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Principles

Resp. Management ATI 53, ppt

QuestionAnswer
Managing respiratory compromise includes? performing a respiratory assessment along with obtaining a complete set of vital signs
Oxygen is used to maintain adequate? cellular oxygenation
Maintaining a pt airway is? a nursing priority
What is a pulse oximeter? device with a sensor probe that is attached securely to the client's fingertip, toe, bridge of nose, earload, and forhead
A pulse oximeter measures? arterial oxygen sauration
Oxygen is a ? tasteless or colorless gas that accounts for 21% of atmospheric air
Pulse oximetry is indicated for conditions or situations in which a pt's? repiratory status should be monitored, such as during post op
What indicates a need for oxygen saturation ? increased work of breathing, wheezing, coughing, cyanosis
O2 stat may be slightly lower for? old, and dark skin
What are reasons for low readings? hypothermia, poor blood flow, too much light
Oxygen is administered to maintain? adequate cellular oxygenation
What is hypoxemia? inadequate level of oxygen in the blood
What are s/s of hypoxemia? tachypnea, tachycardia, restless, pale, increase BP, confusion, bradycardia, hypotension, cardiac dysrhythmias
What are s/s of hypercarbia (elevated CO2)? restlessness, hypertension and headache
What are s/s of respiratory depression? decrease resp rate, level of consciousness
What are different delivery methods? nasal canula, simple mask, venturi mask, nonbreather mask, fact tent
Oxygen toxicity may result from? high concentration of oxygen
What are s/s of oxygen toxicity? cough, pain, nasal stiffness, N&V, fatigue, headache, sore throat
Oxygen induced hypoventilation may develop in clients with? COPD who have chronic hypoxemia and hypercarbia
mucus and aspiration can? obstruct pt's airway
Clients at risk for developing airway compromise include? infants, clients with neuromuscular disorders, clients who are quadriplegic, and clients with cysstic fibrosis
Coughing is more effectie than? artificial suctioning at moving secretions into the upper trachea
Nubulization breaks up? medications into minute particles that are then dispersed throughout the resp tract
Chest physiotherapy involves? the use of chest percussion, vibration and postural drainage to assist the client to mobilize secretions
Early morning postural drainage mobilizes secretions that have? accumulated through the night
Suctioning can be accomplished? orally, nasally or endotracheally
Suctioning is not performed on a routine basis but only? when indicated
Surgical asepsis must be maintained when performing any form? of tracheal suctioning to avoid bacterial contaminiation of the airway
Obtain specimens? early in the morning
Wait till when to obtain a specimen to decrease the likelihood of emesis or aspiration? Wait 1 to 2 hrs
Use a sterile container for? routine cultures and acid fast bacillus
Use a container with a preservative to obtain a specimen for? cytology
What should be attached to the suction catheter when getting mucus? sputum trap
Specimens should be delivered to the lab within? 30 min
What are different types of chest physiotherapy? percussion, vibration, postrual drainage, postitioning
What is percussion? the use of cupped hands to clap rhythmically on the chest to break up secretion
What is vibration? the use of shaking movement applied during exhalation to help remove secretions
What is postrual drainage? the use of various positions to allow secretions to drain by gravity
Schedule treatments when? 1 hr before meal or 2 hr after and at bedtime
Fowelers positin drains what part of the lungs? apical secretion from upper lobes
Side lying position drains what part of the lungs? posterior secretions of the upper lobes
What drains the left lobe? what position? trendelenburg
What position should the pt be in for suctioning? high fowlers
What type of suction is used for oropharyngeal suctioning? yankauer, or tonsil tipped rigid suction
What type of catheter is used for nasopharyngeal and nasotracheal suctioning? flexible
Endotracheal suctioning is performed through? tracheostomy or endotracheal tube
Suction pressure should be no higher than? 120
limit each suction attemp to no longer than? 10-15 sec
How many attempts should be made at suctioning? 2-3
What should you do before and after each suctioning pass? hyperoxygenate
Who is a single lumen used for? pt with long or thick necks, no excess sectretions
What is a double lumen used for? Guide for instering outer cannula, okay with pt with excess secretions
What is a cuffed tume? ballon inflated producing seal between the upper and lower airway, pt cannot talk
What is a cuffless tube? no balloon, for pt long term, pt can speak
What is a fenestrated tube with cuff? one large or multiple openings, balloon, also has inner cannula, mechanical ventilation, can speak
What is fenstrated tube without cuff? one larger or multiple openings, no ballow, has inner cannula, can speak
How many extra tracheostomy tube should you have? 2
What should you clean a trach with? hydrogen peroxide
How often should trach tubes be changed? 6-8 weeks
What should cuff pressure be? between 14-20
Check cuff pressure? once every 8 hours
Cardiac and respiratory must? work together
What is ventilation? movement of gases
Oxygen transfer occurs at the? alveoli
What factors affect oxygenation? physiological, developmental, lifestyle, environmental
What are physiological factors affecting oxygenation? cardiac, chest wall movement, illness
What are lifestyle factors affecting oxygenation? smoking
What are environmental factors affecting oxygenation? smog, occupational risk
What should you assess about resp. hx? infections, medications
Is fatigue subjective or objective? Subjective
Is dyspnea subjective or objective? subjective sensation of difficult breathing
Cough only at night= drainage
Cough only with temp changes? asthma
What do you inspect with resp. in pt's? distress? Comfortable? Posture, expression, color of skin, clubbing, RR, muscle on chest wall, flail chest
What do you palapte for resp.? Temperature, symmetrical expansion, tactile fermatas (vibrations
What do you percuss with resp? Resident (echo), hyper resident (higher echo, seen in emphysema and children)
What do you auscultate with resp.? hear air moving in and out
Rales and crackels= popping
Ronchi= snoring sound
Review finding on page? 922-923 (SHE SAID SO)
What are tests for resp.? labs, TB, Radiology, heart, pulmonary function
For O2 you need? an order, except for emergency
For oxygen running greater than 4l/ml needs what? humidify
What is goal of 02? relieve hypoxia
Masks are? simple, safe, easily tolerated, easy to talk, cn eat and drink
What is reservoir o2? humidified, bag must be inflated, higher o2 delivered
What is venturi O2? CONTROLLED AMOUNT of o2 delievered, humidified, not easy for pt to manipulate
Why is suctioning done? unable to clear secretions
One suctioning passes the ________ it must be sterile? pharynx
Who is orpharygeal/nasopharyngeal used on? pts that has effective cough but unable to expectorate or swallow
Why is a orotracheal/nasotracheal used? pt cannot manage secretions by coughing and no artifical airway is present
What is an et tube or trach? artificial airway
Suction cath no great than? 1/2 diameter of opening of ube
While insterting there should be? no suction
What setting should suction be on? intermittent
Rotate cath while moving it? up and out
Open? used only one time, set up sterile area
Closed? still sterile but has multiple uses and saves time
O2 can be administered while? suctioning
What do you measure for oral airway? corner of mouth to angle of jaw just below ear
How do you put in an oral airway? turn curve toward cheeck, over tongue, then when it is in all the way turn the curve so it is pointing down
Oral airways are? simple, prevent obst.
When is endotracheal used? short term
If ventilation is needed for extended time, may need to move forward to? trach
Trach is a ? surgical procedure
Created by: alicia.rennaker