USCR Air

Question 1

Transport of 02 is dependent on what systems?

Answer 1

Respiratory System(lungs, trachea, pharynx, gas exchange)
Cardiovascular System (02 transported in blood)
Hematologic System (blood with 02 attached)
Nervous System (control centre)

Question 2

What is ventilation?

Answer 2

movement of air in and out of lungs; the process of inhalation and exhalation

Question 3

What is respiration?

Answer 3

The act of breathing; transport of oxygen from the atmosphere to the body’s cells and transport of carbon dioxide from the cells to the atmosphere

Question 4

What is diffusion?

Answer 4

The movement of gases or other particles from an area of greater pressure or concentration to an area of lower pressure or concentration

Question 5

What is perfusion?

Answer 5

Passage of blood constituents through the vessels of the circulatory system

Question 6

Function of respiratory system?

Answer 6

gas exchange & transport of respiratory gases in & out of body

Question 7

Process of respiration?

Answer 7

Pulmonary ventilation (breathing in-out)
Gas exchange
Transport of respiratory gases (taking gas to tissues)

Question 8

What is pulmonary ventilation?

Answer 8

movement of air in & out of lungs

Question 9

Phases of pulmonary ventilation?

Answer 9

1. Inspiration/Inhalation (pressure gradient needed. pressure inside cavity must be lower than outside)(requires energy)
   active phase where the muscles of thorax bring air into lungs

2.Expiration/Exhalation
passive phase where air moves out of lungs (relax + recoil, no energy needed)

Question 10

What does pulmonary ventilation depend on?

Answer 10

clear airways
intact nervous system
functioning thoracic cavity
adequate lung compliance (expand) & recoil

Question 11

Respiration pathway?

Answer 11

Oxygen (O2) diffuses from alveoli into blood in the pulmonary capillaries

Carbon dioxide (CO2) diffuses from the blood into the alveoli & is exhaled

(blood) Right side of heart to lungs to left side of heart to tissue

Question 12

Respiration diffusion is influenced by?

Answer 12

any change (Δ) in the surface area available for gas exchange

thickening of the alveolar-capillary membrane

partial pressures of respiratory gases (high altitude) (pulmonary embolism can affect this)

Question 13

What is transport of respiratory gases?

Answer 13

Depends on cardiovascular system

Delivers oxygenated blood to left (L) side of heart (♥) & tissues = perfusion

Delivers deoxygenated blood to pulmonary system

Question 14

How is 02 transported?

Answer 14

bound to hemoglobin (oxyhemoglobin)

Question 15

3 ways 02 is transported in the body?

Answer 15

mostly carried in plasma as bicarbonate (HCO3-)
small amount binds with Hgb = carboxyhemoglobin
minimal in plasma

Question 16

Transport of respiratory gases is influenced by?

Answer 16

exercise
cardiac output
tissue perfusion
# of erythrocytes (RBC)

Question 17

Where is respiratory regulation located?

Answer 17

medulla oblongata of brain stem

respiratory center stimulation leads to increase rate & depth of respiration

Question 18

Factors that influence oxygenation?

Answer 18

Age and Developmental Considerations
Health Status
Medication
Lifestyle
Environment
Psychological Health

Question 19

Age & developmental considerations?

Answer 19

lifespan consideration (surface ares for gas exchange decreases with age)

Question 20

Health considerations?

Answer 20

Underlying health problems (obesity)
Pregnancy
Surgery (OR)/Pain

Question 21

Medication considerations?

Answer 21

A variety of medications can decrease the rate and depth of respirations.

Opioids: morphine, codeine, sleeping pills, alcohol
Pills + Alcohol = decreased rate of respiration; can lead to death

Question 22

Lifestyle factors?

Answer 22

Sedentary individuals (not expanding their lungs by sitting)

Smoking

Diet:
Vegetarians (no arteriosclerosis, because not eating fat)
High intake of saturated fats
High salt intake

Occupation

Question 23

Factors that influence oxygenation?

Answer 23

environment: altitude, air pollution heat, cold

Question 24

Psychological health status influence?

Answer 24

Psychological & physiological responses to stress can affect oxygenation: (stress-anxiety-shallow breathing)

Stress stimulates sympathetic nervous (constriction of airway)

Release of epinephrine & norepinephrine
epinephrine causes ♥ to contract more forcefully & bronchioles to dilate
norepinephrine causes vasoconstriction ⇒ ↑BP

Question 25

assessment of air consist of what 3 components?

