Chapter 38 Oxygen and Perfusion

Upon evaluation of a client's medical history, the nurse recognizes that which condition may lead to an inadequate supply of oxygen to the tissues of the body? Graves' disease Pancreatitis Parkinson's disease Chronic anemia

Chronic anemia

What is the action of codeine when used to treat a cough? Antihistamine Expectorant Suppressant Antisuppressant

Expectorant

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: bronchiectasis. bronchiolitis. bronchitis. a bronchospasm.

a bronchospasm.

The nurse is caring for a postoperative adult client who has developed pneumonia. The nurse should assess the client frequently for symptoms of: atelectasis. croup. bronchospasm. epiglottitis.

atelectasis.

To drain the apical sections of the upper lobes of the lungs, the nurse should place the client in which position? high-Fowler's position left side with a pillow under the chest wall side-lying position, half on the abdomen and half on the side Trendelenburg position

high-Fowler's position

The nurse is caring for a client with respiratory alkalosis. Which arterial blood gas data does the nurse anticipate finding? pH greater than 7.45; HCO3 high; PaCO2 high pH greater than 7.45; HCO3 low; PaCO2 low; hyperventilation pH less than 7.35; HCO3 high; PaCO2 high pH less than 7.35; HCO3 low; PaCO2 low

pH greater than 7.45; HCO3 low; PaCO2 low; hyperventilation

The nurse determines that the student who has been instructed about lung function and smoking requires additional teaching when the student says "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."

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

A client receiving home oxygen calls the telehealth nurse to report that her caretaker removed her oxygen tank from the wheeled carrier. What is the appropriate telehealth nurse response? "That will help the oxygen flow more freely." "The caregiver will need to place the oxygen tank back into the secure carrier." "That will make it easier to carry with you." "Call your oxygen supplier immediately."

"The caregiver will need to place the oxygen tank back into the secure carrier." Oxygen tanks are transported on a wheeled carrier to avoid accidental force. Accidental force could cause the tank to explode. The tank should not be carried, and taking it out of the carrier does not affect the flow of oxygen.

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? Ambu bag Nasal cannula Oxygen tent Oxygen mask

Ambu bag

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? Oxygen analyzer Flow meter Nasal cannula Nasal strip

Flow meter

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? Tachypnea Pleural effusion Pneumonia Wheezes

Pleural effusion

A client returns to the telemetry unit after an operative procedure. Which diagnostic test will the nurse perform to monitor the effectiveness of the oxygen therapy ordered for the client? Thoracentesis Pulse oximetry Spirometry Peak expiratory flow rate

Pulse oximetry

The nurse is caring for a client who has been prescribed humidified oxygen at 6 L/minute. Which type of liquid will the nurse gather to set up the humidifier? normal saline distilled water tap water mineral oil

distilled water

In which client would the nurse assess for a depressed respiratory system? a client taking opioids for cancer pain a client taking insulin for diabetes a client taking amlodipine for hypertension a client taking antibiotics for a urinary tract infection

a client taking opioids for cancer pain

Which dietary guideline would be appropriate for the older adult homebound client with advanced respiratory disease who informs the nurse that she has no energy to eat? Eat smaller meals that are high in protein. Eat one large meal at noon. Contact the physician for nutrition shake. Snack on high-carbohydrate foods frequently.

Eat smaller meals that are high in protein.

The nurse is preparing discharge teaching for a client with a history of recurrent pneumonia. What deep breathing techniques will the nurse plan to teach? "Take in a little air, hold your breath 15 seconds, and exhale slowly." "Take in a large volume of air and hold your breath as long as you can." "Take in as much air as possible, hold your breath briefly, and exhale slowly." "Take in a small amount of air and exhale quickly."

"Take in as much air as possible, hold your breath briefly, and exhale slowly."

The nurse is teaching the client with a pulmonary disorder about deep breathing. The client asks, "Why is it important to start by breathing through my nose, then exhaling through my mouth?" Which appropriate response would the nurse give this client? "If you breathe through the mouth first, you will swallow germs into your stomach." "Breathing through your nose first encourages you to sit up straighter to increase expansion of the lungs during inhalation." "We are concerned about you developing a snoring habit, so we encourage nasal breathing first." "Breathing through your nose first will warm, filter, and humidify the air you are breathing."

