Podcast
Questions and Answers
A patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital. During assessment, the nurse notes the patient is breathing at a rate of 10 breaths per minute and has an oxygen saturation of 88% on room air. The patient is drowsy but arousable. Which of the following physiological principles should the nurse prioritize when planning oxygen therapy for this patient?
A patient with chronic obstructive pulmonary disease (COPD) is admitted to the hospital. During assessment, the nurse notes the patient is breathing at a rate of 10 breaths per minute and has an oxygen saturation of 88% on room air. The patient is drowsy but arousable. Which of the following physiological principles should the nurse prioritize when planning oxygen therapy for this patient?
- Administering high-flow oxygen to quickly improve oxygen saturation.
- Focusing on SpO2 targets above 95% to prevent cellular hypoxia.
- Maintaining a high PaO2 to ensure adequate tissue oxygenation.
- Understanding the hypoxic drive and avoiding excessive oxygen administration. (correct)
A nurse is caring for a patient receiving oxygen via a non-rebreather mask. To ensure optimal oxygen delivery and patient safety, which of the following actions is MOST critical?
A nurse is caring for a patient receiving oxygen via a non-rebreather mask. To ensure optimal oxygen delivery and patient safety, which of the following actions is MOST critical?
- Ensuring the reservoir bag remains inflated during inspiration. (correct)
- Setting the oxygen flow rate at precisely 6 L/minute.
- Checking the mask fit every 4 hours to prevent skin breakdown.
- Humidifying the oxygen to prevent mucosal drying.
A patient with acute respiratory distress syndrome (ARDS) is being mechanically ventilated. The physician orders an arterial blood gas (ABG) to assess the patient's respiratory status. Which of the following ABG values is MOST indicative of hypoxemia?
A patient with acute respiratory distress syndrome (ARDS) is being mechanically ventilated. The physician orders an arterial blood gas (ABG) to assess the patient's respiratory status. Which of the following ABG values is MOST indicative of hypoxemia?
- PaCO2 of 48 mmHg
- HCO3- of 26 mEq/L
- pH of 7.30
- PaO2 of 55 mmHg (correct)
An elderly patient with pneumonia is being treated with oxygen therapy. The nurse notes the patient is increasingly confused and restless, with a SpO2 reading of 91%. The initial nursing intervention should be to:
An elderly patient with pneumonia is being treated with oxygen therapy. The nurse notes the patient is increasingly confused and restless, with a SpO2 reading of 91%. The initial nursing intervention should be to:
A patient is prescribed incentive spirometry after abdominal surgery. To effectively educate the patient on the proper use of an incentive spirometer, the nurse should explain that the primary goal of this therapy is to:
A patient is prescribed incentive spirometry after abdominal surgery. To effectively educate the patient on the proper use of an incentive spirometer, the nurse should explain that the primary goal of this therapy is to:
A nurse is performing an Allen test prior to drawing arterial blood for an ABG. The purpose of the Allen test is to:
A nurse is performing an Allen test prior to drawing arterial blood for an ABG. The purpose of the Allen test is to:
A patient with a tracheostomy requires oxygen therapy. Which oxygen delivery device is MOST appropriate for providing humidified oxygen directly to the tracheostomy?
A patient with a tracheostomy requires oxygen therapy. Which oxygen delivery device is MOST appropriate for providing humidified oxygen directly to the tracheostomy?
A patient is receiving oxygen via nasal cannula at 4 L/min. The nurse observes the patient has developed skin breakdown behind the ears. Which intervention is MOST appropriate to prevent further skin injury?
A patient is receiving oxygen via nasal cannula at 4 L/min. The nurse observes the patient has developed skin breakdown behind the ears. Which intervention is MOST appropriate to prevent further skin injury?
A patient with suspected pulmonary embolism is experiencing acute hypoxemia. Which oxygen delivery system is BEST suited to provide the HIGHEST possible concentration of oxygen in a non-intubated patient?
A patient with suspected pulmonary embolism is experiencing acute hypoxemia. Which oxygen delivery system is BEST suited to provide the HIGHEST possible concentration of oxygen in a non-intubated patient?
A nurse is teaching a patient with chronic bronchitis how to perform pursed-lip breathing. The nurse should explain that the primary benefit of this technique is to:
A nurse is teaching a patient with chronic bronchitis how to perform pursed-lip breathing. The nurse should explain that the primary benefit of this technique is to:
A patient with heart failure is experiencing dyspnea and has an oxygen saturation of 90%. The physician orders oxygen therapy via nasal cannula to maintain SpO2 above 92%. Which nursing intervention is MOST important to implement while initiating oxygen therapy?
A patient with heart failure is experiencing dyspnea and has an oxygen saturation of 90%. The physician orders oxygen therapy via nasal cannula to maintain SpO2 above 92%. Which nursing intervention is MOST important to implement while initiating oxygen therapy?
A patient is prescribed BiPAP therapy for sleep apnea. Which statement BEST describes the mechanism of action of BiPAP?
A patient is prescribed BiPAP therapy for sleep apnea. Which statement BEST describes the mechanism of action of BiPAP?
