NP Ch 38 Oxygenation and Perfusion

The charge nurse is observing a new nurse care for a client who is receiving oxygen via a simple mask with an FIO2 of 40%. The client states, "This moisture on my face is bothersome. Can something be done about it?" Which of the following responses by the new nurse would require clarification by the charge nurse?

"After I dry your face, I can apply powder to absorb the moisture and protect your skin."

A client with chronic obstructive disorder pulmonary disease requires low-flow oxygen. How will the oxygen be administered? Select all that apply

-Simple oxygen mask -Partial rebreather mask -Nasal Cannula

In which of the following clients would the nurse assess for a depressed respiratory system?

A client taking opioids for cancer pain.

A client 57 years of age is recovering following a bilateral mastectomy and breast reconstruction two days earlier. Since her surgery, the client has been unwilling ti mobilize despite the nurse's education on the benefits of early mobilization following surgery. The nurse would recognize that the client's prolonged immobility creates a risk for what?

Atelectasis.

Upon auscultation of the client's lungs, the nurse hears loud, high-pitched sounds over the larynx. What term would the use in documentation to describe this breath sound?

Bronchial

Upon evaluation of a client's medical history, the nurse recognizes that which of the following conditions may lead to an inadequate supply of oxygen to the tissues of the body?

Chronic Anemia

The nurse is informed while receiving a nursing report that the client has been hypoxic during the evening shift. Which of the following assessment findings is consistent with hypoxia?

Confusion

A client with no prior history of respiratory illness has been admitted to a postsurgical unit following foot surgery. What intervention should the nurse prioritize in an effort to prevent postoperative pneumonia and atelectasis during this time of reduced mobility following surgery?

Educating the client on the use of incentive spirometry.

A nurse is caring for a client who breathes very shallowly and has been complaining of severe back pain. What suggestion could the nurse make to help the client breathe efficiently?

Encourage the client to take deep breaths.

The nurse is conducting a respiratory assessment of a client age 71 years who has been recently admitted to the hospital unit. Which of the following assessment findings should the nurse interpret as abnormal?

Fine crackles to the bases of the lungs bilaterally.

During oxygen administration to the client, which of the following pieces of equipment would enable the nurse to regulate the amount of oxygen delivered?

Flow meter

An older adult is visibly pale with a respiratory rate of 30 breaths per minute. Upon questioning, the client states to the nurse, "I can't seem to catch my breath." The nurse has responded by repositioning the client and measuring the clients oxygen saturation using pulse oximetry, yielding a reading of 90%. The nurse should interpret this oxygen saturation reading in light of the client's....

Hemoglobin level

The nurse is caring for a client who is diagnosed with an impaired gas exchange. While performing a physical assessment of the client, which of the following data is the nurse likely to find, keeping in mind the client's diagnosis?

High respiratory rate

The nurse is preparing to educate a client on how to perform incentive spirometry. Which of the following concepts should you include?

Incentive spirometry provides visual reinforcement of deep breathing.

A nurse uses a nasal cannula to deliver oxygen to a client who is extremely hypoxic and has been diagnosed with chronic lung disease. What is the most important thing to remember when using a nasal cannula?

It can cause the nasal mucosa to dry in case of high flow.

A nurse is caring for an asthmatic patient who requires low concentration of oxygen. Which of the following delivery devices should the nurse use in order to administer oxygen to the client?

Nasal Cannula

The nurse is caring for a client who has spontaneous respirations and needs to have oxygen administered at a FIO2 of 100%. Which of the following oxygen delivery systems should the nurse utilize?

Non-rebreather mask

The nurse should assess for respiratory depression before and after the administration of what drugs?

Opioid analgesics

While examining a client, the nurse palpates the client's chest and back. Which of the following would the nurse expect to identify with this technique?

Pattern of thoracic expansion.

A nurse is assigned to care for a client admitted to the health care facility with the diagnosis of atelectasis. When interviewing the client, the nurse would anticipate a history of which of the following?

Pneumonia

What structural changes to the respiratory system should a nurse observe when caring for older adults?

Respiratory muscles become weaker.