Oxygenation

Question 1

How many lobes make up the right lung?

Answer 1

3

Question 2

How many lobes make up the left lung?

Answer 2

2

Question 3

What is the purpose of the epiglottis?

Answer 3

Covers the opening of the trachea during swallowing

Question 4

What is the medical term for the “windpipe” or the entrance way for air into the lungs?

Answer 4

Trachea

Question 5

What are the terminal ends of the airways called?

Answer 5

Alveoli

Question 6

What are the alveolis function?

Answer 6

Exchange of gases; Oxygen & Carbon Dioxide

Question 7

What is the drive for a healthy adult to take a breath?

Answer 7

Hypercarbia; systolic below 60mmHg CO2 forces lungs to breath

Question 8

Purpose of “clip on the finger”?

Answer 8

Called a Pulse Oximetry- Detects the oxygenated hemoglobin molecules in the blood perfusing past the sensors and gives in percentage (oxygenated vs. deoxyenated)

Question 9

What is the normal 02 saturation range for a healthy adult?

Answer 9

95-100%

Question 10

“Normal” respiratory rate for an adult?

Answer 10

10-20 breaths per min

Question 11

more than 20 breaths/min

Answer 11

Tachypnea

Question 12

less than 10 breaths/min

Answer 12

Bradypnea

Question 13

Difficult, painful, breathing or SOB called?

Answer 13

Dyspnea

Question 14

Absence of breath?

Answer 14

Apnea

Question 15

What is the FiO2 of atmospheric air?

Answer 15

21%

Question 16

Flow rates set 5 to 10 L/min

Fi02 30-50%

Answer 16

Simple Face Mask

Question 17

Nasal route
Flow rate set at 2 to 6 L/min
FiO2 24-44%

Answer 17

Nasal Cannula

Question 18

Set with specific O2 flow rate and Jet adapter device

Answer 18

Venturi Mask

Question 19

Approp. level of O2 are inhaled with no CO2 from exhaled gases

Answer 19

Non-rebreather Mask

Question 20

What emergency equipment should the nurse check for immediately upon assuming care of a patient with a tracheostomy?

Answer 20

• Working suction equipment
• Oxygen sources
• New tracheostomy tube with obturator

Question 21

How does a nurse prevent hypoxia during suctioning?

Answer 21

Avoid prolonged suction time.

Question 22

decreased level of oxygen?

Answer 22

hypoxemia

Question 23

late sign & as seen as a blue tinge to the skin in fair individuals or grey in darker indiv.

Answer 23

Cyanosis

Question 24

Clubbed nail beds

Answer 24

Chronic hypoxemia

Question 25

Respiratory acidosis

Answer 25

CO2 levels increase

Question 26

difficulty breathing on one’s back

Answer 26

Orthopnea

Question 27

identifies microbes, metabolites of inflammation and immunoglobulins

Answer 27

Sputum specimen

Question 28

direct indication of 02 & CO2 exchange and acid base balance with in the blood

Answer 28

Arterial Blood Gases ABG’s

Question 29

provides info. on ventilation and flow, lung vol. and capacity and diffusion of gas.

Answer 29

Pulmonary Function Tests PFT’s

Question 30

partial lung collapse

Answer 30

Pneumothorax

Question 31

pattern of rapid breathing and slow shallow periods of apnea. dying , drug overdose, head injury

Answer 31

Cheyne-Stokes

Question 32

Very deep, & rapid breathing pattern with metabolic acidosis

Answer 32

Kussmaul’s

Question 33

Rapid & Deepened inhalation & exhalation

Answer 33

Hyperventilation

Question 34

Shallow with periods of Apnea

Answer 34

Biot’s

Question 35

Slow or Shallow air entering alveoli

Answer 35

Hypoventilation

Question 36

Shape-the anteroposterior diameter is half of the transverse diameter.

Symmetry-The chest is symmetric with no deformities of the ribs, sternum, scapula or vertebrae, and equal movements during respiration.

InterCostalSpaces (ICS)-No excessive retractions.

Respiratory Effort-
Rate & Pattern: 10 to 20/min and regular
Character of breathing (diaphragmatic, abdominal, thoracic)
Use of accessory muscles
Chest wall expansion
Depth of respirations-unlabored, quiet breathing

Cough-if productive, note color, consistency of sputum.
Trachea midline
Skin & mucous membrane color-consistent with genetic background.

Answer 36

Inspection

Question 37

Inspection 1st
Palpation advanced
Percussion advanced
Ausculation 2nd

Answer 37

Physical Assessments for Oxygenation

Question 38

Expected Sounds;

• Bronchial-Loud, high-pitched, expiration longer than inspiration over the trachea
• Bronchovesicular-medium pitch and intensity with equal inspiration and expiration times over the larger airways
• Vesicular-soft, low-pitched, inspiration 3x longer than expiration over most of the peripheral areas of the lungs

Answer 38

Expected Sounds from the lungs during Ausculation

Question 39

Unexpected Sounds;
Crackles or rales; Fine to coarse popping as air passes through fluid (grinding pepper/popping)
Wheezes; high-pitched whistling
Rhonchi; coarse sounds (snoring sound; could clear with coughing)
Pleural Friction Rub-grating sound as the inflamed visceral & parietal pleura rub against ea. other (sounds like walking through snow)
Absence of breath sounds from collapsed or surgically removed lobes.

Answer 39

Unexpected Sounds from the lungs during Ausculation

Question 40

Breathing is quiet; effortless
Rate is appropriate for age
O2 Sat is 95% or higher
Skin, nailbeds, lips are approp. for race
Thorax is symmetric with equal bilateral expansion
Anteroposterior is 1/2 the transverse diameter
Trachea is midline
Breath sounds clear bilaterally

Answer 40

Normal oxygenation

Question 41

tachypnea
tachycardia
restlessness, anxiety
pale skin, and mucous membranes
elevated blood pressure
Use of accessory muscles 
nasal flaring, trachea tugging, 
adventitous breath sounds

Answer 41

Early Signs of Hypoxemia (Hypoxia)

Abnormal Findings

Question 42

Confusion, stupor
Cyanotic skin, mucous membranes 
bradypnea, bradycardia
hypotension
cardiac dysrrhythmia

Answer 42

Late Signs of Hypoxemia (Hypoxia)

Question 43

Noisy and labored
tachypnea over 20
bradypnea under 10
dyspnea 
pulse ox under 95%
grey or blue cyanosis hue 
barrel chested
chest shift to side
lungs not clear; adventitious sounds

Answer 43

Abnormal Lung Oxygenation