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59 Cards in this Set
- Front
- Back
What are the respiratory factors that may effect oxygenation?
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Decreased oxygen-carrying capacity
Decreased inspired oxygen concentration Hypovolemia Increased metabolic rate |
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Hypovolemia
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Reduced circulating blood volume
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What is used to carry oxygen to 99% of the tissues?
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Hemoglobin
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What are the cardiac factors that may effect oxygenation?
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Obesity and pregnancy
Musculoskeletal abnormalities (scoliosis) Trauma (Rib fractures) Neuromuscular disease (Mysthenia Gravis or Gillain-Barre syndrome) CNS alterations (cervical or spinal cord damage) Influences of Chronic disease (direct or secondary effect of disease) |
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Developmental factor that effects oxygenation
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Age of the patient
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Lifestyle factors that effect oxygenation
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Nutrition
Exercise Smoking Substance abuse Stress |
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Environmental factors that effect oxygenation
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Residence location
Occupation |
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Normal sputum
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clear or white, no odor
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Asthma sputum
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stringy like hardened egg white
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Pulmonary Edema sputum
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frothy pink
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Infection sputum
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green or yellow, musty color
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Hemoptysis
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Bloody, red mucous
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Bronchoscopy
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- scope is introduced into the nose, the mouth, an endotracheal tube, a tracheostomy tube, or a
rigid bronchoscope - right lung is usually examined FIRST than the left lung |
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Thoracentesis
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inserting a needle through the chest wall and into the pleural space, usually to remove fluid for diagnostic or therapeutic purposes
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When assessing a client on oxygen the nurse should always...
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Double check the flow, make sure all devices are working properly and no cords have been disconnected, etc
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Hypoxemia
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A deficiency of arterial blood oxygen
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Hypoxia
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Insufficient oxygen to meet metabolic demands of tissue and cells
(Results from hypoxemia) |
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Cyanosis
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The bluish discoloration of skin and mucous membranes
(Late sign of hypoxia) |
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Acute signs and symptoms of hypoxia
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Apprehension
Anxiety Decreased level of consciousness Decreased lung sounds Increased pulse rate Increased rate and depth of respiration Increased blood pressure Dyspnea Use of accessory muscles for breathing Cardiac dysrhythmias |
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Gradual signs and symptoms of Hypoxia
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Pallor
Increased fatigue Decreased ability to concentrate Dizziness Behavioral changes Cyanosis Clubbing Adventitious lung sounds |
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What determines the level of oxygen that an individual is on?
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Physician's order
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What should be placed on the outside entrance of homes where oxygen is being used?
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An "oxygen in use" sign
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The system should be kept at least 10 feet from...
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An open flame
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What type of blanket can't you use when on oxygen?
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Wool
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Before initiating treatment you should...
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Check flowmeters for accuracy
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Only administer LOW dose oxygen to these types of patients
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COPD (2-3 liters)
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Low flow oxygen system
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Provides only part of the total inspired air
More comfortable Oxygen delivery varies with breathing patten |
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High flow oxygen system
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Provides TOTAL inspired air
Oxygen delivery does not vary with breathing pattern |
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Flowmeter
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Attaches to the oxygen outlet to adjust the amount of oxygen being delivered
ALWAYS know what your patient oxygen level should be set at and check it each time you enter the room |
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Humidifier
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Container of sterile water which provides moisture to oxygen
*Sterile water prevents infection |
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Moisture in O2
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Prevents drying, cracking, and bleeding of nasal mucosa
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Nasal Cannula
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Most common method of delivery
Effective, easy, comfortable Can be used with mouth breathers Clients can eat, drink, talk and perform ADL's 1-6 L/minute More than 6 does not increase delivery only dries out membranes 24-44% O2 Skin breakdown is possible around nose and ears and must be assessed Check adequacy with pulse ox |
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Normal flow rate
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2-3 L/min
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Simple face mask
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Covers the mouth and nose
Provides the most consistent, effective delivery of oxygen Interferes with talking, eating, and drinking May cause claustrophobic reaction 30-60% 3-8 L/min |
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Rebreather
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High flow system with a bag attached to the bottom of the mask
NOT commonly used |
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Contraindications for a Rebreather
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CO2 retaining clients
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What percentage of O2 concentration can a Rebreather deliver?
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70%
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Difference between a Non-Rebreather and a Rebreather
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A Rebreather has a two-way valve between mask and reservoir bag allowing the patient to rebreathe their exhaled air
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Non-Rebreather
(Reservoir Mask) |
High flow system with a bag attached to the bottom of the mask
High concentration oxygen supply flows into reservoir bag Has a valve that largely prevents the inhalation of room or exhaled air |
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What percentage of O2 concentration can a Non-Rebreather deliver?
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80-90%
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Venturi
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High flow system
The oxygen mixes with the air in this system Clients receive constant 02 concentration regardless of rate or depth of inspirations |
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A venturi system delivers _______percent oxygen on _______L/min.
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24-50% on 3-8 L/min
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Endotracheal (ET) Tube
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Placed down the throat of a client to deliver oxygen directly to the lungs
Intubation |
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Tracheostomy
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Opening into the trachea through which oxygen can be delivered
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A tracheostomy is used when...
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The upper airway is blocked due to trauma or ilness
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Respirator
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Mechanical ventilation
Used to breathe for a client unable to breathe independently |
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Ambu bag
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Used during CPR until a client is placed on a respirator
Used prior to and after suctioning May provide temporary artificial ventilation during transport May be attached to an O2 supply |
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Artificial airways may be..
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Oral or nasal
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BiPAP
Bilevel Positive Airway Pressure |
Mechanical ventilator to assist inspiration
Pushes air into lungs Client's inspiratory effect triggers the ventilator |
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Positive pressure helps to prevent...
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atelectasis
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CPAP
Continuous Positive Airway |
Oxygen under constant pressure
Used at night to decrease periodic hypoxemia For clients with sleep apnea |
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Deep Breathing Exercises
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Are used to FULLY expand the alveoli and mobilize the removal of secretions
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How to direct a client to do deep breathing exercises
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Position client for maximum lung expansion
Client inhales slowly and then exhale twice as long Watch for chest and ABD expansion Repeat for 10 breaths |
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Incentive Spirometry
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Encourages deep breathing
Measures inspiratory volume Should be used ten times an hour |
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Pulse Oximetry
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Non-invasive way to show the % of hemoglobin carrying O2 to peripheral tissues
Normal range is 92-100% |
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ABGs
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pH of ABGs should be 7.35-7.45
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CO2 range
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35-45
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HCO3 range
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22-26
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Possible Nursing Diagnosis for patients on oxygen or with respiratory problems
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Ineffective airway clearance
Ineffective breathing pattern Ineffective tissue perfusion Decreased cardiac output Impaired gas exchange Impaired spontaneous ventilation Activity intolerance Risk for infection Fear Anxiety Impaired verbal communication |