Respiratory Assessments and Oxygen Therapy
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Questions and Answers

What is the primary requirement for oxygen therapy?

  • Tracheostomy management
  • Doctor's order (correct)
  • Nursing intervention
  • Client education

    • What is the oxygen flow rate range for a nasal canula?

  • 6-10L
  • 0-55% O2
  • 1-6L (correct)
  • 0-6L

    • What is a complication of oxygen therapy?

  • Cystic fibrosis
  • Asthma
  • Oxygen toxicity (correct)
  • COPD

    • What is the primary goal when administering oxygen therapy?

    <p>To provide the lowest amount of oxygen necessary to manage the patient's symptoms</p> Signup and view all the answers

    What is the indication for tracheostomy management in oxygen therapy?

    <p>If mechanical ventilation is required for more than 2 weeks</p> Signup and view all the answers

    What is a late sign of hypoxia?

    <p>Decrease in level of consciousness</p> Signup and view all the answers

    What is the purpose of a Venturi mask in oxygen therapy?

    <p>To titrate the oxygen concentration between 0-55%</p> Signup and view all the answers

    What is an early sign of hypoxia?

    <p>Tachycardia</p> Signup and view all the answers

    What is the primary cause of chronic bronchitis?

    <p>Smoking</p> Signup and view all the answers

    What is the name of the breathing technique used to help patients with chronic bronchitis?

    <p>Pursed lip breathing</p> Signup and view all the answers

    What is the name of the test used to diagnose cystic fibrosis?

    <p>All of the above</p> Signup and view all the answers

    What is the primary complication of cystic fibrosis?

    <p>Organ failure</p> Signup and view all the answers

    What is the purpose of chest physiotherapy in the treatment of cystic fibrosis?

    <p>To increase mucus clearance</p> Signup and view all the answers

    What is the abnormal result of the ABG test in lung cancer?

    <p>All of the above</p> Signup and view all the answers

    What is the symptom of chronic bronchitis characterized by a bluish discoloration of the skin?

    <p>Cyanosis</p> Signup and view all the answers

    What is the purpose of administering oxygen therapy in chronic bronchitis?

    <p>To improve oxygen saturation</p> Signup and view all the answers

    What is the primary difference between hypoxemia and hypoxia?

    <p>Hypoxemia is a lack of oxygen in the arterial blood, while hypoxia is a lack of oxygen in the tissues.</p> Signup and view all the answers

    What is the primary goal of incentive spirometry?

    <p>To improve lung function and prevent respiratory complications</p> Signup and view all the answers

    What is a common symptom of influenza?

    <p>Rhinorrhea</p> Signup and view all the answers

    What is the primary cause of pneumonia?

    <p>All of the above</p> Signup and view all the answers

    What is the primary goal of chest physiotherapy?

    <p>To promote drainage of secretions from the lungs</p> Signup and view all the answers

    What is a common symptom of tuberculosis?

    <p>Fever</p> Signup and view all the answers

    What is the primary treatment for asthma?

    <p>Bronchodilators</p> Signup and view all the answers

    What is the primary difference between COPD and asthma?

    <p>Asthma is a reversible condition, while COPD is an irreversible condition</p> Signup and view all the answers

    What is the primary goal of nursing interventions for patients with pneumonia?

    <p>To improve lung function and reduce the risk of complications</p> Signup and view all the answers

    What is the primary risk factor for obstructive sleep apnea?

    <p>All of the above</p> Signup and view all the answers

    Study Notes

    Respiratory Assessments

    • Assessments include history of present illness, physical assessment, and laboratory tests
    • Physical assessment includes:
      • Clubbing of fingernails
      • Mucous membranes
      • Position of trachea (is it midline?)
      • Breathing (are they using accessory muscles? Is their breathing even?)
      • Vital signs
      • Sputum
      • ESR & CRP
      • Chest x-ray
      • CBC & CMP

    Oxygen Therapy Management

    • Oxygen therapy requires a doctor's order and is considered a medication
    • Noninvasive oxygen delivery methods:
      • Nasal Canula (1-6L, can titrate)
      • Simple Mask (6-10L, can titrate)
      • Venturi Mask (0-55% O2, "titrate" varies on the valve used)
      • Non-Rebreather (100%, no titration)
      • Continuous positive airway pressure (CPAP)
      • Bi-level positive airway pressure (BIPAP)
      • Tracheostomy (indicated if mechanical ventilation is required, max 2 weeks)
    • Complications of oxygen therapy:
      • Oxygen toxicity: symptoms include nonproductive cough, nasal congestion, substernal pain, headache, N/V, fatigue, sore throat, dry mucous membranes, infection
      • Hypoxia: early signs include restlessness, irritability, use of accessory muscles, nasal flaring, tachycardia, tachypnea, hypertension; late signs include decrease in level of consciousness, increase in lactic acid, dysthymias, bradypnea, bradycardia, hypotension, cyanosis
      • Hypoxemia: insufficient oxygen in the arterial blood

