NURS 401_Oxygenation & Asthma Flashcards

Trachea is shorter; angle of right bronchus at bifurcation is more acute (steeper slope)

What are some A&P differences in the respiratory system or that affect the respiratory system of children?

Average respiratory rate for a newborn

Average respiratory rate for infants

Average respiratory rate for preschoolers

Average respiratory rate for school age

Average respiratory rate for adolescents & adults

Airway edema, although serious with any age, is especially dangerous with this population r/t level of diameter decrease it causes

Mechanisms that facilitate or impair the body's ability to supply oxygen to cells

Which of the following individuals would be at greatest risk for pneumonia

1. A 37 year old who recently delivered via a cesarean birth
2. An 8 year old with a history of allergies and asthma
3. A 55 year old who fractured fibula
4. A 72 year old who has the flu

A patient is scheduled to have a ventilation/perfusion (V/Q) scan. The nurse knows this is to diagnose:

1. Asthma
2. Pulmonary fibrosis
3. Pulmonary embolus
4. COPD

When teaching the patient with asthma about the use of the peak flow meter, the nurse instructs the patient to:

1. Increase the use of rescue inhalers (albuterol) if the meter indicates the yellow zone
2. Carry the flow meter at all times
3. Close your mouth around the mouthpiece and inhale quickly when measuring peak flow
4. Go to the emergency room if the meter indicate the yellow zone

You monitor your patient oxygen saturation during exercise and finds that it drops from 94% to 87%. The nurse interprets this data

1. The patient requires higher concentration of oxygen during ambulation
2. The patient needs to be on bedrest
3. The patient needs a blood transfusion to increase oxygen carrying capacity
4. The patient requires more deep breathing and use of the incentive spirometry

Your patient has chronic COPD with hypercapnia. Which of the following would be the safest order for oxygen for this patient?

1. 6 l/m via nasal cannula
2. 50% oxygen via a rebreather mask
3. 28% venturi mask
4. Administer oxygen PRN only when patient complains of dyspnea

Your patient is diagnosed with tuberculosis. Which of the following is most important in treatment

1. Make sure that he is placed in a positive airflow room
2. Institute droplet precautions immediately
3. Ensure that the patient complete the full course of antibiotic treatment
4. Encourage a high protein diet

Jennie Dasher is recovering from and aortic valve replacement. Her intial blood gas values come back as: pH 7.5, PCO2 30, HCO3 22, PO2 92. These date support which acid base disturbance?

1. Compensated respiratory alkalosis
2. Uncompensated respiratory alkalosis
3. Compensated respiratory acidosis
4. Uncompensated respiratory acidosis

Act of inhaling & exhaling air to transport O2 to alveoli

ACTUAL exchange of O2 & CO2 (breathing)

A continuous supply of oxygenated blood to every cell in the body (pumped to all parts)

What are the 3 main components that make up the umbrella of oxygenation?

This age group is known for being obligated nose breathers

Inadequate supply of O2 in the blood

What are some late S/S of hypoxemia?

What are some early S/S of hypoxemia?

What are some red flags r/t hypoxemia?

What other problems may result in S/S similar to SNS response to hypoxemia?

*Would require us to distinguish between whether or not it's hypoxemia

Alphabet soup r/t oxygenation:

C = ?

Alphabet soup r/t oxygenation:

F = ?

Alphabet soup r/t oxygenation:

E = ?

Alphabet soup r/t oxygenation:

I = ?

Alphabet soup r/t oxygenation:

P = ?

Alphabet soup r/t oxygenation:

Q = ?

Alphabet soup r/t oxygenation:

S = ?

Alphabet soup r/t oxygenation:

V = ?

Alphabet soup r/t oxygenation:

a = ?

Alphabet soup r/t oxygenation:

c = ?

Alphabet soup r/t oxygenation:

v = ?

Alphabet soup r/t oxygenation:

p = ?

Alphabet soup r/t oxygenation:

A = ?

This is a measure of the hydrogen ion concentration

Alphabet soup r/t oxygenation:

pCO2 = ?

Alphabet soup r/t oxygenation:

pO2 = ?

Alphabet soup r/t oxygenation:

SO2 = ?

Alphabet soup r/t oxygenation:

HCO3 = ?

"Gold standard" for measuring oxygenation

If performing a radial ABG, which side should you stick?

What type of patient would we not want to perform a brachial stick to obtain an ABG?

Where would you obtain an ABG on a newborn?

ABG:

Normal PaO2

ABG:

Normal SaO2

ABG:

Normal CO2

ABG:

Normal HCO3

ABG:

Normal Base Excess (BE)

Hgb is almost fully saturated at this pO2

Hg saturation with O2 is high in the __1__ and is greatest in the __2__

If Hg experiences an increased affinity for O2, these manifestations will ensue

The ease with which hemoglobin releases oxygen to the tissues is controlled by this

If Hg experiences a decreased affinity for O2, these manifestations will ensue

In what different situations can PaO2 & SaO2 not be consistent?

