Fundamentals mod 6

nonrebreather mask

10-15 L/min = 80-95% delivers the highest concentration of oxygen via a mask to a spontaneously breathing patient

venture mask

4-6L/min 24-40% which allows the mask to deliver the most precise concentrations of oxygen.

partial rebreather mask

8-11L/min = 80-95% has vents on its sides that allow room air to leak in at many places, thereby diluting the source oxygen.

What is the correct order to assess the chest?

Always proceed in a well-organized manner through a sequence of inspection, palpation, percussion, and auscultation.

Which of the following are lab studies to assess cardiopulmonary function? Select all that apply.

CBC Cytologic study pH analysis arterial blood gas cardiac biomarkers

dry suction

Has one-way mechanical valve that allows air to leave the chest and prevents air from moving back into the chest

dry suction water seal

Has three chambers: a collection chamber, water-seal chamber, and dry-suction control chamber Provides between 10 and 40 cm H2O of suction

traditional water seal

Has three chambers: a collection chamber, water-seal chamber, and wet-suction control chamber Has three chambers: a collection chamber, water-seal chamber, and wet-suction control chamber generally used to proved 20cm H20 of suction

Which of the following are age-related changes in an older adult? Select all that apply.

Impaired mobility and inactivity Reduction in vital capacity and increase in residual volume Decreased skeletal muscle strength in thorax Altered pain sensation Impaired mobility and inactivity Progressive atherosclerosis Decreased elastic recoil of the lungs Reduction in vital capacity and increase in residual volume Altered pain sensation

Which of the following are common mistakes in patients using MDIs? Select all that apply.

Inhaling through the nose rather than the mouthFailing to shake the canisterInhaling one spray with each breath

A nurse is teaching a preoperative client how to use an incentive spirometer. Which instruction should be included in the teaching plan?

Instruct the client to inhale slowly and as deeply as possible through the mouthpiece without using the nose.

nasal cannula

Low flow 1-2L/min = 24-28%, 3-5L/min = 32-40%, 6L/min = 44% is the most commonly used oxygen delivery device.

high flow nasal cannula

Maximum flow is 60L/min, 10L/min = 65%, 15L/min = 90% aerosolize oxygen and warmed normal saline with the ability to provide higher flow rates with resulting higher oxygen concentrations.

The nurse is taking a respiratory history for a patient who has come into the clinic with a chronic cough. What information should the nurse obtain from this patient? Select all that apply.

Occupational and environmental influences Risk factors associated with respiratory disease include exposure to allergens and environmental pollutants. Previous history of lung disease in the client Risk factors associated with respiratory disease include previous history of lung disease in the client or family. Previous history of smoking Risk factors associated with respiratory disease include smoking.

Place the following in correct sequence for suctioning a client.

Perform hand hygiene Verify functioning suction device and pressure Open suction kit and basin using aseptic technique Apply sterile gloves Connect suction tubing to suction catheter Lubricate catheter Suction airway Perform oral hygiene for the client

When caring for a client with a tracheostomy, the nurse would perform which recommended action?

Sterile technique is required when suctioning a tracheostomy in order to prevent introduction of microorganisms into the respiratory tract. The area around a new tracheostomy may need to be assessed and cleaned every 1 to 2 hours. A newly inserted tracheostomy needs to be assessed every 1 to 2 hours. (p. 1518) Gauze dressings that are not filled with cotton must be used to prevent aspiration of lint or cotton fibers into the trachea.

PAP therapy uses mild air pressure to keep airways open. This treatment can help the body to maintain better carbon dioxide and oxygen levels in the blood.

TRUE

The instructor of the nursing anatomy and physiology class is explaining respiration to the class. What does the instructor explain is the main function of respiration?

To exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells

alveoli

at the ends of the terminal bronchioles there are clusters of small air sacs

atelectasis

incomplete lung expansion or the collapse of alveoli

diffusion

is the movement of gas or particles from areas of higher pressure or concentration to areas of lower pressure or concentration

Which of the following are nursing measures that support general expected outcomes in patients with an alteration in oxygenation? Select all that apply

serve cardiopulmonary function by maintaining an optimal level of activity. Demonstrate improved gas exchange in the lungs by an absence of cyanosis or chest pain and a pulse oximetry reading more than 95%. Demonstrate self-care behaviors that provide relief from symptoms and prevent further cardiopulmonary problems.

circulation

the continuous one way circuit of blood through the blood vessels, with the heart as the pump

pulmonary ventilation

to the movement of air into and out of the lungs