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7.11 Respiratory Therapeutic Techniques.docx - Clubbing of...

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Clubbing of fingersBreath sounds– or adventitious sounds.SoundsDescriptionPathophysiologyVesicularSoft and longNormalRhonchiSnoringObstructionLaryngealstridorInspiratory harsh,stridentObstruction at the baseof tongue or larynxWheezingExpiratory whistleObstruction in lowertrachea or bronchiolesRalesFine cracklingFluid-filled alveoliLABORATORY TESTFactorsPulse OximetryArterialDistressminormajorStaff risk-potential needle injuryMonitoringcontinuous or regularonceCostlow to moderatehighly expensiveSkillsNurse & non-specialistMedTechMajorsources oferrorPoor skin perfusionUncooperative childMovement artefactClotted specimen> margin of machineerror at lower SpO2Air in syringeLab handlingPulse Oximetrymost accurate non-invasive & cost-efficient method fordetecting hypoxemiaused to measure the percentage of oxygenatedhemoglobin in arterial blood (SpO2).consists of a computerized unit and a sensor probe,which is attached to the patient’s finger, toe or earlobe.The oximeter displays the SpO2 with an audible signalfor each pulse beat, a pulse rate.in most models, a graphical display of the blood flow pastthe probe (the plethysmography or pulse wave). Thetechnology is robust and the cost quite low.96-100% –ideal level94%-– report90%– at risk/emergency (O2 ASAPas it decreases abruptly)STEPS ON USING A PULSE OXIMETER1Turn the pulse oximeter on.2Ensure that the child is sitting comfortably on theparent’s lap3Attach the oximeter probe to the child’s finger or toe.4Wait until there is a consistent pulse signal (20-30s)5Record the SpO2 & pulse rate on a monitoringchart.6If you are uncertain whether the SpO2 and pulse isbeing accurately detected, check the HR with asteth or manually feel the pulse.7If the SpO2 is <90%, give the child O2 – thru nasalprongs or a nasal catheter – at a flow rate of 0.5-2LPM continuously.8Recheck the SpO29Record the SpO2 and PR on a monitoring chart 15min after giving O2.NURSING CAREDocument and report are very important!Note timeand findings (e.g., appearance [cyanosis]).Arterial Blood Gas Analysisanother very accurate method for detecting hypoxemia.used to measure the partial pressure of oxygen (PaO2)and carbon dioxide in blood and also blood pH and theconcentrations of the main electrolytes.very expensive, and the chemical reagents represent ahigh recurrent cost, which may be unaffordable forhospitals with limited resources.invasive and uncomfortable, as it requires taking blood.PO2:80-100 mmHgPCO2:35-45 mmHgpH:7.35-7.45HCO3:22-26 mEq/LOXYGEN ADMINISTRATIONLOW-FLOW ADMINISTRATIONNasal Cannulaakanasal prongs, isa thin tube, oftenaffixed behind theears and used todeliver O2 directly tothe nostrils from asourceconnectedwith tubing.

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Term
Fall
Professor
N/A
Tags
bronchospasm, respiratory insufficiency

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