Module 6: Nursing Support of Oxygenation
atelectasis
Incomplete lung expansion or the collapse of alveoli
People with chronic illness typically have ______?
muscle wasting and poor muscle tone
perfusion
process by which oxygenated capillary blood passes through body tissues
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.
Which of the following are lab studies to assess cardiopulmonary function? Select all that apply.
Arterial blood gas Cytologic study pH analysis Cardiac biomarkers CBC
Alveoli
At the end of the terminal bronchioles there are clusters of small air sacs
Which of the following are nursing measures that support general expected outcomes in patients with an alteration in oxygenation? Select all that apply.
Demonstrate self-care behaviors that provide relief from symptoms and prevent further cardiopulmonary problems. Demonstrate improved gas exchange in the lungs by an absence of cyanosis or chest pain and a pulse oximetry reading more than 95%. Preserve cardiopulmonary function by maintaining an optimal level of activity.
Which of the following are common mistakes in patients using MDIs? Select all that apply.
Failing to shake the canister Stopping the inhalation when the cold propellant is felt in the throat Inhaling through the nose rather than the mouth Holding the inhaler upside down
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.
traditional water seal
Generally, used to provide 20cm H2O of suction Has three chambers: a collection chamber, water-seal chamber, and wet-suction control chamber
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
Which of the following are age-related changes in an older adult? Select all that apply.
Impaired mobility and inactivity Decreased skeletal muscle strength in thorax Altered pain sensation Decreased elastic recoil of the lungs Progressive atherosclerosis Decreased elastic recoil of the lungs
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.
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
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.
Previous history of lung disease in the client Occupational and environmental influences Previous history of smoking
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
hypoventilation
decreased rate or depth of air movement into the lungs
Nasal canula 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.
false
People with acute illnesses often have muscle wasting and poor muscle tone.
false
Simple mask 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.
false
The main function of the aorta is to exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells.
false
When having the patient use an incentive spirometer, instruct the client to inhale fast and as shallow through the mouthpiece without using the nose.
false
What is the correct order to assess the chest?
inspection palpation percussion auscultation
Respiration
involves gas exchange between the atmospheric air in the alveoli and blood in the capillaries
internal respiration
is the exchange of oxygen and carbon dioxide between the circulating blood and the tissue cells
diffusion
is the movement of gas or particles from areas of higher pressure or concentration to areas of lower pressure or concentration
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
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
People with chronic illnesses often have muscle wasting and poor muscle tone.
true
The main function of respiration is to exchange oxygen and CO2 between the atmospheric air and the blood and between the blood and the cells.
true
When having the patient use an incentive spirometer, instruct the client to inhale slowly and as deeply as possible through the mouthpiece without using the nose.
true
When suctioning the tracheostomy tube, the nurse would be using a sterile technique.
true