39 oxygenation and perfusion

A nurse assessing a client's respiratory effort notes that the client's breaths are shallow and 8 per minute. Shortly after, the client's respirations cease. Which form of oxygen delivery should the nurse use for this client? Oxygen tent Oxygen mask Ambu bag Nasal cannula

Ambu bag

A health care provider orders the collection of a sputum specimen from a client with a suspected bacterial infection. Which action best ensures a usable specimen? Have the client clear the nose and throat and gargle with salt water before beginning the procedure. Discard the first sputum produced by the client. Instruct the client to inhale deeply and then cough. Place the client in the dorsal recumbent position to collect the specimen.

Instruct the client to inhale deeply and then cough.

The nurse is suctioning a client's tracheostomy when the tracheostomy becomes dislodged and the nurse is unable to replace it easily. What is the nurse's most appropriate response? Cover the tracheostomy stoma and apply oxygen by nasal cannula Assess the client's respiratory status and check vital signs every 1 minute for the next hour. Maintain the client's oxygenation and alert the health care provider immediately. Page the respiratory therapist STAT.

Maintain the client's oxygenation and alert the health care provider immediately.

During data collection, the nurse auscultates low-pitched, soft sounds over the lungs' peripheral fields. Which appropriate terminology would the nurse use to describe these lung sounds when documenting? Vesicular Crackles Bronchovesicular Bronchial

Vesicular

A nurse assessing a client's respiratory status gets a weak signal from the pulse oximeter. The client's other vital signs are within reference ranges. What is the nurse's best action? Use a blood pressure cuff to increase circulation to the site. Shine available light on the equipment to facilitate accurate reading. Place the probe on the client's earlobe. Warm the client's hands and try again.

Warm the client's hands and try again.

What assessments would a nurse make when auscultating the lungs? volume of air exhaled or inhaled air flow through the respiratory passages presence of edema abnormal chest structures

air flow through the respiratory passages

Which diagnostic procedure measures lung size and airway patency, producing graphic representations of lung volumes and flows? Chest x-ray Pulmonary function tests Skin tests Bronchoscopy

Pulmonary function tests

A client vomits as a nurse is inserting his oropharyngeal airway. What would be the most appropriate intervention in this situation? Remove the airway, turn the client to the side, and provide mouth suction, if necessary. Leave the airway in place and promptly notify the health care provider for further instructions. Immediately remove the airway, rinse the client's mouth with sterile water, and report this to the health care provider. Suction the client's mouth through the oropharyngeal airway to prevent aspiration.

Remove the airway, turn the client to the side, and provide mouth suction, if necessary.

A nurse using a pulse oximeter to measure a client's SpO2 obtains a reading of 95%. What is the nurse's most appropriate action? Raise the head of the client's bed slightly, if tolerated. Encourage the client to do deep-breathing exercises. Document this expected assessment finding. Review the medications that the client has taken in the past 90 minutes.

Document this expected assessment finding.

Which guideline describes the proper method for measuring the appropriate length to use when inserting a nasopharyngeal airway? When holding the airway on the side of the client's face, it should reach from the tip of the ear to the nostril times two. The airways come in standard sizes determined by the height and weight of the client. When holding the airway on the side of the client's face, it should reach from the opening of the mouth to the back angle of the jaw. When holding the airway on the side of the client's face, it should reach from the tragus of the ear to the tip of the nostril.

When holding the airway on the side of the client's face, it should reach from the tragus of the ear to the tip of the nostril.

A client has been put on oxygen therapy because of low oxygen saturation levels in the blood. What should the nurse use to regulate the amount of oxygen delivered to the client? flow meter nasal strip nasal cannula oxygen analyzer

flow meter

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: pneumonia. asthma. alcohol use. croup.

pneumonia.

A client is diagnosed with hypoxia related to emphysema. The client's adult child will be assisting the client with daily hygiene. How will the nurse explain positioning of the client to the caregiver? "A standing position works best to allow your parent to move around in the bathroom and to allow you to help your parent in and out of the shower." "Place your parent at the sink to allow teeth brushing and stand outside of the shower to help if needed." "Whichever position helps your parent feel most comfortable and will allow you to help with hygiene is fine." "An upright, sitting position is the best for daily hygiene so a lightweight chair that can be used in and out of the shower works best to help your parent breathe easier and allow you to assist."

"An upright, sitting position is the best for daily hygiene so a lightweight chair that can be used in and out of the shower works best to help your parent breathe easier and allow you to assist."

The nurse determines that the student who has been instructed about lung function and smoking requires additional teaching when the student says "Smoking only once in a while will not make a person addicted to smoking." "A physically fit athlete breathes more slowly than a sedentary person." "An upright position will help someone breathe with less effort." "An older person may breathe more shallowly than a younger person."

"Smoking only once in a while will not make a person addicted to smoking."

A client is admitted to the hospital with shortness of breath, cyanosis and an oxygen saturation of 82% (0.82) on room air. Which action should the nurse implement first? Educate client on incentive spirometry Raise the head of the bed Assist with intubation Apply oxygen as prescribed

Apply oxygen as prescribed

A client's primary care provider has informed the nurse that the client will require thoracentesis. The nurse should suspect that the client has developed which disorder of lung function? Pleural effusion Tachypnea Pneumonia Wheezes

Pleural effusion

A nurse is volunteering at a day camp. A child is stung by a bee and develops wheezing in the upper airways. The child is experiencing: bronchiolitis. a bronchospasm. bronchiectasis. bronchitis.

a bronchospasm.

A client has edema of the feet and ankles, along with crackles in the lower lobes and a frothy, productive cough. The client is suffering from: myocardial infarction. congestive heart failure. lung cancer. pulmonary embolism.

congestive heart failure.

The nurse is implementing an order for oxygen for a client with facial burns. Which delivery device will the nurse gather? nasal cannula simple mask tracheostomy collar face tent

face tent

While auscultating a client's chest, the nurse auscultates crackles in the lower lung bases. What condition does the nurse identify the client is experiencing? presence of sputum in the trachea presence of fluid in the lungs inflammation of pleural surfaces air passing through narrowed airways

presence of fluid in the lungs