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nur179 chap.28
| Question | Answer |
|---|---|
| normal pathway of oxygenation | nostrils, pharynx, trachea, left or right bronchus, branches into bronchioles, end in the alveoli |
| diffusion | the movement of oxygen from a high to low concentration |
| what happens when the diaphragm contracts? | the diaphragm moves downward and increase the chest cavity. this happens when you inhale |
| what happens when the muscles relax? | the chest cavity goes down and the diaphragm moves upwards and the lungs are compressed forcing air out . this happens as you exhale |
| what role does the muscles play in respiration? | diaphragm contract to create air movement in the lungs |
| what role does the nerves play in respiration ? | transmit signals from the brain to control muscle contractions |
| what role does chemicals play in respirations ? | chemicals such as carbon dioxide act as triggers to stimulate breathing |
| external respirations | occurs between the alveoli and capillaries |
| internal respirations | occurs between the bloodstream and the body cells |
| normal breaths | 12 to 20 beats per min |
| normal blood pH | 7.35 to 7.45 |
| why cant you hold your breath for a long time? | because of carbon dioxide build up |
| COPD | hold on to carbon dioxide |
| a patient with COPD | has a high level of acid, do not give a lot of oxygen |
| how much oxygen can a LPN give a patient without a physician order | 2 Liters |
| early stages of hypoxia | agitation, anxiety, changes in the level of consciousness, disorientation, headache, irritability, restlessness, tachypnea |
| late stages of hypoxia | bradycardia, cardiac arrhythmias, cyanosis, decreased respirations(bradypnea), retractions, substernal retractions |
| if a patient with a trachea has an oxygen level of 86% what do you do first? | you will suction them first |
| if a normal person has a oxygen level of 86% what do you do? | call a rapid |
| dysphagia | difficult swallowing |
| if you walk pass a room and see a patient leaned over what do you do? | check on patient and their pulse oxygen |
| what helps build up of mucus ? | drinking fluid help thin out mucus |
| if a patient is dehydrated what should you not do? | do not give saline |
| excursion | to determine if each side of the chest are moving equally |
| how do you check for crepitus? | you feel |
| stridor | high pitched breathe sound. crowing harsh high pitched |
| crackles | bubbling, cracking, popping, Velcro pulling apart may resemble the sound made by rubbing strands of hair together |
| rhonchi | snoring, rattling, gurgling, squeaking |
| where can you check oxygen saturation ? | forehead, toe, finger, earlobe |
| hypoxia | without enough oxygen in the tissues |
| hypoxemia | oxygen level drop below normal range |
| assessing a respiration assessment | inspect, palpate, and auscultate |
| assessing respiratory status you check | color of skin and mucus membrane, respiratory effort, cough, chest appearance, oxygenation status, oxygen saturation |
| darker skin tone | depend more on the color of the mucus membrane |
| exertional dyspnea | if a patient have to stop and rest or catch their breath when ambulating a brief distance, the patient short of breath |
| air hanger | gasping respirations |
| clear or white sputum | indicate viral infection |
| yellow or green sputum | indicate bacterial infection |
| rust-colored sputum | presence of blood and seen in pneumonia and tuberculosis |
| grey or black sputum | indicate inhaled smoke or soot |
| pink and frothy or bubbly sputum | indicates life threatening condition pulmonary edema |
| skin pulling upward as patient inhale | a late sign of hypoxia |
| difference in cheat wall movement indicates serious problems such as | airway obstruction, pneumothorax, or pleural effusion |
| pleural effusion | fluid in the chest cavity |
| pneumothorax | occurs when air have gotten into the pleural space aka the pleural cavity, where its suppose to be negative pressure |
| tension pneumothorax | a life-threatening type of pneumothorax |
| kussmaul | abnormal deep and rapid respirations |
| cheyne-stokes | cyclic breathing; start very shallow then increase with a period of apnea |
| biots | breaths of equal depth with a period of apnea |
