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RESPIRATORY CH 20
Pgs 559-572
| Question | Answer |
|---|---|
| APNEA | suspension of external breathing. No movement of the muscles of respiration and the volume of the lungs initially remains unchanged |
| DYSPNEA | sign of serious disease of the airway, lungs, or heart. The onset of dyspnea should not be ignored but is reason to seek medical attention. |
| ORTHOPNEA | Inability to breathe easily unless one is sitting up straight or standing erect. |
| TACHYPNEA | Abnormally fast breathing. A respiratory rate that is too rapid. |
| TRACHEOSTOMY | Surgically created opening in the neck leading directly to the trachea. (1) bypass an obstructed upper airway-will prevent oxygen from the mouth to reach the lungs); (2) to clean & remove secretions from airway; (3) easily& safely deliver oxygen to lungs |
| THORACOTOMY | Process of incision (cut) into the chest wall,allows for study of lungs; removal of a lung or part of a lung; removal of a rib; examination of any organs in chest cavity. Provides access to the heart, esophagus, diaphragm, and the portion of the aorta. |
| HEMOPTYSIS | act of coughing up blood, is an important symptom since it frequently reflects serious underlying lung disease. is the blood coming from the bronchial tree or lungs or from some other site? |
| CYANOSIS | bluish or purplish tinge to the skin and mucous membranes. Most often, cyanosis is detected in the lips and fingers. |
| HYPERPNEA | Increased depth of breathing when required to meet demand, as during or following exercise or when the body lacks oxygen (hypoxia) |
| ANOXIA | Severe hypoxia; absence of oxygen in inspired gases or in arterial blood or in the tissues |
| INTUBATION | placement of a tube into a patient's body, or hollow organ, as into the trachea |
| EXTUBATION | The removal of a tube from an organ, structure, or orifice; specifically, the removal of the tube after intubation of the larynx or trachea. |
| TENACIOUS | pertaining to secretions that are sticky or adhesive or otherwise tend to hold together, such as mucus and sputum. |
| SPUTUM | Mucus and other matter brought up from the lungs, bronchi, and trachea that one may cough up and spit out or swallow. |
| NEBULIZER | electrically powered machine that turns liquid medication into a mist so that it can be breathed directly into the lungs through a face mask or mouthpiece. People with asthma can use a nebulizer to take their medications. |
| COPD | COPD, or chronic obstructive pulmonary disease, is a progressive disease that makes it hard to breathe. |
| PLEURAL SPACE | tiny area between the two layers of the pleura (the thin covering that protects and cushions the lungs). The pleural space is normally filled with a small amount of fluid. |
| PLEURAL EFFUSION | accumulation of fluid between the layers of tissue that line the lungs and chest cavity. Symptoms: Chest pain-sharp pain that is worse with cough or deep breaths |
| VERTIGO | feeling that you or your environment is moving or spinning. Usually due to a problem with the inner ear,can also be caused by vision problems. |
| PALLOR | paleness, as of the skin or mucosae. Although it is commonly associated with anemia, many long-term cases show mucosae of normal color; pallor is also a common sign in shock |
| HEMOTHORAX | collection of blood in the space between the chest wall and the lung (the pleural cavity). Symptoms: Anxiety; Chest pain; Rapid heart rate; Restlessness; Shortness of breath |
| PNEUMOTHORAX | A collapsed lung, or pneumothorax, is the collection of air in the space around the lungs. This buildup of air puts pressure on the lung, so it cannot expand as much as it normally does |
| HYPOXIA | Deprived oxygen supply. A mismatch between oxygen supply and its demand @ cellular level. occurs in healthy people when they ascend to high altitude. Also occurs in healthy individuals when breathing mixtures of gases with a low oxygen content |
| HYPOXEMIA | Reduced or interrupted level of oxygen in your blood. can disrupt your body's functioning and harm vital tissues.Can disrupt your body's functioning and harm vital tissues. Severe hypoxemia occurs when oxygen saturation drops below 80 percent. |
| OXYGEN THERAPY | Prevent /Relieve HYPOXIA Impaired tissue Oxygenation pts benefit from O2 treated as a drug due to dangerous side effects Should be ordered & prescribed by Dr. & continuously monitored |
| OXYGEN | Colorless,odorless,and tasteless gas that will burn or explode ONLY if it comes w/ contact w/ electrical spark or fire. • Makes up about 21% of the atmospheric air carried through the body by attaching to HEMOGLOBIN |
| SAFETY PRECAUTIONS DURING OXYGEN USE | "No Smoking"/"Oxygen in Use" signs-No smoking Avoid use of electrical appliances-blankets Secure O2 delivery systems-cylinders Avoid placing O2 cylinders near heat-lamps Avoid static material-wear non-flammable clothing Don’t overload plug circuits, |
