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1
Q

Normal Values for

Oxygen saturation (SpO2 ) is

A

95-100%

2
Q

Normal Values for

Partial pressure of arterial oxygenation: (Pa02) is

A

60-100mm Hg

3
Q

Normal Values for

Arterial carbon dioxide tension (PaCO2) is

A

35-45 mm Hg

4
Q

4 Physiological factors affecting oxygen

A

Decreased oxygen-carrying capacity (anemia then subsequent hypoxemia)

Decreased inspired oxygen concentration (High Altitude)

Hypovolemia (trauma, surgery)

Increased metabolic rate (sepsis, illness)

5
Q

6 Conditions Affecting Chest Wall Movement:

A

Pregnancy

Obesity

Musculoskeletal abnormalities

Trauma

Neuromuscular disease

CNS alterations

6
Q

During early stages of hypoxia the blood pressure is _______ unless the condition is caused by shock. As the hypoxia worsens, the respiratory rate _____ as a result of respiratory muscle fatigue.

A

elevated

declines

7
Q

3 early Central Nervous System Signs and Symptoms of Hypoxia

A

apprehension

restlessness or irritability

confusion, poor concentration and lethargy

8
Q

3 late Central Nervous System Signs and Symptoms of Hypoxia

A
  • Combativeness
  • Coma
  • confusion
9
Q

2 early Respiratory Signs and Symptoms of Hypoxia

A

 Tachypnea

 Dyspnea on exertion (DOE)

10
Q

4 late Respiratory Signs and Symptoms of Hypoxia

A

 Dyspnea at rest
 Use of accessory muscles
 Retractions on inspiration
 Pause for breath between sentences, words

11
Q

3 early Cardiovascular Signs and Symptoms of Hypoxia

A

 Tachycardia
 Mild elevated BP
 Dysrhythmias

12
Q

3 late Cardiovascular Signs and Symptoms of Hypoxia

A

 Dysrhythmias
 Cyanosis
 Cool, clammy skin

13
Q
  • Determines ability of the lungs to efficiently exchange oxygen and carbon dioxide. differentiate pulmonary obstructive from restrictive disease
A

Pulmonary function studies (PFT)

14
Q
  • Specimen of plural fluid obtained for cytological examination
  • Results may indicate an infection or neoplastic disease
A

Thoracentesis

15
Q
  • Visual examination of the tracheobronchial tree through a narrow, flexible fiberoptic bronchoscope
  • Performed to obtain fluid, sputum, or biopsy samples; remove mucus plugs or foreign bodie
A

Bronchoscopy

16
Q
  • Nuclear scanning test used to identify abnormal masses by size and location
A

lung scan

17
Q

can be performed nasally, orally, or via artificial airways such as endotracheal tubes and tracheostomies

A

Suctioning

18
Q

Oral suctioning is performed with a ____ device.

A

Yankauer

19
Q

Goal is to achieve and maintain a maximal inspiration to improve pulmonary ventilation, loosen secretions, facilitates gas exchange and prevent alveolar collapse.

A

Incentive Spirometry

20
Q

Incentive Spirometry Correct use:

A

exhale normally then slowly and deeply inhale as much as possible, hold 3 seconds and exhale, repeat 10X every hour while awake

21
Q

Humidification is necessary for clients receiving O2 therapy >__L/min

A

4

22
Q

Keep O2 delivery systems ___ feet from open flames

A

10

23
Q

Oxygen Capability at 1-6L/min

A

Nasal Cannula

24
Q

Best option for patients with COPD as it delivers very low flow oxygen

A

Nasal Cannula

25
Q

Provide concentrations of O2 at 4-8L/m

A

Face Tent

26
Q

Provides 5-10L of O2

A

Simple Face Mask

27
Q

Minimum of 5L/min O2 required to prevent client from re-breathing exhaled carbon dioxide

A

Simple Face Mask

28
Q

Provides 6-10 L of O2 per minute

A

Partial Non-rebreather with a reservoir bag

29
Q

rebreathe first third of exhaled air in conjunction with O2.

Patient is still taking in room air.

