Oxygenation-Nursing 145

Front 1

oxygen delivery that is well tolerated, allows client to eat and talk. Concentration of O2 24-45% at flow rates of 2-6L per minute

Back 1

Nasal Cannula

Front 2

Why is the nasal cannula not used for flow rates above 6L?

Back 2

Above 6L, the client tends to swallow air, and the FiO2 is not increased.

Front 3

oxygen delivery that provides O2 concentration of 40-60% at flow rates of 5-8L.

Back 3

Simple Mask

Front 4

Oxygen delivery that provides 60-90% O2 concentration at flow rates of 6-10L.

Back 4

Partial Rebreather

Front 5

What is the purpose of the reservoir bag on the partial rebreather mask?

Back 5

it allows the client to rebreathe about the first third of exhaled air along with O2. This increases the FiO2 by recycling expired O2.

Front 6

Why must the reservoir bag not completely deflate? What do you do if it does?

Back 6

deflation causes carbon dioxide build-up. If it does deflate, the nurse should increase the liter flow of O2

Front 7

Oxygen delivery that provides the highest concentration possible-95-100% at liter flows of 10-15L.

Back 7

Nonrebreather Mask
(one way valves on mask and in between mask/bag prevent room air from being inhaled.)

Front 8

Oxygen delivery that allows caregiver to determine precise concentration by using color-coded adapters.
Delivers 24-40 or 50% at liter flows 4-10L

Back 8

Venturi Mask

Front 9

Describe the use of a Face Tent

Back 9

can replace oxygen masks when they are not tolerated. 30-50% concentration at 4-8L.
Frequently inspect client's face for dampness, chafing...face must be kept dry. Also used to provide high humidity, high flow of O2 when connected to Venturi system.

Front 10

What is Hypoxia, and what are the clinical signs?

Back 10

Rapid pulse

Rapid, shallow respirations
and dyspnea

Increased restlessness or
lightheadedness

Flaring of nares

Substernal or intercostal
retractions (using
accessory muscles of
breathing)

Cyanosis

Front 11

Hypoxia resembles anxiety or acute pain. How can the nurse be sure what the problem is?

Back 11

assess pain level on 0-10 scale
assess pulse oximetry
assess lung sounds
ask client what events preceeded the symptoms

Front 12

Hyperventilation that occurrs during metabolic acidosis

Back 12

Kussmaul's breathing
(the body tries to give off excess acid by blowing off carbon dioxide through deep/rapid breathing.)

Front 13

Altered breathing pattern characterized by waxing/waning of respirations from very deep breathing to very shallow breathing with periods of temporary apnea.

Back 13

Cheyne-Stokes respirations
(often associated with cardiac failure, increased intracranial pressure, or brain damage)

Front 14

altered breathing pattern characterized by shallow breaths interrupted by apnea.

Back 14

Biot's respirations
may be seen in clients with CNS disorders

Front 15

Four important measures nurses use to promote respiratory function
(there are therapeutic measures also, but they are separate from these nursing functions)

Back 15

Ensure a patent airway
Proper positioning
Encouraging deep breathing
and coughing
Ensuring adequate hydration

Front 16

Two types of Incentive Spirometers and important points about each

Back 16

Flow-Oriented
Volume-Oriented
Both must be held upright while using. If the flow-oriented device is tilted, it takes less effort to raise balls/discs-not as effective for client.
If volume-oriented is tilted, it will not function correctly

Front 17

Steps to using Incentive Spirometer

Back 17

exhale normally

seal lips around mouthpiece

take in slow, deep breath to
elevate balls/cylinder

hold breath for 2 seconds
initially, increasing to 6 seconds while trying to keep
balls/cylinder elevated

remove mouth and exhale
normally

Cough after incentive effort

Relax, take several normal
breaths before using again

Repeat several times, working up to 4-5 times hourly.

Front 18

What does Incentive Spirometry do for the client?

Back 18

Improves pulmonary
ventilation

Counteract effects of
anesthesia/hypoventilation

Loosen secretions

Facilitate respiratory
gaseous exchange

Expand/prevent collapsed
alveoli (atelectasis)

Front 19

When using a flow-oriented incentive spirometer (SMI), why is it important to avoid brisk, low volume breaths that snap the balls quickly to the top?

Back 19

greater lung expansion is achieved with very slow inspirations, even though they may not raise the balls as high or keep them there while you hold your breath. Practicing will allow you to hold the balls elevated longer... this ensures adequate ventilation of the alveoli (air sacs)

Front 20

Describe characteristics of partial and complete UPPER airway obstruction.

Back 20

Partial obstruction-indicated by low-pitched snoring on inhalation.
Complete obstruction-indicated by extreme inspiratory effort that produces no chest movement, inability to cough/speak

Front 21

LOWER airway obstruction is not always easy to observe... what are some characteristics?

Back 21

Stridor, a harsh/high-pitched sound may be heard on inspiration.
ABGs may be altered
client may be restless
Dyspnea
other adventitious breath
sounds may be present

Front 22

Describe crackles/rales.
usual cause?
usually heard where?

Back 22

Crackles/rales are fine, short, interrupted crackling sounds.
When associated with the alveoli, they may be high-pitched.
Best heard on inspiration, but can be heard on both.
May not be cleared by cough

caused by air passing through fluid or mucus in any air passage

Most commonly heard in the bases of the lower lungs.

Front 23

the inability to breathe in an upright or standing position

Back 23

orthopnea

Front 24

difficult or uncomfortable breathing

Back 24

dyspnea

Front 25

adequate ventilation depends on these 4 factors

Back 25

clear airways

an intact central nervous system and respiratory center

an intact thoracic cavity capable of expanding and contracting

adequate pulmonary compliance and recoil

Front 26

name two defense mechanisms of the respiratory system that work to keep the airways open and clear

Back 26

ciliary action

cough reflex

Front 27

expansion and recoil of the lungs occurs as a result of what?

Back 27

changes in pressures within the thoracic cavity (intrapleural pressure) and the lungs (intrapulmonary pressure)

Front 28

the amount of air inspired and expired with each breath is called what?

Back 28

tidal volume (for an adult, this is approx. 500mL)

Front 29

where is the respiratory center located?

Back 29

in the medulla oblongata and pons of the brain

Front 30

PaO2 refers to what?

Back 30

pressure of oxygen in the ARTERIAL blood-measured in mm/Hg

Front 31

PO2 refers to what?

Back 31

pressure of oxygen in the VENOUS blood-measured in mm/Hg

Front 32

percentage of blood that is erythrocytes (RBCs) is measured as what?

Back 32

hematocrit

Front 33

How does hematocrit affect oxygenation of tissues?

Back 33

excessive increases in hematocrit raise the blood viscosity, which reduces cardiac output, therefore reducing tissue oxygenation.

excessive decreases in hematocrit, such as anemia, reduce the transport of oxygen (remember, hematocrit is the % of RBCs. Oxygen is carried to the tissues in hemoglobin, which is part of the RBC. If there is a low % of RBCs, then there is less transportation for the oxygen to reach the tissues.)

Front 34

what is the term for normal respirations?

Back 34

eupnea