Download NSE 221 WEEK 1 WITH COMPLETE SOLUTIONS 100% VERIFIED!! and more Exams Nursing in PDF only on Docsity!
NSE 221 WEEK 1 WITH COMPLETE SOLUTIONS 100%
VERIFIED!!
what is oxygenation - ANSWER process of delivering oxygen to the blood.
- needed to sustain life
- occurs by mechanisms of ventilation, perfusion, and transport of resp. gas
how do we normally oxygenate our body - ANSWER cardiac and respiratory system work together to ventilate and perfuse
Factors affecting oxygenation - ANSWER physiological:
- decreased O2 carrying capacity
- decreased inspired [O2]
- hypovolemia
- increased metabolic rate
conditions affecting chest wall:
- pregnancy
- obesity
- musculokeletal abnormalities
- trauma
- neuromuscular diseases
- CNS alterations
- chronic diseases
define hyperventilation - ANSWER Ventilation that exceeds needs of the body, lowering blood CO2 levels.
define hypoventilation - ANSWER inadequate ventilation needed to meet body's O demand/eliminate CO
define hypoxia - ANSWER inadequate tissue oxygenation at the cellular level
define cyanosis - ANSWER a bluish discoloration of the ski or mucous membranes resulting from poor circulation or inadequate oxygenation of the blood.
nursing management of pts when impaired oxygenation - ANSWER - promotion of lung expansion
- management of dsypnea
- maintenance of airway
define dyspnea - ANSWER shortness of breath (SOB)
what is postural drainage - ANSWER - positioning techniques that move lung secretions into the trachea
what is the postural drainage position for right lower lobe, posterior - ANSWER Prone in Trendelenburg's position with abdomen and thorax elevated
T or F: suctioning techniques may be used if a pt is unable to clear secretions with coughing - ANSWER TRUE
complete 5-10 breaths per session
encourage pt to cough
how often do you encourage an incentive spirometer - ANSWER Q1h while awake
what is pursed lip breathing - ANSWER involves deep inspiration and prolonged expiration through pursed lips to prevent alveolar collapse
what are coughing techniques - ANSWER - maintain airway patency by removing upper/lower airway secretions
- include: deep inhalation, closure of the glottis, active contraction of expiratory muscles, and glottis opening
causes of decreased O2 carrying capacity - ANSWER - anemia (lack of healthy RBC to carry O2)
- inhalation of toxic substances (CO)
causes of decreased inspired [O2] - ANSWER - upper or lower airway obstructions preventing ventilation
- decreased environmental O
- incorrect O2 therapy setting
causes of hypovolemia - ANSWER - shock
- severe dehydration (loss of ECF)
causes of increased metabolic rate - ANSWER - pregnancy
how does pregnancy affect chest wall mov. - ANSWER - development of fetus > larger uterus > pushes against diaphragm
how does obesity affect chest wall mov. - ANSWER - heavy lower thorax and abdomen
how do musculoskeletal abnormalities affect chest mov. - ANSWER - abnormal structural configurations (ribs or vertebral column)
- trauma
- muscular disease
- CNS disease
how does trauma affect chest wall mov. - ANSWER rib fractures > flail chest > instable chest wall
lungs contact w inspiration and expand with expiration > hypoxia
how does neuromuscular disease affect chest wall mov. - ANSWER - muscular dystrophy > cant expand/contract chest wall
how does CNS alterations affect chest wall mov. - ANSWER - damage to medulla oblongata and spinal cord
how do chronic diseases affect chest wall mov. - ANSWER direct consequence of chronic disease, or secondary (anemia > polycthyemia response)
different types of coughing techniques - ANSWER - deep breathing and coughing
what is the highest [o2] you can give on nasal prongs - ANSWER 6L/min
T or F: student nurses can give up to 2.5L of O2 on nasal prongs - ANSWER FALSE: students can only provide up to 2L
what is the percent oxygen for 1-2 L/min (nasal canula) - ANSWER 24-28%
