Oxygenation

Question 1

Hypoxemia

Answer 1

decrease of oxygen concentration in the blood

Question 2

Ventilation

Answer 2

the movement of air into and out of the lungs for the purpose of delivering fresh air into the lungs alveoli

Question 3

Inhalation

Answer 3

initiated when the diaphragm contracts, increasing the size of the intrathoracic space; decreases intrathoracic pressure so air can be drawn in from the atmosphere

Question 4

Exhalation

Answer 4

respiratory muscles relax, increasing intrathoracic pressure and forcing air to exit

Question 5

Work of breathing

Answer 5

increased when additional muscle forces are required for breathing; otherwise passive process

Question 6

Oxygen uptake

Answer 6

exchange of oxygen from the alveolar space into the pulmonary capillaries; also known as external respiration; carbon dioxide travels the opposite way during this sequence

Question 7

Oxygen in plasma

Answer 7

expressed as partial pressure of oxygen; normal in arterial blood is 80-100mm Hg

Question 8

Hemoglobin

Answer 8

the vast majority of oxygen is carried through the blood bound to hemoglobin; it’s expressed as a %- normal saturation is between 96-98%

Question 9

Oxyhemoglobin dissociation curve

Answer 9

the relationship between dissolved O2 in plasma (PaO2) and O2 saturation

Question 10

Oxygen release in the blood

Answer 10

as O2 rich blood circulates in the peripheral capillaries, dissolved O2 diffuses out of the blood; this causes hemoglobin to lose the affinity to be bound to O2 and the O2 is released to the body’s cells

Question 11

Circulation

Answer 11

the function of the heart and blood vessels

Question 12

Cardiac cycle

Answer 12

cycle of atrial and ventricular contraction and relaxation

Question 13

Diastole

Answer 13

the process of a chamber filling

Question 14

Systole

Answer 14

the process of the chamber emptying

Question 15

Physiology of oxygenation

Answer 15

alveoli-capillary bed of lungs-pulmonary veins-left atrium-left ventricle-aorta- arteries- arterioles- capillary bed of tissues- cells of the body tissue

Question 16

Precapillary sphincters

Answer 16

rings of smooth muscle around the arterioles; blood flow to specific organs may be increased or redused by the relaxation or constriction of these sphincters

Question 17

Internal respiration

Answer 17

O2 diffuses from the blood to the tissues; CO2 moves from the tissues to the blood

Question 18

Obstructive pulmonary disease

Answer 18

the airways become partially or completely blocked, diminishing airflow, or the lungs lose some of their elastic recoil which traps stale air that should be exhaled; common types are asthma, emphysema, chronic bronchitis- collectively known as COPD

Question 19

Restrictive pulmonary disease

Answer 19

pathologies that impair theability of the chest wall and lungs to expand during the inspiratory phase of ventilation; increases the work of breathing; reduces airflow to alveoli

Question 20

Ventilation-perfusion mismatching

Answer 20

balance between amount of fresh air entering the alveoli and the amount of blood flow to various regions of the pulmonary capillary network; this is not uniform throughout the lungs so some areas of the lungs may have better ventilation than others at any given time

Question 21

Atherosclerosis

Answer 21

narrowing and eventual occlusion of hte lumen by deposits of lipids, fibrin and calcium on the interior walls of the arteries; most common cause of altered arterial circulation

Question 22

Ischemia vs Infarction

Answer 22

ischemia is the reduction of blood flow with O2 and infarction is necrosis or death

Question 23

Mitochondria

Answer 23

when mitochondria are damaged, oxygen uptake is impaired (cyanide poisoning, severe sepsis)

Question 24

Aerobic metabolism

Answer 24

utilization of food (glucose) for cellular energy using oxygen; yeilds less energy than aeropic metabolism

Question 25

Hypercapnia

Answer 25

elevated blood levels of carbon dioxide

Question 26

Physical examination

Answer 26

nurse looks for efforts of ventilation, flaring nostrils, position preferences and general chest configuration; rate and rhythm

Question 27

Hypoxia

Answer 27

early manifestations- restlessness, cyanosis of the tongue, soft palate, and conjunctiva of the eyes; chronic hypoxia- clubbing of the fingers

