Oxygenation

Question 1

Tachypnea

Answer 1

Rapid shallow respiratory rate/breathing 

Question 2

Hyperpnea

Answer 2

Rapid respiratory rate with increased depth

Question 3

Bradypnea

Answer 3

Slow respiratory rate

Question 4

Orthopnea

Answer 4

Discomfort when breathing while laying down

Question 5

Hyperventilation

Answer 5

Increased rate or depth of respirations causing an alveolar ventilation that is above the body’s normal metabolic requirements

Question 6

Hypoventilation

Answer 6

Decreased rate or depth of respiration causing alveolar ventilation that is less than the body’s requirements

Question 7

Perfusion

Answer 7

+ usually referring to rate at which blood is delivered to tissues
+ Passage of fluid through the circulatory system to an organ or tissue

Question 8

Respiration

Answer 8

Inhalation and exhalation – primarily to take up oxygen to deliver through pulmonary capillaries

Question 9

Ventilation

Answer 9

Process of moving air in and out of lungs

Question 10

Describe bullet points of oxygen

Answer 10

+21% of normal air
+ tasteless, odorless, colorless gas
+ considered a medication – must be ordered by HCP

Question 11

Clinical application and significance of oxygen

Answer 11

+ Must be ordered by an HCP + in situations with a clear clinical indication such as decreasing oxygen saturation, tachypnea, emergency, the absence of a prescription should not delay the administration of oxygen to the patient

Question 12

What is hypoxia

Answer 12

Inadequate amount of oxygen available to cells – low levels of oxygen in body tissues

Question 13

What is “air hunger” + causes

Answer 13

+ Caused by low levels of oxygen in air or by disease
+ Caused by COPD, emphysema, asthma, anemia, CHF, pneumonia, bronchitis, pneumothorax, PE, sleep apnea
+ ANY condition that reduces amount of oxygen in your blood or restricts blood flow - ie. High altitude

Question 14

Regional and generalized affects of hypoxia

Answer 14

+ Hypoxia causes blood vessels in the pulmonary circulation to go under marked vasoconstriction
+ Regional – one area of the lungs directs blood flow away from the hypoxic area
+ Generalized – causes vasoconstriction throughout the lungs

Question 15

Early symptoms of hypoxia – most common

Answer 15

+ Tachycardia + irritable + restless + tachypnea + dyspnea + labored breathing + cool, clammy
+ ABGs 60-80
+ headache
+ agitation
+ confusion
+ BP: systolic increases diastolic decreases
+ Pulse increases, bounding, pressure widening
+ respirations rapid

Question 16

Late signs and symptoms of hypoxia

Answer 16

+ Bradycardia + increasing dyspnea and tachypnea, possible bradypnea or agonal breathing
+ ABG is less than 60
+ Cyanosis + brain swelling + seizures + lethargy + nasal flaring
+ Using accessory muscles

Question 17

Nursing interventions for breathing and oxygenation issues

Answer 17

+ ASSESS – quality of breath, using accessory muscles, skin color
+ raise head of bed, sit them up
+ check oxygen orders
+ SBAR HCP

Question 18

How to assess cough

Answer 18

+ Productive/non-productive
+ effective/ineffective
+ needs assistance
+ description – raspy, dry, barking, painful, seductive, absent cough reflex

Question 19

How to assess sputum/phlegm

Answer 19

Color, character, amount, odor

Question 20

How to assess dyspnea

Answer 20

+ Difficulty breathing ➡️ subjective to patient
+ Feeling short of breath during ADLs
+ perception of difficulty breathing and reaction to that sensation
+ Note: LOC, RR, nasal flaring, accessories muscle usage

Question 21

Hemoptysis - definition

Answer 21

Blood in lungs + bright red usually + blood and sputum

Question 22

How to assess hemoptysis

Answer 22

+ Bloody sputum, usually bright red
+ note source – forceful cough
+ presence of TB, cancer, pneumonia, chronic bronchitis

Question 23

How to assess cyanosis

Answer 23

+ + blue or gray color to skin + Note LOC
+ heart or lung disease presence
+ inadequate respiration
+ check earlobes, lips, mucous membranes, nail beds, palms of hands and feet

Question 24

3 adventitious breath sounds

Answer 24

 Crackles, wheezes, rhonchi

Question 25

Explain crackles

Answer 25

+ WET - usually on inspiration
+ NOT CLEARED BY COUGH
+ Fine crackles — high-pitched discontinuous intermittent popping sounds + course – low pitched
+ discontinuous
+ air passing through fluid and airways, usually lower
+ Pneumonia, COPD, bronchitis, heart disease, many more

Question 26

Explain wheezes

Answer 26

+ Continuous musical sounds on inspiration or expiration
+ usually louder – expiration
+ air through constricted swollen airways + asthma, COPD

Question 27

Explain rhonchi

Answer 27

+ Low pitched snoring – rumbling coarse snore
+ movement of fluid and secretions in larger airways
+ may clear with coughing or suctioning
+ COPD, chronic bronchitis, cystic fibrosis

Question 28

PFT - pulmonary function test

Answer 28

+ Evaluates lung function, airwaves traction through respiratory mechanics
+ spirometry – measures the volume of air in liters exhaled or inhaled
+ peak expiratory flow rate —PEFR — point of highest flow during forced expiration

Question 29

Explain pulse oximetry

Answer 29

+ Measures arterial oxygen hemoglobin saturation of arterial blood
+ used to evaluate patient’s hemoglobin level before evaluating oxygen saturation
+ Attaches to finger but can be attached earlobes

Question 30

Thoracentesis – explain

Answer 30

Needle in the pleural cavity – fluid is drawn out and analyzed

Question 31

Bronchoscopy – explain

Answer 31

Tube inserted into lungs through nose down back of throat – used to look at lungs with a camera

Question 32

Factors that affect respiratory function

Answer 32

+ Illness
+ lifestyle
+ environment
+ gerontologic
+ medication’s
+ psychologic

Question 33

Nursing interventions and implementations for oxygen and breathing

Answer 33

+ Education
+ reduce anxiety
+ positioning
+ humidified air
+ incentive spirometry
+ diaphragmatic breathing
+ deep breathing
+ pursed lip breathing
+ coughing
+ fluid intake increased
+ chest physiotherapy
+ oxygen administration
+ suctioning
+ inhalants
+ medications

Question 34

Which oxygen apparatus is most precise way of delivering 02

Answer 34

Venturi mask — Deliver 6 to 10 L per minute

Question 35

Which oxygen apparatus delivers the highest concentration of O2 with its delivery method

Answer 35

Nonrebreather mask — delivers 6 to 15 L per minute

Question 36

Changes in older adults respiratory system

Answer 36

+ Chest tissues and airways become less elastic
+ reduction in power of respiration and abdominal muscles
+ less diaphragmatic movement, less efficient
+ decrease in maximum inspiration and expiration
+ airways collapse easily
+ high risk for pneumonia and other respiratory infections
+ fewer alveoli
+ thickened walls of alveoli
+ Decrease gas exchange and increase work of breathing
+ decreased ventilation and ineffective cough
+ decreased cardiac output and ability to respond to stress

Question 37

Which oxygen delivery system provides the lowest flow rate

Answer 37

Nasal cannula – 1 to 6 L per minute

Question 38

Which “oxygenation “nursing intervention promotes relaxation and gets rid of CO2 

Answer 38

Pursed lip breathing!