oxygen lecture
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| upper respiratory system | pharynx, larynx, trachea
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| lower respiratory system | lungs, bronchi branching throughout lungs
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| 3 functions of the respiratory system | gas exchange, fluid balance, acid-base balance (pH)
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| phases of oxygen needs | ventilation, diffusion, perfussion
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| 4 requirements essential for adequate ventilation | adequate atmospheric oxygen, clear air passages, adequate stretch ability and recoil, intact CNS center
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| RBC normal blood values | men= 4.2-5.4 million/mm3 women=3.6-5 million/mm3
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| Hct normal blood values | men= 40-54% women=37-50%
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| Hgb normal blood values | men= 14-16 gm/dl women= 12-15 gm/dl
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| highly responsive to inc. in blood CO2 | medulla oblongata
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| hypoxia | O2 dec. in cells/body
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| hypoxia can be related to what parts of respiration | ventilation, diffusion, transport of gases by blood
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| early manifestations of hypoxia | restlessness, anxiety, tachycardia, tachypnea
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| late manifestations of hypoxia | bradycardia, extreme restlessness, dyspnea, cyanosis
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| chronic hypoxia | fatigue, clubbing of fingernails
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| how to get a sample of sputum | have patient cough from deep lungs into sterile container hydrate patient before and take deep breaths
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| hand held nebulizer | aerosol mist, mobilization and expectoration of thick secretions, inc. perfusion ration, treatment of post-op atelectasis and hypostatic pneumonia
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| altered breathing pattern | loss of adequate ventilation due to altered breathing patterns
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| nursing order of ineffective breathing patterns r/t anxiety AMB tachypnea, resp30/min | stay calm, give short clear directions, orthopneic position, breath into paper bag
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| what is the rational for the orthopneic position | maximize lung expansion
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| inspirometer | measure amount of inspiration
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| assessments prior to and during oxygen therapy | assess VS, breathing, airway, circulation
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| reasons for oxygen therapy | low O2 in blood and air, trauma, blood loss, ischemic tissues
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| pulse ox | measures oxygen saturation of hemoglobin. should be 92% and over
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| arterial blood gases | measurements obtained to assess adequacy of oxygenation and ventilation, evaluate acid-base balance and to monitor effectiveness of therapy
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| oxygen is a drug that is... | regulated, humidified, and signs are posted for caution
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| nursing responsibilities for oxygen | patient body image changes, compliances, dryness and discomfort
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| nasal cannula maximum O2 % and liter flow | 24-44% 1-6L
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| simple face mask maximum O2 % and liter flow | 40-60% 5-10L
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| venturi mask maximum O2 % and liter flow | 24-60% 4-12L
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| nursing action for patient with venturi mask | ensure correct mask to meet doctors order, order needs to specify the fraction of inspired oxygen desired NOT the liter flow
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| non-rebreather mask maximum O2 % and liter flow | 60-100% 6-15L
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| non-rebreather mask is used for... | short term (1-2 days), delivers highest concentration possible
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| complications of oxygen therapy | respiratory and circulatory depression, atelectasis, trachea-bronchitis, oxygen toxicity
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| activity intolerance | state which patient experiences an inability, physiologically and psychologically, to tolerate activity
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| most activity intolerance is r/t... | generalized weakness and debilitation secondary to acute or chronic illness and disease
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| defining characteristics for altered response to activity | dyspnea, shortness of breath, abnormal HR and BP response to activity, failure for VS to return to resting rate after 3minutes, weakness, fatigue
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| risk factors for peripheral vascular disease: Arterial | obesity, smoking, stress, family history
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| chronic arterial peripheral vascular disease | atherosclerotic plaque which can lead to amputation, gangrene foot and poor healing
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| acute arterial peripheral vascular disease | occlusive or complete obstruction > clot formed in arterial system
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| arteries | distribute oxygenated blood to body
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| arterioles | smaller arteries>these go to capillaries
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| capillaries | smallest vessels, connector between arterioles and venules
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| venule | smallest of veins>then turn into veins and carry blood back to heart
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| vein valves | prevented backward flow of blood
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| acute venous peripheral vascular disease | thrombus, thrombophlebitis