Question 28

Diagnostic and lab testing

Answer 28

SPO2 and sputum collection can assess oxygenation; lactic acid, hemoglobin, and hematocrit are also useful in determining the body’s effectiveness of O2 delivery

Question 29

Nursing diagnosis

Answer 29

ineefective airway clearance, innefective breathing patterns, impaired gas exchange, decreased cardiac ouput, innefective tissue perfusion

Question 30

Effective coughing

Answer 30

nurses teach effective coughing by instructing clients to take a series of slow, deep breaths or huffing (forceful exhalations) prior to coughing; intention is to raise sputum level so it can be expectorated

Question 31

Postural drainage and chest physiotherapy

Answer 31

promotes drainage of secretions from the lungs; use a cupped hand to beat firmly on the chest wall

Question 32

An ER nurse is assessing a client with BFT to the chest wall. Which of the following would indicate the presence of a pneumothorax?

Answer 32

Diminished breath sounds

Question 33

A nurse is caring for a pt hospitalized with acute exacerbation of COPD. Which of the following would the nurse expect to note on assessment of this client?

Answer 33

A hyperinflated chest noted on the chest xray

Question 34

A nurse instructs a pt to use the pursed lip method of breathing and the pt asks the nurse about the purpose of this type of breathing. The nurse responds, knowing that the primary purpose of pursed lip breathing is to:

Answer 34

Promote carbon dioxide elimination

Question 35

The nurse is suctioning fluids from a pt via a trach tube. When suctioning, the nurse must limit the suctioning to a max of:

Answer 35

10 seconds

Question 36

A pt has experienced pulmonary embolism. A nurse assesses for which syptom, which is most commonly reported?

Answer 36

chest pain that occurs suddenly

Question 37

A client has an O2 sat of 90% on 4L O2 via NC. The nurse would interpret this finding as?

Answer 37

Too low for a client receiving oxygen

Question 38

The highest possible concentration of O2 will require the use of which delivery system?

Answer 38

mask witha reservoir bag

Question 39

A client who experiences a collection of blood in the plueral space is experiencing which of the following conditions?

Answer 39

hemothorax

Question 40

Which medication would be indicated to promote broncial dilation and increase ciliary movement?

Answer 40

aminophylline

Question 41

A pt with a history of COPD and ches pain is admitted to the ICU to rule out a MI. Which test would determine the extent to which the pt is experiencing air trapping?

Answer 41

arterial blood gas analysis

Question 42

Clubbing is a physical assessment finding that indicates:

Answer 42

chronic hypoxia

Question 43

THrough which structure does freshly oxygenated blood return to the heart in preparation for entering the general circulation?

Answer 43

pulmonary vein

Question 44

A pt comes to the ER c/o right lower chest pain and SOB. Which question should be asked during the focal interview to provide most information about th pts problem?

Answer 44

“Describe your pain for me”

Question 45

Which assessment finding indicates that a client needs to be suctioned?

Answer 45

audible gurgling sounds when the client breathes

Question 46

A common nursing diagnosis for a post op pt is Risk for Ineffective Airway Clearance. Which intervention would not be appropriate for a client with this potential problem?

Answer 46

restricting fluid intake

Question 47

What is the max time suction should be applied to the respiratory mucosa?

Answer 47

10-15 seconds

Question 48

Which instructions should be included in the nurses discharge teaching plan about lifestyle changes that affect oxygenation?

Answer 48

dependence on nicotine can be decreased by joining a smoking cessation program

Question 49

What is the appropriate amount of suction to use when performing oropharyngeal suctioning?

Answer 49

80-100 mmHg

Question 50

The nurse suspects a client has a pulmonary bacterial infection b/c the clients sputum color is:

Answer 50

yellow green

Question 51

A pt is diagnosed with widespread atelectasis b/c of oxygen toxicity. THe nurse realizes this client is experiencing:

Answer 51

adult respiratory distress syndrome

Question 52

A client with respiratory and cardiac problems is prescribed an ACE inhibitor. THe nurse realizes this medication will:

Answer 52

lower BP and decrease workload of the heart

Question 53

A client tells the nurse that he uses an herb to help promote the loosening of lung secretions. Which herb has this property?

Answer 53

licorice