| oxygenation status | determine the patients orientation to time , place, and person not any minor changes which can indicate hypoxia |
| arterial blood gases | drawn from an artery not a vein |
| arterial blood gases collection | insert into artery at 90 degree, no vacuum tube is used |
| how to transport a ABG collection | syringe is transported to the lab in a bag or cup containing icy water called slurry to keep it cold if not tested within 20 minutes |
| what do ABGs measure | the pH, partial pressure of oxygen, carbon dioxide, bicarbonate, and the oxygen saturation of arterial blood. |
| PaO2 | partial pressure of oxygen |
| PaCO2 | carbon dioxide |
| HCO3 | bicarbonate level |
| SaO2 | oxygen saturation |
| pulmonary function test (PFT) | to determine lung capacity, volume, and flow rate. diagnosis such as COPD and asthma |
| peak flow | to measure the amount of air that can be exhaled with force using a peak flowmeter. help determine the effectiveness of medications |
| chest X-ray | to visualize lung fields. air appears black to determine if all lobes are filling with air . fluid dense tissue, and infiltrate appear white. help identify tumor, pneumonia, infiltrate, and effusion |
| bronchoscopy | to visualize trachea and bronchi and obtain biopsies of abnormal tissues.. help to diagnose lung conditions such as interstitial disease |
| nursing intervention for patients with impaired oxygenation | turn, cough, and deep breathe every 2 hours. if patient has an abnormal or chest incision encourage them to hold a pillow against incision while taking deep breaths |
| huff coughing | cough during exhalation at least 3 times |
| incentive spirometry | a device used to take frequent deep breaths (inhalations) |
| chest physical therapy (CPT) | help drain mucus from the lobes of the lungs |
| postural drainage | positioning the patient in ways to specifically drain each lobe of the lungs |
| right and left upper lobes are best drained in what position | orthopneic and high fowlers position |
| middle lobes are best drained in what position | trendelenburg position with patient laying in the right lateral position and then the left lateral position |
| lower lobes are best drained in what position | trendelenburg position with patient laying in the left semi-prone and right semi- prone position and then lie in the prone position |
| percussion | refers to cupping or clapping over the lung fields to loosen mucus. this is done by clapping your hands against the rib cage and pausing to let the patient cough as needed |
| room air contains how much oxygen | 21% |
| patients with chronic lung disease keep supplemental oxygen and what level unless otherwise ordered | 3L/min |
| nasal cannula | 1-6L/min |
| simple face mask | 5-10L/min |
| partial rebreathing mask | 6-15L/min |
| nonrebreathing mask | 6-15L/min |
| venturi mask | 24%-80% |
| tracheostomy collar | 4-10L/min |
| how to conserve energy during bathing | place a nonrusting chair or bench in the shower and use a terrycloth robe |
| how to conserve energy for nutrition | use pulmocare: a high fat/low carbohydrate or similar meal supplements to increase protein and calories w/o light carbohydrate intake |
| bilateral positive airway pressure machine | delivers oxygen and air into the lungs through pressure |
| bilateral positive airway pressure machine is best used | at night to come people who have severe sleep apnea |
| oropharyngeal airway | a medical device used to hold the tongue so that that it cannot obstruct the airway of an unconscious person |
| nasopharyngeal airway | designed to be inserted through the nose into the pharynx aka the nasal trumpet |
| yankauer suction catheter or tonsil tip suction tube | used to suction secretions from the throat |
| endotracheal airways | may be inserted through the nose or mouth, short term, contain a inflatable cuff to prevent air from leaking out |
| tracheostomy | an incision into the trachea that is held open with a tube to promote breathing, long term |
| outer cannula with it w/o cuff | cuff is inflated to prevent air leaking when pt is on a ventilator |
| obturator | fits inside the outer cannula and form a smooth end for inserting the tracheostomy tube, then is removed after tube is in place |
| inner cannula | inserted after the obturator is removed may or may not be disposable . is this where mucus is collected |
Created by:
natre