NUR 112 Oxygenation

CPAP and BiPAP

21-100% Treats sleep apnea

Venturi mask

24-50% specific flow rate must be followed

nasal cannula

Flow rates of 1-6 L/min O2 concentration of 24%-44%

ventricular tachycardia

Life threatening dysrhythmia bc of decreased cardiac output

Invasive mechanical ventilation

Life-saving technique used with artificial airways (ET or tracheostomy)

Postural drainage

Aids in improving secretion clearance and oxygenation by positioning, turning, percussion, and vibration

Oxygen given to clients during stage four chronic obstructive pulmonary disease would be administered in which manner? -1 to 2 L via nasal cannula to keep SaO2 above 90% -1 to 2bL via nasal cannula to maintain SaO2 at or above 95% -3 L be a mask to maintain SaO2 at 95% -do not give oxygen because it may suppress hypoxic drive in the client

- 1 to 2 L via nasal cannula to keep SaO2 above 90%

Which factor would elevate a clients oxygen saturation? -Nail polish -Carbon monoxide -Intravascular dyes -Skin pigmentation

-Carbon monoxide

The nurse is caring for a patient with pneumonia. On entering the room, the nurse finds the patient laying in bed , coughing and unable to clear secretions. What should the nurse do first? -start oxygen 2 L a minute via nasal cannula -Elevate the head of the bed to 45° -Encourage the patient to use the incentive spirometer -Notified the healthcare provider

-Elevate the head of the bed to 45°

Which with the nurse include when teaching a client about the use of an incentive spirometer? -Inhale completely and exhale in short rapid breaths -Inhale deeply through the spirometer hold it as long as possible, and slowly exhale -Exhale completely take a slow, deep breath hold it as long as possible and slowly exhale -Exhale halfway didn't hill a rapid, small breath repeat several times

-Exhale completely take a slow, deep breath hold it as long as possible and slowly exhale

The client with a history of chronic obstructive pulmonary disease (COPD) is admitted with acute pneumonia. The client is in moderate respiratory distress. The nurse will place the client which position to enhance comfort.? -side lying with head elevated 45° -Modified left lateral recumbent with head elevated 90° -Semi Fowler with legs elevated -High Fowler, using the bedside table to rest the arms

-Hi Fowler, using the bedside table to rest the arms

Which type of breathing pattern with a client experience hypercarbia exhibit? -Eupnea -tachypnea -Hypoventilation -Kussmaul respirations

-Hypoventilation

After the nurse has taught a client about how to use a dry powder inhaler, which statement by the client indicates an understanding of how to use the medication safely and effectively? -I will forcefully inhaled the powder -I will exhale into the delivery device -I will shake the inhaler before using it -I will submerged the inhaler and water to wash it

-I will forcefully inhale the powder

The nurse is caring for a client with severe dyspnea who is receiving oxygen via a Venturi mask. which action would the nurse take when caring for this client? -assess frequently for nasal drying -Keep the mask tight against the face -Monitor oxygen saturation levels with the client is eating -Set the oxygen flow at the highest setting that the client can tolerate

-Monitor oxygen saturation levels with the client is eating

When a nurse needs to administer oxygen, add a fraction of inspired oxygen (FiO2) of about 40% to keep a clients oxygen saturation greater than 94% which method would be best? -face tent -Venturi mask -Nasal cannula -Simple facemask

-Nasal Cannula

Which observation by the nurse indicates a client with pneumonia is able to use an incentive spirometer correctly? Select all that apply. -Records the volume of air inspired -performs 10 breaths per session every hour -Inhaled air fully before inserting the mouthpiece -Takes long, slow, deep breaths, keeping the mouthpiece in place -Exhales deep breaths with the mouthpiece in their mouth

-Records the volume of the air inspired -Performs 10 breaths per session every hour -Takes long, slow, deep breath keeping the mouth piece in place

The nurse assesses that several clients have low, oxygen saturation levels. which client will benefit the most from receiving oxygen via nasal cannula? -The client who has dry oral mucous membranes from mouth breathing -The client who has a nasogastric tube in place for gastric decompression -The client who has many visitors and spend much time sitting in a chair -The client who has an upper respiratory infection and spends much time sleeping

