Oxygenation
Terms
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- What two systems supply O2 needs?
- cardiac and respiratory
- What carries 97% of O2
- HgB
- A disorder which is caused by a decreased O2 carrying capacity?
- anemia
- When would you find a decreased inspired O2 concentration?
- airway obstruction, higher attitudes
- What is a decrease in circulatory blood volume from blood loss?
- hypovolemia
- What can shock and dehydration cause?
- hypovolemia
- What happens with an increase in O2 demand that results in an elevated temp?
- increased metabolic rate
- What is hyperventilation induced by?
- anxiety, infections, drugs, acid base imbalance
- What is atelectasis
- collapse of alveoli
- Abnormal structural configurations that can affect O2?
- kyphosis
- Trauma situations that can cause O2 problems?
- rib fx, chest/abd incisions
- Name a muscle disease that can affect O2.
- MD
- Name some nervous systems diseases that can affect O2
- myocenia gravis, gedeon beret
- What in pain management can affect O2?
- narcotics
- Name a developmental factor that can affect O2?
- premature infants - down surfactant level
- What happens when blood backs up in pulmonary circ?
- congestion and decreased Cardiac Output
- What is left sided heart failure usually caused by?
- chronically elevated arterial pressures and pulmonary congestion
- Part of heart affected by left sided heart failure?
- left ventricle
- Part of heart affected by right sided heart failure
- right ventricle
- In right sided heart failure what happens to the jugular vein?
- gets distended, and has peripheral edema
- What does right sided heart failure commonly result from?
- pulmonary diseases or caused by left sided heart failure
- Name some S/S of hyperventilation?
- tachycardia, dizziness, blurred vision, disorientation, SOB
- S/S of hypoventilation
- dizziness, headache, lethargy, disorientation, coma, cardiac arrest, convulsions
- Causes of Hypoxia
- decreased HgB, decreased conc. inspired O2, poor tissue perfusion, decreased diffusion 02, impair. vent.
- S/S hypoxia
- restlessness, anxiety, fatigue, dizziness, up BP, SOB, up pulse, rate and depth, Down LOC
- Retractions
- visible sinking in of soft tissues of chest
- paradoxical
- asynchronous, contractions during inspirations and expansion during expiration
- People who are pardoxical require this type of resp. intervention?
- ventilator
- Person whos A-P diameter is greater than transverse diameter?
- barrel chest
- What down an EKG assess?
- determines adequacy of cardiac conduction system
- ABG
- arterial blood gas
- CBC
- Complete blood count
- CXR
- Chest X-Ray
- What does humidification do?
- keeps airway moist and helps to mobilize secretions
- What does nebulization do?
- dilates bronchials
- 3 types of breathing exercises
- deep breathing and coughing exercises, pursed lip breathing, diaphragmatic breathing
- normal sequence on an ECG
- normal sinus rhythm
- oxygenation
- amount of oxygen entering the lungs
- perfusion
- blood flow to lungs and tissues
- diffustion
- oxygen carrying capacity of the blood
- amount of carbon dioxide excreted by lungs
- ventilation
- what causes hypovolemia?
- extracellular fluid losses
- what reduced tissues need for O2?
- fever
- hypercapnia
- increased carbon dioxide
- hypoxemia
- decreased arterial oxygen level in the blood
- a person presents with clubbed fingers, SOB, and increased fatigue, what would you suspect?
- hypoxemia
- dysrhythmias
- deviation from normal sinus rhythm
- coronary artery not supplying sufficient blood to myocardium
- myocardial ischemia
- What happens when cardiac tissue becomes completely blocked and becomes necrotic?
- myocardial infarction
- Myocardial Infarction
- heart attack
- S/S of MI
- severe chest pain, SOB, diaphoresis, Down BP
- Acquired or congenital valve disorder char. by stenosis and obstructed blood flow or valvular degen and regurg?
- valvular heart disease
- What is hyperventilation?
- increase in resp. rate resulting in excess amts of CO2 elimination
- What is hypoventilation?
- ventilation is inadequate to meet body's O2 deamand or to eliminat CO2
- COPD
- Chronic Obstructive Pulmonary Disease
- What does surfactant do?
- prevents alveolar collapse
- dyspnea
- SOB
- Fatigue
- subj sensation reported as a loss of endurance
- When is cardiac pain generally manifested in males?