Answer 25

pt health history (bcf, subjective data, scp) objective data (physical exam, intake/output observation) diagnostic & laboratory data

Question 26

Health history BCF includes?

Answer 26

``` Developmental data Age Health state data Health care systems factors Patterns of living ```

Question 27

Subjective data includes?

Answer 27

``` Usual patterns of respiration Recent Δs Cough Sputum Chest pain (heart telling you there is not enough 02 supply) Dyspnea Fever Fatigue ```

Question 28

self care practices of health includes?

Answer 28

``` Exercise Smoking Food Health Surveillance Vaccine practices ```

Question 29

Who should get flu Vx?

Answer 29

+ 65 residents of long term care facilities weakened immune system individuals individuals whose work puts them at risk (RN, MD)

Question 30

Objective data assessment of air?

Answer 30

Physical Examination Proceed in an organized manner ``` Use techniques of: Inspection (look) Palpation (touch) Auscultation (listen) Peripheral cyanosis is not a good indication but central (inside) (ex:tongue color) is a good indication ```

Question 31

Inspection techniques?

Answer 31

``` rate, rhythm, depth Cough Sputum Use of supplemental O2 O2 saturation (O2 sat) Temperature PO, AX, PR (T° in degrees Celsius) ``` Increase in temp. = increase oxygen demand

Question 32

Physical exam?

Answer 32

color of skin, mucous membranes, conjunctiva Cyanosis: Bluish discoloration of skin and mucous membranes caused by reduced oxygen in blood Posture, thorax, speed of cap refill, nail clubbing, palpation, temp., auscultation, BP,

Question 33

Why do we need to monitor and record a patient’s fluid intake?

Answer 33

When you drink, you increase blood volume

Question 34

Why do we need to monitor and record a patient’s output?

Answer 34

urine, to see if it matches the input of fluid

Question 35

What factors may influence a patients ability to receive fluids?

Answer 35

edema | patient that cannot swallow

Question 36

Labs & Diagnostic Tests?

Answer 36

Sputum/throat culture (will tell you what microorganism is living in the organism and multiplying) best time for specimen collection is early AM before (ac) breakfast Pulmonary Function Tests (PFTs) (tells us lung expansion) Complete Blood Count (CBC) (measure hemoglobin, WBC) Chest X-ray

Question 37

Hypoxia?

Answer 37

Insufficient tissue oxygenation anywhere in the body 02 stat measure used

Question 38

Hypoxemia?

Answer 38

A condition in which the level of oxygen in the blood is less than normal. measured by blood gas

Question 39

** SIGNS & SYMPTOMS (S+S) OF INADEQUATE OXYGENATION?

Answer 39

``` Respiratory: Tachypnea Dyspnea on exertion &/or at rest Pause for breath between sentences, words Flaring of nares Use of accessary muscles ``` ``` Cardiovascular: Tachycardia Mild hypertension Arrhythmias Hypotension Cyanosis (central cyanosis) Cool, clammy skin ``` ``` Central Nervous System: Unexplained anxiety restlessness or irritability confusion or lethargy Combativeness ↓ed level of consciousness (LOC) -to coma ``` ``` Other Diaphoresis ↓d urinary output Unexpected fatigue usually sitting, often lean forward ```

Question 40

**PROMOTING OXYGENATION**?

Answer 40

Nurse interventions; Position patient for maximum chest expansion, (semi-fowler 45 degrees) Encourage frequent changes in position, Encourage/assist with postural drainage, Encourage ambulation/mobility, Providing analgesics for pain (promoting comfort), Providing adequate hydration and encourage use of humidifiers, Encouraging deep breathing and coughing exercises, Encourage use of Incentive Inspirometry, Providing medications as prescribed e.g.. Bronchodilators, anti-inflammatory’s, Providing oxygen therapy. incentive inspirometer

Question 41

**STANDARD ACTION DEMAND: OXYGENATION**? Maintain/improve oxygenation in a (an) --- year old male/female patient diagnosed with -------, POD# ----, by:

Answer 41

1. Following a regular exercise program with 30-45 minutes of moderate activity 3-4 times /week. 2. Maintaining a normal body weight. 3. Avoiding chemical substances that cause respiratory depression. 4. Practicing pursed-lip breathing q1-2h. 5. Practicing deep breathing & coughing (DB+C) q1-2h. 6. Using an incentive spirometer 10x/hour while awake. 7. Δing position frequently q1-2h, allowing for expansion of the chest wall & free movement of the diaphragm. 8. Breathing humidified air prn. 9. Managing pain prn.