Oxygenation & Respiratory Function

Question 1

Some chronic conditions result in loss of elasticity of the lungs causing air to get trapped in alveoli. Certain breathing exercises can strengthen the accessory muscles of respiration and result in better oxygenation

Answer 1

Effective Breathing

Question 2

creates a smaller opening to air outflow and thus increases resistance to exhalation slightly. The end result is that the expiratory phase is lengthened, which helps prevent alveoli from collapsing while maximally expelling air from the lungs. Exhalation should take twice as long as inhalation. Teach patient to breathe in through nose (count “1…2…”) and exhale through pursed lips (count “1…2…3…4…”).

Answer 2

Pursed Lip Breathing

Question 3

to strengthen the accessory muscles of respiration, which reduces air trapping and promotes complete emptying of the lungs. Have patients exhale with their hand on their abdomen, feeling for the inward motion of the abdomen. Have them work to increase their “push” with the abdomen by tightening the muscles to facilitate complete emptying.

Answer 3

Diaphragmatic breathing

Question 4

One of the main benefits of Diaphragmatic breathing techniques is helping the patient

Answer 4

to “gain control” over breathing

Question 5

Breathing is almost always easier in an

Answer 5

upright position

Question 6

When a patient is having difficulty breathing, IMMEDIATELY

Answer 6

raise the head of the bed

Question 7

Helps to remove secretions and keep alveoli open

Answer 7

Coughing

Question 8

may be contraindicated for patients who have had eye, brain, or spine surgery because of the possible increase in intraocular or intracranial pressure.

Answer 8

Coughing

Question 9

a set of techniques to help loosen and drain secretions from the lungs.

Answer 9

Chest Physiotherapy

Question 10

is a gentle shaking pressure applied to the chest wall only during exhalation to shake secretions into larger airways.

Answer 10

Vibration

Question 10

Used in conjunction with postural drainage. Rhythmic clapping on the chest wall over the area to be drained forcing secretions into larger airways so they can be expectorated. Hand is “cupped”

Answer 10

Chest percussion

Question 11

Most commonly performed by Respiratory Therapist

Answer 11

Chest percussion

Question 12

You use vibration most often with patients with

Answer 12

cystic fibrosis

Question 13

A device that encourages deep inspiration (and, consequently, full expansion of alveoli) by providing a visual goal. The most common type is a disposable plastic device in which slow steady inspiration causes a ball to rise in a graduated plastic column.

Answer 13

Incentive Spirometry (IS)

Question 14

Why are medications given by inhalation

Answer 14

The alveolar-capillary network absorbs medications rapidly

Question 15

Deliver precise doses of medication directly to the lungs, dispersed through an aerosol spray, mist, or powder that penetrates lung airways. These devices consist of a mouthpiece and actuator into which a medication canist

Answer 15

Pressurized Metered-Dose Inhalers (pMDIs)

Question 16

Used for asthma, emphysema, COPD, and bronchitis.

Answer 16

Pressurized Metered-Dose Inhalers (pMDIs):

Question 17

are short acting and provide immediate relief for acute respiratory distress. They are for relief of symptoms.

Answer 17

“Rescue” medications

Question 18

are used daily at scheduled times to prevent acute respiratory distress. Many of them are corticosteroids. They treat the underlying pathology

Answer 18

“Maintenance” medications

Question 19

Patients may use a _______ with pMDIs.

Answer 19

spacer

Question 20

allow the particles of the medication to slow down and break into smaller pieces therefore leading to improved drug absorption in the patient’s airway

Answer 20

Spacers

Question 21

hold medication in a powdered form and create an aerosol when the patient inhales through the reservoir holding the medication. This requires less hand-breath coordination. The device is activated when the patient breathes; no spacer is needed

Answer 21

Dry Powder Inhalers (DPIs)

Question 21

releases medication when the patient lifts a lever, but the medication doesn’t flow out until the patient inhales. Useful for patients with hand-breath coordination issues, or patients who have so little hand strength that they can’t push the actuator down enough to release the dose.