"Breathing through your nose first will warm, filter, and humidify the air you are 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: "He is using his chest muscles to help him breathe." "His lung muscles are swollen so he is using abdominal muscles." "He will require additional testing to determine the cause." "His infection is causing him to breathe harder."

"He is using his chest muscles to help him breathe."

The nurse is demonstrating oxygen administration to a client. Which teaching will the nurse include the humidifier? "The humidifier prescribes the concentration of oxygen." "It measures the percentage of delivered oxygen to determine whether the client is getting the amount prescribed." "Small water droplets come from this, thus preventing dry mucous membranes." "This is a gauge used to regulate the amount of oxygen that a client receives."

"Small water droplets come from this, thus preventing dry mucous membranes."

The nurse is demonstrating oxygen administration to a client. What teaching will the nurse include about the flowmeter? "The flowmeter prescribes the concentration of oxygen." "It measures the percentage of delivered oxygen to determine whether the client is getting the amount prescribed." "This is a gauge used to regulate the amount of oxygen that a client receives." "Small water droplets come from this, thus preventing dry mucous membranes."

"This is a gauge used to regulate the amount of oxygen that a client receives."

A client who was prescribed CPAP reports nonadherence to treatment. What is the priority nursing intervention? Contact the healthcare provider to report the client's current status. Ask the client what factors contribute to nonadherence. Explain the use of a BiPAP mask instead of a CPAP mask. Document outcomes of modifications in care.

Ask the client what factors contribute to nonadherence.

The nurse is educating an adolescent with asthma on how to use a metered-dose inhaler. Which education point follows recommended guidelines? Inhale through the nose instead of the mouth. Be sure to shake the canister before using it. Inhale the medication rapidly. Inhale two sprays with one breath for faster action.

Be sure to shake the canister before using it.

A 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? Non-rebreather mask Nasal cannula Simple mask Face tent

Nasal cannula

When reviewing data collection on a client with a cardiac output of 2.5 L/minute, the nurse inspects the client for which symptom? Weight loss Mental alertness Increased urine output Rapid respirations

Rapid respirations

The nurse schedules a pulmonary function test to measure the amount of air left in a client's lungs at maximal expiration. What test does the nurse order? Total lung capacity (TLC) Tidal volume (TV) Forced Expiratory Volume (FEV) Residual Volume (RV)

Residual Volume (RV)

The nurse is auscultating the lungs of a client and detects normal vesicular breath sounds. What is a characteristic of vesicular breath sounds? They are low-pitched, soft sounds heard over peripheral lung fields. They are loud, high-pitched sounds heard primarily over the trachea and larynx. They are medium-pitched blowing sounds heard over the major bronchi. They are soft, high-pitched discontinuous (intermittent) popping lung sounds.

They are low-pitched, soft sounds heard over peripheral lung fields.

During the physical assessment of a client who has been inactive due to a leg injury, the nurse notes that the client tends to breathe very shallowly. What technique should the nurse teach the client in order to breathe more efficiently? diaphragmatic breathing incentive spirometry deep breathing pursed-lip breathing

deep breathing

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: alcohol abuse. asthma. croup. pneumonia.

pneumonia.

The nurse is caring for a client who was had a percutaneous tracheostomy (PCT) following a motor vehicle accident, and has been prescribed oxygen. What delivery device will the nurse select that is most appropriate for this client? nasal cannula face tent simple mask tracheostomy collar

tracheostomy collar A tracheostomy collar delivers oxygen near an artificial opening in the neck. This is appropriate for a client who has had a PCT. All other devices are less appropriate for this client.

The nurse is caring for an older adult client on home oxygen who has dentures, but has quit wearing them stating that the dentures irritate the gums. What nursing action is appropriate? Discontinue oxygen therapy until the client is reassessed by the healthcare provider. Check fit of oxygen mask. Contact the oxygen supplier to request an oxygen tent. Increase the flow of oxygen.

Check fit of oxygen mask.

