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Fund - Module 7
Fundamentals Exam 3 - Respiratory
| Question | Answer |
|---|---|
| What does oxygenation of body tissues depend on? | 1. integrity of airway system to transport air to and from lungs 2. adequate alveolar system in lungs to oxygenate and remove CO2 from blood 3. adequate CV system & blood supply to carry nutrients and wastes to and from body cells |
| what is the importance of the alveoli? | site of gas exchange |
| what are components of the upper respiratory tract? | nose, sinuses, mouth, pharynx, and larynx |
| what are components of the lower respiratory tract? | trachea, bronchi, bronchioles, and lungs |
| what is the pleura? | serous membrane lining the lungs and thoracic cavity |
| pulmonary ventilation | movement of air into and out of lungs; inspiration and expiration |
| what are facts affecting pulmonary ventilation? | condition of musculature, lung tissue compliance, and airway resistance |
| respiration | gases exchanged between air and blood via diffusion that occurs at terminal alveolar capillary system |
| what are factors affecting respiration? | available surface area, thickening of alveolar- capillary membrane, partial pressure |
| perfusion | oxygenated capillary blood passing through body tissues |
| what are factors affecting perfusion? | blood flow, blood supply, activity level, properly functioning CV system |
| where is the respiratory center located? | medulla in the brainstem |
| Problems in ventilation, respiration, or perfusion may result in _____? | hypoxia (hypoxemia) |
| s/sx of hypoxia | dyspnea, increase respiratory rate, tachycardia, pallor, anxiety, confusion, hypertension, cyanosis, restlessness, drowsiness |
| factors affecting cardiopulmonary functioning and oxygenation | level of health, developmental stages, medications, lifestyle, environment, psychological health |
| level of health | cardiac & renal disorders, muscle wasting/poor muscle tone, anemia, MI, scoliosis, obesity |
| developmental considerations (older adults) | less elasticity of tissues & airways of respiratory tract, reduced power of respiratory & abdominal muscles, decline in maximum inspiration & expiration, decreased heart functioning |
| sedentary lifestyle | decreased heart, lung, and muscle fitness |
| active lifestyle | increased heart, lung, and muscle fitness |
| cigarette smoking | causes lung and heart disease, respiratory distress, and lung cancer |
| social determinants of health | high correlation b/w air pollution and lung diseases |
| what does exposure to air pollution cause? | chocking, coughing, dizziness, headache, stinging of eyes and nasal passages |
| what are examples of air pollution substances? | asbestos, silica, coal dust, radon, radiation, arsenic |
| what does hyperventilation cause? | lowered level of arterial carbon dioxide |
| what is the first step in assessing the respiratory system? | assure that the patient is not in acute distress: airway, breathing, circulation |
| inspection | LOC, skin, mucous membranes, circulation, nostrils, muscles, chest structure (convex, kyphosis, barrel chest), movement, respiratory rate/rhythm/depth |
| palpation | skin temperature and chest expansion, masses, edema, pulsations, vibrations, point of maximal impulse, capillary refill |
| percussion | position of lungs, density of lung tissue, changes in lung tissue |
| auscultation | air flow through respiratory passages and lungs, breath sounds, adventitious sounds, CV sounds |
| promoting optimal function | healthy lifestyle (weight, diet, exercise, blood pressure), vaccinations (influenza, pneumococcal), reducing anxiety, pollution free environment |
| what should you teach your patient regarding nutrition and the respiratory system? | decrease saturated fats, cholesterol, sodium, and sugar increase fiber, protein, vitamins, and minerals limit alcohol intake encourage frequent meals, oral hygiene, and rest periods |
| what position should the patient be in when experiencing dyspnea or orthopneia? | high fowlers |
| what position is common when patients are acutely ill? | prone |
| what should the patient know about humidified air? | inhaling dry air removes normal moisture in respiratory passages that protect against irritation and infection |
| deep breathing | used to overcome hypoventilation |
| instructions for deep breathing | breathe deeply enough to move bottom ribs, inhale through the nose and exhale through the mouth, completed hourly while awake |
| incentive spirometry | visual reinforcement for deep breathing; slow deep breaths to sustain maximal inspiration; maximizes lung inflation and prevents atelectasis |
| pursed lip breathing | creates smaller opening for air movement to slow and prolong expiration |
| diaphragmatic breathing | reduces respiratory rate, increases alveolar ventilation, and helps expel as much air as possible during expiration |
| chest physiotherapy | percussion, vibration, postural drainage |
| percussion | use of cupped palm to loosen secretions for expectoration; strike over lung lobes for 1-2 minutes |
| vibration | use of manual compression and tremor on chest to loosen secretions for expectation |
| postural drainage | use of gravity to drain secretions from smaller pulmonary branches into larger ones for expectoration; preform for 10-15 minutes 2-3 times a day |
| what is the function of suctioning? | to maintain a patent airway by removing saliva, pulmonary secretions, blood, vomitus, and foreign material |
| what are the complications of suctioning? | infection, cardiac dysrhythmias, hypoxia, mucosal trauma, atelectasis, and death |
