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What is a Nasal Cannula?
A way of giving oxygen therapy that is pretty accurate
How is oxygen ordered for a Nasal Cannula?
In liters/minute, which can be converted to % of inspired O2 (FiO2)
What percentage of oxygen is in a normal room's air?
What are the amounts (in L) and the % of oxygen that can be ordered for a Nasal Cannula?
- 1-2 L = 24-28 %
- 3-4 L = 32-36 %
- 5-6 L = 40-44 %
Can you use a simple face mask for a COPD patient?
No - b/c of retension
Explain a Venturi Mask.
- Can deliver higher concentrations of O2
- Much more reliable
- Has color coded adaptor with FiO2 printed on it & instructions for flow meter
A Venturi Mask looks almost like a simple face mask...
What should you look for to know it is a V-Mask?
- colored adaptors
- (yellow, white, green, blue, pink, and orange)
What is the 5th vital sign?
The ____ ________ requires pain assessments for all patients.
The Non-Rebreathing Face Mask :
- Has reservoir
- Delivers highest (up to 90%) w/o intubating the patient
- READ the directions!! Fill the reservoir bag 1st
Which type of mask delivers the highest O2 (up to 90%) w/o intubating the patient?
The Non-Rebreathing Face Mask
Which Mask has a reservoir?
The Non-Rebreathing Face Mask
The pressure of the blood as it is forced against arterial walls during cardiac contraction is known as ________
The contraction phase of blood pressure is known as _______
The relaxation/resting phase of blood pressure is known as _______
The Stroke Volume is:
The amount of blood forced out by the left ventricle upon each contraction
The Cardiac Output is:
The total quanitity upon each contraction pumped per minute
Pulse Pressure is:
- The difference b/t systolic and diastolic pressures
- The indicator of volume output of the Left Ventricle
The Pulse Pressure should generally be _____ of the systolic pressure.
no greater than 1/3
Blood pressure of 120/80 has a pulse pressure (PP) of ____
What does a Narrow pulse pressure indicate?
the potential of CV Collapse
Increased Cardiac Output = _______ BP
Decreased Cardiac Output = _______ BP
Peripheral Resistence =
- Blood Viscosity (thickness)
- Vascular Compliance
Blood Volume =
- Hemorrhage (if BV decreases)
- Renal Failure (if BV increases)
Cardiac Output =
- The amount of blood pumoed each minute
- Heart Rate x Stroke Volume
The amount pumped with each contraction = ________ & per minute = ________
Stroke Volume & Cardiac Output
What is the Equation for Cardiac Output?
CO = HR x SV
What unit is Blood Pressure measured in?
mm/Hg - millimeters of mercury
The difference b/t systolic and diastolic pressure is known as the _____ ______
What is the most common way of measuring BP?
Indirect or Noninvasive - gets an accurate estimate or arterial BP obtained by external measuring devices
Explain the Direct Method of measuring BP:
- Done only in in-client setting
- Catheter is threaded into an artery under sterile conditions
- Attached to tubing that is connected to an electronic monitoring system
- Pressure is constantly displayed as a waveform on the monitor screen
What equipment do you need to obtain an Indirect BP measurement?
- Sphygmomanometer - consists of a vinyl or cloth cuff, a pressure bulb with a regulating valve, and a manometer
- Stethoscope - used to auscultate the systolic and diastolic pressure
What are the steps to use a BP Cuff?
- Select appropriate arm (No AV Shunt/Mastectomy)
- Place stethoscope over an artery
- Inflate the cuff; the artery is occluded as the pressure of the cuff exceeds the pressure in the artery
- Deflate the cuff; blood begins to flow rapidly through the partially open artery, producing turbulent flow you will hear through the stethoscope
When are the 5 Korotkoff sounds heard?
- 1st occurs during systole/tapping/systolic BP
- 2nd soft/swishing
- 3rd Midway/sharp/tapping
- 4th softer than 3rd
- 5th Silence corresponds to diastolic BP
A BP Cuff bladder should encircle ___ of arm
- Too small cuff = false high
- Too large cuff = false low
- Cuff with arm at side
- Keep arm at heart level if recumbent
Normal Systolic/Diastolic pressure is:
<120 / <80
Pre-hypertension Systolic/Diastolic pressure is:
120-139 / 80-89
Stage 1 Hypertension Systolic/Diastolic pressure is:
140-159 / 90-99
Stage 2 Hypertension Systolic/Diastolic pressure is:
>160 / >100
- The “silent killer ”: often no symptoms
- Often idiopathic. (unknown etiology)
Contributing factors of hypertension are:
family hx, obesity, smoking, heavy ETOH use, high NA intake, sedentary lifestyle
BP reading of 120-130 systolic or 80-89 diastolic
obtained with two readings, taken 6 minutes apart, with the client sitting (JNC 7, 2003)
BP persistently higher than normal
Diagnosed when BP is >140 mm Hg systolic or>90 mm Hg diastolic on two or more separate occasions
Primary or Essential Hypertension:
- Diagnosed when there is no known cause for the increase
- Accounts for at least 90% of all cases of hypertension
Systolic blood pressure <100 mm Hg; some clients normally have low BP; ask if client is light-headed or dizzy
What is a sudden drop in BP on moving from a lying to a sitting or standing position?
Orthostatic or postural hypotension
What factors influence Blood Pressure?
- •Age (Both I/D)
- •Stress (Increase)
- •Race (Increase in A.A.)
- •Diurnal Variations
- •Pain (Both I/D)
- •Body Position (Both I/D)
- •Diseases (Both I/D)
- •Lifestyle (Both I/D)
- •Medications (Both I/D)
- •Obesity (Increase)
- •Family History (Both I/D)
- •Sex (Both I/D)
- •Exercise (Both I/D)
BP _______ when standing and _______ when sitting
BP _____ with pain and _____ with excesive pain
BP is higher in a _____ than in a ______