A nurse is caring for a patient with a chest tube connected to a water-seal drainage system. Continuous bubbling in the water-seal chamber is noted. The MOST appropriate initial nursing action is to:
A nurse is caring for a patient with a chest tube connected to a water-seal drainage system. Continuous bubbling in the water-seal chamber is noted. The MOST appropriate initial nursing action is to:
A patient with acute exacerbation of asthma is prescribed oxygen therapy. The nurse recognizes that humidification is particularly important for this patient because:
A patient with acute exacerbation of asthma is prescribed oxygen therapy. The nurse recognizes that humidification is particularly important for this patient because:
When preparing to administer oxygen via a nasal cannula, the nurse understands that this device is appropriate for delivering which approximate range of FiO2?
When preparing to administer oxygen via a nasal cannula, the nurse understands that this device is appropriate for delivering which approximate range of FiO2?
A patient is scheduled for hyperbaric oxygen therapy (HBOT). The nurse explains to the patient that HBOT is expected to enhance oxygen delivery to tissues primarily by:
A patient is scheduled for hyperbaric oxygen therapy (HBOT). The nurse explains to the patient that HBOT is expected to enhance oxygen delivery to tissues primarily by:
A nurse is reviewing the arterial blood gas results of a patient with metabolic alkalosis. Which of the following compensatory mechanisms would the nurse expect the respiratory system to initiate?
A nurse is reviewing the arterial blood gas results of a patient with metabolic alkalosis. Which of the following compensatory mechanisms would the nurse expect the respiratory system to initiate?
A patient with known heart failure reports increased shortness of breath. Pulse oximetry on room air is 89%. Before applying oxygen, which position should the nurse prioritize to facilitate improved breathing and lung expansion?
A patient with known heart failure reports increased shortness of breath. Pulse oximetry on room air is 89%. Before applying oxygen, which position should the nurse prioritize to facilitate improved breathing and lung expansion?
A nurse is educating a patient about the risks of oxygen therapy in the home setting. Which of the following safety instructions is MOST critical to emphasize to the patient and family?
A nurse is educating a patient about the risks of oxygen therapy in the home setting. Which of the following safety instructions is MOST critical to emphasize to the patient and family?
A patient receiving oxygen therapy complains of nasal dryness and irritation. Which intervention is MOST appropriate to alleviate this discomfort?
A patient receiving oxygen therapy complains of nasal dryness and irritation. Which intervention is MOST appropriate to alleviate this discomfort?
A patient with a history of sleep apnea is scheduled for discharge. The nurse is providing education on CPAP therapy. Which statement by the patient indicates a need for further teaching?
A patient with a history of sleep apnea is scheduled for discharge. The nurse is providing education on CPAP therapy. Which statement by the patient indicates a need for further teaching?
A nurse is assessing a patient for signs of inadequate oxygenation. Which of the following is a LATE sign of hypoxemia and requires immediate intervention?
A nurse is assessing a patient for signs of inadequate oxygenation. Which of the following is a LATE sign of hypoxemia and requires immediate intervention?
During a home visit, the nurse observes that a patient using portable oxygen tanks has several unsecured tanks stored in the corner of a room. Which safety risk associated with improper oxygen cylinder storage is MOST concerning?
During a home visit, the nurse observes that a patient using portable oxygen tanks has several unsecured tanks stored in the corner of a room. Which safety risk associated with improper oxygen cylinder storage is MOST concerning?
A patient is admitted with suspected oxygen toxicity. Which symptom is MOST indicative of early oxygen toxicity?
A patient is admitted with suspected oxygen toxicity. Which symptom is MOST indicative of early oxygen toxicity?
A patient with a history of severe COPD is admitted for an elective surgical procedure. Pre-operatively, the patient's baseline arterial blood gas (ABG) results show compensated respiratory acidosis. During the post-operative period, the nurse should be MOST vigilant for:
A patient with a history of severe COPD is admitted for an elective surgical procedure. Pre-operatively, the patient's baseline arterial blood gas (ABG) results show compensated respiratory acidosis. During the post-operative period, the nurse should be MOST vigilant for:
A patient with cystic fibrosis is admitted with an acute respiratory exacerbation. The patient is currently receiving high-flow oxygen via nasal cannula. Which assessment finding would warrant the MOST immediate intervention?
A patient with cystic fibrosis is admitted with an acute respiratory exacerbation. The patient is currently receiving high-flow oxygen via nasal cannula. Which assessment finding would warrant the MOST immediate intervention?
A patient with a chest tube connected to a water-seal drainage system is being transported to radiology for a CT scan. During transport, the chest tube becomes dislodged from the drainage system. The nurse's IMMEDIATE action should be to:
A patient with a chest tube connected to a water-seal drainage system is being transported to radiology for a CT scan. During transport, the chest tube becomes dislodged from the drainage system. The nurse's IMMEDIATE action should be to:
A patient receiving mechanical ventilation develops subcutaneous emphysema around the tracheostomy site. The nurse should suspect which of the following as the MOST likely cause?
A patient receiving mechanical ventilation develops subcutaneous emphysema around the tracheostomy site. The nurse should suspect which of the following as the MOST likely cause?
A patient with a history of obstructive sleep apnea (OSA) is prescribed CPAP therapy at home. Which statement by the patient indicates an understanding of how to manage potential skin breakdown related to the CPAP mask?
A patient with a history of obstructive sleep apnea (OSA) is prescribed CPAP therapy at home. Which statement by the patient indicates an understanding of how to manage potential skin breakdown related to the CPAP mask?
