOB, dizziness & kightheadedness, numbness, tinnitus, disorientation, chest pain, decreased concentration, tetany, muscle spasms |
| Rapid heart beat | Tachycardia |
| Ringing in ears | Tinnitus |
| Inadeqequate to meet the O2 needs of the body, or not enough to eliminate excess CO2 | Hyperventilation |
| Hypoventalation causes: | Atelectasis |
| Collapse of alveoli | Atelectasis |
| O2 sat of 99% very dangerous for patients with | Ateletasis |
| Signs & Symptoms of hypoventilation: | Dizziness, disprientation, headache, lethargy, coma, & convulsions, heart arrythmias, cardiac arrest |
| Inadequate tissue O2 at cellular level | Hypoxia |
| Hypoxia causes: | Decreased Hgb levels, decreased in inspired O2 & impaired ventilation, inability of tissues to extract O2 from blood, inability of alveoli to perfuse O2 to blood |
| Signs and symptoms of hypoxia: | SOB, dyspnea, apprehension, behavior changes, heart arrythmias, dizziness, tachycardia, tachypnea, restlessness, decreased level of consciousness, cyanosis |
| Pain, most often on left side of chest, and may radiate (pressure) to left arm. Different for men and Women | Cardiac Pain |
| Cardiac pain in men: | Sub sternal & radiates to left arm & jaw |
| Cardiac pain in women: | Epigastric pain, c/o indigestion, chocking feeling, & dyspnea |
| Sharp, knife like pain, worse with inspiration | Pleural pain |
| Difficult breathing | Dyspnea |
| Need pillows, can't breathe while laying flat in bed | Orthopnea |
| High pitch squeeky (musical sound) movement of air through a narrow airway | Wheezing |
| Bloody sputum: | Hemoptysis |
| Blood in vomitus: | Hematemesis |
| Before administering flu shot the nurse should: | Check allergies to eggs, chicken, or feathers |
| Pneumonia vaccine given every: | 5 - 10 years or greater |
| TB Test: | Mantoux test |
| Position of bed for patients with dyspnea | High Fowlers |
| Medications which manage dyspnea: | Bronchodilators,steroids, Mucolytics, anti anxiety drugs |
| Loosen mucus: | Mucolytics |
| Helps loosen respiratory secretions and used for Tylenol overdose | Mycomyst |
| Used for the relief of anxiety: | medication, relaxtion techniques, teach pursed lip breathing. |
| Deep inspiration with prolonged expiration through pursed lips | Pursed lip breathing |
| ABG: | Arterial Blood Gas - (put on ice) |
| Maintaining a patent airway: | When trachea, bronchi and large airway free from obstuction |
| Removes secretion from upper and lower airways via deep inhalation do at least every two hours while awake | Deep breathing and coughing techniques |
| Used when unable to clear respiratory secretions with coughing: | Suctioning techniques |
| Suctioning: Patient able to cough effectively, but enable to clear secretions by expectorating or swallowing secretions | Oro/nasopharangeal |
| Suctioning: Trachea is sterile: To suction deep use: | Strict Sterile Tecnique |
| Suctioning: After suctioning oro/ nasal | Oxygenerate with 100% O2 for a few minutes |
| Tube from mouth or nose to trach | Endotracheal tube |
| The last part to be suctioned: | The mouth: always suction mouth last, clean technique |
| Suctioning: Endo/trach | Use sterile technique - pre & post oxygenate 10 - 15 seconds |
| Artificial airway (via mouth or nose, short term, emergency At bedside for mechanical assistance to maintan airway patency | Endotracheal tubes |
| Artificial airway by surgical incision into trachea for airway. | Tracheal tube |
| To clean Tracheal tubes: | Hydrogen peroxide and sterile normal saline |
| Suctioning: Use fresh catheter every time | Open suction |
| Suctioning: Use multiply times, catheter enclosed in plastic sheath , and used 24 - 48 hours, usually vented. Permits continous delivery of O2 | Closed suction |
| Hydration: Nurse should encourage patient to: | Drink fluids |
| Encouraging Fluids: | Removes mucus and cellular debris from respiratory tract. Prevents thickening of pulmonary secretions |
| Hydration: The amount of fluids patient should be drinking | 1500 - 2000 ml daily unless contraindicated |
| Humidification: If receiving oxygen therapy, need to use: | A Bubbler to humidify oxygen Especially > 4 liters. Use water humidfication. |
| Nebulization used to deliver medcations, such as: | Albuterol and Atrovent |
| Most respiratory patients need HOB at: | Least 45 degrees ( Fowlers) because it decreases pressure from the abdomen |
| Position of bed with Exacerbation of COPD: | High Fowlers |
| Includes percussion, vibration, and postural drainage | Chest Physical Therapy |
| With cupped hands, alternately percuss on back ( surface of chest wall) over one layer of clothing - not on bare skin | Percussion |
| A fine shaking pressure applied to chest wall. Only during exhalation. Shakes secretions off chest wall, to be moved around during percussion | Vibration |
| Position technique to draw secretions from specific segments of lung | Postural Drainage |
| Promotes drainage of secretion from lung fields | Postural Drainage |
| Removes air or fluids from the pleural space of the lungs. Used after chest surgery and chest trauma | Postural Drainage |
| Collapse of lung from air | Pneumothorax |
| Collapse of lung from blood and or fluid accumulation between the parietal layer of lung and the visceral layer | Hemothorax |
| Requires an MD order | O2 |
| When administering oxygen the nurse needs to monitor: | For irritation to oral and nasal mucosa, mucous membranes, check back of ears for breakdown, apply protection pads to ears. |
| Position of patient with unilateral disease: | Position with healthy lung down, better perfusion of health lung, increased O2 |
| Position of patient with abscess or hemorrhage: | Position with affected lung down, to prevent drainage toward health lung |
Created by:
betty boop
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