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OxProfusion
Oxygen Delivery Methods
Nasal Cannula
Simple Face Mask
Non-Rebreather Mask
Venturi-Mask
Safety Precautions
Oxygen In Use Sign
No Electrical Sparks
Six Feet Away from Open Flames
Nursing Considerations
Dry Nasal and Upper Airway Mucosa
Skin Irritation
Home Education
1 min
Hypoxia (Early Symptoms)
Diaphoresis
Restlessness
Tachypnea
Dyspnea on Exertion
Tachycardia
Hypertension
Arrhythmias
Decreased Urine Output
Unexplained Fatigue
1 min
Hypoxia (Late Symptoms)
Cyanosis
Cool, Clammy Skin
Use of Accessory Muscles
Retractions
Hypotension
Arrhythmias
2 mins
Lung Sounds - Pleural Friction Rub
Location
Anterior Lateral Lung
Description
Dry, Rubbing, or Squeaking
Sounds Like
Rubbing a Balloon with Finger
Cause
Inflamed Pleura
50 secs
Pleural Effusion
Excess fluid accumulation
Treatment
thoracentesis
Types
Transudate
Congestive Heart Failure
Nephrotic Syndrome
Cirrhosis
Exudate
Malignancy
Pneumonia
Collagen vascular disease
Trauma
Lymphatic (Chylothorax)
Thoracic duct injury
Increased Triglycerides
Pleural Effusion - Character and Odor of Fluid
Pus = Empyema
Viscous = Mesothelioma
Debris = Rheumatoid Pleurisy
Turbid = Inflammatory Exudate or Lipid Effusion
Anchovy Paste = Amebic Liver Abscess
Putrid Odor = Anaerobic Empyema
Ammonia Odor = Urinothorax
Causes of exudative pulmonary effusion
Connective Tissue Disorders
Infection
Autoimmune disorder
Neoplasms
Pulmonary Embolism (PE)
Flail Chest
Cause/Mechanism
Trauma
Assessment
Shallow Respirations
Chest Pain
Paradoxical Chest Movement
Interventions
Mechanical Ventilation
Analgesics
Intercostal Nerve Blocks
Considerations
Surgical Rib Fixation
Monitor Pulmonary Contusion
2 mins
Chest Tubes: Management and Care
Confirm suction order
Assessment
Crepitus
Kinking
Shortness of Breath (SOB)
Infection
Excessive bubbling
Quick Interventions
If tube dislodges from patient, use petroleum gauze taped 3 ways
If drainage system is damaged, place disconnected drainage tube in sterile water
1 min
Do NOT Miss Differential for Chest Pain
Pulmonary embolism
Pericarditis / Myocarditis
Pneumonia
Esophageal Rupture (Boerhaave's syndrome)_
Tension pneumothorax
Tuberculosis
Tumor
Myocardial Infarction
Mediastinitis
Aortic Dissection
aortic stenosis
Anemia
Acute Chest syndrome (sickle cell anemia)
Cardiac Tamponade
Spinal cord compression
Initial Workup
EKG
Chest X-ray
Pneumothorax
Mechanism
Air Enters Pleural Space
Assessment
Sudden Dyspnea
Absent or Restricted Movement on Affected Side
Decreased or Absent Breath Sounds on Affected Side
Chest Pain
Tracheal Deviation
Vital Sign Changes
Crepitus
Considerations
High Fowler's Position With Oxygen
Prepare For Chest Tube Placement
Educate High Risk Patients
2 mins
Lung Cancer Assessment
2nd Most Common Cancer
Assessment
Chronic Cough
Hoarseness
Abnormal Breath Sounds
Hemoptysis
Chest Pain
Anorexia or Weight Loss
Considerations
Symptoms Appear Late in Disease
2 mins
Restrictive vs. Obstructive Lung Diseases
Restrictive Lung Disease
Decreased Lung Volume
FEV1/FVC Ratio Normal to Increased
Obstructive Lung Disease
Increased Lung Volume
Decreased FEV1/FVC Ratio
2 mins
Lung Sounds - Crackles
Location
Lower Lobes
Description
Fine/Coarse
Sounds Like
Fine: Twisting Hair through Fingers
Coarse: Velcro
Cause
Collapsed Small Airways and Alveoli "Popping Open"
1 min
Lung Sounds - Rhonchi
Location
Trachea and Bronchi
Description
Low Pitched Rumbling
Sounds Like
Gurgling
Cause
Narrowed Airway
Secretions or Bronchospasm
49 secs
Lung Sounds - Wheezes
Location
Throughout Lung
Description
High Pitched
Sounds Like
Musical
Cause
Air Moving through Narrowed Airways
38 secs
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