Resp. Management ATI 53, ppt
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| Managing respiratory compromise includes? | performing a respiratory assessment along with obtaining a complete set of vital signs
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| Oxygen is used to maintain adequate? | cellular oxygenation
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| Maintaining a pt airway is? | a nursing priority
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| 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
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| A pulse oximeter measures? | arterial oxygen sauration
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| Oxygen is a ? | tasteless or colorless gas that accounts for 21% of atmospheric air
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| Pulse oximetry is indicated for conditions or situations in which a pt's? | repiratory status should be monitored, such as during post op
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| What indicates a need for oxygen saturation ? | increased work of breathing, wheezing, coughing, cyanosis
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| O2 stat may be slightly lower for? | old, and dark skin
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| What are reasons for low readings? | hypothermia, poor blood flow, too much light
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| Oxygen is administered to maintain? | adequate cellular oxygenation
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| What is hypoxemia? | inadequate level of oxygen in the blood
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| What are s/s of hypoxemia? | tachypnea, tachycardia, restless, pale, increase BP, confusion, bradycardia, hypotension, cardiac dysrhythmias
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| What are s/s of hypercarbia (elevated CO2)? | restlessness, hypertension and headache
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| What are s/s of respiratory depression? | decrease resp rate, level of consciousness
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| What are different delivery methods? | nasal canula, simple mask, venturi mask, nonbreather mask, fact tent
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| Oxygen toxicity may result from? | high concentration of oxygen
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| What are s/s of oxygen toxicity? | cough, pain, nasal stiffness, N&V, fatigue, headache, sore throat
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| Oxygen induced hypoventilation may develop in clients with? | COPD who have chronic hypoxemia and hypercarbia
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| mucus and aspiration can? | obstruct pt's airway
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| Clients at risk for developing airway compromise include? | infants, clients with neuromuscular disorders, clients who are quadriplegic, and clients with cysstic fibrosis
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| Coughing is more effectie than? | artificial suctioning at moving secretions into the upper trachea
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| Nubulization breaks up? | medications into minute particles that are then dispersed throughout the resp tract
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| Chest physiotherapy involves? | the use of chest percussion, vibration and postural drainage to assist the client to mobilize secretions
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| Early morning postural drainage mobilizes secretions that have? | accumulated through the night
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| Suctioning can be accomplished? | orally, nasally or endotracheally
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| Suctioning is not performed on a routine basis but only? | when indicated
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| Surgical asepsis must be maintained when performing any form? | of tracheal suctioning to avoid bacterial contaminiation of the airway
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| Obtain specimens? | early in the morning
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| Wait till when to obtain a specimen to decrease the likelihood of emesis or aspiration? | Wait 1 to 2 hrs
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| Use a sterile container for? | routine cultures and acid fast bacillus
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| Use a container with a preservative to obtain a specimen for? | cytology
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| What should be attached to the suction catheter when getting mucus? | sputum trap
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| Specimens should be delivered to the lab within? | 30 min
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| What are different types of chest physiotherapy? | percussion, vibration, postrual drainage, postitioning
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| What is percussion? | the use of cupped hands to clap rhythmically on the chest to break up secretion
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| What is vibration? | the use of shaking movement applied during exhalation to help remove secretions
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| What is postrual drainage? | the use of various positions to allow secretions to drain by gravity
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| Schedule treatments when? | 1 hr before meal or 2 hr after and at bedtime
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| Fowelers positin drains what part of the lungs? | apical secretion from upper lobes
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| Side lying position drains what part of the lungs? | posterior secretions of the upper lobes
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| What drains the left lobe? what position? | trendelenburg
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| What position should the pt be in for suctioning? | high fowlers
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| What type of suction is used for oropharyngeal suctioning? | yankauer, or tonsil tipped rigid suction
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| What type of catheter is used for nasopharyngeal and nasotracheal suctioning? | flexible
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| Endotracheal suctioning is performed through? | tracheostomy or endotracheal tube
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| Suction pressure should be no higher than? | 120
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| limit each suction attemp to no longer than? | 10-15 sec
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| How many attempts should be made at suctioning? | 2-3
