Alexandra Bozan
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Unit VII: Promoting Healthy Physiologic Responses Chapter 38: Oxygenation and Perfusion

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Alexandra Bozan
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Chapter 38: Oxygenation and Perfusion

Chapter 38: Oxygenation and Perfusion

Question 1 of 50

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A nurse caring for a patient with chronic obstructive pulmonary disease (COPD) knows that hypoxia may occur in patients with respiratory problems. What are signs of this serious condition?

Select one or more of the following:

  • Dyspnea

  • Hypotension

  • Small pulse pressure

  • Decreased respiratory rate

  • Pallor

  • Increased pulse rate

Explanation

Question 2 of 50

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A nurse is suctioning the nasopharyngeal airway of a patient to maintain a patent airway. For which condition would the nurse anticipate the need for a nasal trumpet?

Select one of the following:

  • The patient vomits during suctioning

  • The secretions appear to be stomach contents

  • The catheter touches an unsterile surface

  • Epistaxis is noted with continued suctioning.

Explanation

Question 3 of 50

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The will protect the nasal mucosa from further trauma related to suctioning.

Explanation

Question 4 of 50

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A nurse is choosing a catheter to use to suction a patient's endotracheal tube via an open system. On which variable would the nurse base the size of the catheter to use?

Select one of the following:

  • The age of the patient

  • The size of the endotracheal tube

  • The type of secretions to be suctioned

  • The height and weight of the patient

Explanation

Question 5 of 50

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A nurse is caring for a 16 year old male patient who has been hospitalized for an acute asthma exacerbation. Which testing methods might the nurse use to measure the patient's oxygen saturation?

Select one or more of the following:

  • Thoracentesis

  • Spirometry

  • Pulse oximetry

  • Peak expiratory flow rate

  • Diffusion capacity

  • Maximal respiratory pressure

Explanation

Question 6 of 50

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are used to monitor the health status of patients with respiratory disorders, such as asthma. is used to obtain baseline information about the patient's oxygen saturation level and is also performed for patients with asthma, along with to monitor airflow. These 3 tests may be administered by the nurse.

Explanation

Question 7 of 50

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estimates the patient's ability to absorb alveolar gases and determines if a gas exchange problem exists. help evaluate neuromuscular causes of respiratory dysfunction. Both tests are usually performed by a respiratory therapist.

Explanation

Question 8 of 50

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The physician or other advanced practice professional can perform a at the bedside with the nurse assisting, or in the radiology department.

Explanation

Question 9 of 50

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is a procedure in which a needle is inserted into the pleural space between the lungs and the chest wall. This procedure is done to remove excess fluid, known as a pleural effusion, from the pleural space to help you breathe easier.

Explanation

Question 10 of 50

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A patient with COPD is unable to perform activities of daily living (ADLs) wihtout becoming exhausted. Which nursing diagnosis best describes this alteration to oxygenation as the etiology?

Select one of the following:

  • Decreased Cardiac Output related to difficulty breathing

  • Impaired Gas Exchange related to use of bronchodialators

  • Fatigue related to impaired oxygen transport system

  • Ineffective Airway Clearance related to fatigue

Explanation

Question 11 of 50

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A nurse working in a long-term care facility is providing teaching to patients with altered oxygenation due to conditions such as asthma and COPD. Which measures would the nurse recommend?

Select one or more of the following:

  • Refrain from exercise

  • Reduce anxiety

  • Eat meals 1 to 2 hours prior to breathing treatments

  • Eat a high-protein/high calorie diet

  • Maintain a high Fowler's position when possible

  • Drink 2 to 3 pints of clear fluids daily

Explanation

Question 12 of 50

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A nurse is providing postural drainage for a patient with cystic fibrosis. In which position should the nurse place the patient to drain the right lobe of the lung?

Select one of the following:

  • High Fowler's position

  • Left side with pillow under chest wall

  • Lying position/half on abdomen and half on side

  • Trendelenberg position

Explanation

Question 13 of 50

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A nurse is teaching a patient how to use a meter-dosed inhaler for her asthma. Which comments from the patient assure the nurse that the teaching has been effective?