A nurse is caring for a patient with acute respiratory failure who is being mechanically ventilated. The physician orders an increase in the positive end-expiratory pressure (PEEP). The nurse understands that the PRIMARY purpose of increasing PEEP is to:
A nurse is caring for a patient with acute respiratory failure who is being mechanically ventilated. The physician orders an increase in the positive end-expiratory pressure (PEEP). The nurse understands that the PRIMARY purpose of increasing PEEP is to:
A patient with a long-standing tracheostomy is being discharged home. Which teaching point is MOST critical to include in the discharge instructions to ensure patient safety?
A patient with a long-standing tracheostomy is being discharged home. Which teaching point is MOST critical to include in the discharge instructions to ensure patient safety?
A nurse is preparing a patient for transtracheal oxygen delivery. Which of the following pre-procedure interventions is MOST important to ensure the success and safety of this method?
A nurse is preparing a patient for transtracheal oxygen delivery. Which of the following pre-procedure interventions is MOST important to ensure the success and safety of this method?
During a home visit, the nurse assesses a patient with a history of heart failure who is receiving oxygen therapy. The patient reports increased dyspnea and demonstrates peripheral edema. Which intervention is MOST critical to address FIRST?
During a home visit, the nurse assesses a patient with a history of heart failure who is receiving oxygen therapy. The patient reports increased dyspnea and demonstrates peripheral edema. Which intervention is MOST critical to address FIRST?
A nurse is caring for a patient receiving hyperbaric oxygen therapy (HBOT). The patient suddenly reports ear pain and pressure. The nurse's MOST appropriate initial intervention is to:
A nurse is caring for a patient receiving hyperbaric oxygen therapy (HBOT). The patient suddenly reports ear pain and pressure. The nurse's MOST appropriate initial intervention is to:
A patient with a history of asthma is admitted to the emergency department with severe respiratory distress. Despite initial oxygen therapy and bronchodilator treatments, the patient's condition worsens. The nurse should anticipate that the NEXT line of treatment will MOST likely include:
A patient with a history of asthma is admitted to the emergency department with severe respiratory distress. Despite initial oxygen therapy and bronchodilator treatments, the patient's condition worsens. The nurse should anticipate that the NEXT line of treatment will MOST likely include:
A patient is being discharged home on oxygen therapy. The patient expresses concern about the cost of oxygen. What is the nurse's BEST response?
A patient is being discharged home on oxygen therapy. The patient expresses concern about the cost of oxygen. What is the nurse's BEST response?
A patient with a suspected tension pneumothorax is rapidly deteriorating. While awaiting the physician, the nurse's MOST crucial action is to:
A patient with a suspected tension pneumothorax is rapidly deteriorating. While awaiting the physician, the nurse's MOST crucial action is to:
The nurse is caring for a patient following a bronchoscopy. Which finding requires the MOST immediate intervention?
The nurse is caring for a patient following a bronchoscopy. Which finding requires the MOST immediate intervention?
A nurse is providing education to a patient with newly diagnosed sleep apnea. The patient asks, "Why do I have to wear this CPAP machine every night? Can't I just use it when I feel like I need it?" What is the nurse's BEST response?
A nurse is providing education to a patient with newly diagnosed sleep apnea. The patient asks, "Why do I have to wear this CPAP machine every night? Can't I just use it when I feel like I need it?" What is the nurse's BEST response?
A patient with acute respiratory distress syndrome (ARDS) is being mechanically ventilated. The nurse notices a sudden decrease in oxygen saturation and increased peak inspiratory pressure. Which of the following should the nurse suspect FIRST?
A patient with acute respiratory distress syndrome (ARDS) is being mechanically ventilated. The nurse notices a sudden decrease in oxygen saturation and increased peak inspiratory pressure. Which of the following should the nurse suspect FIRST?
A patient receiving oxygen therapy via nasal cannula at 6 L/min complains of severe nasal dryness and irritation, but oxygen saturation remains low if the flow rate is reduced. Which intervention is MOST appropriate?
A patient receiving oxygen therapy via nasal cannula at 6 L/min complains of severe nasal dryness and irritation, but oxygen saturation remains low if the flow rate is reduced. Which intervention is MOST appropriate?
A registered nurse (RN) is supervising a newly licensed nurse (LPN) who is providing tracheostomy care. Which action by the LPN would require IMMEDIATE intervention by the RN?
A registered nurse (RN) is supervising a newly licensed nurse (LPN) who is providing tracheostomy care. Which action by the LPN would require IMMEDIATE intervention by the RN?
A patient is being treated for carbon monoxide poisoning with hyperbaric oxygen therapy (HBOT). Which of the following assessments would indicate a positive response to the therapy?
A patient is being treated for carbon monoxide poisoning with hyperbaric oxygen therapy (HBOT). Which of the following assessments would indicate a positive response to the therapy?
The nurse is caring for a patient with a chest tube connected to a water-seal drainage system. The nurse observes tidaling in the water-seal chamber. Which action should the nurse take?
The nurse is caring for a patient with a chest tube connected to a water-seal drainage system. The nurse observes tidaling in the water-seal chamber. Which action should the nurse take?
A patient with a history of chronic bronchitis is admitted with an acute exacerbation. The patient is receiving oxygen at 2 L/min via nasal cannula. The nurse notes that the patient is increasingly lethargic. What is the nurse's BEST immediate action?