Answer 21

Breath-Actuated Inhaler (BAI)

Question 22

If patient is using a bronchodilator (rescue) AND a steroid inhaler (maintenance), instruct the patient ______________FIRST (to open the airway) and then use the steroid inhaler

Answer 22

to use the bronchodilator

Question 23

Patients taking inhaled steroids should ___________-after using inhaler to prevent thrush due to local immunosuppressive properties of steroids

Answer 23

rinse and spit

Question 24

The percentage of oxygen breathed by a person is called is called the

Answer 24

fraction of inspired oxygen (FiO2)

Question 25

Oxygen can be toxic; therefore, the aim is ________________ to keep arterial oxygen saturation within a normal range

Answer 25

to provide the lowest percentage of oxygen needed

Question 26

Volume of oxygen delivered is less than the patient’s minute ventilation (amount of air inhaled by a patient in one minute)

Answer 26

Low flow

Question 27

Mask has lateral perforations to allow exhaled CO2 to escape to decrease the amount the patient re-breaths.

Answer 27

Simple face mask

Question 28

It fills with oxygen, and when the patient breathes in, he/she mostly breathes the oxygen from the bag, so hardly any atmospheric air is present which results in higher FiO2 results (in excess of 90%)

Answer 28

Partial and nonrebreather masks

Question 29

Volume of oxygen delivered is in excess of the patient’s minute ventilation.

Answer 29

High flow

Question 30

This is a relatively new method of oxygen delivery providing heated, humidified oxygen through a nasal cannula at flow rates as high as 60 L/minute while an air-oxygen blender allows for the titration of the FiO2

Answer 30

High-flow nasal cannula (HFNC)

Question 31

Noninvasive Ventilation

Answer 31

Continuous positive airway pressure (CPAP) and bilevel positive airway pressure (BPAP)

Question 32

Precautions related to oxygen

Answer 32

Fire, humidification, and flow rate

Question 33

Use a humidifier (“bubbler”) whenever flow rate is equal to or going to exceed

Answer 33

4L/min

Question 34

When patients can’t effectively cough out sputum, suctioning may be necessary.

Answer 34

Suctioning

Question 35

is suctioning of the mouth. It is a clean, rather than sterile, procedure. Often a Yankauer tip is used. It is usually employed when the patient can cough up sputum from the lungs but can’t get it past the oropharynx

Answer 35

Oral suctioning

Question 35

Suctioning should NEVER be done when the patient is

Answer 35

able to cough effectively

Question 36

involves the use of a soft whistle-tip catheter to enter the trachea (and perhaps the bronchi). Two current methods of suctioning are: open and closed.

Answer 36

Endotracheal suctioning

Question 37

sterile technique is maintained with a new sterile catheter for each suctioning event, sterile gloves are worn, and Standard Precautions are utilized during the suctioning procedures

Answer 37

open suctioning

Question 38

usually performed when the patient requires an invasive mechanical ventilator to support their respiratory efforts – this allows the continuation of oxygen while performing suctioning and decreases the risk of oxygen desaturation during the procedure

Answer 38

closed suctioning

Question 39

This type of airway is for patients with decreased level of consciousness or airway obstruction and aids with the removal of secretions

Answer 39

Artificial Airways

Question 40

It is done when there is an airway obstruction above the trachea or when the patient can benefit from decreased work of breathing associated with decreased dead space.

Answer 40

Tracheostomy

Question 41

ventilation

Answer 41

breathing

Question 42

Blood flow to lungs and 
body tissues

Answer 42

perfusion

Question 43

O2 into blood, CO2 removed from blood

Answer 43

Diffusion

Question 44

What is used to treat these: Airway obstruction, Neuromuscular problem, Chest wall problems

Answer 44

ventilation

Question 45

What is used to treat these: Pulmonary embolismand Hypotension

Answer 45

perfusion

Question 46

What is used to treat these: Pulmonary edema, Mucus, and Destruction of alveoli

Answer 46

Diffusion

Question 47

low oxygen(not enough oxygen)

Answer 47

Hypoxia

Question 48

breathing to slow

Answer 48

Hypoventilation

Question 49

breathing to fast

Answer 49

Hyperventilation

Question 50

trouble(dysfunctional) breathing

Answer 50

Dyspnea

Question 50

only able to breathe when upright

Answer 50

Orthopnea

Question 51

when the alveoli in the lungs collapses

Answer 51

Atelectasis

Question 52

Different masks and tubing have

Answer 52

different flow rates and different percentages of oxygen

Question 53

PCT/UAP role for oxygen

Answer 53

cannot start oxygen on all patients, cannot touch flow meter to give patient more or les oxygen

Question 54

COPD patients should not have _____________ of oxygen unless the provider says so

Answer 54

more than 1 to 2 L

Question 55

assess the patient for how much oxygen is needed and can adjest how uch oxygen is given to a patient

Answer 55

Nurses role for oxygen