Oxygen and Perfusion

functions of the upper airway

1. warm air 2. filter air 3. humidify inspired air

non rebreathers mask 1. ____% 2. 10 - ___ LPM 3. keep reservoir bag ___________ (prevents breathing expired air)

100; 15; inflated

simple face mask 1. ____- 60% 2. 5 - ___ LPM 3. comfort/fit

40; 8

nasal cannula 1. 25 - ____% 2. ___ - 6 LPM 3. drying/irritating

45; 2

venturi mask 1. precise concentrations 2. 4 - ___ LPM 2. ____ - 50% FiO2 (fraction of inspired oxygen)

6; 24

a health care provider has prescribed oxygen to be delivered at 8 L/minute for a client who does not have a tracheostomy. which oxygen delivery device(s) will the nurse consider using? select all that apply a) simple mask b) partial rebreather mask c) venturi mask d) nonrebreather mask e) t piece

a, b; simple mask, and partial rebreather mask accommodate a flow of 8 L/min - a venturi mask accommodates 4-6 L/min - a nonrebreather mask accommodates 10-15 L/min

which of the following are factors of properly functioning alveolar system in lungs? select all that apply a) oxygenates venous blood b) carry nutrients and wastes to body cells c) carry nutrients and wastes from body cells d) removes carbon dioxide from blood

a, d b and c are factors of a properly functioning cardiovascular and hematologic system

most common diagnostic test for checking oxygenation a) pulse oximetry b) bronchoscopy c) pulmonary function tests d) complete blood counts

a; pulse oximetry - pulse oximetry measures % hemoglobin saturated with oxygen - bronchoscopy requires sedation - pulmonary function tests measure volumes/capacity and requires cooperation - complete blood counts are mostly used for anemia

a nurse is admitting a 6-year-old child after a tonsillectomy to the surgical unit. the nurse obtains the client's weight, and places electrocardiogram (EKG) leads on the chest and a pulse oximeter on the left finger. the client's heart rate reads 100 bpm, and the pulse oximeter reads 99%. these readings best indicate: a) adequate tissue perfusion b) diminished stroke volume c) high cardiac output d) heart failure

a; pulse oximetry is often used as a measure of tissue perfusion. oxygen saturation of greater than 94% is typically indicative of good tissue perfusion

when reviewing data collection on a client with a cardiac output of 2.5 liter/minute, the nurse inspects the client for which symptom? a) rapid respirations b) weight loss c) increased urine output d) strong, rapid pulse

a; rapid respirations normal cardiac output averages from 3.5 to 8.0 liter/minute

signs of hypoxia 1. often missed early, especially in older adults 2. confusion, restlessness/____________, anxiety, lightheadedness 3. rapid _________ and _______________ (tachycardia & tachypnea)

agitation; pulse; respirations hypoxia is often followed by dyspnea (retractions, nasal flaring), bradycardia, and cyanosis

high chest tube drains

air

node in the right ventricle of the heart that causes contraction of the ventricles

atrioventricular node right ventricle contracts first, then left ventricle

a patient with metabolic acidosis (diabetic ketoacidosis; kidney failure) would most likely have which which altered breathing pattern? a) cheyne-stokes b) kussmaul's c) apnea d) tachypnea

b; kussmaul's air hunger, rapid, deep labored breathing

a child is admitted to the pediatric division with an acute asthma attack. the nurse assesses the lung sounds and respiratory rate. the mother asks the nurse, "why is his chest sucking in above his stomach? the nurse's most accurate response is: a) "he will require additional testing to determine the cause" b) "he is using his chest muscles to help him breathe" c) "his infection is causing him to breathe harder" d) "his lung muscles are swollen, so he is using abdominal muscles"

b; the client will use accessory muscles to ease dyspnea and improve breathing

the nurse is caring for an asthmatic client who requires a low concentration of oxygen. which delivery device should the nurse use in order to administer oxygen to the client? a) simple mask b) nasal cannula c) face tent d) nonrebreather mask