A patient with a history of chronic bronchitis is admitted with an acute exacerbation. The patient is receiving oxygen at 2 L/min via nasal cannula. The nurse notes that the patient is increasingly lethargic. What is the nurse's BEST immediate action?
The nurse is caring for a patient who is being mechanically ventilated. The high-pressure alarm keeps going off. What is the FIRST action the nurse should take?
The nurse is caring for a patient who is being mechanically ventilated. The high-pressure alarm keeps going off. What is the FIRST action the nurse should take?
A patient who underwent a tonsillectomy is now being prepared for discharge. Which discharge instruction is MOST important for the nurse to emphasize to the patient and their family?
A patient who underwent a tonsillectomy is now being prepared for discharge. Which discharge instruction is MOST important for the nurse to emphasize to the patient and their family?
A patient with a pneumothorax has a chest tube inserted. When assessing the chest tube drainage system, the nurse notes continuous bubbling in the water-seal chamber. Which of the following actions is MOST appropriate?
A patient with a pneumothorax has a chest tube inserted. When assessing the chest tube drainage system, the nurse notes continuous bubbling in the water-seal chamber. Which of the following actions is MOST appropriate?
A patient with a severe exacerbation of COPD requires high-flow oxygen therapy. Which of the following oxygen delivery devices would be MOST appropriate to provide precise oxygen concentrations while minimizing the risk of CO2 retention?
A patient with a severe exacerbation of COPD requires high-flow oxygen therapy. Which of the following oxygen delivery devices would be MOST appropriate to provide precise oxygen concentrations while minimizing the risk of CO2 retention?
A nurse is instructing a patient on the proper use of an incentive spirometer. Which statement by the patient indicates a need for further teaching?
A nurse is instructing a patient on the proper use of an incentive spirometer. Which statement by the patient indicates a need for further teaching?
A patient is receiving BiPAP therapy for acute respiratory failure. Which assessment finding would warrant IMMEDIATE notification of the physician?
A patient is receiving BiPAP therapy for acute respiratory failure. Which assessment finding would warrant IMMEDIATE notification of the physician?
A patient with a known history of asthma is admitted to the hospital with complaints of chest tightness, wheezing, and shortness of breath. After initial assessment, the nurse auscultates decreased breath sounds bilaterally. Which of the following is the MOST appropriate intervention?
A patient with a known history of asthma is admitted to the hospital with complaints of chest tightness, wheezing, and shortness of breath. After initial assessment, the nurse auscultates decreased breath sounds bilaterally. Which of the following is the MOST appropriate intervention?
A nurse is caring for a patient who is receiving oxygen therapy. Which of the following assessment findings indicates a potential complication of oxygen therapy?
A nurse is caring for a patient who is receiving oxygen therapy. Which of the following assessment findings indicates a potential complication of oxygen therapy?
A nurse is teaching a patient about pursed-lip breathing. Which statement by the patient indicates understanding of the technique?
A nurse is teaching a patient about pursed-lip breathing. Which statement by the patient indicates understanding of the technique?
A patient with a history of congestive heart failure is admitted with shortness of breath and an oxygen saturation of 88% on room air. Which of the following oxygen delivery devices is MOST appropriate to initiate oxygen therapy?
A patient with a history of congestive heart failure is admitted with shortness of breath and an oxygen saturation of 88% on room air. Which of the following oxygen delivery devices is MOST appropriate to initiate oxygen therapy?
A patient is being evaluated for possible obstructive sleep apnea (OSA). Which assessment finding is MOST indicative of this condition?
A patient is being evaluated for possible obstructive sleep apnea (OSA). Which assessment finding is MOST indicative of this condition?
A nurse is educating a patient who is about to start using nasal strips to facilitate better breathing. What information is MOST important for the nurse to include?
A nurse is educating a patient who is about to start using nasal strips to facilitate better breathing. What information is MOST important for the nurse to include?
A patient with a tracheostomy is being discharged home. Which statement by the caregiver indicates a need for further education?
A patient with a tracheostomy is being discharged home. Which statement by the caregiver indicates a need for further education?
A patient with a history of smoking is admitted with pneumonia. The nurse anticipates which of the following findings during assessment?
A patient with a history of smoking is admitted with pneumonia. The nurse anticipates which of the following findings during assessment?
A nurse is caring for a patient with a chest tube connected to a water-seal drainage system. The patient is coughing forcefully. The nurse observes a brief increase in bubbling in the water-seal chamber. Which action should the nurse take?
A nurse is caring for a patient with a chest tube connected to a water-seal drainage system. The patient is coughing forcefully. The nurse observes a brief increase in bubbling in the water-seal chamber. Which action should the nurse take?
A patient is receiving oxygen therapy via a non-rebreather mask. Which of the following nursing actions is MOST important to ensure effective oxygen delivery?
A patient is receiving oxygen therapy via a non-rebreather mask. Which of the following nursing actions is MOST important to ensure effective oxygen delivery?
A premature infant is receiving oxygen therapy. The nurse understands that it is crucial to monitor the infant closely for signs of:
A premature infant is receiving oxygen therapy. The nurse understands that it is crucial to monitor the infant closely for signs of:
Flashcards
Arterial Blood Gas (ABG)
Arterial Blood Gas (ABG)
A test measuring oxygen and carbon dioxide levels in the blood, assessing respiratory and acid-base balance.