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| chronic venous peripheral vascular disease | incompetent valves, stasis ulcers, varicose veins
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| arterial assessment | pain, cold temp., pallor, absent pulse, paresthesia
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| pitting edema +3 | deep pit, puffy appearance
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| pitting edema +4 | deep pit, trankly swollen
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| 5 methods of heat transfer | conduction, convection, radiation, evaporation, diathermy
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| body's control of heat and cold | hypothalamus, ANS
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| local application of heat... | inc. blood flow, dec. blood viscosity, inc. capillary permeability, perspiration, dec. venous congestion, inc. tissue metabolism, dec. muscle tension
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| local application of cold... | dec. skin sensation, blood flow, capillary permeability, lymph flow, metabolic needs, and inc. muscle tension, blood viscosity
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| factors which will modify both local and systemic application of heat and cold | integrity of skin, ability to feel, diabetes, scar, peripheral vascular disease, LOC, spinal cord injury, malignancy
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| Hypoxia occurs if... | the amount of oxygen delivered to tissues is too low
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| primary functions of the heart | deliver deoxygenated blood to the lungs for oxygenation and oxygen and nutrients to the tissues
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| The nursing history includes information about the patient’s... | cough, dyspnea, fatigue, wheezing, chest pain, environmental exposures, respiratory infection, cardiopulmonary risk factors, and use of medications
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| Nursing assessment include | respiratory pattern, thoracic inspection, palpation, and auscultation for deviations from normal
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| what completes the database for a patient with decreased oxygenation | Diagnostic and laboratory tests
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| Health promotion include | vaccinations against flu and pneumonia, exercise programs, nutrition support, smoking cessation, and environmental assessment for pollutants and air quality
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| Airway maintenance requires mobilization of secretions by... | increased fluid intake, humidification, or nebulization
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| Breathing exercises improve... | ventilation, oxygenation, and sensations of dyspnea
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| Chest physiotherapy include | postural drainage, percussion, and vibration to mobilize pulmonary secretions
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| Promotion of lung expansion can be achieved by... | mobility, positioning, incentive spirometry, and chest tube insertion
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| Nasal cannulas and oxygen masks deliver oxygen therapy, which improve... | tissue oxygenation
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| what actions benefit patients with chronic pulmonary diseases | breathing exercises such as pursed-lip breathing and diaphragmatic breathing
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| why does hypoxia occur | decreased circulating blood volume, which leads to decreased oxygen to muscles, causing fatigue, decreased activity tolerance, and a feeling of shortness of breath
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| Decreased effective contraction of left side of heart leads to | back up of fluid in the lungs, increasing hydrostatic pressure and causing pulmonary edema, resulting in crackles in lung bases
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| what happens when the lung collapses? | the thoracic space fills with air on each inspiration, and the atmospheric air irritates the parietal pleura, causing pain
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| an incentive spirometer is used to | encourage deep breathing to inflate alveoli and open pores of Kohn
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| A nasal cannula delivers | precise, high-flow rates of oxygen
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| atelectasis | collapse of alveoli ta prevents normal exchange of O2 and CO2
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| patient with COPD lose... | elastic recoil of the lungs and thorax
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| surfactant | chemical produced in the lungs to maintain surface tension of alveoli and keep them from collapsing
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| hypoventilation | occurs when alveolar ventilation is inadequate to meet O2 demand of the body or eliminate sufficient CO2
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| patients with COPD the administration of excessive oxygen results in... | hypoventilation
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| S&S of hypoventilation | mental status changes, dysrhythmias, cardiac arrest
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| hyperventilation | ventilation which lungs remove CO2 faster than it is produced by cellular metabolism
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| myocardial ischemia | results when supply of blood to myocardium from coronary arteries is insufficient to meet myocardial oxygen demands
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| impaired gas exchange r/t dec. lung expansion AMB... | confusion, fatigue, restlessness, dyspnea, pallor, cyanosis, tachypnea
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| humidification | process of adding water to gas. keeps air moist and loosens and mobilizes pulmonary secretions
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| incentive spirometry | promotes deep breathing and prevents or treats atelectasis in the postoperative patient
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| pneumothorax | collection of air in pleural space as a result of chest trauma
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