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Ch 41
Oxygen needs
| Question | Answer |
|---|---|
| dr prescribes the ________ of O2, ______ used, and _______for therapy | amount, devices, times |
| O2 is a _____________ | medication |
| O2 can be used all the time or prn t/f | t |
| before assisting with O2: | 1)know provincial policies 2)within scope of practice 3)necessary training 4)how to use equipment 5)review task w/ rn 6)have supervision |
| for cells to get O2, the _________ and __________ system must be working properly | cardiovascular, respiratory |
| any surgery, disease or injury involving the R or cardio system can affect the bodys ability to absorb O2 t/f | t |
| function of R system involves: | 1)air moves into/ out of lungs 2)O2/ CO2 exchanged in alveoli 3)blood transports O2 to cells/ removes CO2 |
| a client with altered R function is SOB or SOBOE and this prevents ____________ easily | breathing |
| altered R function can be _________ or ______________ | acute, chronic |
| orthopnea | SOB in supine; can breath easily standing/ sitting |
| never turn up the oxygen tank if the care plan does not direct you to t/f | t |
| factors affecting O2 needs inc: | 1)R system function 2)cardio system function 3)RBC count 4)NS function 5)aging 6)exercise 7)fever 8)drugs OD 9)smoking 10)allergies 11)pollutant exposure 12)nutrition 13)alcohol |
| patent | airway being open |
| signs and symptoms of altered R function inc: | 1)hypoxia 2)abnormal breathing pattern 3)cough 4)SOB 5)sputom 5)noisy R 6)chest pain 7)cyanosis 8)VS shifts 9)body position changes |
| typical R rate is _____ to _______ per min | 12,20 |
| eupnea | normal respirations |
| tachypnea | rapid breathing (24+/ min) causes; fever, exercise, pain, airway obstruction, hypoxmia |
| hypoxemia | below normal level of O2 in blood |
| bradypnea | slow breathing (-12/min) causes; OD, NS disorder |
| apnea | lack of breathing. occurs in cardia arrest/ R arrest. eg; sleep apnea, newborn periodic apnea. |
| kussmaul R | deep, rapid R characteristic of diabetic acidosis |
| hypo ventilation | slow, shallow (sometimes irregular) R. causes; lung disorders affecting alveoli, obesity, airway obstruction, drug side effects, NS/ MKS disorders affecting R muscles |
| hyperventilation | rapid and deeper than typical R. causes; asthma, emphysema, infection, fever, NS disorder, hypoxia, anxiety, pain, some drugs |
| dyspnea | difficult laboured/ painful breathing. causes; heart disease, exercise, anxiety |
| cheyne stokes | R that gradually increase in rate/ depth then become shallow/ slow. apnea may happen (20-30 secs) causes; OD, heart failure, renal failure, brain disorder, death is near |
| hypoxia | deficiency of O2 in cells. life threatening condition |
| hypoxia causes inc: | 1)illness 2)disease 3)injury 4)surgery |
| early signs of hypoxia inc: | 1)restlessness 2)dizziness 3)disorientation/ confusion 4)fatigue 5)anxiety 6)increased P, R (depth/ rate) |
| some signs of hypoxia inc: | 1)personality/ behaviour changes 2)difficulty concentrating/ following direction 3)apprehension 4)cyanosis 5)dyspnea |
| breathing is usually easier in _____________ or ________________ position | semi fowlers, fowlers |
| orthopneic position | sitting up and leaning over table |
| if a client is not repositioned at least every 2 hrs, lungs cannot expand on one side, secretions could pool at bottom of lungs t/f | t |
| coughing removes ___________ from lungs and deep breathing moves _______ into most parts of the lungs | mucus, air |
| ___________ and ____________ exercises are done after surgery and during BR regardless of clients reluctance due to pain | coughing, deep breathing |
| atelectasis | complete or partial collapse of entire lung or area (lobe) of lungs due to mucus collecting, mucus is attracted to mucus preventing lungs from expanding properly |
| coughing and deep breathing can prevent _____________ and ______________ | pneumonia, atelectasis |
| risk factors for atelectasis inc: | 1)postsurgical BR 2)BR 3)lung disease 4)paralysis |
| never wear powders or apply powders to clients who have altered R functioning t/f | t |
| open windows or use a fan to increase air circulation when caring for a client with altered R function t/f | t |