-The client who has many visitors and spends much time sitting in a chair

The nurse is performing discharge teaching for a patient with chronic obstructive pulmonary disease. What statement made by the patient indicates a need for further teaching? -pursed lip breathing. It's like exercise for my lungs and will help me strength and my breathing muscles. -when I am sick, I should limit the amount of fluid I drink so that I don't produce excess mucus -I will ensure that I receive my influenza vaccine every year preferably in the fall I will look for a smoking cessation support group in my neighborhood

-When I am sick, I should limit the amount of fluids I drink so that I don't produce excess mucus

Which complication with the nurse prevent by addressing the needs of a hyper ventilating client? -cardiac arrest -Carbonic acid deficit -Reduction in serum pH -Excess oxygen saturation

-carbonic acid deficit

Which nursing interventions would provide safe oxygen therapy? select all that apply - Check tubing for kinks -Run wires under carpeting -Post no smoking signs in the clients room -Play oxygen tanks flat in the cart when not in use -Make sure the client is using oil based products to lubricate the nose

-check tubing for kinks -Post no smoking signs in the clients room

Which technique using a metered dose inhaler buy a client with chronic obstructive pulmonary disease would cause a nurse to conclude that additional teaching is needed? -places the tip of the inhaler just passed the lips -Hold the inspired breath for at least three seconds -Activate the inhaler during inspiration -Inhales rapidly with the lips sealed around the nebulizer opening

-inhales rapidly with the lips sealed around the nebulizer opening

Which method of oxygen delivery with the nurse anticipate will be prescribed for a client with a pulse oximetry reading of 65% -Face tent -Venturi mask -Nasal cannula -Nonrebreather mask

-nonrebreather mask

With the oxygen saturation of a client with pneumonia is at 89% to 90% while using a nonrebreather mask, which collaborative action will the nurse anticipate? -Administration of oxygen using a simple face mask -Use of a Venturi mask for administration of high flow oxygen -Continue to oxygen administration with a nonrebreather mask -Oxygen administration with bilevel positive airway pressurev(BiPAP)

-oxygen administration with bilevel positive airway pressure (BiPAP)

A client asked about the purpose of a pulse oximeter. which measurement is a pulse oximeter used for? -Respiratory rate -amount of oxygen in the blood -percentage of oxygen carrying hemoglobin -amount of carbon dioxide in the blood

-percentage of oxygen carrying hemoglobin

The nurse has just witnessed her patient go into cardiac arrest. What priority interventions should the nurse perform at this time? (Select all that apply) -perform chest compressions -ask someone to bring the defibrillator to the room for immediate defibrillation -apply oxygen via nasal cannula -place the patient in high Fowler position -educate the family about the need for CPR

-perform chest compressions -ask someone to bring the defibrillator to the room for immediate defibrillation

A client with chronic obstructive pulmonary disease (COPD) is breathing rapidly and using accessory muscles of respiration. The nurse auscultates the lungs and here's crackles and wheezes which action would the nurse take? -encourage the client to take slow, deep breaths and administers 5L/ minute oxygen per nasal cannula -Place the client in a side, lying position and perform chest physiotherapy using clapping and vibration -Raise the head of the bed to a high Fowler position and administer 2 L/ minute oxygen per nasal cannula -assist the client in assuming a position of comfort and perform postural drainage

-raise the head of the bed to a high Fowler position and administer 2 L/ minute oxygen per nasal cannula

Which assessment findings indicate that the patient is experiencing an acute disturbance in oxygenation and requires immediate intervention select all that apply -SPO2 of 95% -Retractions -Respiratory rate is 28 breaths per minute -Nasal flaring -Clubbing of the fingers

-retractions -respiratory rate of 28 breathes per min -nasal flaring

ventricular fibrillation

A life-threatening heart rhythm that results in a rapid, inadequate heartbeat

electrocardiogram

A recording of the electrical activity of the heart

Chest tube

Catheter inserted through the thorax into the chest cavity for removing air or fluid; used after chest or heart surgery or pneumothorax.

