HESI Critical Care Cardiac Pulmonary.pdf

Skin integrity top of ears under chin dislodges

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Skin integrity: Top of ears. Under chin. Dislodges easily. Make sure cannula is in patient’s nose. Humidification: a dds moisture and prevents drying of mucosa. After 4 L. Don’t need an order. It is okay to put on even if pt is on 2 L. Assess nasal mucosa for irritation. Masks: Patients who are hypoxemic or has chronic hypercapnia requires low levels of O2 delivery @ 1-2L bc low arterial O2 levels is pt’s primary drive for breathing 1) Simple Face Mask 5-12 L : used for short-term O2 therapy or to deliver O2 in emergency situations Interferes with talking/eating. Ensure mask fits over nose & mouth. Provide skin care to area covered by mask. Monitor for risk of aspiration (ex. Vomiting occurs). 2) Venturi Mask : use different valves. Use when you want to give specific amt of O2. Ex. 31% of O2. Used for pts at risk for or experiencing acute respiratory failure. Make sure masks fit patient’s face. Ex. Man has big beard. Ensure tubing is free of kinks bc FIO2 is altered with kinks or if mask fits poorly. Asses nasal mucosa for irritation. 3) Partial Rebreather 35-60% O2: used when O2 concentration needs to be raised; not usually prescribed for pt with COPD Make sure reservoir bag doesn’t twist or kink. Deflation of bag leads to decrease O2 delivery & rebreathing of exhaled air. 4) Non-rebreather 60-80% O2: used for pts with deteriorating respiratory status who might require intubation Make sure bag is inflated for Rebreathing masks. Make sure bag doesn’t twist/kink and O2 source is not disconnected bc pt will suffocate. 5) Aerosol Mask : used on pts recently extubated (breathing tube removed). Provides mist when connected to water to soothe pts throat. 6) Face Tent: Sits under the chin & comes forward to provide O2. Used on kids & pts who have packing in nose. Used for pts with facial trauma/burns instead of tight-fitting mask. Ex. Remove tumor from pituitary gland through the nose; put packing in nose. Pt has nose bleed. Tracheostomy Collar : way to provide O2 to someone with trach. T-piece: special adaptor connecting to pts breathing tube. Have aerosol tubing on either side. Provides O2 to pt with artificial airway. Ex. You have pt with breathing tube in place. Before you extubate, you use T-piece & connect it to pt. If pt can breathe okay, you pull tube out. Keep exhalation port in T-piece open & uncovered (if occluded, pt can suffocate) Ambubag: If bag is connected to O2, you give 100% O2 to pt.
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Critical Care NR 340 Exam 1 (3) Ventilator Tape Devices: 1. Oral airway : oropharyngeal airway. Purpose is to prevent tongue from dropping back & occluding the pharynx. Only use in pts with decreased LOC because they are very uncomfortable & can stimulate the gag reflex. “Bite Block”. 2. Nasopharyngeal airway : Nasal trumpets. Used in pts who are contraindicated with oral airway. Can be used in pts who are more awake.
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  • Fall '18

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