Oxygenation of your Patient and Lung Function Interventions....

ARDS = Acute Respiratory Distress Syndrome
Pt w/intubation & PEEP = assess response Pt w/ heart failure and crackles = High Fowlers – promotes lung expansion & gas exchange, decreases venous return and cardiac workload Problem w/ pneumonectomy = ventilory exchange O2 & CO2 exchange is a priority Obese pt, smoker, major abdomen surgery. Postop what is priority? – O2 stats To monitor for s/sx of hyperventilation monitor for? – resp. alkalosis – increase rate and depth of breathing results in excessive elimination of CO2 Where do you hear stridor? Over the trachea or larynx Good breathing exercise is? Breathe from abdomen – improves lung expansion What to do with condensation collecting in the vent tubing? Empty the fluid from tubing – What to do in ER when trach is expelled? Hold open with tracheal dilator and call for help Pt is in pain on right side of chest, is dyspneic and coughs violently after abd surgery, nurse should? Elevate head of bed – may be pulmonary embolus and this promotes breathing by reducing the pressure of the abd. Organs on the diaphragm and increasing thoracic excrusion What can suctioning cause and what to do about it? Can cause dysrhythmias so hyperoxygenate prior to, during and after suctioning If nasogastric feedings are required in a pt with trach what should the nurse do with the cuff? Inflate the cuff before and for 30 min after ea feeding

A trach tube with high vol., low-pressure cuff is used to prevent? Mucosal necrosis – these cuffs do not compress the capillary beds and thus do not cause trach damage emphysema pt is using accessory muscles to breathe, his dyspnea is caused by? Difficulty expelling the air trapped in the alveoli – these pts use these muscles to breathe A pt with a PCO2 of 60 needs? Mechanical ventilation – this indicates progressive resp. failure, vent. Support is needed when the Pco2 is above 40 A lung cancer pt hooked to chest tube for drainage. Nurse should report what to physician? Subcutaneous emphysema on the 2nd day – evidence of a leak from the chest tube or the lung into the subq tissue A pt presents to ER after being hit in chest with a baseball. X-ray shows pneumothorax. What does nurse find on assessment? An absence of breath sounds on auscultation – collapsed lung