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39 Cards in this Set
- Front
- Back
What is Hypoxia?
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Lack of oxygen at the cellular level, inadequate tissue oxygenation at the cellular level
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What is hypoxia caused by?
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>decrease hemoglobin >not taking in enough inspired oxygen >inability of tissue to get extra oxygen(cyanine poisoning) >poor tissue perfusion >chest trauma |
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What are some sign and symptoms of hypoxia?
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Early signs >Confusion >Restlessness >Agitation >change in mental status |
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Why does pulse and respiratory increase?
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to compensate for decrease O2 initially go up with hypoxia.
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Cyanosis is a late sign in hypoxia and can be seen in?
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>Mouth >lips >conjunctiva(dark skin people) >Earlobes >Fingers |
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Hypoxemia different from hypoxia by?
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Decrease of oxygen in the blood generalized cyanosis
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Things that can cause issue with gas excgange |
>decrease oxygen carrying capacity >anemia- reduction of hemoglobin's ability to carry oxygen |
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What are some signs and symptoms of anemia?
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>Fatigue >Increase SOB >Pallor >Tired >Increase heart rate >Decrease inspired oxygen concentration |
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Anything that causes a patient to not be able to breath in(considered a decrease in their inspired oxygen)
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>Obstruction >Overdose >High altitude |
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What is hypovolemia?
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Blood volume being reduced
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Decreased_______ = Decreased _____+______
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blood volume= hemoglobin and O2
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What is hypovolemia caused by?
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>Shock >Sever dehydration |
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Why is there vasoconstriction in distal extremities with hypovolemia?
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Keep blood where we have to have it, at the organs (central body)
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If your metabolic rate increase what does it do to your oxygen need?
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Increases
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Chest wall movements that can affect gas exchange?
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>Chest trauma >Flail chest (broken rib does opposite) >Scoliosis >Kyphosis >Pectus excavatum >Pigeon chest >Funnel >Any abnormality in chest wall |
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How does pregnancy affect gas exchange?
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>Uterus starts to displace the diaphragm which is not going to allow for chest to fully expand |
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Why do Obese patients have a harder time breathing versus average people?
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Their abdomen is heavily weighing down their diaphragm making it harder to breath especially while laying down.
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Why are obese patients more at risk for pneumonia and respiratory complications after surgery?
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Because they have trouble fully expanding the lungs to take deep breaths in
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Neuromuscular diseases that affect the patients ability to expand and contract the chest wall?
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>Myasthenia Gravis- muscle weakness and can happen from top to bottom >Guillian Barre- attacks nerves |
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VQ ratio(VQ mismatch)
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means either an increase in ventilation and a decrease in perfusion or a decrease in ventilation and an increase in perfusion (chronic obstruction or a blood clot) |
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VQ mismatch= Hypoxia
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>#1 common reason of hypoxia >if there is a mismatch with perfusion and ventilation you will end up with hypoxia |
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If your patient is having chest pain get adequate information about it like?
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>What causes it? >When does it go away? >When does it start? >Does it go away if you rest? >Do you have to take medication? >What doe sit feel like, sharp or stabbing? |
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If a patient is having cardiac problems what is the pain going to feel like?
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Pressure like an elephant sitting on your chest
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Stabbing pain can indicate what?
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Pleurisy
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What are 2 categories of medications that can cause a dry chronic cough?
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>Beta blockers >Ace inhibitors Are they on bronchodilators because they can interact with a lot of OTC medications |
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What is a good physical assessment?
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>Look how their respiratory looks (is it labored or shallow) >Look at their general appearance -skin -cap refill |
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What is clubbing of the fingers a sign of?
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Long term affect of decrease O2 over many years
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What to palpate that relates to gas exchange?
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>Pulses >Edema in feet >Swelling >Excursion- chest wall expands together >asculate |
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Sounds we are listening for?
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Normal >Vesicular >Bronchovesicular >Bronchi >Adventicous Abnormal >Wheeze- high pitch, exhale and inhale >Crackles-popping, end of exhale *fluid* >Rhonchi-snoring, gurgling |
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What are some diagnostic test we can do for gas exchange?
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>PFT-pulmonary function test (total capacity of inhalation and exhalation) >CXR -chest xray >ABG- brachial artery >Sputum culture >CBC/h+h >TB skin test >Thoracentesis- needle into pleura space and draw up fluid >Bronchoscopy |
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After any diagnostic test we the nurse must monitor the patient to make sure they do not develop any ________ ______?
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Respiratory complications
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What are some Interventions ?
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>Smoking cessation >Losing weight >Getting vaccines **#1 have to treat underlying cause** |
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What medications can we use for gas exchange issues?
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>Nebulizer >Symbicort and Advair- long acting beta agonist combined with steroid >Atrovent >Anticholinergic- it dries secretions or decrease mucous, relax smooth muscle around airways **Albuterol+ Levelbuterol -bronchodilator that relaxes muscle around airway** |
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Positioning is very important so simply ________ can help the patient.
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Sitting the patient up in the bed
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What is a good intervention to make sure secretions do not settle in the lung?
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Incentive spirometry
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If the patient stays well hydrated what does it help with?
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Helps keep the secretions thin and more easily couched up
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Corticosteroids and Prednisone help with inflammation but long term use can cause ?
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Osteoporosis and short term use can cause high blood sugar readings even in non diabetic patients
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What is a basic but effective intervention to do for gas exchange patients?
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Deep breathing and coughing exercises
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After you have implemented some interventions what must you do?
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Go back and make sure the interventions you did are working effectively
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