- substernal radiating to left arm and jaw
- Where is cardiac pain generally manifested in females
- epigastric pain, indigestion, choking feeling, SOB
- Orthopnea
- person must use multiple pillows when lying down to be able to breath
- Wheezing
- high pitched musical sound
- What is wheezing caused by?
- high-velocity movement of air through narrowed airwayq
- Cough
- sudden audible expulsion of air from lungs
- What is a protective reflex to clear the trachea, bronchi, and lungs of irritants and sercretions
- Cough
- productive cough
- sputum production coming out in a cough
- hemoptysis
- bloody sputum
- Eupnea
- normal breathing rate
- What is a normal breathing rate?
- 16-20
- What are the numbers for tachypnea
- rate >35
- apnea
- periods of no respiration lasting >15
- What does of rate does apneustic breathing have?
- increased
- What disease is associated with Kussmauls breathing?
- diabetic ketoacidosis
- Cheyne Stokes
- increasing and decreasing pattern
- What causes Cheyne Stokes?
- alterationgs in acid-base status, underlying metabolic prob
- Biots
- periods of apnea and shallow breathing
- What can cause Biots
- CNS disorder
- When is an airway patent?
- when trachea, bronchi and large airways are free from obstructions
- How is cough evectiveness evaluated by?
- sputum expectoration, report of swallowed sputm, and clear lung sounds
- Cascade Cough
- slow deep breath and hold for 2 sec, cough during exhalation
- Huff Cough
- when exhaling ct opens glottis and says huff
- What does the huff cough do?
- stim. nat. cough reflex only clears central airways
- Quad Cough?
- while breathing out ct or nurse pushes in and up and abd mus. to cause cough
- When do you use the Quad cough tech?
- when you have a ct w/o abd muscle control
- What does the cascade cough do?
- promotes airway clearance and patent airway
- What are the primary suctioning tech?
- oropharyngeal and nasopharyngeal, orotracheal and nasotracheal, tracheal through artificial
- When do you use orophar. and nasophar suctioning?
- to assist ct who can cough effectively but cannot clear secretions
- When do you use orotrach and nasotrach suctioning?
- when ct cant cough and does not have artifical airway
- when is an artificial airway indicated?
- ct with down LOC, airway obstruction, mech. vent
- Where is tracheal suctioning performed through?
- artifical airway
- Two methods of tracheal suctioning
- open and closed
- Open suctioning
- freshly opened sterile suction catheter each time
- Closed suctioning
- multiple use catheter can be used for 24 to 48 hours
- What is the simplest type of artificial airway
- oral airway
- What does an oral airway prevent?
- obstruction of trachea by displacement of tongue into oropharynx
- types of tracheal airways
- endotracheal, nasotracheal, tracheal tubes
- What must you do with a tracheal airway
- ensure humidification
- How much fluid must you intake a day to keep secretions thin
- 1500-2000ml day
- Most effective position for people with cardia pulmonary prob
- semi fowlers
- Incentive spiromenty
- method that encourages voluntary deep breathing by providing visual feedback
- CPT
- hest physiotherapy
- What is CPT used for?
- mobilize pulmonary secretions
- Chest percussion
- striking the chest wall over the area being drained
- vibration
- fine, shaking pressure applied to chest all only during exhalation
- What does vibration do?
- increase velocity and turvulence of exhaled air facilitating secretion removal
- Postural Drainage
- use of positioning tech that drain secretions from specific segments of the lungs and bronchi into the trachea
- chest tube
- catheter inserted through thorax to remove air and fluid from pleural space
- What is the goal of a chest tube?
- restore normal intrapleural and intrapulominc pressures
- pneumothorax
- collection of air or other gas in pleural space
- hemothorax
- accumulation of blood and fluid in pleural cavity between the parietal and visceral pleurae
- CPR
- cardiopulmonary resusciation
- ABC's
- airway, breathing, circulation
- cardiopulmonary rehabilitation
- actively assisting ct to achieve and maintain an optimal level of health through controlled phys exercise, nutrition counse, relaxation and stree manage
- pursed lip breathing
- deep inspiration and prolonged expiration through pursed lips
- What is the purpose of pursed lip breathing
- preven alveolar collapse
- diaphragmatic breathing
- use diaphram to breath