Mod 4 Info To Know

Question 1

is the process of oxygen transport to the cells and carbon dioxide transport away from the cells through ventilation and diffusion. This process begins with ventilation triggered by neurons in the brain sensing the need for gas exchange.
​

Answer 1

Gas exchange-

Question 2

• adequate arterial blood flow through the peripheral tissues (peripheral ?) and blood that is pumped by the heart to oxygenate major body organs (central ?).

is a normal physiologic process of the body; without adequate ?, cell death can occur.
​

Answer 2

Perfusion

Question 3

-decreased (below normal) arterial oxygen level in the blood/arteries.

Answer 3

Hypoxemia

Question 4

-an extreme form of hypoxia. Hypoxia occurs when one part of a person’s body, such as the brain, can only obtain a reduced amount of oxygen.

occurs when the body does not get any oxygen.
​

Answer 4

Anoxia

Question 5

-Low blood oxygen levels that persist even when 100% oxygen is given.
​

Answer 5

Refractory hypoxemia

Question 6

-The quality of elasticity of the lungs. This measures the extent to which the lungs will expand

Answer 6

Lung compliance

Question 7

1. What are the signs and symptoms of pulmonary embolism?

Answer 7

Sudden shortness of breath, sharp chest pain that is worse when you cough or take a deep breath, a cough that brings up pink, foamy mucus, rapid heart rate, rapid breathing, sweating, anxiety, fainting, heart palpitations, and signs of shock.

Question 8

2. List risk factors for pulmonary embolism

Answer 8

Bed rest, sitting for long periods of time, family history, increased age, smoking, birth control, slowed blood blow, clotting disorder, paralysis, blood vessel diseases, surgery, broken bone, and pregnancy are all risk factors.

Question 9

3. How is a pulmonary embolism diagnosed and treated?

Answer 9

Common tests to detect an embolism include ultrasound, D-dimmer, CT, MRI, and echocardiogram. Treatment includes anticoagulant medication to thin the blood, embolectomy surgery to remove life-threatening clots, or a vena cava filter which is inserted into a large central vein which helps prevent blood clots from reaching the lungs which is often used when patients have issues taking an anticoagulant.

Question 10

4. Heparin: What lab value do you monitor? And what is the antidote?

Answer 10

It is important to monitor the aPPT with this medication. Protamine sulfate is the antidote to Heparin.

Question 11

5. Warfarin: What lab value do you monitor? And what is the antidote?

Answer 11

It is important to monitor the INR with this medication. Vitamin K is the antidote to warfarin.

Question 12

6. What precautions should be taken during the care of patient on anticoagulant or fibrinolytic therapy?

Answer 12

Prevent bleeding by using a soft washcloth, a soft toothbrush, electric razor, avoid activities that can cause bruising or bleeding. Know that green leafy vegetables may contain vitamin k which is the antidote for coumadin. With fibrinolytic therapy it is important to know that a complication is intracranial hemorrhage and should not be used if one has had prior hemorrhaging, a stroke within three months, known cerebrovascular abnormalities, intracranial tumor history, or significant head trauma within the past three months.

Question 13

7.What critical lab values (abg) are seen with respiratory failure?

Answer 13

Increased PaCO2 (above 45-50)levels and decreased PH levels (below 7.34) would indicate respiratory failure.

Question 14

8.Name causes of ventilatory failure

Answer 14

The most common causes are severe acute exacerbations of

asthma and

chronic obstructive pulmonary disease (COPD),

overdoses of drugs that suppress ventilatory drive,

and conditions that cause respiratory muscle weakness such as

Guillain-Barré syndrome,

myasthenia gravis, and

botulism.

Question 15

9.Name at least two causes of oxygenation failure

Answer 15

Potential causes include disorders of the spine, such as

scoliosis,

inhalation injuries, such as inhaling smoke from fires or fumes,

lung-related conditions, such as acute respiratory distress syndrome (ARDS),

cystic fibrosis,

chronic obstructive pulmonary disease (COPD),

pneumonia, or a

pulmonary embolism.

Question 16

What are the signs and symptoms of Acute Respiratory Distress Syndrome?

Answer 16

​Hyperpnea, noisy respiration, cyanosis, pallor, and retraction intercostally (between the ribs) or substernal (below the ribs).

Sweating, respiratory effort, hypotension, tachycardia, dysrhythmias, and change in mental status may be present.

Abnormal lung sounds are not heard on auscultation because the edema occurs first in the interstitial spaces and not in the airways.

Many patients with ARDS have an altered core body temperature on admission.

Those with a temperature elevation early in the course of ARDS appear to have a better outcome with lower mortality than do those who have hypothermia.

Abnormal ABG levels may be present as well as haziness or a “whited-out” chest x-ray appearance of the lung.

Question 17

What is the significance of lung compliance and mechanical ventilation in ARDS
​

Answer 17

Decreased lung compliance is a prominent feature of ARDS. The static compliance of the respiratory system (lung + chest wall) in a ventilated patient is calculated by dividing the tidal volume (Vt) by end inspiratory plateau pressure (Pplat) minus end expiratory pressure + intrinsic PEEP.

Question 18

8.What does the acronym DOPE stand for?

Answer 18

Assess intubated patients to recognize indications of decreased GAS EXCHANGE. When these indications are present, respond by checking for DOPE:

displaced tube,

obstructed tube (most often with secretions),

pneumothorax, and

equipment problems.

Question 19

List at least two interventions for preventing ventilator associated pneumonia

Answer 19

Provide excellent oral hygiene care, provide suctioning, maintain optimal positioning, and encourage mobility.

Question 20

How do you position a patient with a pulmonary contusion?

Answer 20

Moderate fowlers or seated position is recommended with a pulmonary contusion.

Question 21

11.What assessment findings are seen with flail chest and what is the treatment?

Answer 21

Chest pain, pain and tenderness of the affected area, inflammation and bruising on the chest, difficulty breathing, uneven chest rise, and abnormal x-ray.

Question 22

A client appears dyspneic, but oxygen saturation is 97%. What action by the nurse is best?
A. Assess for other manifestations of hypoxia**
B. Change the sensor on the pulse oximeter
C. Obtain a new oximeter from central supply
D. Tell the client to take slow, deep breaths.

Answer 22

A

Question 23

A client who is being mechanically ventilated has positive end expiratory pressure set at 20 cm of water. Which of the following should the nurse assess for in this client?
A. Hemothorax
B. Pneumothorax**
C. Increased venous return
D. Hypertension

Answer 23

B

Question 24

The client is ventilator dependent. What is the best way for the nurse to decrease the risk of ventilator-associated pneumonia (VAP)?
​A. Keep the head of the bed elevated**
​B. Use only sterile gloves when changing ventilator settings
​C. Maintain an oximeter reading of 90% or higher at all times
​D. Perform chest percussion in the morning following breakfast

Answer 24

A