    Infectious Respiratory Disorders

    • Influenza:
      • Highly contagious acute viral respiratory infection
      • Symptoms: fever, chills, malaise, muscle aches, HA, rhinorrhea, cough, sore throat
      • Diagnosis: rapid flu test
      • Treatment: saltwater gargles, increase fluids, Tamiflu (first 48 hours), analgesics
      • Nursing interventions: handwashing, vaccinations, avoiding close contact with infected people
    • Pneumonia:
      • Excess fluid in the lungs due to inflammation
      • Symptoms: fever, SOB, chest pain, cough, dyspnea, crackles/wheezes
      • Laboratory tests: increased WBC, decreased O2/increased CO2
      • Diagnosis: chest x-ray (consolidation)
      • Treatment: antibiotics, bronchodilators, oxygen therapy, Guaifenesin (Mucinex)
      • Nursing interventions: high fowlers, oxygen therapy, cough and deep breath, incentive spirometer, increase fluid intake
    • Tuberculosis:
      • Upper airway disorders:
      • Rhinitis/Rhinosinusitis:
        • Nasal inflammation/sinus inflammation (allergies)
        • Symptoms: nasal itching, runny nose
        • Treatment: nasal spray, decongestants, antihistamine
        • Nursing interventions: medication compliance, avoiding triggers
      • Obstructive sleep apnea:
        • Breathing disruption that occurs during sleep
        • Causes: upper airway blockage
        • Risk factors: overweight, birth defects, smoking
        • Symptoms: persistent daytime sleepiness, irritability
        • Treatment: C-pap, smoking cessation, weight loss
      • Laryngitis:
        • Inflammation of the larynx
        • Laryngeal cancer:
          • Cancerous growth on the vocal cords
          • Symptoms: hoarseness, persistent sore throat, pain with swallowing, SOB
          • Diagnosis: barium swallow, MRI, PET scan
          • Treatment: chemotherapy, radiation, surgery, trach
      • Laryngeal trauma:

    Lower Airway Disorders

    • Asthma:
      • Chronic inflammation disorder of the airway
      • Intermittent and reversible
      • Triggered by allergen
      • Symptoms: dyspnea, wheezing, chest tightness, coughing, tachypnea, prolonged expiration, increased sputum
      • Diagnosis: pulmonary function test, ABG's
      • Treatment: bronchodilators (can cause an increase in HR)
      • Albuterol: short-acting bronchodilator for acute asthma attacks (reliever drug)
      • Solumedrol (control therapy)
      • Corticosteroids
      • Nursing interventions: avoid triggers, pursed lip breathing, smoking cessation, track asthma with a peak flow meter (3 times and record the highest number)
    • Status Asthmaticus:
      • Life-threatening asthma attack
      • Airway obstruction that is unresponsive to usual therapy
      • Symptoms: extremely labored breathing, gasping, decreased level of consciousness, cyanosis, neck vein distention, pulsus paradoxes
      • Treatment: bronchodilators, epinephrine, corticosteroids
      • Nursing interventions: administer oxygen to the patient, prepare for emergency intubation and mechanical ventilation

    Chronic Obstructive Pulmonary Disease (COPD)

    • Combination of emphysema and chronic bronchitis
    • Airway obstruction irreversible
    • Emphysema:
      • Destruction of the alveoli
      • Decreases lung elasticity
      • Hyperinflation and air trapping in the lungs
    • Chronic bronchitis:
      • Inflammation of the airways
      • Hypersecretions of mucous
    • Risk factors: smoking, air pollution, occupational
    • Symptoms: cough, excess sputum, crackles/wheezes, barrel chest, red/blue skin, clubbing of nails, cyanosis, increased work of breathing, tripod position, SOB
    • Laboratory tests:
      • Decreased SpO2 (less than 90)
      • ABG: 50/50 club
      • PFT
      • Chest x-ray
    • Treatment: bronchodilators, corticosteroids, anticholinergics, oxygen therapy
    • Nursing interventions: place patient in upright position, administer oxygen, monitor for R-sided HF, smoking cessation, pursed lip breathing, incentive spirometer, increase fluid and protein intake

    Cystic Fibrosis

    • Genetic disorder (autosomal recessive disorder)
    • Severely impairs lung function and other organ functions
    • Abnormally thick sticky mucous (plugs organ ducts)
    • Can lead to organ failure
    • Symptoms:
      • Respiratory: wheezing, coughing, dyspnea, mucous plugs, cyanosis, clubbing, barrel chest, chronic respiratory infection
      • Gastrointestinal: steatorrhea (fatty, malodorous stool), delayed growth, ADEK deficiencies
      • Integumentary: abnormally high NaCl in sweat, saliva, tears
    • Diagnosis: sweat Cl test, PFT, DNA testing, stool analysis
    • Treatment: bronchodilators, anticholinergics, antibiotics, pancreatic enzymes
    • Nursing interventions: chest physiotherapy, administer oxygen as ordered, increase fluid, protein, and calorie intake, supplement fat-soluble vitamins

    Lung Cancer

    • No specific notes provided in the text

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    Description

    Assess respiratory function through physical examination, laboratory tests, and oxygen therapy management. Learn about vital signs, chest x-ray, and more.

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