Question | Answer |
Lobes in L lung | 2 lobes |
Lobes in R lung | 3 lobes |
Function of upper airways | carry air to and from lungs |
Function of cilia/mucous membranes | trap and remove foreign particles in respiratory tract |
Function of alveoli | contain microphages that phagocytize inhaled bacteria |
Hypoxemia | decreased amount of oxygen in the blood (at a cellular level) |
Main causes of hypoxemia | obstruction of airway and restriction of thoracic cage |
Obstructions of airway | tongue, mucous, foreign body, aspiration, vomitus, burns, COPD, drowning |
Restriction of thoracic cage | chest injury, flail chest, pneumothorax, extreme obesity, diseases |
Central cyanosis | blue tongue/mucous membranes; very serious |
Signs of hypoxemia, early | confusion, restlessness, irritable, dyspnea, tachypnea, stridor |
Signs of hypoxemia, late | cyanosis, muscle retractions, dysrhythmias, hypotension, acid-base disturbance, decreased O2 sat |
Pulse ox | measures hgb in blood |
Normal range for pulse ox | above 90% |
Pulse ox rotation | q4h or disposable change q24h |
Nasal cannula | plastic tube with curved pronges that is held in place by looping it over the ears and cinching under the chin |
Benefits of nasal cannula | patient can still talk, move, and eat with receiving oxygen |
Oxygen | colorless, tasteless, odorless gas present in the air |
Oxygen administration | used to supplement oxygen in inspired air |
Inspired air is _____% oxygen | 21% |
Delivery systems for oxygen administration | nasal cannula, mask, tent, croupette, catheter |
Administered oxygen requires | humidification |
Common oxygen flow rate | 4-6L, prescribed by physician |
COPD oxygen flow rate | 2-3L to prevent respiratory arrest |
Oxygen mask | used for oxygen concentrations ranging from 24%-55% at flows 3-7L/min |
Oxygen concentration above 60% rarely used because | danger of toxicity |
Oxygen artificial airways, nasopharyngeal and oropharyngeal | keeps the tongue from falling back into the throat |
Before giving oxygen, you must | check flow meter check for oxygen passing through delivery system |
Tracheostomy, temporary or permanent | surgical opening intot he trachea to facilitate insertion of a cuffed tube |
To clean tracheostomy | 1/2 strength peroxide and saline to wash; saline to rinse; clean prior to deflating cuff |
How often to clean tracheostomy | q8h or more if secretions blocking airway |
Aseptic suctioning | for patients unable to clear secretions from their own airway effectively |
Types of aseptic suctioning | nasopharyngeal and oral |
Instrument to perform aseptic suctioning | 14-16 Fr suction catheter or Yankauer suction tip |
Negative pressure setting for aseptic suctioning | 80-120mm/Hg |
Nasopharyngeal aseptic suctioning | used most often for infants, gravely debilitated, or unconscious patients, and patients with an ineffective cough |
Tracheobronchial sterile suctioning | most often performed on intubated patients or patients with tracheostomy |
Directions for tracheobronchial sterile suctioning | Preoxygenation for patients, short period of time, hold with dominant hand using sterile gloves |
Time for tracheobronchial sterile suctioning | no longer than 10 seconda at a time with oxygenation in between |
Chest drainage tubes | used to remove air from patient with a pneumothorax or hemothorax or after chest surgery |
Nursing Role in airway support | maintain airway; turn patients; encourage cough/deep breathe q2h when in bed; splilnt wiht pillow to help deep breathe/cough; encourage use of incentive spirometer |
Incentive spirometer | ball moves upward when patient takes deep breath, amount of air is measured so results are visible to user |
First signs of hypoxia | restlessness, irritability, confusion |
How to use incentive spirometer | patient strives to reach certain colume of air and hold it for 3 seconds, taking 10 slow deep breaths every hour when awak |
Huff coughing | deep breath through nose, hold 3-5 sec, exhale pursed lips, another deep breath and short segmented forcible exhaled open mouth coughs for 1/3 expiratory volume with each cough |
Heimlich maneuver | can person speak, place hands halfway between xiphoid process and umbilicus with thimb of fist inward, forcefully thrust hands into abdomen using upward rotating motion, repeat until clear or unconscious |
Types of oxygen masks | simple, partial rebreathing, non-rebreathing, venturi |
Simple mask | low to medium oxygen concentrations 40-60%, liter flow above 5L/min |
Partial rebreathing mask | higher concetrations oxygen 60-80%, reservoir bag must stay inflated at all times |
Non-rebreathing mask | higest concentration of oxygen 80-95%, reservoir bag must stay inflated at all times |
Venturi mask | constant flow of oxygen regardless of breathing pattern, concentration marked on apparatus, 24-50% available |
Nasal prongs (nasal cannula) | low concetraion of oxygen, dependent on rate and depth of person breathing, 24-44% |
Tracheostomy collar and T-bar (Briggs adapter) | oxygen and humidification delivery, must be connected to nebulizer, flow set on nebulizer |
Drainage systems | drain air or fluid from pleural space and prevents being sucked back into chest |
Water-seal drainage system | there should be constant bubbling in suction chamber |
Normal respiratory rate | 12-20 breaths/min |