Oxygenation
If a person has a tight airway, and trouble breathing: blood oxygen _____ , while blood carbon dioxide ________. Blood acidity _______ and blood pH __________. This then triggers to respiratory center to have the respiratory rate ________.
(increase or decrease)
decreases; increases
increases; decreases
increase
What is the inflammation of respiratory bronchioles and alveoli that results due to an infection?
Bonus 50 points: What are the different types of pneumonia one can acquire?
Pneumonia
Hospital-acquired, bacterial, viral, community acquired, and aspiration pneumonia
Drug class
Bronchodilator
What is the most common oxygen delivery device seen in hospital settings? And what is the normal range of oxygen it delivers?
Nasal cannula and 1-6 LPM
This is the term for bluish discoloration of the skin due to low oxygen levels in the blood.
Bonus 50 points: Where is this bluish discoloration seen and what area is it worse (to be found)?Cyanosis
Bonus: cyanosis is found in toenail/fingernail beds and can be seen "centrally" around mouth/lips (which is worse)
What are some ways to help a patient with a tight airway and trouble breathing?
- sit them up -- opens airway
- deep breathing techniques
- medications - administer albuterol
- give supplement oxygen
What are common risk factors associated with Pneumonia?
- Immature immune system
- Chronic exposure to cigarettes or cigarette smoke
- Chronic cardiac and respiratory conditions
- Alcohol and drug abuse
- Age: infants, young children, older adults
Mechanism of action
a beta-2 adrenergic receptor agonist primarily used as a bronchodilator to relieve bronchospasm in conditions like asthma and COPD
How high of a flow rate does the non-rebreather set to and what percent of oxygen does it deliver?
15 L and 100%
What term is used to describe chronic accessory muscle usage?
Barrel chest
How would the body compensate for Hyperventilation?
Dizziness --> decreased respiratory rate
What are some nursing interventions to support a patient with Pneumonia?
- Fluids and rest (encourage and educate)
- Incentive spirometry Bonus 50 points: How often should a incentive spirometer be used and for how many times?
- Promote vaccines like flu vaccine for all, if over age 65 then pneumococcal too.
Nursing considerations
- Monitor for adverse effects: tremors, tachycardia, GI issues
- Monitor lab tests: ABGs, pulmonary function, and pulse oximetry
What signs and symptoms would you be noticing if your patient "isn't doing well" and may need to put them on oxygen?
- Restlessness and irritable
Describe a general description of a person with normal respiratory and cardiac function
- relaxed
- skin: warm, dry, pink
- breathing: relaxed, effortless, regular rate and depth
- position/posture: upright, no extra pillows, no use of accessory muscles, no flaring of nostrils
What is the normal level of pH in the blood? Too high means too much _______; too low means too much _________ in blood.
7.35-7.45
oxygen; carbon dioxide
List some local vs systemic clinical findings of Pneumonia
Local: cough w/chest discomfort, excess mucus production or hemoptysis, SOB, hypoxia, dyspnea
Systemic: fever, diminished appetite, malaise, cyanosis
Why is it important to recognize systemic vs local pneumonia?
What should we evaluate for the medication effectiveness?
- increased oxygen saturation
- decreased wheezing, cough, and dyspnea
What machine is the last option available before having to intubate the patient?
BiPAP machine
What areas are necessary to assess if patient is receiving oxygen therapy (such as nasal cannula)
- behind chin
- behind ears
- cheeks
- under nostrils
What are the normal values for Hemoglobin and Hematocrit?
Hemoglobin: 13-17 g/dL males; 12-15 g/dL females
Hematocrit: 40-50% males; 35-45% females
Diagnostic testing for Pneumonia
- Chest X-ray
- Sputum culture, sensitivity, and gram stain
- Serology testing
- Pulse ox
- CBC
What are contraindications and drug interactions for albuterol?
Contraindications: severe hypersensitivity to milk proteins, congenital long QT syndrome
Interactions: epinephrine, other sympathomimetic bronchodilators, tricyclic antidepressants, and beta-adrenergic blockers
What is the difference between CPAP and BiPAP?
CPAP - delivers constant air
BiPAP - delivers different air pressure at inhalation and exhalation
What are some early signs and late signs of hypoxia?
Early: Neuro (first signs) - restlessness, apprehension, inability to concentrate; decreased LOC; Dizziness; behavioral changes
Late: unable to lay flat; appears fatigued; central cyanosis; desaturated hemoglobin in capillaries