Hg & O2:

__1__ is the maximum amt. of O2 that can be combined with Hg, whereas __2__ is the actual amount of O2 being carried by Hg

How does O2 blood saturation affect Hg saturation?

Classical cyanosis is present when 5 g/dL of __1__ or greater is present, and is usually apparent when SaO2 is less than or equal to __2__

This sign is not a good indicator of oxygenation

These 3 systems regulate acid-base balance

This counteracts changes to pH due to ability to either absorb or release H+ ions

First line of defense vs. pH changes

3 main buffers of the buffer system of pH maintenance include:

Can directly affect acid-base balance status more quickly & efficiently than all the buffer systems combined

Can activate pH changes within 1-3 minutes

Slower process; requires 1-5 days for complete activation to correct acid-base imbalances

How do kidneys react to changes in pH?

How soon are pH buffer systems operational?

Do newborns have the ability to control pH using their respiratory system?

The renal buffer system is limited in its capacity to respond to pH changes in this age group

pH <7.35

pCO2 >45mm Hg

pH <7.35

HCO3 <22mm Hg

The body has accumulated too much acid & doesn't have enough HCO3 to neutralize its effects

This acid-base imbalance is often r/t hyperventilation

pH >7.45

pCO2 <35mm Hg

pH >7.45

HCO3 >26mm Hg

pH is abnormal

pCO2 & HCO3 abnormal

pH is normal

pCO2 & HCO3 abnormal

At what age will most children first have respiratory symptoms indicative of asthma?

What is one of the first signs that a person is having airway restriction indicative of asthma?

What's the most common trigger for children's asthma attacks?

These factors often predispose children to having asthma later in life

Asthma is an INFLAMMATORY disease with these 3 characteristics

Can mild asthma have a severe exacerbation?

This doesn't disappear along with the symptoms of asthma following treatment

In a large number of children, asthma remits at this point in life

This medication is both a bronchodilator & anticholinergic used to treat asthma; thus, you're treating inflammation via both sympathetic & parasympathetic routes

Incidence of asthma is greater in boys up until this point in life; after this point, it's more prevalent in girls

What are the 2 major groups of medications used to TX asthma?

Types of rescue medications for asthma

Types of controller medications for asthma

What objective information is needed for asthma treatment?

This helps w/diagnosis & ongoing TX decisions r/t asthma

Provides objective data for management

Measures obstruction to airflow in airways

Early phase of acute asthma exacerbation:

1. What causes symptoms?

2. What is the treatment?

Late phase of acute asthma exacerbation:

1. What is happening to respiratory A&P?

2. What is the treatment?

Early warning signs of asthma

Late warning signs of asthma

What does giving a daily inhaled mcg dose of corticosteroid controller medication prevent?

What are some worrisome signs during an acute asthma exacerbation?

Asthma guidelines address these 3 different age ranges

How many puffs are in a normal dose of your rescue inhaler?

Analyze asthma severity chart on reverse side

Along with rescue meds, this will most likely be added to the TX plan of a mild asthmatic

Along with rescue meds, this will most likely be added to the TX plan of a moderate asthmatic

Along with rescue meds, this will most likely be added to the TX plan of a severe asthmatic

What's the "Rule of 2's", as proposed by Baylor University?

What happens if there's a "yes" answer to any of the questions in the "Rule of 2's" from Baylor University?

The always-present inflammatory cells in the asthmatic's airway result in hyper-__1__ & hyper-__2__ airways that, when hit with a __3__, become further inflamed & edematous, increasing __4__ production & constricting of smooth muscle

What's the ultimate goal of asthma treatment?

With a child of this age, they may help with minimal task, such as holding equipment

With a child of this age, they may be able to get some equipment, ID some body parts involved in asthma, & help with TX

With a child of this age, parents are still responsible for care, but the child can learn early warning signs, triggers, and correct words to label body parts & symptoms

With a child of this age, parents are still needed, but child is starting to take more active care role; can set up equipment, recite meds & info, and link cause & effect

During normal, asymptomatic days, the asthmatic will take a/an __1__ (green zone); when entering the caution zone (yellow), where symptoms develop, the asthmatic will add a/an __2__; when symptoms are severe (red zone - danger), a/an __3__ will be added

The nurse reviews an arterial blood gas report for a client with chronic obstructive pulmonary disease (COPD). The results are: pH 7.25; PCO2 62; PO2 70; HCO3 34. The nurse should first:

1. Apply a 100% nonrebreather mask
2. Assess the vital signs
3. Reposition the client
4. Prepare for intubation

A client’s arterial blood gas values are as follows: pH 7.31; PaO2 80 mmHg; PaCO2 65 mmHg; HCO3 36 mEq/L. The nurse should assess the client for:

1. Cyanosis
2. Flushed skin
3. Irritability
4. Anxiety