| never use oil or grease based lip lubricants as they are combustible t/f | t |
| in the winter increase humidity in air by using a humidifier or laying pans of water near heat sources t/f | t |
| report and record these observations after assisting a client with coughing and deep breathing: | 1)number of times client coughed/ took deep breaths 2)how well tolerated |
| incentive | provides encouragement |
| spirometer | machine that measures amount of air inhaled |
| incentive spriometer | machine with flat disk, ball or bar that moves to show client air movement, client inhales as deeply as possible then breath is held for 3 secs |
| incentive spriometer is also referred to as a ________________ | sustained maximal inspiration (SMI) |
| a PSW does not _________ O2 | give |
| a portable O2 tank is also referred to as a__________ | stroller unit |
| a _____________ or ____________ are responsible for starting and maintaining a clients O2 therapy | nurse, R therapist |
| three main sources of O2 inc: | 1)oxygen concentrator 2)oxygen cylinder 3)liquid oxygen system |
| oxygen concentrator | makes oxygen by taking room aor and filtering out O2 |
| oxygen cylinder | tank of compressed O2. uses a gauge to show how much O2 left |
| liquid oxygen system | store O2 in liquid form.kept in reservoir, stationary unit filled there and can last up to 8 hrs. gauge show amt left. ca freeze skin, do not touch, |
| oxygen conserving devices | help reduce waste so )2 supply lasts longer, cut down on cylinders needed delivered |
| ___________, ______________ and _______________ are responsible for teaching client and family about O2 safety | dr, n, R therapist |
| O2/ fire safety guidelines: 1)no smoking signs 2)remove smoking/ igniting/ static electricity material | 3)keep away from heat sources/ open flames 4)turn off electric items before unplugging 5)only use in good repair electrical items 6)location of fire extinguishers known 7)turn off then remove client in case of fire 8)remind client of safety guidlines |
| safety guidelines for O2 therapy: 1)never remove the device (cannula, mask)used to admin O2 2)report of client removes device 3)ensure device secure, not tight 4)prevent skin irritation 5)clients face dry/ clean | 6)never shut off 7)do not adjust flow 8)report high/ low flow rate 9)report bubbling humidifier 10)secure connecting tubing 11)no kinks 12)provide oral hygiene 13)mucus free 14)adequate water level maintained |
| report signs and symptoms during O2 therapy such as: | 1)hypoxia 2)R distress 3)abnormal R pattern |
| nasal cannula | used at home/ facility to admin extra O2. set of two prongs placed in nostrils and tubes fit behind ears. report signs of skin irritation/ soreness |
| flowmeter | regulates flow of O2 |
| simple face mask | covers nose/ mouth and connected to O2 source |
| partial rebreather mask | bag added to simple face mask to collect exhaled air. bag should not totally deflate during inhalation |
| nonbreathing mask | prevents exhaled air/ room air from reentering nag, allows exhaled air to leave through holes in mask. bag must not totally deflate during inhalation |
| venturi mask | allows precise amts of O2 to be given. colour coded plastic adaptors fit into mask connected to O2. each colour represent amt of O2 used. keep clients face dry/ clean as moisture can build up. nasal cannula usually used during eating |
| flow rate | O2 amt ordered by dr and administered to client. measured in L/ min. can change from 2-15. n/ R therapist sets. always check when caring for client, report too high/ low stat, n / R therapist will adjust |
| humidifier | O2 forced through distilled water allowing it to bubble and collect in tubing. never use tap water |
| distilled water | pure, sterile water that has been boiled, allowed to cool and condense |
| humidified O2 | O2 containing water vapour, less dry and irritating |
| low flow rates (1-2 L/min) by ________ usually do not need humidified O2 | nasal cannula |
| common R tests inc: | 1)chest Xray (CXR) 2)lung scan 3)bronchoscopy 4)thoracentesis 5)pulmonary function test 6)arterial blood gases (ABGs) |
| pulse oximetry | device used to measure O2 concentration in arterial blood and PR. sensor attached to finger, toe, nose, lobe, forehead |