BIPAP and CPAP Masks
BIPAP and CPAP Masks
Devices providing positive airway pressure, BiPAP adjusts pressure, while CPAP maintains constant pressure.
Diaphragmatic Breathing
Diaphragmatic Breathing
Breathing technique using the diaphragm, enhancing oxygen intake.
Hypercarbia and Hypoxemia
Hypercarbia and Hypoxemia
Signup and view all the flashcards
Oxygen Delivery Devices
Oxygen Delivery Devices
Signup and view all the flashcards
Inspiration and Expiration
Inspiration and Expiration
Signup and view all the flashcards
External Respiration
External Respiration
Signup and view all the flashcards
Internal Respiration
Internal Respiration
Signup and view all the flashcards
Role of Hemoglobin
Role of Hemoglobin
Signup and view all the flashcards
Physical Assessment (Oxygenation)
Physical Assessment (Oxygenation)
Signup and view all the flashcards
Pulse Oximetry
Pulse Oximetry
Signup and view all the flashcards
Arterial Blood Gases (ABGs)
Arterial Blood Gases (ABGs)
Signup and view all the flashcards
Oxygen Therapy
Oxygen Therapy
Signup and view all the flashcards
Positioning (Oxygenation)
Positioning (Oxygenation)
Signup and view all the flashcards
Partial Pressure of Oxygen (PaO2)
Partial Pressure of Oxygen (PaO2)
Signup and view all the flashcards
Oxygen Saturation (SaO2)
Oxygen Saturation (SaO2)
Signup and view all the flashcards
Partial Pressure of Carbon Dioxide (PaCO2)
Partial Pressure of Carbon Dioxide (PaCO2)
Signup and view all the flashcards
Blood pH
Blood pH
Signup and view all the flashcards
Bicarbonate (HCO3) Levels
Bicarbonate (HCO3) Levels
Signup and view all the flashcards
Allen Test
Allen Test
Signup and view all the flashcards
Acidosis
Acidosis
Signup and view all the flashcards
Alkalosis
Alkalosis
Signup and view all the flashcards
Hypoxemia
Hypoxemia
Signup and view all the flashcards
Nasal Cannula
Nasal Cannula
Signup and view all the flashcards
High Fowler Position
High Fowler Position
Signup and view all the flashcards
Preventing Oxygen Toxicity
Preventing Oxygen Toxicity
Signup and view all the flashcards
Respiratory Assessment
Respiratory Assessment
Signup and view all the flashcards
Oxygen Therapy Documentation
Oxygen Therapy Documentation
Signup and view all the flashcards
Oxygen in COPD patients
Oxygen in COPD patients
Signup and view all the flashcards
Managing Oxygen Demand
Managing Oxygen Demand
Signup and view all the flashcards
Transtracheal Oxygen
Transtracheal Oxygen
Signup and view all the flashcards
Deep Breathing Exercises
Deep Breathing Exercises
Signup and view all the flashcards
Pursed-Lip Breathing
Pursed-Lip Breathing
Signup and view all the flashcards
Pre-operative Breathing Exercises
Pre-operative Breathing Exercises
Signup and view all the flashcards
Oxygen Toxicity Symptom
Oxygen Toxicity Symptom
Signup and view all the flashcards
What are signs of oxygen toxicity?
What are signs of oxygen toxicity?
Signup and view all the flashcards
What is a Nasal Cannula?
What is a Nasal Cannula?
Signup and view all the flashcards
What is the High Fowler Position?
What is the High Fowler Position?
Signup and view all the flashcards
Oxygen Analyzer
Oxygen Analyzer
Signup and view all the flashcards
Deep Breathing
Deep Breathing
Signup and view all the flashcards
Nonrebreather Mask
Nonrebreather Mask
Signup and view all the flashcards
Venturi Mask
Venturi Mask
Signup and view all the flashcards
Face Tent Mask
Face Tent Mask
Signup and view all the flashcards
T-piece Mask
T-piece Mask
Signup and view all the flashcards
Oxygen Therapy Protocol
Oxygen Therapy Protocol
Signup and view all the flashcards
Study Notes
Key Terms
- Arterial Blood Gas (ABG) measures oxygen and carbon dioxide levels, offering insights into respiratory function and acid-base balance.
- BiPAP and CPAP masks provide positive airway pressure, with BiPAP varying pressure during inhalation/exhalation and CPAP maintaining constant pressure.
- Diaphragmatic breathing enhances oxygen intake by emphasizing diaphragm use for deeper breaths.
- Hypercarbia and hypoxemia are conditions marked by high carbon dioxide and low oxygen levels in the blood.
- Oxygen delivery devices include nasal cannulas, nonrebreather masks, and oxygen tents.
Importance of Oxygen in Human Physiology
- Oxygen accounts for about 21% of Earth's atmosphere and supports cellular metabolism and energy.
- Oxygen deprivation leads to cell necrosis, causing organ failure and potential death.
- The respiratory system's primary job is gas exchange, ensuring oxygen to tissues and expelling carbon dioxide.
Mechanics of Ventilation
- Inspiration involves diaphragm contraction and intercostal muscle elevation, while expiration is usually passive due to lung elasticity.
