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Principles
Resp. Management ATI 53, ppt
| Question | Answer |
|---|---|
| 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
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