| Hypoxemic vs. Circulatory vs. Anemic vs. Histotoxic Hypoxias | Hyp:decreased O in blood, C:inadequate capillary circulation, A:ineffective hemoglobin concentration, Histo:caused by toxic substance |
| Stimulus for respiration r/t COPD | Decrease in blood O |
| Normal stimulus r/t Respiration | Elevated CO2 |
| Cannula vs. Partial rebreather vs. Non-rebreather vs. Venturi r/t O flow rate | C:1-6 L/min, P:8-11 L/min, N:12 L/min, V:4-8 L/min |
| Low-flow vs. High-flow oxygen delivery systems | LF:combines O w/Pt's inspiration & inspired O changes, HF:Pt's that require constant and precise amount of O |
| Reservoir bags must remain inflated during | Inspiration and expiration |
| Non-rebreathing masks prevent | Room air from entering mask during inhalation |
| Noninvasive mask that provides most reliable/accurate O concentration | Venturi mask |
| Venturi mask r/t COPD | Accurate O supplementation avoid suppressing hypoxic drive |
| Amount of O dissolved in plasma r/t Hyperbaric O therapy | O level in plasma increases, O levels in tissues increases |
| Humidity r/t O therapy | Counteracts dry, irritating effects of compressed O, Moistens secretions |
| Method of deep breathing encouraging Pt to inhale slowly and deeply | Incentive spirometry |
| Incentive spirometry functions | Maximize lung inflation, Prevent/reduce atelectasis |
| Volume vs. Flow spirometers | V:increases volume of inhaled air gradully & volume is pre-set, F:same function but volume is not pre-set |
| Proper breathing/Incentive spirometer positioning | At least semi-Fowlers |
| Breathing technique to prepare for nebulizer use | Diaphragmatic breathing |
| Area of body r/t Diaphragmatic breathing | Abd protrudes as far as possible |
| Time r/t Postural drainage | 2-4x a day, Before meals, Bedtime |
| Intervention d/t Pt inability to cough | Sunction secretions |
| Percussion technique r/t Secretion loosening | Cup hands and lightly strike chest wall, Wrists are alternately flexed |
| Technique that applies compression to chest wall | Vibration |
| Vibration is done while Pt is | Exhaling |
| Breathing retraining are exercises and practices to achieve more efficient and controlled | Ventilation & decrease work of breathing |
| Pt's in which breathing retraining is indicated | COPD and dyspnea |
| Examples r/t breathing retraining exercises | Diaphragmatic breathing, Pursed-lip breathing |
| Pt's w/altered level of consciousness are at risk for ________ d/t _______ | Upper airway obstructions, Loss of protective reflexes and tone of pharyngeal muscles |
| Endotracheal intubation Pt indications | Cannot maintain adequate airway, Need mechanical ventilation, Secretion suctioning of pulmonary tree |
| Cuff pressures are checked | Every 6-8 hours |
| Intubation is used no longer than | 3 weeks |
| Disadvantages r/t Endotracheal/Tracheostomy tubes | Depressed cough reflex, Thicker secretions, Depressed swallowing reflex |
| Preventing tube removal by Pt | Explain purpose of tube, Distract Pt w/one-to-one interaction, Maintain comfort |
| Tracheostomy incision location | B/w 2nd and 3rd tracheal rings |
| Inflated portion of tracheostomy tube | Cuff |
| Long-term complication r/t Tracheostomy tube | Airway obstruction, Infection, Innominate artery rupture, Dysphagia, Tracheoesophageal fistula, Ischemia, Necrosis |
| May develop after tracheostomy tube is removed | Tracheal stenosis |
| Tracheostomy tube is kept patent by | Sunctioning |
| Semi-fowler's position r/t Tracheostomy tube | Facilitate ventilation, Promote drainage, Minimize edema, Prevent strain on sutures |
| Sterility r/t Tracheostomy tubes | Prevent pulmonary and systemic infections |
| Cuff pressure limits | > 15 mm Hg, <25 mm Hg |
| Preventing complications r/t Tracheostomy tubes | Maintain skin integrity, Maintain adequate hydration |
| Cotton applicators moistened w/__________ during wound cleansing | Hydrogen peroxide |
| Turned on before opening suction catheter kit | Suction source |
| Suction catheter insertion depth | Just far enough to stimulate cough reflex |
| Suction is applied while | Withdrawing |
| Mechanical ventilation indications | Continuous decrease in PaO(hypoxemia), Increase in PaCO2(hypercapnia), Persistent acidosis |
| Most commonly used Positive-pressure ventilator | Volume-cycled ventilator |
| Volume-cycled ventilator r/t O delivery | Volume of air delivered is relatively constant |
| Examples r/t Noninvasive Positive-pressure Ventilators | Nasal cannula and all masks |
| Bucking the ventilator | Pt is out of sync w/ventilator |
| Humidifier levels are checked | 3x a day |
| Continuous positive-pressure ventilation r/t Secretions | Secretion production is always increased |
| Method to assess for secretions | Lung ascultation at least every 2-4 hours |
| Prevent atelectasis and retention of secretions r/t Ventilators | Periodic sighs |
| Permits talking r/t Mechanical ventilation | Passy-Muir valve |
| Order r/t Respiratory weaning | Gradual removal of ventilator, Tube, Oxygen |
| Indications r/t Tube weaning | Pt can breathe spontaneously, Maintain patent airway, Effectively cough, Swallow, Move jaw |
| Supplemental O recommended when, PaO < 70 mm Hg on room air | (blank) |
| PaO level r/t Medicare/Medicaid reimbursement | < 55 mm Hg |
| Metabolism of fat vs. Metabolism of carbohydrates r/t CO2 production | Fat metabolism produces less CO2 |
| Postoperative risk factors r/t Surgery-related Atelectasis/Pneumonia | Immobilization, Supine, Decreased consciousness, Prolonged intubation/mechanical ventilation |
| Re-expands lungs and Removes excess air/fluid/blood from pleural spaces | Chest tubes, Closed drainage systems |
| Fluid fluctuations stop when | Lung has reexpanded, Tubing is obstructed, Suction is not properly working |
| Constant bubbling r/t Water seal chamber | Air leak in drainage system |
| Drainage system r/t Pt chest level | System is kept below Pt chest level |
| Water level r/t Inspiration | Water level increase |
| Normal bubbling | Intermittent |