- Thoracic cavity pressure decreases during inspiration, allowing air in; pressure increases during expiration, pushing air out.
- Accessory muscles, like the pectoralis minor and sternocleidomastoid assist in expanding the thoracic cavity during increased oxygen demand.
Gas Exchange Processes
- External respiration occurs in alveoli where oxygen enters blood and carbon dioxide exits.
- Internal respiration exchanges gases at the cellular level, with oxygen for metabolism and carbon dioxide as waste.
- Hemoglobin in red blood cells transports oxygen, releasing it to tissues when needed.
Methods of Assessment
- Physical assessment involves checking respiratory rate, breathing patterns, and lung sounds.
- Pulse oximetry is a non-invasive way to monitor blood oxygen saturation.
- Arterial Blood Gases (ABGs) provide thorough data on oxygenation, ventilation, and acid-base balance.
Signs of Inadequate Oxygenation
- Common symptoms are nasal flaring, accessory muscle use, rapid, shallow breathing, and changes in mental state like confusion.
- Physiological signs include elevated heart rate and hypertension.
Nursing Interventions for Oxygenation
- Oxygen therapy involves administering supplemental oxygen through various methods, ensuring correct delivery and monitoring.
- Positioning involves using positions like Fowler's or orthopneic to ease breathing and promote lung expansion.
- Education includes teaching about portable oxygen equipment and importance of social interactions.
Gerontologic Considerations
- Older adults may have reduced gas exchange and increased respiratory effort due to age-related changes.
- Evaluate older adults carefully to differentiate between lack of oxygen and cognitive issues like delirium or dementia.
- Vaccinations for influenza and pneumonia are crucial for older adults to prevent respiratory infections.
ABG Analysis
- Partial Pressure of Oxygen (PaO2) measures dissolved oxygen in plasma, crucial for assessing respiratory function.
- Partial Pressure of Carbon Dioxide (PaCO2) assesses CO2 levels for evaluating respiratory status.
- Blood pH reveals blood acidity or alkalinity, essential for understanding acid-base balance.
- Bicarbonate (HCO3) levels show the metabolic aspect of acid-base balance, aiding identification of metabolic acidosis or alkalosis.
Indications for ABG Testing
- ABGs are essential in assessing patients with acute respiratory distress.
- ABGs are used to monitor treatment to evaluate interventions like oxygen therapy or mechanical ventilation.
- ABGs help in preoperative assessment to assess patients' respiratory status before surgery.
Nursing Guidelines for ABG Collection
- Preparation: Client should rest 30 minutes before sampling to avoid transient oxygen level changes.
- Allen Test: This test ensures enough blood supply to the hand before puncturing the radial artery.
- Post-Puncture Care: Apply direct pressure for 5-10 minutes to prevent bleeding, and watch for hematoma formation.
Abnormal Findings and Their Implications
- Acidosis indicates excess acid, often from respiratory or metabolic issues.
- Alkalosis suggests acid deficiency or bicarbonate excess, potentially from hyperventilation or metabolic causes.
- Hypoxemia is classified by PaO2 levels, indicating degree of oxygen deficiency.
Pulse Oximetry
- Pulse oximetry is a noninvasive way to measure oxygen saturation through light absorption by hemoglobin.
- Pulse oximetry components comprises a photodetector, red and infrared light emitters, and a microprocessor for data interpretation.
- Pulse oximetry is commonly applied to fingers, toes, earlobes, or the bridge of the nose.
Factors Affecting Pulse Oximetry Accuracy
- Poor circulation from conditions like peripheral vascular disease can affect readings.
- Nail polish, thick toenails, and direct sunlight can interfere with light transmission.
- Movement or tremors can affect sensor contact and accuracy.
Interpreting Pulse Oximetry Readings
- Normal Range: SpO2 should be 95%-100%; below 90% indicates possible intervention need.
- PaO2 can be estimated from SpO2 readings using the oxygen-hemoglobin dissociation curve.
Troubleshooting Pulse Oximetry Issues
- Sensor should be moved to a different site if readings are inaccurate.
- Ensure the pulse oximetry equipment is functioning well.
- Remove barriers like nail polish or shield the sensor from direct light.
Nursing Interventions for Oxygenation
- High Fowler's position is recommended for clients with hypoxia to assist with lung expansion.
- Breathing techniques should be taught to improve ventilation and oxygenation.
- Nasal Strips can reduce airway resistance, and improve airflow.
Monitoring and Assessment
- Vital signs regularly monitor temperature, respiratory rate, and activity level to accurately interpret ABG results.
- Oxygen therapy includes documenting the quantity of oxygen received, which helps in evaluating the outcome.
- For follow-up, report lab findings quickly to the doctor to help with timely modification to treatment.
Oxygenation Factors
- Adequate oxygenation requires 21% oxygen in the environment, along with normal heart and lung function.
- COPD patients rely on low blood oxygen and are sensitive to oxygen levels.
- Smoking introduces carbon monoxide, lowering oxygen transport.
- Pregnant people who smoke risk low-weight babies due to fetal oxygenation issues.
Physical Conditions Impacting Oxygenation
- Obesity, pregnancy, and enlarged organs can compress the diaphragm, hindering lung expansion.
- Pulmonary secretions and interstitial fluid can obstruct gas exchange, and clearing airways is highly important.
