N242 > midterm > Flashcards

midterm Flashcards

(58 cards)

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1
Q

oxygen transport to tissues depends on

A
  • cardiac output
  • arterial oxygen concentration of hemoglobin
  • metabolic requirements
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2
Q

room air has how much oxygen

A

21%

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3
Q

what is the goal of oxygen therapy

A

provide adequate transport of oxygen in the blood while decreasing the work of breathing and reducing stress on the myocardium

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4
Q

what is hypoxemia

A

decrease in arterial oxygen tension in the blood

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5
Q

manifestations of hypoxemia

A
  • change in mental status
  • dyspnea
  • increased blood pressure
  • change in heart rate
  • dysrhythmia
  • diaphoresis
  • cool extremities
  • central cyanosis (late sign)
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6
Q

what does hypoxemia lead to

A

hypoxia

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7
Q

what is hypoxia

A

a decrease in oxygen supply to the tissues

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8
Q

rapidly developing hypoxia may resemble what

A

alcohol intoxication

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9
Q

hypoxemic hypoxia

A

decreased oxygen levels in the blood resulting in decreased oxygen perfusion to the tissues

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10
Q

causes of hypoxemic hypoxia

A
  • hypoventilation
  • high altitude
  • pulmonary embolism
  • shunts (alveoli collapsed)
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11
Q

treatment for hypoxemic hypoxia

A
  • increase alveolar ventilation

- oxygen

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12
Q

types of hypoxia

A
  • hypoxemic
  • circulatory
  • anemic
  • histotoxic
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13
Q

circulatory hypoxia

A

inadequate capillary circulation causes reduced tissue pressure (arterial oxygen remains normal)

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14
Q

causes of circulatory hypoxia

A
  • decreased cardiac output
  • local vascular obstruction
  • low flow (shock, cardiac arrest)
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15
Q

treatment for circulatory hypoxia

A

identify and treat the cause

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16
Q

anemic hypoxia

A

decreased effective hemoglobin concentration causes decrease in oxygen carrying capacity of blood
(rarely accompanied by hypoxemia)

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17
Q

what causes a similar effect as anemic hypoxia

A

carbon monoxide poisoning

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18
Q

histotoxic hypoxia

A

a toxic substance that interferes with the ability of tissues to use available oxygen
ex. cyanide

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19
Q

oxygen toxicity

A

when too high an oxygen concentration (>50%) is administered for extended periods (>48 hours)

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20
Q

what causes oxygen toxicity

A

overproduction of oxygen free radicals

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21
Q

what can help defend against free radicals

A

vitamin E, C and beta-carotene

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22
Q

S&S of oxygen toxicity

A
  • substernal discomfort
  • dyspnea
  • restlessness
  • fatigue, malaise
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23
Q

flow rate of nasal cannula

A

1-6 L/min

>4 requires humidification

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24
Q

simple face mask flow rate

25
partial nonrebreather flow rate
10-15 L/min
26
how do patients with COPD stimulate respiration differently
they use a decrease in oxygen to stimulate respiration rather than increased CO2 do not give oxygen because it removes this stimulation and can cause a progressive increase in arterial CO2 pressure
27
what is an incentive spirometer used for
- helps a patient to deep breathe | - should be used 10 times an hour
28
what is an oropharyngeal airway for
allows airway patency in an unconscious patient
29
what is postural drainage
- allows gravity to assist in removal of bronchial secretions - 2-4 times a day, before meals and at bedtime - patient should remain in position for 10-15 minutes, breathe in slowly through nose and out slowly through pursed lips - chest percussion and vibration help dislodge mucus (performed 3-5 minutes in each position)
30
how much urine should be collected for a culture
3mL
31
how much urine should be collected for routine analysis
20mL
32
how long should a catheter be clamped before collection
10-15 minutes
33
medical asepsis
"clean technique" | hand hygiene, gloves, cleaning the environment
34
in medical asepsis, something is considered contaminated if it
contains or is suspected to contain microorganisms
35
surgical asepsis
"sterile technique" | eliminates microorganisms and spores
36
in surgical asepsis, something is considered contaminated if it
touches something not sterile
37
3 situations surgical asepsis should be used for
- during procedure that perforates the skin - if the skin integrity is broken (trauma, burns, incisions) - during procedures that involve insertion of catheters or instruments into body cavities
38
4 things that contaminate something sterile
- out of vision - below waist - a wet contaminated surface (capillary action) - 2.5 cm edges of a field
39
subQ: volume
0.5-1.5 mL
40
an IM injection should have how much muscle penetration
5mm
41
IM: needle length
1-2 inch
42
subQ: needle length
3/8-1/2 inch | usually 5/8
43
what type of insulin do you prepare first
short/rapid acting
44
subQ: guage
25-27
45
subQ: site
abdomen, back of arm, thigh
46
subQ pediatrics: volume
< 0.5mL
47
subQ pediatrics: guage
25-30
48
subQ pediatrics: needle length
< 1/2 inch
49
subQ pediatrics: site
either back of arm or thigh
50
subQ butterfly: volume
2-3 mL
51
subQ butterfly: guage
24g
52
clean needle stick protocol
- wash soap and water - if necessary: first aid attendant - review PPE and safe work practices
53
splash on intact skin/clothing protocol
- wash soap and water - change clothes if necessary - if necessary: first aid attendant - review PPE and safe work practices
54
dirty needle stick AND splash on non-intact skin protocol
- wash soap and water - disinfect with alcohol swab - apply sterile dressing if necessary - DO NOT: squeeze, disinfect
55
blood/body fluid splash in eyes/nose/mouth protocol
- rinse membrane with tepid water/saline - notify CNL - ER within 2 hours - source blood exposure work complete - report exposure to occupational health nurse
56
hypotonic solution osmolarity
< 250 mOsm/L
57
isotonic solution osmolarity
250-375 mOsm/L
58
hypertonic solution osmolarity
> 375 mOsm/L
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