what is the amount of O2 given for 24-28% o2 (nasal canula) - ANSWER 1-2 L
what is the percent oxygen for 3-4 L/min (nasal canula) - ANSWER 32-36%
what is the amount of O2 given for 32-36% o2 (nasal canula) - ANSWER 3-4 L/min
what is the percent oxygen for 5-6 L/min (nasal canula) - ANSWER 40-44%
what is the amount of O2 given for 40-44% o2 (nasal canula) - ANSWER 5-6L/min
what is the percent oxygen for 5-6 L/min (simple face mask) - ANSWER 40L%
what is the percent oxygen for 6-7 L/min (simple face mask) - ANSWER 50%
what is the percent oxygen for 7-8 L/min (simple face mask) - ANSWER 60%
what is the percent oxygen for 4L/min (venturi mask) - ANSWER 24-28%
what is the percent oxygen for 8L/min (venturi mask) - ANSWER 35-40%
what is the percent oxygen for 12L/min (venturi mask) - ANSWER 50-60%
what is the highest amount of o2 you can give on a venturi mask - ANSWER 12L/min at 50-60% o
what is the highest amount of o2 you can give on a simple face mask - ANSWER 7-8L/min at 60% o
what SpO2 range do COPD pt's need to be - ANSWER 88-92%
what percent of o2 is in room air - ANSWER 21%
what do you need to teach your pt when they are using nasal prongs? - ANSWER remind pt's to breath through their nose
should you put a simple oxygen face mask onto COPD patients? - ANSWER NO! - CO will build up, concentrations can be too high
a pt using a nasal prong complains about having a "crusty and bleeding nose" what do you do - ANSWER humidify the nose (attach sterile water to the o2)
T or F: pt's with nasal prongs are at risk of skin breakdown - ANSWER TRUE: under the nose and behind the ears
- ensure that the tube isnt too tight
- place gauze/padding on the back of ears
indications/pros for nasal cannula - ANSWER - for mobile or restless pts
- safe, simple, comfortable
- first options with pt's w low O
cosn of simple face masks - ANSWER - less comfortable > tight seal on face
- cant use while eating/drinking
- not tolerated well
- pressure injury on face due to seal and moisture trapped
- must wash/dry skin under mask q2h
T or F: CO2 can accumulate in a simple face mask - ANSWER TRUE
indications/pros of partial rebreathers - ANSWER - lightweight, easy to use
- O2 conserved in a reservoir bag
- good when blood [O2] needs to be raised
cons of partial rebreathers - ANSWER - cant be used when a high degree of humidity is required
- not recommended for COPD pts
- never use w a nebulizer
T or F: it is fine if the rebreather or nonrebreather bag deflates during inspiration - ANSWER FALSE - want to avoid this
indications/pros of nonrebreathers - ANSWER - accurate delivery of highly [O2]
- valve is present to prevent expired air from flowing back into the bag
cons of nonrebreathers - ANSWER - cant be used when a high degree of humidity is required
- tight seal needed > pressure injury
indications/pros of venturi mask - ANSWER - precise, high flow of O
- lightweight, shaped to fit the face
- can be humidified
- can talk > muffled
- good for COPD
cons of venturi mask - ANSWER - need to change the individual valves
- uncomfortable, cant be used while eating
- similar disadvantages as simple face mask
- need to check if the ports are occluded
define humifidication - ANSWER - adding water to gas
- moisten airways and removes secretions
- using nebulizers, vapotherm, bubble-through humidifiers
define nebulization - ANSWER - adding medication to the air/o
discharge planning on o2 therapy - ANSWER - can the pt ambulate with o2?
- assess the need for home o
define o2 toxicity - ANSWER - occur with overdosage or prolonged exposure to high lvls of O
- damage to alveolar capillary membrane
- inactivates surfactant
what is considered a high lvl of O2 - ANSWER >50%
- record which o2 delivery device is used, litre flow
- pt response (subjective and objective)
- client and family education
