COPD
Name 1 complication or common concern of COPD
Hypoxia
Acidosis
Respiratory infections
Cardiac failure
Cardiac Dysrhythmias
Name 2 indications for insertion of a chest tube
Pneumothorax
Hemothorax
Abscess/empyema
Pleural effusion
Post-surgical drainage
What is the process of moving air into and out of the lungs? (Medical terminology)
Ventilation
How many liters of flow should a non-rebreather be set to?
10-15L/min
Where can you find the bag-valve mask device (aka Ambu bag) and an oxygen flowmeter?
The bottom drawer of any code cart
What breathing techniques can the nurse teach the patient with COPD to help with breathing?
Pursed lip breathing
Tri pod position
Abdominal breathing
Effective coughing
What do you need to assess and document for a patient with a chest tube?
Oxygenation
Work of breathing
Lung sounds
Drainage
Insertion site
Device settings & functionality (signs of air leak?)
What is the absence of respirations? (Medical terminology)
Apnea
Name 2 high flow oxygen delivery devices?
Non-rebreather mask
Venturi Mask
High flow Nasal Cannula
Bag Valve Mask (BVM or Ambu bag)
High Humidity High Flow (Airvo)
BiPap
If you are needing to transport a patient to another unit on oxygen, where should the oxygen tank be placed?
In an approved holder either attached to the bed or wheeled with the bed
What other therapies can help a patient with COPD?
Effective coughing
Oxygen as necessary to treat hypoxia and wean as able (goal SpO2 indicated by provider)
Medications (inhalers, breathing treatments, etc)
Suctioning
Hydration
Cool air
If a patient has a chest tube, when should the nurse notify the provider?
Tracheal deviation
Sudden onset or worsening dyspnea
Spa02 less than 90
Change in drainage (amount, color, etc)
Visible eyelet in chest tube or sutures are ripped out
Signs of infection at site
What is the name the lung structure where gas exchange occurs?
Which oxygen delivery device uses color adaptors to set a specific FiO2 delivery, but flow can be adjusted, which can be useful for patients with chronic lung disease?
Venturi Mask
How many liters of oxygen can you give on a regular nasal cannula?
1 to 6L
What is one patient education point for a COPD/Asthma patient while using their inhaler?
Make sure they are using the right technique
Use of a spacer
Risk of thrush (Rinse out mouth)
Wait 1 minute between each puff
What should the nurse do if they walk into a room and the patient's chest tube is out?
Cover the opening in the chest with occlusive sterile dressing on three sides
Prepare for emergent chest tube reinsertion
What is an adventitious breath sound that can often be cleared by coughing and most commonly heard in patients with asthma or pneumonia?
Rhonchi
Explain a difference between a CPAP and BiPAP?
CPAP is continuous pressure level and BiPAP provides different levels of pressure between inspiration and expiration
BiPAP can be used for respiratory compromise to help keep airway passages open with pressure support where CPAP can also be helpful with CHF patients
What do we commonly refer to as the percentage of oxygen in the air we breathe or devices we utilize?
Fraction of inspired oxygen (FiO2)