fundumentals MOD2 Chp. 7
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| What is Oxygen Therapy? | Goal is to prevent or relieve hypoxia.
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| Oxygen is treated like? | A drug.
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| What is ordered by a physician pertaining to Oxygen? | Dosage, or concentration.
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| Who initiates Oxygen Therapy? | Physician, or Resp. Therapist.
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| Nasal Cannula- | 2 Prong plastic device.
Watch for skin break down.
Can eat with it in place.
Flow is usually 2-4 LPM
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| Face Mask- | Fits over nose and mouth.
Usually - 6-20 LPM
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| Transtracheal Catheter- | Catheter in between 2nd-3rd tracheal cartilage.
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| Tracheostomy- | Tube inserted in trachea.
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| ET Tube- | Endotracheal tube for patients on a ventilator.
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| Non-rebreather Mask- | Used mostly by paramedics, no mixing of exhaled air.
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| What is a Pulse Oximetry? | Device used to measure the percentage of oxygen bound to hemoglobin compared to the amount available.
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| What is normal oxygen sat? | 90%-100%
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| What is the easiest way to determine the oxygen sat? | Pulse Oximetry
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| Where do you place the pulse Ox? | Finger or Earlobe. Foot on babies
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| Can you place pulse ox on cold hands, feet, or ears? | NO
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| What does COPD stand for? | Chronic Obstructive Pulmonary Disease
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| What is normal PH? | 7.35-7.45
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| What is alkalotic? | Above 7.45
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| What is acidotic? | Below 7.35
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| What happens if the PT. has a high blood level of carbon dioxide? | The respiratory rate will increase to compensate.
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| What is the first path of oxygen? | Unoxygenated blood enters the right atrium.
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| What is the second path of oxygen? | Unoxygenated blood enters the right ventricle.
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| What is the third path of oxygen? | Pulmonary artery takes blood to capillary system of the alveoli.
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| What is the fourth path of oxygen? | CO2 diffuses and O2 infuses into the blood in the alveoli.
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| What is the fifth path of oxygen? | Blood enters the left atria via the pulmonary vein.
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| What is the sixth path of oxygen? | Blood enters the left ventricle.
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| What is the seventh and final path of oxygen? | Blood enters the aorta.
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| How does SO blood circulate? | Through the lungs via the pulmonary artery & pulmonary vein.
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| What is the type of sterile suctioning? | Tracheostomy suctioning.
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| What are the types of non-sterile suctioning? | Orophrayngeal, and nasopharyngeal.
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| May need to ___________ & O2 stats should return to normal after the procedure. | Hyperoxygenate.
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| What postion should the patient be in while suctioning? | Semi-Fowlers
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| Where does your sputum collection come from? | Deep in the bronchial tree.
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| What is the best time to collect a sputum specimen? | Early morning?
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| What does sputum contain? | Mucus, cellular debris, and micro organisms, and may contain blood or puss.
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| What is sputum? | Secretion from the lungs.
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| What is the best way to break up sputum? | WATER!!
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| How do you get a sputum sample if the patients can not cough? (BABY or ELDERLY) | Tracheal suctioning.
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| What are the types of tests that are preformed on sputum? | Culture, Sensitivity, Cytology, and Acid-fast bacillus.
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| What is a culture test? | Test to look for viral or bacterial cells.
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| What is a sensitivity test? | Trying to define which medications can be used to treat the infection.
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| What is a cytology test? | Tests to find abnormal cells.
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| What is an "Acid-fast bacillus" test? | This is the specific test for tuberculosis.
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| What is the first step to obtaining a throat culture? | Instruct the patient to tilt head backward.
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| What is the second step to obtaining a throat culture? | Ask patient to open and say "AH!"
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| What is the third step to obtaining a throat culture? | If pharynx is not visualized, depress tongue w/tongue blade, and note inflamed area of pharynx and tonsils.
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| What is the fourth step to obtaining a throat culture? | insert swab w/o touching lips, teeth, tongue, or cheeks.
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| What is the fifth step to obtaining a throat culture? | Gently but quickly swab tonsil area side to side, making contact with inflamed or purulent sites.
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| What is the sixth step to obtaining a throat culture? | Carefully withdraw the swab w/o striking oral structures; immediately place swab in culture tube and crush ampule at bottom of tube.
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| What is the seventh step to obtaining a throat culture? | Securely attach properly completed label and requistion slip to side of specimen container.
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| What is the nineth step to obtaining a throat culture? | Enclose in a plastic bag.
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| What is the tenth step to obtaining a throat culture? | Send specimen immediately to lab or refrigerate.
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| What is respiratory isolation? | A combination of practices that prevent germs from spreading in the hospital.
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| What are the CDC guidelines for TB? | Requires AFB precautions which include a negative pressure room and PAPR masks or N95 respiratior mask for healthcare workers.
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| What is TB? | A lung infection that is transmitted by air, contact, and droplets.
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| Does all TB have to be isolated? | No, only ACTIVE TB needs to be isolated.
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| How do you transport an active TB patient? | Surgical mask.
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| How often should a person laying in bed be turned? | Every two hours.
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| How often should a person setting in a chair be repositioned? | Every fifteen to thirty minutes.
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| When should deep breathing be initiated? | When PT is able to respond.
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| When should deep breathing teaching be done? | Preoperatively.
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| What does coughing help prevent? | Pulmonary complications associated with surgery.
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| When is coughing contradicted? | Spinal, Cranial, and Eye surgeries.
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| What is the first step to using a Incentive Spirometry? | Hold IS level.
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| What is the second step to using a incentive spirometry? | Maintain a firm seal with the lips around the mouth piece during inhalation.
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| What is the third step to using a incentive spirometry? | Inhale slowly.
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| What is the fourth step to using a incentive spirometry? | Keep the visual indicator at the inspiratory goal for several seconds.
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| What is the fifth step to using a incentive spirometry? | Remove mouth piece. Exhale normally.
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| What is a Pneumothorax? | Collection of air or gas in the pleural space.
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| How is a pneumothorax normally diagnosed? | Chest X-ray.
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| What might your patients complain of with a pneumothorax? | Shortness of breath, chest pain, or air hunger.
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| How do you decompress a pneumothorax? | Chest tube.
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| What are nursing interventions for a pneumothorax? | Treat pain, promoting oxygenation, assisting in procedures, and providing patient education.
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| What does a chest tube achieve? | Drain fluid, blood, air, or gas from pleural area.
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| What type of system is a chest tube? | Water seal system.
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| What is it called when water bubbles in the chest tube system and is it normal? | Tidaling, and yes. It means that your pt is still healing.
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| What type of dressing do you put over a chest tube hole if the chest tube comes out? | Petroleum gauze dressing.
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| What is chest percussion? | Taps on the sides of chest wall to encourage drainage of the secretions.
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| When is chest percussion not appropriate? | Elderly, Osteoprosis.
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| What is a tracheostomy? | An artificial opening in the trachea made by a surgical incision.
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| Why are most trach's put in place? | Obstructed airway.
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| What is the first step to trach care? | Don sterile gloves.
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| What is the second step to trach care? | Adjust the suction to 100-150 mmHg.
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| What is the third step to trach care? | Preoxygenate patient.
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| What is the fourth step to trach care? | Check function of suction catheter.
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| What is the fifth step to trach care? | Insert catheter without suction.
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| What is the sixth step to trach care? | Apply intermittent suction while rotating catheter.
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| What is the seventh step to trach care? | Asses for secretion clearance.
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