Brief Respiratory Review

This page provides a very brief and concise review over important respiratory information.

  •  Pulse oximetry – 95-100%
    • COPD will be lower
  • Hypoxemia vs hypoxia
    • Hypoxia – blood not carrying oxygen to tissues
    • Hypoxemia – not going into tissues
      • Decrease in hemoglobin
  • Gas exchange happens in alveoli
    • Vascular capillaries
    • Inspiration – expand
    • Exhale – collapse
  •  Arterial blood test
    • Allen test – apply pressure over radial and ulnar arteries then let of one go and hand should pink up and then you can stick
    • Painful – “electric current”
    • Prepare the patient for discomfort – tell them it won’t be comfortable
    • Specimen in ice and then to lab immediately
    • Heprenized syringe
    • Hold pressure for at least 5 min or 20 if on blood thinner
    • Air embolism – will see SOB, cyanosis, air hunger, vein distension, flushed
  • Bronchocopy
    • Visualization of bronchial
    • Sitting/high fowlers
    • Before
      • Need consent
      • No allergies to anesthesia
      • NPO
    • After
      • Wait for gag reflex to return before feeding
      • May have mild fever
      • Blood tinged sputum
    • Laryngospasm is bad after procedure
    • Sore throat after – give lozenge or cough drop
  •  Punctured lung
    • Deflates
    • Air into pleural cavity
  • Thorocentesis
    • Remove fluids or air from pleural cavity
    • Done in pt room at bedside
    • Prepare
      • Tray
      • Consent
      • Anesthetic
    • Intra op
      • Client in a forward position with arms on table
      • Inject needle through side
      • Client needs to be completely still
      • Document fluid removed
      • Send to lab
      • 1 L removal at a time
    • Post op
      • Dressing over puncture site
      • Lye in uneffective side for at least 1 hours
      • Deep breathing
      • Can resume normal activity after one hr
      • Post op xray
  • Pneumothorax
    • Partially collapsed lung or anything putting pressure on lungs
    • Diminished lung sounds
  • Chest tubes
    • Single, double or triple
    • Water seal keeps negative pressure – sterile fluid 2 cm line
    • Monitor water level due to evaporation – only sterile water can be added
    • Tidaling – movement of water in water seal chamber with inspiration and expiration
    • USED FOR
      • Collapsed lung
      • Blood in lung
      • Post op
  •  Post procedure
    • Monitor vitals, breath sounds, resp effort
    • Deep breathing – 2 hrs
    • Keep the chamber below client wound
    • Check water seal every 2 hours
    • Document color and drainage hourly in 1st24 hours then every 8
      • Notify when 75 or more ml an hour
    • Keep 2 hemostats and gauze at bedside
    • Occlusive dressing after removed
  •  Mechanical ventilation
    • PIP – positive inspiration pressure
    • PEEP – Positive end expiration pressure
    • CPAP – all PEEP