Gas exchange

The nurse realizes the educational session conducted on due dates was successful when a participant is overheard making which statement?

"The ability of my placenta to provide adequate oxygen and nutrients to my baby after 42 weeks' gestation is thought to be compromised."

A client who uses portable home oxygen states, "I still like to smoke cigarettes every now and then." What is the appropriate nursing response?

"You should never smoke when oxygen is in use."

A 13-year-old boy has had a near-drowning experience. The nurse notices he has labored breathing and a cough. Which of the following would be the priority?

Administer 100% oxygen by mask.

A 3-year-old child with asthma and a respiratory tract infection is prescribed an antibiotic and a bronchodilator. The nurse notes the following during assessment: oral temperature 100.2°F (37.9°C), respirations 52 breaths/minute, heart rate 90 beats/minute, O2 saturation 95% on room air. Which action will the nurse take first?

Administer the bronchodilator via a nebulizer.

Which physiologic principle will result in an increase in alveolar/alveoli dead space?

Air supply exceeds blood flow.

After instituting interventions to increase oxygenation, the client shows no signs of improvement. What is the nurse's priority action?

Communicate with the health care provider for additional orders.

A 71-year-old woman is dependent on oxygen therapy and bronchodilators due to her diagnosis of emphysema. Which pathological processes occur as a result of her emphysema? Select all that apply.

Decreased elastic recoil due to alveolar damage. Increased anatomical dead space due to reduced tidal volume. Increased alveolar dead space due to incorrect intrapleural pressure.

What is the most important factor in myocardial oxygen demand?

Heart rate

A child has developed respiratory stridor and is displaying a crowing sound. The parents ask the nurse what is causing this sound. The best response would be:

Increased turbulence of air moving through the obstructed airways

People with emphysema often have a difficult time with air trapping, which is air left in the lungs following expiration, often due to the destruction of the alveoli. Pulmonary rehabilitation educates people who suffer from this disease to use which of the following to help air leave the lungs more effectively?

Intercostal and abdominal muscles

Urine catecholamine metabolites, homovanillic acid (HVA), and vanillylmandelic acid (VMA)

Lung auscultation and measurement of vital capacity and tidal volume

A client with a traumatic brain injury is showing early signs of increasing intracranial pressure (ICP). While planning care for this client, what would be the priority expected outcome?

Maintains a patent airway

A client in her 29th week of gestation reports dizziness and clamminess when assuming a supine position. During the assessment, the nurse observes there is a marked decrease in the client's blood pressure. Which intervention should the nurse implement to help alleviate this client's condition?

Place the client in the left lateral position.

A parents brings their 2-year-old to the emergency department in respiratory distress. SThe child's oxygen saturation is 81% and there is audible stridor. What intervention will the nurse anticipate?

Placement in an oxygen tent

The nurse is assessing a client who is receiving mechanical ventilation. Which assessment data obtained by the nurse may indicate that the client is experiencing respiratory alkalosis?

Positive Chvostek sign

The nurse is teaching a client how to use a metered-dose inhaler. Place the steps for using a metered-dose inhaler in order. All options must be used.

Remove cap and hold the inhaler upright. Shake the inhaler. Tilt head back slightly and breathe out slowly all the way. Open mouth and position inhaler 1 to 2 in (2.5 to 5 cm) away from mouth. Press the button on the inhaler while breathing in. Breathe in slowly and deeply for as long as possible.

A respiratory therapist is describing the characteristics of the oxygen-hemoglobin dissociation curve to a group of nurses caring for some respiratory clients. The respiratory therapist is describing what will happen to a client's oxygen saturation level if the partial pressure of oxygen decreases from 100 to 95 mm Hg. What will happen if this occurs?

The client will experience a negligible decrease in oxygen saturation.

A client is brought in by ambulance in a nauseous and confused state and demonstrating carpopedal spasm. Initial arterial blood gases show increased pH and HCO3 and normal PaCO2 levels. Breathing is slow and shallow. As the nurse caring for this client, you know that potassium salt should be a part of the treatment for this client when?

When hypokalemia is present

A client who is 29 weeks pregnant comes to the labor and childbirth unit. She states that she is having contractions every 8 minutes. The client is also 3 cm dilated. Which can the nurse expect to administer? Select all that apply.

a β-2 agonist betamethasone intravenous fluids

An adolescent diagnosed with thalassemia major (Cooley's anemia) is at risk for which condition?

chronic hypoxia and iron overload

A mother in premature labor asks the nurse why her doctor has prescribed corticosteroids. The nurse's response is based on the fact that:

cortisol can accelerate maturation of type II cells and stimulate the formation of surfactant.

A nurse is caring for a client who has a tracheostomy and temperature of 103° F (39.4° C). Which intervention will most likely lower the client's arterial blood oxygen saturation?

endotracheal suctioning

A common symptom that would alert the nurse that a preterm infant is developing respiratory distress syndrome is:

expiratory grunting.

A newborn requires resuscitation secondary to asphyxia. The resuscitation team frequently assesses the newborn's response and continues resuscitation efforts based on which assessment finding?

heart rate of 70 beats/min

A 29-week gestation client arrives in the labor and birth suite for an emergency cesarean section. The neonate is born and artificial surfactant is administered. Which action best explains the main function and goal of surfactant use?

helps lungs remain expanded after the initiation of breathing improving oxygenation

A 10-month-old infant with tetralogy of Fallot (TOF) experiences an cyanotic episode. To improve oxygenation during such an episode, the nurse should place the infant in which position?

knee-to-chest

A nurse is caring for a client with bronchogenic carcinoma. Which nursing intervention takes highest priority?

removing pulmonary secretions

A newborn has been diagnosed with a congenital heart disease. Which congenital heart disease is associated with cyanosis?

tetralogy of Fallot

A young child is brought to the ER with CPR in progress. The parent found the child lying on the kitchen floor without respirations, although a heartbeat was initially detected. The triage nurse anticipates the most likely cause of the situation is an obstruction of the conducting airways that caused an interruption in:

ventilation.