NUR 211: Gas Exchange
Oxygen is exchanged with CO2 at the terminal end of the ________ by the process of diffusion
via the capillary membrane - ANS alveoli
CPAP - ANS continuous positive pressure airway throughout inspiration and expiration
uses: sleep apnea, mechanical intubation weaning
BIPAP - ANS bilevel positive airway pressure works by providing assistance during inspiration
and preventing airway closure during expiration.
uses: severe sleep apnea, COPD
Prior to a ABG collection, a Allen test is performed; normal return of blood flow is - ANS within 6
seconds
A patient shows s/s of anxiety prior to intubation; an ____ should be collected - ANS ABG
Balloon pressure with ET tube that is below 20 can cause - ANS aspiration pneumonia
Balloon pressure with ET tube that is above 25 can cause - ANS trachea bleed/rupture,
ischemia, necrosis
Extubation by the patient can cause - ANS laryngeal swelling, aspiration, hypoxemia, low blood
pressure, death
disadvantages of a ET tube - ANS decreased cough and swallowing reflex, risk for aspiration,
risk for infection, risk for ulcer of the trachea
a __________ line suctions the ET tube consistently - ANS sub-clottial
What needs to be at the bedside for a patient with a tracheostomy? - ANS operator
What position does a patient need to remain in that has a trach? - ANS semi-fowlers
How often do you need to assess the pressure gauge for a trach? - ANS q 8 hrs
should be 20-25 mmhg
How do you check the placement of an ET tube? - ANS CXR
, can also be assessed by a CO2 monitor and a laryngoscope, CXR is best; CO2 = in lungs
What are the complications of a trach tube? - ANS tube dislodgement, pneumothorax, SUBq
emphysema, air emboli, laryngeal nerve damage, rupture, necrosis, tracheal wall penetration,
aspiration
if an ET tube is dislodged what are the S/S? - ANS unilateral decreased breath sounds
alarm sounds, low BP
when extubating a patient use a ________ Cath while extubating to decrease risk of aspiration -
ANS suction
the balloon that was inflated traps mucus in the lower trach and can cause the mucus to be
dislodged when deflating
If a patient is talking with a ET tube or a trach it is most likely caused from - ANS low balloon
pressure (the vocal cords should be compressed by the pressure of the balloon)
call RT to inflate balloon
the main purpose of mechanical ventilation is to decrease the ______ - ANS CO2
volume cycled ventilator - ANS *MOST COMMON TYPE*
Volume of air devlied with each inspiration is preset
(provides a certain amount of volume with each inspiration and helps the patients o2 level in the
lungs being inhaled)
at risk for barotrauma r/t too much o2
pressure cycled ventilator - ANS ventilator forces air into the lungs until a specific airway
pressure is reached.
Think short term, post anesthesia care units.
at risk for airway resistance r/t not enough o2
high frequency oscillatory support - ANS keeps the alveoli open at 180-900 breaths per minute
When is a CPAP/BIPAP contraindicated? - ANS head trauma, respiratory arrest, dysrhythmias,
cognitive impairment
an ET tube used longer than 21 days can cause - ANS vocal cord paralysis
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