The nurse is caring for a client in respiratory distress. The health care provider prescribes oxygen therapy with a Venturi mask to be set at 35% oxygen. Which mask would the nurse use ? -A -B -C -D

D

Which condition would the nurse suspect when a clients respiratory rate increases and the respirations are abnormally deep and regular - hypoventilation -biot respiration - kussmauls respirations - Cheyenne stokes respirations

Kussmauls respirations

Non-invasive positive pressure ventilation

Maintains positive airway pressure and improves alveolar ventilation with out the need for an artificial airway

Orthopnea

Patient uses multiple pillow when laying to breathe easier

Cheyenne-Stokes respirations

Periods of apnea followed by periods of deep then shallow breathing and back to apnea

bronchoscopy

Procedure that allows Dr to look at your lungs and air passages

bi-level positive airway pressure (BiPAP)

Provided assistance during inspiration and preventing alveolar closure during expiration

capnpgraphy

Provides instant information about the patients ventilation, perfusion, and how effectively CO2 is produced by cellular metabolism

acute coronary syndrome

Results from decrease in coronary blood flow

Perfusion

The ability of the cardiovascular system to pump oxygenated blood to the tissues and return deoxygenated blood to the lungs

Stroke volume

The amount of blood ejected from the heart in one contraction

Pursed lip breathing

a technique of exhaling against pursed lips to prolong exhalation, preventing alveolar collapse

hemothorax

accumulation of blood and fluid in the pleural cavity

Nebulization

adds moisture to inspired air by mixing particles of varying sizes with the air

Pneumothorax

air in the pleural cavity. Loss of negative intrapleural pressure causes lung collapse

Cardiac output

amount of blood ejected from the left ventricle each minute

diaphragmatic breathing

breathing with the use of the diaphragm to achieve maximum inhalation and slow respiratory rate

angina pectoris

chest pain that results when the heart does not get enough oxygen

hemoptysis

coughing up blood

Hypovolemia

decreased blood volume

Hypoventilation

decreased rate or depth of air movement into the lungs body cannot eliminate sufficient carbon dioxide

myocardial ischemia

deficiency of blood supply to the myocardium

hypoxemia

deficient amount of oxygen in the blood

nasal cannula

delivers 1-6 L/min 24-44% can dry mucous membranes and cause skin breakdown easily tolerated

partial nonrebreather mask

delivers 10-15 L/ min 60-90% Does not dry mucous membranes easily humidifies 02

Simple face mask

delivers 6-12 L/min 35-50% Useful for short periods increased risk of aspiration

cardiopulmonary resuscitation (CPR)

emergency procedure consisting of external cardiac compressions and artificial ventilation

incentive spirometry

encourages voluntary deep breathing by providing visual feedback to patients about inspiratory volume

chest physiotherapy

external chest wall manipulation using percussion, vibration, or high-frequency chest wall compression

Myocardial Infraction

heart attack; occurs when a blockage in the coronary arteries cuts off the supply of blood to the heart

Cardiopulmonary rehabilitation

helps patients achieve and maintain an optimal level of health through controlled physical exercise, nutrition counseling, relaxation and stress-management techniques, and prescribed medications and oxygen

Hypoxia

inadequate tissue oxygenation at the cellular level

Tracheotomy

incision of the trachea to enter an artificial airway

Kussmaul resporation

increase in rate and depth of respirations

Hyperventilation

increased rate and depth of breathing body removes carbons dioxide faster than it's produced

continuous positive airway pressure (CPAP)

maintains a steady stream of pressure throughout a patient's breathing cycle

High flow nasal cannula

modifiable flow up to 60 L/m

Ventilation

movement of air in and out of the lungs

Diffusion

moving respiratory gases from one area to another by concentration gradients

ventilator associated pneumonia

pneumonia that develops in hospitalized patients who are on a ventilator

Humidification

process of adding water to gas

Afterload

resistance to left ventricular ejection

Endotracheal tube

short-term artificial airway to administer mechanical ventilation, relieve upper airway obstruction, protect against aspiration, or clear secretions

Preload

volume of blood in ventricles at end of diastole

hematamesis

vomiting blood

Diagnosed with chronic pulmonary disease (COPD), a 50 year old clients clinical data after treatment is heart rate of 100 bpm, blood pressure of 138/82 mm Hg, respiratory rate of 32 breaths per minute, tympanic temperature 98.2° and an oxygen saturation of 80% which vital sign attained by the nurse indicates a positive outcome? Select all that apply. -radial pulse 70 bpm -Temperature 98.6° -Respiratory rate 14 breaths per minute -Blood pressure 110/70 mm Hg -Oxygen saturation 92%

— respiratory rate 14 breaths per minute -Blood pressure 110/70 mm Hg -Oxygen saturation 92%