| what should a nurse consider when providing suctioning? | it is an uncomfortable procedure, increase supplemental oxygen prior to and during procedure, apply suction intermittently while withdrawing the catheter |
| when should you stop suctioning immediately? | cyanosis, excessive bradycardia or tachycardia, sudden bloody secretions |
| nebulizer | dispenses fine particles of liquid medication into deeper passages of respiratory tract |
| metered dose inhaler (MDI) | delivers controlled dose of medication with each compression of canister |
| dry powder inhaler (DPI) | flow of medication activated by deep breath |
| what are nursing considerations for oxygen therapy? | it is considered a medication and required an order from a health care provider, ordered in liter per minute |
| what is the exception in giving supplemental oxygen? | low flow oxygen (2 LPM via nasal cannula) if patient is in distress |
| what should you know about giving supplemental oxygen to a patient with chronic lung disease? | excessive oxygen may cause patient to stop breathing |
| what is the oxygen constitutes of normal or room air? | 21% |
| what is FiO2? | oxygen level inhaled by or delivered to patient; the concentration of oxygen a patient inhales |
| how much does the FiO2 increase when giving 1 L of supplemental oxygen? | about 4 % |
| why is humidification used when providing supplemental oxygen? | humidification is used when providing more than 4 LPM because oxygen dries and dehydrates mucous membranes |
| what are fire and injury prevention strategies that are important when providing supplemental oxygen? | avoid open flames, synthetic fabrics that build up static, oils; place "no smoking" signs; check status of electrical equiptment |
| when is home oxygen used? | if patient is unable to maintain SpO2 greater than 88% |
| what are oxygen toxicity s/sx? | nonproductive cough, substernal pain, N/V, fatigue, dyspnea, restlessness, paresthesia's |
| what nursing actions should you take in a patient with oxygen toxicity? | use the lowest amount of O2 to maintain adequate SpO2, monitor ABG's |
| how does oxygen induced hypoventilation occur? | clients who have conditions that cause alveolar hypoventilation can be sensitive to the administration of O2 (COPD) |
| what nursing actions should you take for a patient with oxygen induced hypoventilation? | monitor RR and pattern, LOC, behavior, and SpO2; use lowest amount of O2 flow rate, notify the provider of respiratory distress |
| oropharyngeal airway | semi-circular plastic tube inserted into back of pharynx through mouth in spontaneously breathing patient; keeps tongue and secretions clear of airway and often used for postoperative patients until consciousness regained (stimulates gag refelx) |
| nasopharyngeal airway | semi-circular rubber tube inserted into back of pharynx through nose in spontaneously breathing patient and allows for frequent nasotracheal suctioning; may be left in place in alert and conscious patient (does not stimulate gag reflex) |
| tracheostomy | artificial opening made into trachea; tracheostomy tube inserted through opening |
| what are indications for a tracheostomy? | replace endotracheal time, mechanical ventilation, bypass upper airway obstruction, remove tracheobronchial secretions |
| outer cannula | remains in place in trachea |
| inner cannula | removed for cleaning or replaced with a new one |
| tracheal suctioning | preformed using sterile technique in hospital by passing catheter through tracheostomy; suction catheter should be small enough not to occlude airway but large enough to remove secretions |
| nasal cannula | flow rate: 1-6 LPM FiO2: 24-44% |
| nasal cannula nursing considerations | indicated for patients with minor breathing problems; keep prongs in patient's nares - easily dislodged |
| oxymizer | similar in design to a nasal cannula but has an oxygen reservoir that doubles the oxygen liter flow rate; 1 L increases FiO2 by about 8% |
| face mask | flow rate: 6-8 LPM FiO2: 40-60% |
| face mask nursing considerations | indicated for patients requiring moderate flow rate for a short period of time; do not use LPM less than 6 due to CO2 buildup in mask |
| partial rebreather face mask | flow rate: 6-11 LPM FiO2: 60-75% allows patient to rebreathe up to 1/3 of exhaled air together with room air |
| partial rebreather face mask nursing considerations | indicated for patients requiring higher concentrations of oxygen; keep reservoir bag from deflating completely by adjusting oxygen flow rate to keep reservoir bag 1/3 to 1/2 full of air on inspiration |
| nonrebreather face mask | flow rate: 10-15 LPM FiO2: 80-95% prevents rebreathing expired air and inhalation of room air |
| nonrebreather face mask nursing considerations | indicated for patients requiring high flow rates and high concentrations of oxygen; do not allow reservoir bag to deflate because the patient will breathe in large amounts of healed CO2; keep reservoir bag 2/3 full of air |
| venturi mask | flow rate: 4-12 FiO2: 24- 50% |
| venturi mask nursing considerations | indicated for patients requiring specific concentration of oxygen; most accurate and precise form of oxygen delivery; best for patients with chronic lung disease and COPD; humidification not required |
| face tent | flow rate: at least 10 LPM FiO2: 24-100% |
| face tent nursing considerations | indicated for patients following nasal/oral surgery; difficulty to control concentration of oxygen administered since actual concentration of oxygen depends on rate and depth of pt's respirations |
Created by:
ballen9519
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