Select one or more of the following:

  • I will be careful not to shake up the canister before using it

  • I will hold the canister upside down when using it

  • I will inhale the medication through my nose

  • I will continue to inhale when the cold propellant is in my throat

  • I will only inhale one spray with one breath

  • I will activate the device while continuing to inhale

Explanation

Question 14 of 50

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When planning care for a patient with chronic lung disease who is receiving oxygen through a nasal cannula, what does the nurse expect?

Select one of the following:

  • The oxygen must be humidified

  • The rate will be no more than 2 to 3 L/min or less

  • Arterial blood gases will be drawn every 4 hours to assess flow rate

  • The rate will be 6 L/min or more

Explanation

Question 15 of 50

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A rate higher than L/min may destroy the hypoxic drive that stimulates respirations in the medulla in a patient with chronic lung disease.

Explanation

Question 16 of 50

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A nurse is securing a patient's endotracheal tube with tape and observes that the tube depth changed during the retaping. Which action would be appropriate related to this incident?

Select one of the following:

  • Instruct assistant to notify the primary care provider

  • Assess the patient's vital signs

  • Remove the tape, adjust the depth to ordered depth and reapply the tape

  • No action is required as depth will adjust automatically

Explanation

Question 17 of 50

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What action does the nurse perform to follow the safe technique when using a portable oxygen cylinder?

Select one of the following:

  • Checking the amount of oxygen in the cylinder before using it

  • Using a cylinder for a patient transfer that indicates available oxygen is 500 psi

  • Placing the oxygen cylinder on the stretcher next to the patient

  • Discontinuing oxygen flow by turning cylinder key counterclockwise until tight

Explanation

Question 18 of 50

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A nurse providing care of a patient's chest drainage system observes that the chest tube has become separated from the drainage device. What would be the first action that should be taken by the nurse in this situation?

Select one of the following:

  • Notify the physician

  • Apply an occlusive dressing on the site

  • Assess the patient for signs of respiratory distress

  • Put on gloves and insert the chest tube in a bottle of sterile saline

Explanation

Question 19 of 50

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An emergency department nurse is using a manual resuscitation bag (Ambu bag) to assist ventilation in a patient with lung cancer who has stopped breathing on his own. What is an appropriate step in this procedure?

Select one of the following:

  • Tilt the patient's head forward

  • Hold the mask tightly over the patient's nose and mouth

  • Pull the patient's jaw backward

  • Compress the bag twice the normal respiratory rate for the patient

Explanation

Question 20 of 50

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Which assessments and interventions should the nurse consider when performing tracheal suctioning?

Select one or more of the following:

  • Closely assess the patient before, during and after the procedure.

  • Hyperoxigenate the patient before and after suctioning

  • Limit the application of suction to 20 to 30 seconds

  • Monitor the patient's pulse frequently to detect potential effects of hypoxia and stimulation of the vagus nerve

  • Use an appropriate suction measure (80-150 mm Hg)

  • Insert the suction catheter to further than 1cm past the length of the trachea or endotracheal tube

Explanation

Question 21 of 50

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Risks of tracheal suctioning include: , , , , and .

Explanation

Question 22 of 50

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The airway begins at the and ends at the .

Explanation

Question 23 of 50

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Each lung is divided into two . Each lobe is subdivided into or .

Explanation

Question 24 of 50

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The main branches to each lung from the . It subdivides into , they subdivide again and again becoming smaller and smaller. The smallest of these branches are the , ending at the .

Explanation

Question 25 of 50

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The ( visceral, parietal ) pleura covers the lung, and the ( parietal, visceral ) pleura lines the thoracic cavity.

Explanation

Question 26 of 50

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Pressure w/in the pleural space ( ) is always (a negative pressure).