| oxygen concentration | amt (percentage) of hemoglobin that contains O2. 95-100% typical. |
| sputum | mucus from the R system |
| sputum samples can be studied for : | 1)blood 2)microbes 3)atypical cells |
| sputum samples should be collected in the _________________ | morning |
| do not use mouth wash before collecting ____________ samples | sputum |
| types of artificial airways inc: | 1)oro pharyngeal airway 2)nasopharyngeal airway 3)endo tracheal (ET) tube 4)tracheostomy tube |
| intubation | process of inserting an artificial airway, usually plastic/ disposable and come in different sizes for different age groups |
| oro pharyngeal airway | inserted through mouth into pharynx |
| nasopharyngeal airway | inserted through nostril into pharynx |
| endo tracheal (ET) tube | inserted through mouth or nose into trachea |
| tracheostomy tube | inserted through surgical incision into trachea. made of plastic/ metal. includes obturator, inner cannula ,outer cannula |
| tracheostomy | surgically created opening through neck into trachea |
| obtrurator | inserted into outer cannula and then removed, has rounded end |
| inner cannula | inner tube; requires cleaning. maintains hygiene because it can be removed and cleaned |
| outer cannula | secured in place with ties or velcro. is not removed |
| nothing should ever enter the _________________ | stoma |
| tracheostomy care inc: | 1)cleaning inner cannula 2)cleaning stoma 3)applying ties or velcro collar |
| secretions collecting in upper airway results in: | 1)obstructing air in and out 2)environment for microbes 3)interfere with O2-CO2 exchange 4)hypoxia |
| ties of tracheostomy on a child are too loose if you can slide a whole _________ under need, only a _____________ should slide under | finger, fingertip |
| suctioning | process of withdrawing or sucking up fluids (secretions) |
| suctioning sites inc: | 1)upper airway; nose, mouth, pharynx 2)lower airway; trachea, bronchi |
| oropharayngeal route suctioning | mouth and pharynx; suction cath is passed through mouth into pharaynx |
| nasopharengeal route suction | nose and pharynx; suction cath passed through nose into pharynx |
| lower airway suctioning | done through an ET tube or tracheostomy tube |
| PSW can only operate an ____________ attached to an O2 source if its within our scope of practice | ambubag |
| suctioning cycle is usually 10 sec and inc: | 1)insert cath 2)apply suction 3)remove cath |
| suction in infants and children are applied for no more than 10 secs t/f | f; 5 secs |
| the cath is cleaned with ___________ or ______________ after use of suctioning | water, saline |
| the suction cath should not be passed more than _________ times | 3 |
| do not suction any deeper than clients ____________________ | oral cavity |
| check clients vitals _____________, _______________ and ____________ suctioning | before, during, after |
| problems resulting in severe breathing problems that may need mechanical ventilation inc: | 1)hypoxia caused by weak muscle effort, airway obstruction, damaged lung tissue 2)NS disease, injuries that effect the R centre interfering with messages between lung/ brain 3)OD that depress hypothalamus (R control centre) |
| mechanical ventilation | use of a machine to move air in/ out lungs allowing O2 to enter/ CO2 to exit |
| do not reset alarm of a mechanical ventilator t/f | t |
| chest tube | hollow plastic tube surgically inserted into the chest cavity which allows for removal of trapped air and drainage of blood/ fluid |
| pneumothorax | air in pleural space |
| hemothorax | blood in pleural space |
| pleural effusion | the escape/ collection of fluids in pleural space |
| keep drainage ___________ chest level | below |
| report _______ changes stat | vital |
| prevent tubing ___________ | kinks |
| report any changes in chest ______________ | drainage |
| note any ___________ in drainage system, report stat | bubbling |
| keep sterile ____________ gauze at bedside, its needed if chest tube comes out | petrolatum |
| call for help if ________ comes out, cover insertion with sterile petrolatum gauze, stay with client | chest tube |
Created by:
Wil.Wilson
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