Adult Health I Study Guide PDF

Oxygen therapy ​ Oxygen therapy is initiated with the intent of treating and preventing the clinical manifestations of hypoxia. ○​ Hypoxia occurs secondary to insufficient oxygen to metabolic demands of the cells, tissues, and organs. ​ Indications for oxygen therapy: Oxygen d...

Oxygen therapy ​ Oxygen therapy is initiated with the intent of treating and preventing the clinical manifestations of hypoxia. ○​ Hypoxia occurs secondary to insufficient oxygen to metabolic demands of the cells, tissues, and organs. ​ Indications for oxygen therapy: Oxygen delivery breakdown video ○​ PaO2 < 60 mmHg ○​ SaO2 < 90% ○​ Fever, infection, anxiety, and/or anemia ​ Contraindications to oxygen administration: ○​ Generally no contraindications with O2 therapy when an appropriate assessment of respiratory disease and indications are present. ○​ Use extreme caution with patients who are hypoxic and have chronic hypercapnia or hypercarbia (increased PaCO2 levels in the blood) often seen in patients with COPD. ​ Oxygen monitoring and measurement ○​ Monitored by physical assessment of patient, pulse oximetry, and ABG analysis. ○​ ABG values: ​ PH: 7.35 - 7.45 ​ PaCO2: 35-45 mmHg ​ HCO2: 22-26 mEq/L ​ PaO2: 80-95 mmHg ​ Oxygen delivery devices: Oxygen Delivery device Video ○​ Nasal Cannula - low flow delivery device ​ Delivers 24% - 44% ( 1 L/min - 6 L/min) ​ Most common and least expensive. ​ Can cause skin breakdown and dry mucous membranes ​ Comfortable, mobile, and easy to use. ​ Patients who require low levels of oxygen ​ Works well for patients who have adequate ventilation but requires a higher concentration than room air. ​ Common with hospital patients, long-term care, and home settings. ​ Common in patients with COPD ( 1 - 2 L/min) ○​ ○​ Simple face mask - low flow delivery device ​ Delivers 40% - 60% ( 5 - 10 L/min) ​ For patients who require a higher moderate amount of oxygen to maintain PaO2 levels. ​ Short-term oxygen ​ Easy for patient transportation ​ Can be painful for patients with facial injury due to the style of mask. ​ ○​ Partial rebreather mask - low flow delivery device ​ Delivers 50% - 75% ( 8 - 10 L/min) ​ Reservoir bag with oxygen ​ Quickly stabilizes a patient ​ The patient breathes in the oxygen from the reservoir bag; on exhalation, the bag refills with oxygen, and the exhaled gases exit through the small holes on both sides of the mask. ​ Short-term oxygen therapy ​ Can be painful for patients with facial injury due to the style of mask. ​ ○​ Nonrebreather mask - low flow delivery device ​ Delivers 90% (10 L/min) ​ One-way breathing valves ​ Prevents rebreathing of CO2  ​ Reservoir bag must be kept inflated one-third to one-half full on inspiration. ​ Can be painful for patients with facial injury due to the style of mask. ​ ○​ Venturi Mask - High flow delivery device ​ Delivers 24% - 60% (2 - 15 L/min) ​ Most commonly used high-flow delivery device because it delivers the most accurate oxygen concentration. ​ A patient with a chronic lung disorder benefits from this device because it delivers more accurate oxygen concentration to a patient on inspiration. ​ ○​ Aerosol Mask - High flow delivery device ​ High humidity oxygen concentration ​ Ideal for patients who have been discontinued on an endotracheal tube, have had upper airway surgery, or with thick secretions. ​ Relieves bronchospasm, humidify respiratory tract, and reduce edema of the respiratory tract ○​ Tracheostomy collar - High flow delivery device ​ Patients with tracheostomy ​ Humidified oxygen ○​ T-piece Adapter - High flow delivery device ​ Used when weaning a patient from the mechanical ventilator who still has an endotracheal, nasotracheal, or tracheostomy tube in place.  ○​ Face tent - High flow delivery device ​ For patients who have facial trauma, burns, or upper airway surgery ○​ High flow nasal cannula ​ Uses air-oxygen blender, active humidifier, single-heated tube, and nasal cannula to deliver heated and humidified medical gas up to 60 L/min ​ Soft and flexible nasal prongs ideal for patients. Alterations in oxygenation ​ Influenza: Upper respiratory infections ○​ Highly contagious infection that rapidly spreads from one person to another. ○​ The primary event that initiates the influenza infection is the aerosolization of small droplets ( sneezing or coughing) ○​ Clinical manifestations: The flu explained ​ Rapid onset ​ Fever ​ Headache ​ Sore throat ​ Severe nasal congestion ​ Cough ​ Myalgia (muscle aches and pains) ​ Fatigue ○​ Diagnosis/ Management ​ Sample respiratory secretions for viral cultures ​ Most common method is rapid influenza diagnostic tests (RIDTs) ​ Blood tests ○​ Treatment/medications ​ Annual vaccination ​ Hand washing/infection control ​ Coughing etiquette ​ antipyretics/analgesics ​ Antiviral medications (extreme cases) ​ In extreme cases the flu can lead to pneumonia ​ Pneumonia Pneumonia video ○​ Risk factors: ​ Immunocompromised ​ HIV/AIDS ​ COPD ​ Older adults (65 and older)  ​ Chronic respiratory diseases ○​ Clinical manifestations ​ Fever and chills ​ Tachypnea/ tachycardia ​ Dyspnea ​ Cough ( productive and nonreproductive) ​ Chest pain ​ Fatigue ​ Rusty sputum ​ Malaise and respiratory distress ○​ Diagnosis ​ X-ray ​ Sputum culture ​ Blood test ○​ Interventions ​ Oxygen ​ Antibiotics - PRIORITY ​ Bronchodilators ​ Increase fluid intake ​ Elevated position ​ Priority vital signs - ​MONITOR FOR SEPSIS ​ Incentive spirometer - turn, cough, and deep breathing ○​ Prevention ​ Infection control - washing hands PRIORITY ​ Vaccination ​ Cough etiquette ​ Vitamins ​ Hydration ​ Tuberculosis Tuberculosis video ○​ Risk factors ​ Immunocompromised (HIV/AIDS) ○​ Clinical manifestations ​ Nonspecific ​ Fatigue ​ Weight loss ​ Night sweats ​ Asymptomatic ○​ Diagnosis ​ Lab testing - sputum culture ​ Skin test  ​ Chest x-ray ○​ Treatment ​ Isoniazid - antibiotic ​ Rifampin - antibiotic ​ Pyrazinamide - antibiotic ​ Ethambutol - antibiotic ​ Fluids ​ Negative airflow room ​ Head elevation ​ Oxygen ​ Asthma Asthma explained with practice questions ○​ Airway inflammation leading to bronchospasm ○​ Different phenotypes trigger asthma ○​ Clinical manifestations: ​ Dyspnea ​ Chest tightness ​ Coughing /dry cough ​ Wheezing ​ Increased respiratory rate ○​ Medical management ​ Patient history ​ Pulmonary function test ​ Chest x-ray ​ Pulse oximetry ​ ABG ○​ Treatment: ​ Corticosteroids ​ Bronchodilators ​ anticholingerics ​ Status asthmaticus ​ Rapid onset of severe asthma ​ Potential acute ventilatory failure or death ○​ Manifestations: ​ Chest tightness ​ Wheezing ​ Dry cough ​ shortness of breath ​ Severe respiratory distress ○​ Treatment: ​ Oxygen  ​ Iv fluids ​ Bronchodilators ​ Steroids ​ COPD COPD ○​ Chronic bronchitis and emphysema ○​ Airway abnormalities ○​ Clinical manifestations: ​ Chronic low oxygen saturation ​ shortness of breath ​ Accessory muscle use ​ Anterior posterior diameter is 2:1 ratio instead of the typical 1:1 ratio = barrel chest ​ Productive cough ​ Wheezing and crackles ​ Tripod position ○​ Nursing interventions ​ Deep breathing and coughing ​ High calorie and protein meals ​ Good hydration ​ Aspiration precautions ​ Monitoring for respiratory infections like influenza and pneumonia ○​ Priority nursing diagnosis: ​ Impaired gas exchange ​ Anxiety ​ Altered mental status (Hypoxia) ​ Risk for dehydration ​ Risk for falls ○​ Medications: ​ Corticosteroids ​ Bronchodilators ​ Corticosteroid inhaler - shake before use, rinse mouth after use (patient education) ​ Chronic Bronchitis (A Type of COPD) ○​ Definition ​ A long-term condition causing inflammation of the bronchi, leading to excessive mucus production and a persistent cough. ○​ Causes ​ Smoking (primary cause) ​ Air pollution, dust, and chemical exposure ​ Recurrent respiratory infections  ○​ Symptoms ​ Chronic productive cough (lasting at least 3 months for 2 consecutive years) ​ Excess mucus production ​ Shortness of breath ​ Wheezing ​ Cyanosis (bluish skin due to low oxygen levels) ​ Frequent respiratory infections ○​ Diagnosis ​ Chest X-ray (to rule out other lung diseases) ​ Pulmonary function tests (PFTs) ​ Arterial Blood Gas (ABG) test ​ Sputum culture (to check for infections) ○​ Treatment & Management ​ Smoking cessation (most important) ​ Bronchodilators (to open airways) ​ Corticosteroids (reduce inflammation) ​ Oxygen therapy (for severe cases) ​ Pulmonary rehabilitation (breathing exercises) ​ Increased fluid intake (to thin mucus) ○​ Complications ​ Respiratory failure ​ Frequent lung infections (e.g., pneumonia) ​ Right-sided heart failure ○​ Prevention ​ Avoid smoking & secondhand smoke ​ Get flu & pneumonia vaccines ​ Use protective gear in polluted environments ​ Proton pump inhibitors end in - zole