| • OXYHEMOGLOBIN Complex | (OXYGENATED HEMOGLOBIN) Is what gives the red color to Red-blood cells.xygen-carrying pigment of red blood cells that gives them their red color and serves to convey oxygen to the tissues |
| In case of emergency-Pt w/ Hypoxia | Minimum is 2 Liters but usually the physician determines the method & amount of administration |
| OXYGEN ADMINISTRATION-pg 560 | Solution in humidifier container; O2 always humidified w/ flow rate 3-6. Always use Sterile water |
| FACE MASK | |
| PARTIAL-REBREATHER MASK | |
| NONBREATHING MASK | |
| OLDER ADULT CONSIDERATIONS | |
| HOME HEALTH CONSIDERATIONS | |
| NURSING MEASURES | O2 toxicity L/min Humidifying device to prevent Drying tissues Frequent MOUTH CARE Position-dont block outlet in mask TCDB Check nares-irritation,clean nasal cannula Tale temp by another route Frequent amubulation- |
| • TCDB | TURN,COUGH,DEBREATH prevents HYPOSTATIC PNEUMONIA |
| TRANSTRACHEAL OXYGEN DELIVERY | 2nd & 3rd tracheal cartilages.Doesnt interfer with drinking, eating & talking. Nasal cannula delivers O2 only during Inhalation.Rate flow decreased due to no O2 Lost (2L/m=1L/m). Usually for heart failure or Pulmonary disease.Clean it twice per day 8-9 f |
| TRIFLOW/INCENTIVE SPIROMETRY | Improves pulmonary ventilation-Loosen secretion Expands collapse Alveoli pts take deep-slow breaths & hold it s long as possible-Count of 5 |
| AMBU- Air MASK Bag Unit | Resuscitator bag used to assist respiratory ventilation |
| ABGs- ARTERIAL BLOOD GASES | Withdraw of Blood (invasive) for arterial blood gases |
| Pulse OXIMETRY | MEASURES O2 sat-Continuous or PRN Normal levels= 92-100% non-invasive:fingers,toes,earlobes,tip of nose S&S of HYPOXIA= As advances, bradychardia results,which decrease OXYGEN SATURATION |
| Disadvantages of Using OXYGEN | Very drying to tissues Need good, frequent Mouth care |
| S&S OF HYPOXIA==> EARLY SIGNS | Apprehension, anxiety, restlessness & irritability |
| S&S OF HYPOXIA | Decreased ability to concentrate, LOC; Increased BP,rate & depth resp., fatigue,Pulse rate-Bradycardia when is progressive. Vertigo, behavioral changes & cardiac dysrhythmias |
| S&S OF HYPOXIA ==> Late sign | CYANOSIS, CLUBBING-Chronic hypoxia & DYSPNEA |
| O2 Toxicity | Due to incorrect amt of O2 |
| NASAL CANNULA-560 | two-pronged plastic device that is used to deliver low concentrations of O2. Pt can EAT & DRINK normally, appropriate for all age groups fLOWMETER: 6-10 L/min anything <6L/min=LOW |
| nurse's responsibility's w/ nasal Cannula | Maintain method-prevent O2 direct contact w/ nasal mucosa,makes breathing uncomfortable,flow rate, comfort & safety |
| TRACHEOSTOMY COLLAR- 10 L/min | Curved device w/ adjustable strap that fits neck. Provides HUMIDIFICATION to lower airways. Exhalation port remains patent @ all times & another connects the Large-bore tubing |
| OUTER CANNULA | |
| INNER CANNULA | Locked in place |
| OBTURATOR | Facilitates insertion into the stoma |
| CUFFED TUBES | Inflated cuff seals space btw tube & tracheal wall. Tmporary use, to hold tube during special treatments- IPPB & ventilation |
| FENETRATED TUBE | Holes in the outer cannula. Allows pt to talk & breath around tube |
| PASSEY MUIR VALVE | Enables pt to talk |
| T-Piece/Tube | T-shaped device w/ .6 inch connection w/ large-lumen tubing. FLOW RATE= 10 L/min |
| Care for T-Piece or Tracheostomy | Constant humidification |
| Mobilization of pulmonary secretions | Semi-Fowler/check rate-flow Humidification/Nose & mouth care/SEcure collar-or-T-piece over Tracheostomy/Adjust Oxygen flow/ Adjust Temp.-Humidifed O2/ Tubing should removed frequently to b drained & cleaned to prevent aspiration of moisture |
| CLEARING AIRWAY-Pg 571 | Semi-Fowler/Pour normal saline H2O/Select |
| If pt is Unconscious | Place pt side-lying facing nurse- Place towel lengthwise under chin & pillow |
| Part of tracheostomy removed for cleaning | INNER CANNULA |
| Precautions taken due to Tracheostomy tube | Keep curved hemostat @ bedside |
| iN SUCTIONING, it is recommended to wait 3 mins after repeatedly interventions to allow? | REPLENISHING OXYGEN |
| Nurse interventions with a pt that has a NASAL CANNULA | Assess patency of the cannula every 2 hrs |
| More precising Oxygen concentration can be achieved by using.. | VENTURI MASK SYSTEM |
| Appropriate technique for NASOTRACHEAL SUCTIONING | Applying intermittent suctioning for 10 seconds during catheter removal |
| HOME OXYGEN THERAPY | Teaching the Use of the equipment |
| Minimize SENSORY DEPRIVATION | Notepad to communicate Explain procedures Reorient pt frequently Encourage family to talk to pt Call button within reach |
| SUBCUTANEOUS EMPHYSEMA | CUPITUS= Presence of air beneath the skin |
| CHAMBER A COLLECTION CHAMBER | Fluid/air drains > 100ml/hr may indicate HEMORRHAGING < 100 mL/hr indicate RE-EXPANSION or OBSTRUCTION |
| chamber B WATER SEAL CHAMBER |
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