Quiz 1

Question 1

PaO2

Answer 1

80-100

Question 2

PaCO2

Answer 2

Alkalineacidic

Question 3

HCO3

Answer 3

Acidicalkaline

Question 4

SaO2

Answer 4

> 95%

Question 5

Gas exchange

Answer 5

O2 in and CO2 out
Happens in the alveoli
Gases diffuse across the membrane

Question 6

Ventilation-perfusion mismatch

Answer 6

Breathing in and diffusion not equal

Results in hypoxemia

Question 7

Causes of respiratory failure

Answer 7

Ventilation-perfusion mismatch
Impaired gas diffusion
Hypo ventilation

Question 8

Impaired gas diffusion

Answer 8

How CO2 and O2 move across membrane into blood

Causes hypoxemia and hypercapnia

Question 9

Hypoventilation

Answer 9

Not enough breathing

Hypoxemia and hypercapnia

Question 10

Hypoxemia

Answer 10

Low levels of O2 in the blood

Question 11

Hypercapnia

Answer 11

Increased CO2

If too much CO2 brain stops telling you to breathe

Question 12

Manifestations of hypoxemia

Answer 12

Hypertension 1st, then hypotension
tachypnea
Poor tissue perfusion
Cyanosis
Anxious
Dyspnea
Change in LOC
Diaphoresis

Question 13

Manifestations of hypercapnia

Answer 13

Dyspnea
pH > 7.45
Diminished lung sounds
Dizzy, drowsy
Tachy
Change in LOC

Question 14

Diagnostic assessment of gas exchange

Answer 14

VS
O2 use
CXR
VQ scan
CBC
ABGs 
Sputum

Question 15

Lactic acidosis

Answer 15

Too much lactic acid
Higher the level the longer the problem
Anaerobic
Cells don't have enough O2
Causes tissue death

Question 16

Modified aliens test

Answer 16

Put pressure on bilateral sides

See if you can draw blood and they will still have flow

Question 17

Why intubate a pt

Answer 17

Inability to oxygenated
Inability to ventilate
Mental status

Question 18

Ventilation allows

Answer 18

Increased lung volume
Fluid redistribution in alveoli
Decreased O2 demand
Positive pressure airway

Question 19

Nurses responsibility during intubation

Answer 19

Document
Monitor
Supplies
Advocate

Question 20

Rapid sequence for intubation

Answer 20

Analgesic
Sedative
Paralytic

Question 21

Sedatives

Answer 21

Benzo
Propofol
Dexmedetomidine
Etomidate

Question 22

Analgesic

Answer 22

Fentanyl

Hydromorphone

Question 23

Paralytic S

Answer 23

Vecuronium
Cisatracurium
Complete control
Must be sedated

Question 24

How to check tube placement

Answer 24

Chest x-Ray
CO2 detector
Listen for bilateral lung sounds

Question 25

Nursing responsibilities post intubation

Answer 25

NG or Og | Restrain pt

Question 26

Effectiveness of the intubation

Answer 26

``` O2 sats stable Lung sounds Vent compliance ABGs Mental status ```

Question 27

SAT

Answer 27

Spontaneous awakening trial Determines how much sedation Shut off sedation and see if they are breathing

Question 28

SBT

Answer 28

Done after SAT

Question 29

RASS scale

Answer 29

``` Sedation level Allows titration of sedation + is crazy - is sedated 0 is normal ```

Question 30

Cardio impact of intubation

Answer 30

Tachy | Change in BP

Question 31

Respiratory impact

Answer 31

Improve gas exchange | Get rid of liquid

Question 32

Complications of ventilation

Answer 32

Infection Barotrauma Ulcer Imbalanced nutrition

Question 33

Care of intubated pt

Answer 33

``` Oral care Reposition Q2hrs DVT, PUD Glucose control HOB 30 degrees Nutrition Communication Assess readiness for SAT and SBT Mobility Assess and treat delirium ```

Question 34

FiO2

Answer 34

21-100% | Direct impact on gas exchange

Question 35

Rate

Answer 35

Number of breaths given by the vent/min

Question 36

Tidal volume

Answer 36

Amount of air given in each breath | Help with oxygenation

Question 37

Pressure support

Answer 37

Weaning mode

Question 38

Positive end expiration you pressure(PEEP)

Answer 38

Positive pressure at the end of expiration Keeps alveoli open Critical in oxygenation

Question 39

Assist control mode

Answer 39

Preset number of breaths | And preset VT on the vent regardless of ventilator or patient initiated breaths

Question 40

SIMV

Answer 40

Preset number of breaths delivered at VT set on the vent | Patient controls VT of any other breaths

Question 41

BiPAP

Answer 41

``` Non-invasive ventilation 2 pressure Inspiratory and expiration Monitor for anxiety FiO2 ```

Question 42

Pneumothorax

Answer 42

Air in pleural cavity Absent lung sound where deflated Tachypnea Accessory muscles

Question 43

Hemothorax

Answer 43

Blood in pleural space Diminished breaths sounds in lower lobe Hemoglobin

Question 44

Flail chest

Answer 44

2 or more consecutive ribs broken See-saw resp. Painful resp.

Question 45

Pulmonary contusion

Answer 45

Bruising to lung, alveoli rupture 12-24hrs Severe dyspnea Blood tinged sputum

Question 46

Nursing assessment of chest trauma

Answer 46

Lung sounds Mental status Chest X-ray VS

Question 47

Chest drainage system

Answer 47

Position below waist Reestablish negative pressure Advocate for pain meds

Question 48

Chest system water level

Answer 48

Bubbling could indicate a leak, check tubing and site Tidaling is movement of water with breathing

Question 49

COPD

Answer 49

Chronic airflow obstruction Exacerbations Smoking

Question 50

Chronic bronchitis

Answer 50

``` Thick excessive secretions Recurrent infections Expiration is difficult Then inspiration Blu bloaters ```

Question 51

Emphysema

Answer 51

Progressive destruction of alveoli Decreased ability to oxygenate blood Cough, barrel chest, sit forward Pink puffers

Question 52

COPD nursing interventions

Answer 52

``` Wear O2 Bi-pap, c-pap Lung assessment Nutrition Cyanosis Smoking cessation ```

Question 53

Bronchodilators

Answer 53

Albuterol-short acting | Aminophyline-long acting

Question 54

Anticholinergic

Answer 54

Tiotropium | Daily use

Question 55

Steroid

Answer 55

Fluticasone

Question 56

Normal pH

Answer 56

Acidic alkaline