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| What should you do before and after each suctioning pass? | hyperoxygenate
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| Who is a single lumen used for? | pt with long or thick necks, no excess sectretions
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| What is a double lumen used for? | Guide for instering outer cannula, okay with pt with excess secretions
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| What is a cuffed tume? | ballon inflated producing seal between the upper and lower airway, pt cannot talk
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| What is a cuffless tube? | no balloon, for pt long term, pt can speak
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| What is a fenestrated tube with cuff? | one large or multiple openings, balloon, also has inner cannula, mechanical ventilation, can speak
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| What is fenstrated tube without cuff? | one larger or multiple openings, no ballow, has inner cannula, can speak
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| How many extra tracheostomy tube should you have? | 2
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| What should you clean a trach with? | hydrogen peroxide
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| How often should trach tubes be changed? | 6-8 weeks
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| What should cuff pressure be? | between 14-20
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| Check cuff pressure? | once every 8 hours
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| Cardiac and respiratory must? | work together
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| What is ventilation? | movement of gases
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| Oxygen transfer occurs at the? | alveoli
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| What factors affect oxygenation? | physiological, developmental, lifestyle, environmental
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| What are physiological factors affecting oxygenation? | cardiac, chest wall movement, illness
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| What are lifestyle factors affecting oxygenation? | smoking
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| What are environmental factors affecting oxygenation? | smog, occupational risk
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| What should you assess about resp. hx? | infections, medications
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| Is fatigue subjective or objective? | Subjective
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| Is dyspnea subjective or objective? | subjective sensation of difficult breathing
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| Cough only at night= | drainage
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| Cough only with temp changes? | asthma
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| What do you inspect with resp. in pt's? | distress? Comfortable? Posture, expression, color of skin, clubbing, RR, muscle on chest wall, flail chest
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| What do you palapte for resp.? | Temperature, symmetrical expansion, tactile fermatas (vibrations
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| What do you percuss with resp? | Resident (echo), hyper resident (higher echo, seen in emphysema and children)
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| What do you auscultate with resp.? | hear air moving in and out
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| Rales and crackels= | popping
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| Ronchi= | snoring sound
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| Review finding on page? | 922-923 (SHE SAID SO)
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| What are tests for resp.? | labs, TB, Radiology, heart, pulmonary function
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| For O2 you need? | an order, except for emergency
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| For oxygen running greater than 4l/ml needs what? | humidify
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| What is goal of 02? | relieve hypoxia
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| Masks are? | simple, safe, easily tolerated, easy to talk, cn eat and drink
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| What is reservoir o2? | humidified, bag must be inflated, higher o2 delivered
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| What is venturi O2? | CONTROLLED AMOUNT of o2 delievered, humidified, not easy for pt to manipulate
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| Why is suctioning done? | unable to clear secretions
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| One suctioning passes the ________ it must be sterile? | pharynx
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| Who is orpharygeal/nasopharyngeal used on? | pts that has effective cough but unable to expectorate or swallow
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| Why is a orotracheal/nasotracheal used? | pt cannot manage secretions by coughing and no artifical airway is present
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| What is an et tube or trach? | artificial airway
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| Suction cath no great than? | 1/2 diameter of opening of ube
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| While insterting there should be? | no suction
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| What setting should suction be on? | intermittent
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| Rotate cath while moving it? | up and out
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| Open? | used only one time, set up sterile area
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| Closed? | still sterile but has multiple uses and saves time
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| O2 can be administered while? | suctioning
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| What do you measure for oral airway? | corner of mouth to angle of jaw just below ear
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| 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
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| Oral airways are? | simple, prevent obst.
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| When is endotracheal used? | short term
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| If ventilation is needed for extended time, may need to move forward to? | trach
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| Trach is a ? | surgical procedure
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Created by:
alicia.rennaker
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