Oxygenation - Exam IV

Question 1

effect of age on ventilation

Answer 1

• infants and toddlers: at risk for URI when exposed to second hand smoke/other children (anatomically smaller airways at risk for obstruction)
• school aged/adolescents: at risk for infections from smoke
• older adults:less elastic chest wall and airways, decreased muscle strenth air exchange ciliary action, increased secretions remain in lunges

Question 2

effect of age on gas exchange

Answer 2

• young and middle aged adults: at risk for cardiopulmonary issues because of unhealthy diet, lack of exercise, stress, drugs, smoking
• older adults: - osteoporosis leads to change in shape of the thorax, alveoli enlarge decreases the surface area for gas exchange

Question 3

effect of age on perfusion

Answer 3

older adults: calcification of heart valves, vascular stiffening, atherosclerosis plaques,

Question 4

effect of lifestyle on ventilation

Answer 4

• pregnancy: enlarging uterus pushes abdominal contents upward against the diaphragm
• obesity: morbidly obese have reduced lung volumes
• exercise increases metabolic activity and allows a person to inhale more O2 and let out excess CO2
• smoking is bad
• substance abuse: suppresses respiratory center = reducing rate =.depth of respiration

Question 5

effect of lifestyle on gas exchange

Answer 5

nutrition: - good nutrition affects gas exchange by supporting normal metabolic functions
- smoking is bad
- substance abuse: poor nutritional intake results in decline in hemoglobin

Question 6

effect of environment on ventilation

Answer 6

• trauma: rib fracture/bruising causes reduced ventilation
• smoking is bad
• rural populations likelier to have COPD related to smoking

Question 7

effect of enviornment on gas exchange

Answer 7

• smoking is bad
• pts. workplace might be inhaling toxins

Question 8

effect of environement on perfusion

Answer 8

inhalation of toxic substances decreases oxygen carrying capacity of blood by reducing the amount of hemoglobin available
- smoking is bad

Question 9

effect of lifestyle on perfusion

Answer 9

hydration: fluid intake affects cellular health
- smoking is bad

Question 10

effect of health on perfusion

Answer 10

anemia is the results of decreased hemoglobin production, and or blood loss
- smoking is bad

Question 11

what medication interventions help promote respiratory factors and oxygenation

Answer 11

• vaccinations: flu vaccine, pneumococcla vaccine <2 yrs, Covid,
• bronchodilators, mucolytics, low-dose antianxiety meds

Question 12

what inhalation therapies help promotes respiratory factors and oxygenation

Answer 12

• inhaled steroids,
• incentive spirometry

Question 13

what oxygen therapies help promotes respiratory factors and oxygenation

Answer 13

noninvasive positive pressure ventilation: (CPAP and BiPAP)
Nasal Cannula, nonrebreather (keep reservoir bag inflated) , venturi mask, high-flow cannula,

Question 14

what artifical airway interventions help promotes respiratory factors and oxygenation

Answer 14

Endotracheal airway
Tracheostomy
Nasopharyngeal adjunct airway
Oropharyngeal adjunct airway

Question 15

what airway suctioning interventions help promotes respiratory factors and oxygenation

Answer 15

open : for sputum speciments, use of sterile catheter
closed: reusable sterile suction catheter - oxygn continued to be deliverd while suction performed
Invasive mechanical ventilation used with artifical airways

Question 16

what diagnostic tests/examinations does the nurse do when a patient has impaired oxygenation

Answer 16

physical examination - inspection, palpation, auscultation
ABG
pulmonary function test
peak expiratory flow rate
bronchoscopy
lung scan

Question 17

what diagnostic tests/examinations does the nurse do when a patient has impaired oxygenation

Answer 17

physical examination - inspection, palpation, auscultation
ABG
pulmonary function test
peak expiratory flow rate
bronchoscopy
lung scan
Thoracentesis

Question 18

ABG - arterial blood gases

Answer 18

provides important information for assessment of patients respiratory and metabolic acid/base balance and adequacy of oxygenation

Question 19

Thoracentesis

Answer 19

surgical perforation of chest wall/pleural space with a needle to aspirate fluid fir diagnosis identifies infection

Question 20

ABG

Answer 20

pH: 7.35-7.45
pCO2: 35-45 mmHg
HCO3: 22-26 mEq/L
pO2: 80-100 mmHg

Question 21

pulse oximetry

Answer 21

% hemoglobin saturated with O2

Question 22

forced vital capacity

Answer 22

volume of air on forceful expiration

Question 23

forced expuiratory volume

Answer 23

volume of air expired in 1 second after maximum inhalation

Question 24

residual volume

Answer 24

amount of air remaining in the lungs after maximum expiration

Question 25

peak expiratory flow rate

Answer 25

maximum speed of expiration , high numbers are best, 80-100% <50% red

Question 26

Endotracheal airway

Answer 26

- ET tube: short term, relieves obstruction, protects against aspiration, clear secretions, passes through vocal cords, baloon prevents aspirations

Question 27

Nasopharyngeal adjunct airway

Answer 27

conscious or unconscious, sizing: tip of nose to earlobe

Question 28

Oropharyngeal adjunct airway:

Answer 28

unconscious only, sizing: corner of mouth to angle of jaw

Question 29

incentive spirometry

Answer 29

- flow-oirented goal: inale slowly and deeply ; hold 2-6 seconds slower inhalation = greater lung expansion

Question 30

how would you know if the patients is getting enough o2 from the oxygenation therapy

Answer 30

- maintenance of patent airways -SpO2 > 94% -secretions are thing, clear - WBC returns to baseline - decreased SOB - clear breath sounds over all lung fileds - no accessory muscle use - able to engage ADLs without limitations

Question 31

what are the signs and symptoms of hyperventilation

Answer 31

- rapid respiration, sighing breaths, numbness in hands/feet, light-headedness, loss of consiousness

Question 32

what are the signs and symptoms of hypoventilation

Answer 32

(COPD) - pts have adapted to a high CO2 level to their receptors don't function normally, - respiroatry acidosis + arrest - mental staus change, dysrhythmeias,, potential cardiac arrest, if untreated: convulsions, unconsciousness, death

Question 33

promote lung expnasion

Answer 33

position/ambulation frequent psotions cahnges IS pursed lip breathing chest tube

Question 34

steps of care for pt. with altered o2

Answer 34

promote lung expanstion mobilize secretions ensure patent arway adminsiter medications patient education

Question 35

early sings of hypoxia

Answer 35

apprehension, restlessness, inability to concentrates, deacrease level of consciousness, dizziness, and beahvioral changes, fatigues and agitated, increased pulse rate

Question 36

late signs of hypoxia

Answer 36

lethargy, bradycardia, bradypnea, hypotension, cyanosis

Question 37

Ensure patent airway

Answer 37

head and neck positioning artifical airways suctioning

Question 38

mobilize secretions

Answer 38

deep breathing/coughing hydration humdified o2 suctioning posutral draining