During oxygen administration to the client, which pieces of equipment would enable the nurse to regulate the amount of oxygen delivered? Oxygen analyzer Humidifier Flow meter Nasal cannula

Flow meter

The nurse is caring for a client with chronic obstructive pulmonary disease (COPD) who expresses concerns about the ability to breathe easier. The nurse will suggest which position to help alleviate the client's dyspnea? Side-lying with head slightly elevated Supine with one pillow Lying with the head slightly lowered High Fowler's position

High Fowler's position

The nurse assesses a client and detects the following findings: difficulty breathing, increased respiratory and pulse rates, and pale skin with regions of cyanosis. What condition would the nurse suspect as causing these respiratory alterations? Hyperventilation Perfusion Atelectasis Hypoxia

Hypoxia

Which actions should a nurse perform when inserting an oropharyngeal airway? Select all that apply. Wash hands and put on PPE, as indicated. Position client flat on his or her back with the head turned to one side. Use an airway that reaches from the nose to the back angle of the jaw. Remove airway for a brief period every 4 hours or according to facility policy. Insert the airway with the curved tip pointing down toward the base of the mouth. Rotate the airway 180 degrees as it passes the uvula.

Wash hands and put on PPE, as indicated. Rotate the airway 180 degrees as it passes the uvula. Remove airway for a brief period every 4 hours or according to facility policy.

The nurse is preparing discharge teaching for a client who has chronic obstructive pulmonary disease (COPD). Which teaching about deep breathing will the nurse include? "Take in a little air over 10 seconds, hold your breath 15 seconds, and exhale slowly." "Take in a large volume of air over 5 seconds and hold your breath as long as you can before exhaling." "Inhale slowly over three seconds, purse your lips, contract abdominal muscles, and exhale slowly." "Take in a small amount of air very quickly and then exhale as quickly as possible."

"Inhale slowly over three seconds, purse your lips, contract abdominal muscles, and exhale slowly."

The nurse is conducting a respiratory assessment of a client age 71 years who has been recently admitted to the hospital unit. Which assessment finding should the nurse interpret as abnormal? fine crackles to the bases of the lungs bilaterally resonance on percussion of lung fields respiratory rate of 18 breaths per minute vesicular breath sounds audible over peripheral lung fields

fine crackles to the bases of the lungs bilaterally

The nurse is caring for a client with shortness of breath who is receiving oxygen at 4 L/minute. Which assessment finding will demonstrate that oxygen therapy is effective? clubbing of fingers respirations 26 breaths/minute SpO2 92% heart rate 110 beats/minute

SpO2 92%

The nurse performs assessments of cardiopulmonary functioning and oxygenation during regular physical assessments. Based on developmental variations, which findings would the nurse consider normal? Select all that apply. The normal infant's chest is small and the airways are short, making aspiration a potential problem. Alterations in respiratory function due to aging in older adults increase the risk for disease, especially pneumonia and other chest infections. The power of the respiratory and abdominal muscles is reduced in older adults, and therefore the diaphragm moves less efficiently. The chest in the older adult is unable to stretch as much, resulting in an increase in maximum inspiration and expiration. The respiratory rate is more rapid in infants until the alveoli increase in number and size to produce adequate oxygenation at lower respiratory rates. Blood pressure increases over time until it reaches the adult level around age 8.

The power of the respiratory and abdominal muscles is reduced in older adults, and therefore the diaphragm moves less efficiently. The normal infant's chest is small and the airways are short, making aspiration a potential problem. Alterations in respiratory function due to aging in older adults increase the risk for disease, especially pneumonia and other chest infections. The respiratory rate is more rapid in infants until the alveoli increase in number and size to produce adequate oxygenation at lower respiratory rates.

The home care nurse visits a client who has dyspnea. The nurse notes the client has pitting edema in his feet and ankles. Which additional assessment would the nurse expect to observe? Inspiratory stridor Wheezing in the upper lobes Crackles in the lower lobes Expiratory stridor

Crackles in the lower lobes Explanation: People with chronic congestive heart failure often experience shortness of breath because of excess fluid in the lungs and low oxygen levels. Stridor is associated with respiratory infections such as croup. Wheezing may be heard in individuals who use tobacco products. 1361

A client suffering from chronic obstructive pulmonary disease (COPD) reports that it is hard to cough up secretions and they are thick and sticky. The nurse should instruct the client to: take a cough suppressant to decrease coughing. increase her fluid intake to thin secretions. decrease exercise and increase rest periods. eat small, frequent meals to conserve energy.

increase her fluid intake to thin secretions.