A

Partial Non-rebreather with a reservoir bag

30
Q

Provides 10L/min of O2

A

Non-rebreather Face Mask with reservoir bag

31
Q

prevent room air and client’s exhaled air from entering the bag so only O2 in bag is inspired

A

Non-rebreather Face Mask with reservoir bag

32
Q

4L=24-28%

8L=35-40%

12L=50-60%

A

Venturi Mask

33
Q

Hydration ________ml/day

Cough and deep breathe every___ hours while awake

A

1500-2000

1-2

34
Q

6 (+1) Rights of Medication Administration

A
Right Patient
 	Right Medication
 	Right Amount (dose & volume)
 	Right Route
 	Right Time
 	Right Documentation
 	Right Reason
 	Remember: PMART DR
35
Q

7 things that must be on a medication order

A
patients full name 
date and time order is written 
medication name 
dosage 
route 
time and frequency of administration 
signature of health care provider
36
Q

the expected or predicted physiological response of the medication

A

Therapeutic effect:

37
Q

: predictable and often unavoidable secondary effect of the medication

A

Side Effect

38
Q

: unintended, undesirable and unpredictable severe responses

A

Adverse effect

39
Q

: a severe and potentially life threatening allergy requiring immediate medical attention

A

Anaphylactic reaction

40
Q

: developed after prolonged intake or when a medication accumulates due to impaired metabolism or excretion

A

Toxic Effect

41
Q
  • Solid, liquid, sustained release
  • Sublingual (under tongue), buccal (side of cheek)
    • Inhalation (Aerosolized)

are all considered what kind of medication form

A

oral

42
Q
  • Skin
  • Body Cavity
  • Irrigation

are all considered what form of medicaion

A

topical

43
Q
  • Intravenous
  • IV, IO
  • Injections
  • IM, SubQ, ID

are all considered what form of medication

A

Parenteral

44
Q

with oral medication Food may _______ therapeutic effect.

A

decrease

45
Q

are enteric-coated or extended release tabs or caps crushable

A

no

46
Q

when Giving a medication through a feeding tube Never add directly to a ______

A

tube feeding

47
Q

when Giving a medication through a feeding tube

Flush tube with _____ before medication, in between medications, and when done

A

water

48
Q

. If GRV is ___ mL or less, return aspirated contents to stomach. If GRV is greater than ____ mL, hold medication

A

250

49
Q

Nasal: For access to frontal and ______, tilt head back over edge of bed or pillow with head turned toward side to be treated

A

maxillary sinus

50
Q

Eye: Avoid instilling any form of eye medications directly onto the _____

A

cornea

51
Q

Ear: instill eardrops at ______ to prevent vertigo, dizziness, or nausea.

A

room temperature

52
Q

: Injection into the dermis just under the epidermis

A

Intradermal (ID)

53
Q
  • typically are used for skin testing

- injection is 5 to 15 degrees

A

Intradermal (ID)

54
Q

Injection into tissues just below the dermis of the skin

A

Subcutaneous:

55
Q

Syringe (1 to 3 mL) and needle (25- to 27-gauge, 3/8- to 5/8-inch)

when injecting, If you can grasp 2 inches insert at a 90-degree angle; (1 inch) of tissue, 45-degree

A

Subcutaneous:

56
Q

: Injection into a muscle

A

Intramuscular (IM)

57
Q

_______ are only given intramuscularly.

A

Immunizations

58
Q

Syringe 2 to 3 mL

90-degree angle

A

Intramuscular (IM)

59
Q

Injection into a vein 25 degree angle

A

Intravenous (IV):

60
Q

Injection locations

recommended for volumes greater than 2 mL

A

Ventrogluteal

61
Q

Injection locations

recommended for 2ml or less

A

Deltoid

62
Q

Injection locations

up to 3 ml

A

Vastus lateralis

63
Q
  • calibrated in sixteenths of a minim and hundredths of a milliliter and has a capacity of 1 mL
A

The tuberculin syringe

64
Q
  • Each milliliter of U-100 insulin contains 100 units of insulin.
A

Insulin syringes

65
Q

Prevents medication from leaking back into the tissues

Reduces pain and discomfort

Good for elderly patients who have decreased muscle mass

A

Z-track Technique

66
Q

Use abdomen, avoiding the 2” area around umbilicus

Never massage

A

Heparin

67
Q

Pre-filled syringe

Do not expel air bubble prior to administration

A

lovenox

68
Q

Insulin is classified by __________

A

rate of action

69
Q

5 Environmental factors affecting nutrition

A
    • Lack of access to full-service grocery stores
  1. high cost of healthy food
  2. widespread availability of less healthy foods in fast-food restaurants
  3. widespread advertising of less healthy food
  4. lack of access to safe places to play and exercise
70
Q

to avoid aspirations

  • Have patient remain sitting upright for at least ____-_____ minutes after meal.
A

