NU 431 Exam 3 With Solution
Indications for supplemental O2
•PaO2 < 60 mmHg
•SaO2 < 90%
O2 %
Room Air - 21%
Ever L of O2 adds 4%
•1L = 24%
• 5L = 40%
• 10L = 60%
• 15L = 80%
Nasal Canula
1-6L/min
High flow nasal cannula
up to 60 L/min humidified
Simple face mASK
Flow rates 5-10 L/min (40%-60%)
when transporting or when NC is not effective for pt (mouth breather)
,Partial rebreather mask
• Flow rate of 8-10L/min, (50%-75%)
•Simple mask with reservoir bag attached
• Reservoir bag filled with oxygen
Nonrebreather mask
• Minimum of 10 L/min (up to 90%)
• One-way valves between mask and bag, side of mask
• Prevents rebreathing of CO2
Venturi mask
• Flow rate 2-15 L/min (24%-60%)
• Most accurate oxygen concentration
Tracheostomy collar
• Used for patients with tracheostomy
• Needs humidified oxygen
• Can deliver supplemental oxygen
T-piece adapter
Used to wean patient off a ventilator
Used for spontaneous breathing trial
Non-invasive Positive Pressure Ventilation: NIPPV
• Continuous positive airway pressure (CPAP)
,• Bi-level positive airway pressure (BIPAP)
Continuous positive airway pressure (CPAP)
continuous positive pressure throughout the respiratory cycle. The positive
pressure is delivered continuously with each breath and is used to keep the
alveoli open and to increase the amount of oxygen delivered. The constant
pressure keeps the alveoli open during inspiration and exhalation
Bi-level positive airway pressure (BIPAP)
combination of pressure support (PS) for inspiration (IPAP) and positive end
expiratory pressure (PEEP) for exhalation (EPAP). This modality provides
positive pressure at the end of exhalation along with a higher positive airway
pressure during inhalation, which allows for better oxygenation and
ventilation
Face mask considerations
•Requires a tight seal
• For short term use only
• Assess if appropriate to take breaks for eating
• Mouth care
• Frequent skin assessments
watch for vomit
Absorption atelectasis
High O2 causes the alveoli to collapse
, Endotracheal tube (ETT)
• Artificial airway
Indications:
• Upper airway obstruction
• Apnea
• High risk for aspiration
• Ineffective airway clearance
• Respiratory distress
Nurses role during intubation
gathering equipment, monitoring the patient during the procedure and
adequately sedating the patient.
Intubation drugs
sedative first then paralytic
Endotracheal tube management
•Oral care every 2 hours
•Restrained in most cases
•Restraint charting per policy
• In line suctioning
Indications for supplemental O2
•PaO2 < 60 mmHg
•SaO2 < 90%
O2 %
Room Air - 21%
Ever L of O2 adds 4%
•1L = 24%
• 5L = 40%
• 10L = 60%
• 15L = 80%
Nasal Canula
1-6L/min
High flow nasal cannula
up to 60 L/min humidified
Simple face mASK
Flow rates 5-10 L/min (40%-60%)
when transporting or when NC is not effective for pt (mouth breather)
,Partial rebreather mask
• Flow rate of 8-10L/min, (50%-75%)
•Simple mask with reservoir bag attached
• Reservoir bag filled with oxygen
Nonrebreather mask
• Minimum of 10 L/min (up to 90%)
• One-way valves between mask and bag, side of mask
• Prevents rebreathing of CO2
Venturi mask
• Flow rate 2-15 L/min (24%-60%)
• Most accurate oxygen concentration
Tracheostomy collar
• Used for patients with tracheostomy
• Needs humidified oxygen
• Can deliver supplemental oxygen
T-piece adapter
Used to wean patient off a ventilator
Used for spontaneous breathing trial
Non-invasive Positive Pressure Ventilation: NIPPV
• Continuous positive airway pressure (CPAP)
,• Bi-level positive airway pressure (BIPAP)
Continuous positive airway pressure (CPAP)
continuous positive pressure throughout the respiratory cycle. The positive
pressure is delivered continuously with each breath and is used to keep the
alveoli open and to increase the amount of oxygen delivered. The constant
pressure keeps the alveoli open during inspiration and exhalation
Bi-level positive airway pressure (BIPAP)
combination of pressure support (PS) for inspiration (IPAP) and positive end
expiratory pressure (PEEP) for exhalation (EPAP). This modality provides
positive pressure at the end of exhalation along with a higher positive airway
pressure during inhalation, which allows for better oxygenation and
ventilation
Face mask considerations
•Requires a tight seal
• For short term use only
• Assess if appropriate to take breaks for eating
• Mouth care
• Frequent skin assessments
watch for vomit
Absorption atelectasis
High O2 causes the alveoli to collapse
, Endotracheal tube (ETT)
• Artificial airway
Indications:
• Upper airway obstruction
• Apnea
• High risk for aspiration
• Ineffective airway clearance
• Respiratory distress
Nurses role during intubation
gathering equipment, monitoring the patient during the procedure and
adequately sedating the patient.
Intubation drugs
sedative first then paralytic
Endotracheal tube management
•Oral care every 2 hours
•Restrained in most cases
•Restraint charting per policy
• In line suctioning
