NUR 453 Role Transition Exam 3 Study Guide All Latest Material
Role Transition Exam 3 Study Guide
Respiratory
Ventilator emergencies
• Should NEVER
... [Show More] be turned off.
• Don’t know what is causing the alarm? What action is next?
o Manually bag the patient
o Can still mechanically ventilate when breathing on their own – bag WITH the pt
• Three Types of ventilator Alarms o Volume (low pressure) alarms - pt disconnected, low volume
o Pressure (high pressure) alarms - biting tube, secretions/fluid in tubing, pneumo o Apnea alarms – not breathing
• WHAT CAUSES THE ALARM?
• Positive End Expiratory Pressure PEEP o > 15 is high PEEP – can cause peumo, damage to lung tissue/barotrauma
Positive pressure decreases CO2 and compresses venous return
Assessment findings emphysema
• Loss of lung elasticity leading to air trapping
• Barrel shaped chest
• Dyspnea – tachypnea, use of accessory muscles, pursed lip breathing
• Pink puffers (high CO2)
• Diminished breath sounds
• Tripod position
Signs/symptoms of hypoxia
o Acute – hyperventilation, H/A, AMS (restlessness, anxious, irritability), diaphoresis
Tx: Oxygen administration, morphine sulfate to control breathing o Chronic - clubbing, cyanosis, diminished oxygenation to vital organs
POSTOP care priorities
Oxygen administration devices - COPD patients
• Nasal cannula o Approximately 24-40% O2, 1-4Là meant for someone that is stable
If you give more than 4 L, you need to use humidifier o SOB—start with nasal cannula
• Masks: Simple; Partial rebreathing; Non-rebreathing o Simple Mask: Can deliver ~40-60% O2; Flow meter- 5-8 L
Pro-more stable and higher concentration
Con—claustrophobic; assess for skin breakdown
Rearrange frequently and oral hygiene o Partial Rebreathing: 60-75%, turn flow meter to minimum of 6 L
O2 in the bag (reservoir of O2)
Valves disallow re-inhalation of CO2 o Non-rebreather: Give close to 100% O2
Unstable patient or patient just recovering from anesthesia - ALL the way to 15 L
Must have airway and breathing on their own
Anticipate: 1. start to get better quickly 2. get advanced airway (intubated) Assess frequently [Show Less]