b; the nurse should use a nasal cannula to administer oxygen to an asthmatic client who requires a low concentration of oxygen. it is used for administering a low concentration of oxygen to clients who are not extremely hypoxic and are diagnosed with chronic lung disease - a simple mask allows the administration of higher levels of oxygen than a cannula - a face tent is used for clients with facial trauma and burns - nonrebreather masks are used for clients requiring a high concentration of oxygen and who are critically ill

a client with a history of chronic obstructive pulmonary disease (COPD) has been ordered oxygen at 3 L/min as needed for treatment of dyspnea. what delivery mode is most appropriate to this client's needs? a) simple mask b) partial rebreather mask c) nasal cannula d) nonrebreather mask

c; a nasal cannula is used to deliver from 2 L/min to 6 L/min of oxygen

which of the following would you expect to see from a toddler/young child? a) abdominal breathing; 18-25 breaths per minute b) thoracic breathing; 25-32 breaths per minute c) abdominal breathing; 25-32 breaths per minute d) thoracic breathing; 18-25 breaths per minute

c; abdominal breathing, 25-32 breaths per minute from a child (6-12), you can expect thoracic breathing; 18-25 breaths per minute

which of the following is not a function of the lower airway? a) conduction of air b) muco-ciliary clearance c) humidify inspired air d) production of pulmonary surfactant

c; humidifying inspired air is a function of the upper airway

a woman comes to the emergency room with her 2-year-old son. she states he woke up and had a loud barking cough. the child is suffering from: a) atelectasis b) pulmonary fibrosis c) asthma d) croup

d; croup and epiglottitis are common in young children. the child has an obstruction of the upper airways, with swelling of the throat tissue. croup is often accompanied by a "barking" cough

which of the following is not a factor affecting cardiopulmonary function and oxygenation in the aging adult? a) increased incidence of GERD (scarring upper airway) b) weakened gag reflex c) drier, fragile mucous membranes d) asthma from secondhand smoke

d; increased risk of asthma from secondhand smoke is a factor affecting the cardiopulmonary function and oxygenation of children (6-12)

the nurse is caring for a client who is wearing oxygen via nasal cannula. the client asks about the bubbling water attached to the oxygen. which response by the nurse is appropriate? a) it prescribes oxygen concentration b) it regulates oxygen concentration c) it determines whether you are getting enough oxygen d) it decreases dry mucous membranes by delivering small water droplets

d; it decreases dry mucous membranes by delivering small water droplets

a patient has difficulty breathing in the recumbent position, this is an example of which altered breathing pattern? a) tachypnea b) bradypnea c) apnea d) orthopnea

d; orthopnea

lungs are composed of __________ tissue

elastic alveoli, surfactant, pleura

emphysema decreases _____________

elasticity

a condition of insufficient oxygen anywhere in the body from the inspired gas to tissues

hypoxia

low chest tube drains

liquid

main organs of respiration

lungs

components of the upper airway

nose, pharynx, larynx, epiglottis think: NLE, an upper G, pushin' P N - nose L - larynx E - epiglottis P - pharynx

functions of a properly functioning cardiovascular and hematologic system 1. carry ______________ and ___________ to and from body cells

nutrients; wastes

how is most oxygen in the body carried?

red blood cells in the form of oxyhemoglobin

gas exchange is called

respiration diffusion of o2 and co2 across alveolar-capillary membrane

lung with 3 lobes

right lung

factors of airway resistance (obstruction in airway) 1. foreign substance (food, toy, liquid) 2. excessive or thick _____________ (cystic fibrosis) 3. decrease in air _____________ size 4. _____________ (collapse of alveoli) 5. __________ (decreases size of bronchioles)

secretions; passage; atelectasis; asthma

node in the right atrium of the heart that causes contraction

sinoatrial node

components of the lower airway

trachea, right/left mainstem bronchi, segmental bronchi, terminal bronchioles think: TRT'S injected in lower glute T - trachea R - right and left mainstream bronchi T - terminal bronchioles S - segmental bronchi

true or false: supplemental oxygen requires an order

true; oxygen can be considered a medication so an order would be necessary unless it is an emergency

functions of a properly functioning alveolar system in the lungs 1. oxygenates ____________ blood 2. removes _____ from blood

venous; CO2

air movement between atmosphere and lungs

ventilation inhalation/exhalation

when should a humidifying device be used?

with flows >4 LPM (liters per min)