- Mental stress and physical activity increase the body's need for oxygen, and effective ventilation strategies are a must.
Nursing Implications for Oxygenation
- Clients with heart and lung disorders may need more oxygen (>21%) to keep oxygen levels steady.
- High oxygen can lower breathing in COPD patients, so constant monitoring is key.
- Smoking cessation is crucial and aids like patches and gum should be promoted.
Positioning Techniques to Enhance Breathing
- The High Fowler position involves sitting upright, helping abdominal organs descend, which increases lung expansion.
- The Tripod position involves the patient sitting with arms supported, improves lung capacity.
- In the Orthopneic position, the patient leans forward over a table or chair to maximize chest expansion.
Breathing Techniques for Improved Ventilation
- Deep breathing maximizes ventilation by filling alveoli to capacity, enhancing gas exchange.
- Incentive spirometry encourages deep breathing with a device to achieve a large amount of inspired air.
- Pursed-lip breathing involves prolonged expiration, assisting in carbon dioxide elimination and improving gas exchange
Diaphragmatic Breathing
- Diaphragmatic breathing focuses more on the diaphragm and less on upper chest muscles, improving efficiency of air exchange.
- Diaphragmatic breathing reduces respiratory effort and alleviates rapid, ineffective patterns.
- Practice entails inhaling deeply, letting the abdomen rise, and exhaling fully.
Additional Interventions for Oxygenation
- Adhesive nasal strips widen nasal passages and promote easier breathing.
- Nasal strips are commonly used by people with breathing issues and athletes to meet increased oxygen needs.
- Nursing Strategies for Effective Breathing includes that clients should maintain an upright position, which allows for better lung expansion.
Oxygen Therapy
- Oxygen therapy is key for patients with hypoxemia with compromised oxygen saturation of the blood.
- Oxygen therapy is also key for medical conditions, including chronic obstructive pulmonary disease (COPD), pneumonia, and during recovery from surgery.
- Oxygen therapy can prevent complications with oxygen and cognitive decline.
- Oxygen therapy can reduce impaired snoring by improving airflow during sleep.
Indications for Oxygen Therapy
- Oxygen therapy is for patients with ineffective breathing patterns unable to maintain oxygen levels.
- Oxygen therapy is for individuals with respiratory disease, heart conditions etc.
- Oxygen therapy may be prescribed for patients in home care settings with chronic respiratory issues.
Types of Oxygen Sources
- Wall outlet provides oxygen through wall outlets connected to a central reservoir, ensuring a continuous supply.
- Portable tanks: Usually used when patience need mobility to prevent accidents.
- Liquid oxygen units Converts liquid oxygen to gas and tends to be lightweighted for portable use.
- Oxygen concentrators are machines extracting oxygen from room, providing convenient at home source.
Equipment Used in Oxygen Administration
- Flowmeter regulates flow of oxygen measured in LPM liters.
- Oxygen Analyzer measures the O2 percentage and ensuring compliance with physician prescription.
- Humidifier adds moisture to O2 to prevent dryness in the the membranes.
Common Oxygen Delivery Devices
- Nasal Cannula used for low concentrations of oxygen.
- Masks of various types used depending depending on the requested oxygen concentration.
- Face Tent Provides an oxygen to Pts who can't accept masks and face surgeries.
- Tracheostomy Collar is used for tracheostomy and allows direct oxygen delivering to the airway.
Administration Techniques and Patient Care
- Ensure proper positioning and breathing techniques are essential for effective oxygen therapy.
- Provide education to patients on maintaining equipment while being being able to recoginze their oxygen and maintaining their skin integrity.
- Regular assessment of the skin around the ears and cheeks is necessary to prevent pressure sores.
Skin Assessment and Care
- The skin around the ears and cheeks should be assessed for pressure in patients using O2 delivery devices.
- Padding may be required to protect the skin integrity in these area.
- Frequent mouth and nasal care is essential.
Importance of Monitoring Oxygen Delivery
- Close monitoring is crucial using a high flow.
- HC providers including nurses + respiratory therapist.
Types of Oxygen Delivery Devices
- Nasal Cannula use in order to administer low concen of O2 to 2-6 liters to and FiO2 of 24-40%.
- Nasal Cannula is perfect for someone who might not be hypoxic.
- Masks are needed with high oxygen is contradicted to COPD and those adapted to lower oxygen levels.
Masks for Oxygen Delivery
- Masks delivers higher concentration than the nasal cannula.
- Each type of mask has flow rates and FIO2 levels.
- Review the comparision of oxygen delivery devices:
- Nasal Cannula: 2-6 L/min, 24-40% FiO2
- High-Flow Nasal Cannula: Up to 60 L/min, 21-100% FiO2
- Simple Mask: 5-8 L/min, 35-50% FiO2
- Partial Rebreather Mask: 6-10 L/min, 35-60% FiO2
- Nonrebreather Mask: 6-10 L/min, 60-90% FiO2
- Venturi Mask: 4-10 L/min, 24-100% FiO2
Specific Mask Types and Their Functions
- A simple mask allows oxygen at no less than 5L/min.
- A partial rebreather mask allows recycle oxygen and ranges from 60-90%.
- The nonerebreather mask deliver oxygen to to the max(FIO2 of 90-100%) without inhaling atmospheric air.
Specific Mask Types and Their Functions Pt.2
- A venturi mask allows O2 with atmosphere to mix.
