Oxygentation- Respiratory & Cardiac
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| Identify individual, environmental, & pathological factors that influence oxygenation | air pollution
pollens & allergens
high blood pressure
cigarette smoking
obesity
diabetes
lack of exercise
medications/drug use
stress
medical/family history
smoking
drugs & alcohol
nutrition
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| describe a focused physical assessment in relation to oxygenation | observe & inspect skin for pallor, palpate lungs, ausculate breath sounds, observe rate & pattern of respiration, inspect the chest to detect obvious chest deformities , wounds or masses, percuss
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| describe a focused physical assessment in relation to breathing | observe the rate & pattern of respiration
observe the assessory muscles
palpate
percuss
auscultate
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| describe a focused physical assessment in relation to circulation | inspect skin for pallor, inspect for edema, capillary refill, palpate & check pulses on both sides, check for dorsi flexion, ausculate for heart sounds in aoric, pulmonic, tricuspid and mitral locations
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| describe a focused physical assessment in relation to gas exchange |
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| interpret diagnostic testing related to oxygentation | pulse oximetry-greater than 95% is normal, below 93% indicates a need for oxygen
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| interpret diagnostic testing related to breathing | Pulmonary function tests
by use of tidal volume, vital capacity, forced expiratory volume
Spirometry-gives graphic representation of lung volumes & flows
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| interpret diagnostic testing related to circulation | Complete Blood Count
Blood Chemistry tests
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| interpret diagnostic testing related to gas exchange | arterial blood levels of O2, CO2, and pH
PaO2 norm: 80-100 mm Hg
PaCO2 norm: 35-45 mm Hg
pH norm: 7.35-7.45
Hypoventilation-a PaCO2 lower than 35
Hyperventilation-a PaCO2 above 45
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| develop a nursing diagnoses related to alteration in oxygentation | Ineffective airway clearance
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| develop a nursing diagnoses related to alteration in breathing | Ineffective breathing pattern
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| develop a nursing diagnoses related to alteration in circulation | Ineffective tissue perfusion
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| develop a nursing diagnoses related to alteration in gas exchange | Impaired gas exchange
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| plan outcomes and patient centered care for maintaing and improving oxygenation | Pt will demonstrate knowledge regarding prevention of respiratory dysfunction
Pts tissues will have adequate oxygenation
Pt will mobilize pulmonary secretions
Pt will effectively cope with changes in self concept & lifestyle
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| identify nursing procedures that promote safety and involve other members of the health care team related to oxygenation, breathing, perfusion, & gas exchange. | Assess the pts response regularly
assess the pts color, alertness, heart rate, breathing effort
inform pt of the importance of the procedure
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| describe methods to evaluate adequacy of oxygenation, breathing, perfusion, & gas exhange |
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| modify outcomes based on patient centered care and safety related to oxygenation. |
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| Name 3 defenses of the respiritory system | nose, epiglottis, sneeze & cough reflex,
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| What is the normal respiritory range for a 25 year old? 85 year old? | 12-20
16-25
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| What does Crepitus or subcutaneous emphasema sound/feel like? | crackles that sound like rice krispies
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| What are adventitious breath sounds? | abnormal breath sounds
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| When would you use CAB as compared to ABC? | CAB-unresponsive pt
ABC-responsive pt
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| What is a syncopal expisode? | passing out
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| What is dyspnea? | labored breathing & breathlessness
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| What is Hemoptysis | coughing up blood
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| What is the purpose of a PFT? (pulmonary function test) | to measure the airway & amt of air you can get into your lungs
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| What does ABG monitoring do? | monitoring of acid base balance
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| Is a consent form needed for a bronchioscopy? | yes
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| What type of pt will use pursed lip breathing? | COPD
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| What is chest physiotherapy? | clears excessive secretions from airway by Percussion, Vibration, Drainage (postural)
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| What is the conduction system? | elecrical activity-SA node, bundle of HIS, etc
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| What are the pumping chambers? | atria, ventrical valves
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| What do the coronary arteries do? | carry oxygenated blood to heart
lies outside the heart
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| What is an arrhytmia? | abnormal electrical activity of the heart
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| What are the normal ranges for Potassium? | 3.5-5mEq/L
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| What are the normal ranges for Sodium? | 135-145mEq/L
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| What are the normal ranges for hematocrit? | Male: 45-52%
Female37-48%
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| What are the normal ranges for hemoglobin? | Male: 13-18 g/100ml
Female: 12-16 g /100ml
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| What type of drug would you give to increase cardiac contractablility and decrease heartrate? | cardiac glycoside
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| What type of drug would you give to decrease blood pressure? | antihypertensive agents (beta blockers & ace inhibitors)
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| What type of drug would you give to increase blood pressure? | vasopressor
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| What type of drug would you give to regulate heart rhythm? | Antiarrythmic
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| What type of drug would you give to relive angina | nitrates
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| What type of drug would you give to decrease cholesterol levels | antilipid agents
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| What type of drug would you give to reduce edema and fluid volume by increasing urinary output? | diuretics
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| What type of drug would you give to decrease potential for clot formation? | anticoagulants
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| What is the normal range for PaO2? | 80-100 mm Hg
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| What is the normal range for PaCO2? | 35-45 mm Hg
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| What is the normal range for pH? | 7.35-7.45
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| What is hypoventilation, in relation to ranges? | PaCO2 level is lower than 35
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| What is hyperventilation, in relation to ranges? | PaCO2 level is higher than 45
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| What is Cachectic? | deteriortion of muscles...looking flacid
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| What is angina? | chest pain
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