Explanation

Question 27 of 50

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( Inspiration, Expiration ) is the active phase, ( expiration, inspiration ) is the passive phase.

Explanation

Question 28 of 50

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During : the contracts and descends, lengthening the throracic cavity; the muscles contract, lifting the ribs upward and outward; and the is pushed forward enlarging the chest. This combination of an increased lung volume and decrease of pressure allows air to move in from an area of greater pressure (outside air) into an area of lesser pressure (w/in the lungs). The relaxation or of these structures then results in . This causes a volume in the lungs and an increased in pressure.

Explanation

Question 29 of 50

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The respiratory center is located in the in the . It is stimulated by an increased concentration of and , and to a lesser degree, by the decreased amount of in the arterial blood. In addition chemoreceptors in the and bodies are also sensitive to the same and can activate the medulla.

Explanation

Question 30 of 50

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Atria receive blood from the veins: superior/inferior and the left/right .

Explanation

Question 31 of 50

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Contractions of the heart start in the , followed by contraction of the , with a subsequent resting of the .

Explanation

Question 32 of 50

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Deoxygenated blood flows from the ( right, left ) side of the heart to the lungs.

Explanation

Question 33 of 50

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Oxygenated blood is returned to the ( left, right ) side of the heart and pumped out to all other parts of the body.

Explanation

Question 34 of 50

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% of oxygen is carried by red blood cells as part of in the form of . Hemoglobin also carries in the form of carboxyhemoglobin.

Explanation

Question 35 of 50

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Be alert for the possibility of or when administering any narcotic or sedative.

Explanation

Question 36 of 50

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Generalized has been show to cause enough bronchospasm to produce an episode of bronchial asthma.

Explanation

Question 37 of 50

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Be aware of the patient's level before evaluating oxygen saturation because the test measures only the percentage of oxygen carried by the available hemoglobin. Thus even a patient with a hemoglobin level could appear to have a SpO2, because most of that hemoglobin is saturated. However the patient may not have enough oxygen to meet body needs. A range of % to % is considered normal SpO2; values <= % are abnormal.

Explanation

Question 38 of 50

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The max amt of fluid removed with Thoracentesis is generally mL.

Explanation

Question 39 of 50

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People who work hard at breathing often do not have much energy for . Many of the medications used for treatment can cause and .

Explanation

Question 40 of 50

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Research has demonstrated that, in patients with pulmonary disease who are acutely ill, turning to the position on a regular basis promotes oxygenation. In this position the posterior dependent sections of the lungs are better ventilated and perfused.

Explanation

Question 41 of 50

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Patients can help keep their secretions thin by drinking to quarts ( L - L) of clear fluids daily. However, encourage patients with heart failure and low sodium levels to limit their fluid intake to L / day.

Explanation

Question 42 of 50

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Some health care providers consider adequate intake and air as effective expectorants.

Explanation

Question 43 of 50

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Suctioning irritates the mucosa and removes from the respiratory tract, possibly causing hypoxemia. Thus it is important to the patient before suctioning.

Explanation

Question 44 of 50

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In an situation the absence of a should not delay the administration of oxygen to the patient.

Explanation

Question 45 of 50

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Removal of chest tubes can be a painful and stressful process for patients. Whenever possible, administer prior to the tube removal and apply to the chest.

Explanation

Question 46 of 50

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The airway is used to keep the tongue clear of the airway.

Explanation

Question 47 of 50

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A airway is inserted through the nare and protrudes into the back of the pharynx. The allows for frequent suctioning without trauma to the nasal passageway.

Explanation

Question 48 of 50

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Patients w/tracheostomies frequently have an infective mechanism and copious .

Explanation

Question 49 of 50

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Exercise care when changing the ties to prevent accidental decannulation or of the tube.

Explanation

Question 50 of 50

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During tracheal suctioning: to prevent hypoxia, before/after suctioning and limit the application of suction to seconds. Suction catheter should be limited to no further than past the length of the tracheal/endotrachel tube to avoid damage.

Explanation

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