30 to 60

71
Q

4 reasons for NG tube

A

1) Decompression 2) Enteral feeding 3) Compression 4) Lavage

72
Q

nutrition

Used with patients who have functional GI tract

A

Enteral

73
Q

nutrition

Used with patients who have un functional GI tract

A

Parenteral

74
Q

4 types of delivery systems for enteral feeding

A
  • Nasogastric tube
  • Gastrostomy tube
  • PEG tube
  • Jejunostomy tube
75
Q

with enteral feeding If residue volume is >____ml HOLD TUBE FEEDING

A

200

76
Q

steps of diet progression

A
  • clear liquid
  • full liquid
  • thickened/ pureed liquids (dysphagia)
  • mechanical soft
  • soft/low residue
  • high fiber
  • low sodium
  • low cholesterol
  • diabetic
  • gluten free
  • regular
77
Q

4 Metabolic complications of parenteral nutrition

A
  • Electrolyte imbalance
  • Hypercapnia
  • Hypoglycemia-Diaphoresis, shakiness, confusion, loss of consciousness
  • Hyperglycemia-
78
Q

10 Complications of enteral feedings:

A
  1. Pulmonary aspiration:
    - Regurgitation of formula, Feeding tube displaced, Deficient gag reflex, Delayed gastric emptying
  2. Diarrhea:
    - Hyperosmolar formula or medications, antibiotic therapy, bacteria contamination, malabsorption
  3. Constipation:
    - lack of fiber, lack of free water, inactivity
  4. Tube occlusion:
    - pulverized medications given per tube, sedimentation of formula, reaction of incompatible medications or formula
  5. Tube displacement:
    - coughing, vomiting, not taped securely
  6. Cramping:
    - high osmolality of formula, rapid increase in rate/volume, lactose intolerance, intestinal obstruction, high fat formula used
  7. Delayed gastric emptying:
    - diabetic gastroparesis, serious illness, inactivity
  8. Serum electrolyte intolerance:
    - excess GI losses, dehydration, presence of disease
  9. Fluid overload:
    - refeeding syndrome in malnutrition
  10. Hyperosmolar dehydration:
    - hypertonic formula with insufficient free water
79
Q

Clear fat-free broth, bouillon, coffee, tea, carbonated beverages, clear fruit juices, gelatin, fruit ices, popsicles

A

Clear Liquid

80
Q

As for clear liquid, with addition of smooth-textured dairy products (e.g., ice cream), strained or blended cream soups, custards, refined cooked cereals, vegetable juice, pureed vegetables, all fruit juices, sherbets, puddings, frozen yogurt

A

Full Liquid

81
Q

As for clear and full liquid, with addition of scrambled eggs; pureed meats, vegetables, and fruits; mashed potatoes and gravy

A

Dysphagia Stages, Thickened Liquids, Pureed

82
Q

As for clear and full liquid and pureed, with addition of all cream soups, ground or finely diced meats, flaked fish, cottage cheese, cheese, rice, potatoes, pancakes, light breads, cooked vegetables, cooked or canned fruits, bananas, soups, peanut butter, eggs (not fried)

A

Mechanical Soft

83
Q

Addition of low-fiber, easily digested foods such as pastas, casseroles, moist tender meats, and canned cooked fruits and vegetables; desserts, cakes, and cookies without nuts or coconut

A

Soft/Low Residue

84
Q

Addition of fresh uncooked fruits, steamed vegetables, bran, oatmeal, and dried fruits

A

High Fiber

85
Q

4-g (no added salt), 2-g, 1-g, or 500-mg sodium diets; vary from no-added-salt to severe sodium restriction (500-mg sodium diet), which requires selective food purchases

A

low sodium

86
Q

300 mg/day l, in keeping with American Heart Association guidelines for serum lipid reduction

A

Low Cholesterol

87
Q

Nutrition recommendations by the American Diabetes Association: focus on total energy, nutrient and food distribution; include a balanced intake of carbohydrates, fats, and proteins; varied caloric recommendations to accommodate patient’s metabolic demands

A

Diabetic

88
Q

Eliminates wheat, oats, rye, barley and their derivatives

A

Gluten Free

89
Q

Oxygen Capability 24-48%

A

Nasal cannula

90
Q

Provide 30-50% concentrations of O2

A

face tent

91
Q

Provide 40-60% concentrations of O2

A

simple face mask

92
Q

Provide 40-70% concentrations of O2

A

Partial Non-rebreather with a reservoir bag

93
Q

Provide 60-80% concentrations of O2

A

Non-rebreather Face Mask with reservoir bag

94
Q

Provides 24%-60% oxygen

A

Venturi Mask