- A Face Tent provides that oxygen to the nose/mouth.
- A Tracheostomy Collar allows direct to patients with trach.
Nasal Catheter
- It's useful for patients breathing through mouths or having difficulty with masks.
- It tends causes skin irritation.
- Make sure you clean for regular cleaning to prevent mucus buildup and ensure comfort.
Transtracheal Oxygen
- It is less noticeable and lower flow rates, reducing O2 costs.
- Pts must learn to clean regularly to prevent infection.
- Beneficial to active patients needing continuous oxygen.
Oxygen Hazards
- High oxygen is a hazard and has to control potential fire hazards.
- Prohibiting open flames is a must and should be followed.
- Devices should be ensured they are grounded from frayed wires.
- Avoid oil to prevent fires.
Oxygen Toxicity
- Over 50% concentrated for over a course of a day ( 48-72 hrs) can lead to lung damage.
- Symptoms lead with a slight fatigue , headache .
- Recognize the FIO2 if toxic.
- Surfactant important for lung function in which damage can occur.
Positive Airway Pressure Machines
- Commonly used to treat sleep apnea.
- Maintains O2 and episodes those.
- Has a positive affect for patients, so does include adjusting the settings.
Importance of Oxygen Saturations
- Affects your O2 levels.
- Impacts the over all pulse O2.
- Has a normal ranges.
Sleep Apnea
- When sleep apnea is active the O2 declines.
- CPAP/BiPAP are most commonly used.
- While CPAP maintains while BiPAP allows for to to pressures which improves comfort.
Nursing Implications for Oxygenation
- Nurses help in assessing to keep O2 levels in stable levels.
- Diagnose altered breathing which causes activity and intolerance.
- Regularly assessing respiratory rate and the the O2 and and maintain appropriate interventions.
Continuous Positive Airway Pressure (CPAP)
- CPAP prevents hypoxia .
- Struggle can result in not wearing the maks.
- Provides a therapeutic output to those who can provide adherence.
Bilevel Positive Airway Pressure (BiPAP)
- BIPAP provides 2 types of pressures to help with convenience.
- It helps the ability for those who can follow through with therapy.
- Other types range, variable, adjustments etc.
Water-Seal Drainage
- Water can extract the air and blood from cavity lungs and can inflate the lungs.
- There are a collection chamber, water and seal chamber.
- Proper management is critical if there is problems with lungs.
Nursing Responsibilities in Water-Seal Drainage
- Nurses should ensure that the tube in maintained.
- Regular assessments of lungs and O2.
- Provide assistance when its there is infection and other issues.
Hyperbaric Oxygen Therapy (HBOT)
- HBOT is when it delivers 100 and at pressures that are 3x times than what is commonly applied which helps with enhance O2 to tissues.
- The therapy assist with wounds C02 poisoning and anaerobic conditions.
- Treatment are repetitive during the course.
Clinical Application of HBOT
- Is helpful to Pt and helps wound regenerate for treatments.
- A short breath is is often used to help treat the treat effectively.
Assessing and Managing Impaired Gas Exchange
- Diagnosing can help breath and airway.
- Assessments involve evaluation of the breaths and with other signs.
- Methods for hydration and O2 is always helpful.
The Importance of Oxygenation
- Oxygen is all key in cellular metabolism and is vital for O2 function.
- The demand may change.
- Hypoventilation needs the lead to various issues.
- Understand the O2 transportation.
Mechanisms of Oxygen Delivery
- A variety devices include :annuls, masks and oxygen.
- The devices depends patients condition and they need.
- Supplement all O2 in a timely basis.
- Ensure a humifier and O2 tank
- Review the risks oxygen hazards, explosion O2 etc .
Assessing Oxygenation Status
- Hypoxia
- ABGS provide lots of data.
- Assessment includes restfulness and accessory breathing.
- The PH should regulate 7.35 to 7.45
- Do the Alignment test to provide better circular for arterial blood sampling.
- Provide monitoring to ensure.
Evaluating Treatment Effectiveness
- High expected of all includes improving patients and respiratory rates
- High effectiveness is key.
- Hydration and improving secretions.
- Abgs helps treatment and improves patient
Techniques to Promote Effective Oxygenation
- The patients is in high fowlers with high O2.
- Technique is good.
- Incentive helps.
- Fluid is supported with.
- Nicotine is key to quit.
- Education should be given for O2.
Oxygen Therapy Protocols
- Ensure the equipment works and there problems are not around..
- Review the hygiene.
- Collaborate to Respiratory and equipment needs.
- Document.
- Educate.
Oxygen Therapy
- Its O2.
- It assist with hypox.
- Device should be set in a working position.
Evaluation of Oxygen Therapy
- The patient does meet the med orders.
Documentation of Oxygen Therapy
- Documentation has everything
- Document the levels O2.
- Example is there is something applied.
Purpose of Chest Tube Insertion
- Tubes inserted as treatment to remove causes.
- Infections common.
- 5-8 the inter coast.
Assessment and Monitoring of Chest Tubes
- Infection and leaks needs to be managed
- Help keep from loosing the patients body system
- Is 2 cm to prevent air.
Troubleshooting and Maintenance
- The source is a leak in the tube.
- Put the drainage below
- Help the patient breath good so their lungs breath properly.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
