Exam (elaborations)
NRSG 201 FINAL EXAM WITH ALL QUESTIONS AND ANSWERS
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NRSG 201 FINAL EXAM WITH ALL QUESTIONS AND ANSWERS...
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If the disease affects the lungs, how can or does this affect other bodysystems? - ANSWER -Ability to exchange gases
-In pain and immobile; high risk for pneumonia (post-surgical)
-COPD; Emphysema and bronchitis
-Pulmonary fibrosis; asbestos
-Lung Ca.
What are some respiratory sounds that may be heard during an
assessment? - ANSWER -Wheezes
-Crackles (coarse/fine)
-Stridor
-Rhonchi
What are some potential complications for medical and surgical clients
to respiratory? - ANSWER -Pneumonia
-Hypoxia
How does age affect tissue oxygenation? - ANSWER As we age...
- Chest wall more ridged and lungs less elastic and more air is retained
in the lungs at the end of each breath; therefore less air exchange
- We become at more risk for acute diseases and chronic diseases
How can environment affect tissue oxygenation? - ANSWER Altitude,
heat, cold, and air pollution
How can lifestyle affect tissue oxygenation? - ANSWER diet & exercise
When can a nurse administer oxygen therapy without a doctor's order? -
ANSWER in the event of hypoxemia
,What are some important things to do, in regards to nursing care, when
working with a respiratory patient? - ANSWER •Report changes in
respiratory decline
•Monitor for respiratory improvement or decline
•Document oxygen therapy intervention and changes
•Assess respiratory function prior to medications and for improvement
post medications
•Assess equipment condition
•Educate patient regarding oxygen care, medications, environmental
triggers
•? "SCENT" free hospital
If titrating oxygen, when do you need to check on the patient and what
do you need to do? - ANSWER 5 minutes after titrating & re-assess
(improvements?)
In regards to nursing care, what do you need to do when a patient is
receiving O2 via NP? - ANSWER •Nasal prongs: ensure patency,
correctly positioned
•Assess nares
•Assess ears for any irritations
•Ensure flowmeter working and set correctly
•Maintain settings as set-up by RT
•Thorough Respiratory Assessments
•With all devices NO SMOKING
•Check tubing - patient laying on tubing, does patient have long enough
tube to reach the bathroom- use extensions, take care to prevent falls
Should you use Vasaline to moisturize the nostrils of a patient receiving
O2 via NP? - ANSWER No
What are some important infection control measures when using O2? -
ANSWER •All O2 equipment is single patient use
•Tubing, masks & cannula are patient specific
•Label with date & patient's name
•Change when visibly soiled
•Change nebulizer tubing & mask weekly & prn
,What can O2 therapy prevent? - ANSWER hypoxia
What can O2 therapy facilitate? - ANSWER combustion
Who is oxygen therapy required for? - ANSWER •Patients who have
difficulty ventilating all areas of their lungs
•Patients whose gas exchange is impaired
•Patients with heart failure
How do we monitor/measure the oxygen levels? - ANSWER Pulse
oximetry (most common) - does not replace clinical presentation!
hypoxemia vs hypoxia - ANSWER Hypoxemia—low levels of oxygen in
the blood
Hypoxia—low levels of oxygen in the tissues
S&S of hypoxemia - ANSWER tachycardia,
tachypnea,
restlessness,
light-headedness,
agitation,
confusion,
increase WOB,
chest pain,
cyanosis
S&S of hypoxia - ANSWER depends where in the body is not receiving
O2
What usually leads to hypoxia? - ANSWER hypoxemia
What types of patients can have high SpO2 reading and still be hypoxic?
- ANSWER - anemic
- carbon monoxide poisioning
What can happen with a patient with chronically elevated PaCO2 and
O2 therapy? - ANSWER •ventilatory depression may occur if the
, patients PaO2 is increased to greater than 60 mmHg as hypoxic drive
may be effected
What is considered questionable practice in regards to COPD patients
and oxygen therapy? - ANSWER to withhold or provide inadequate O2
to meet the patients oxygen requirements just to keep the PaCO2 down
and/or pH up
Normal SpO2 for COPD patients - ANSWER 88%-90%
SpO2 normal range - ANSWER greater than 95%
SaO2 normal range - ANSWER 95-100%
PaCO2 normal range - ANSWER 35-45 mm Hg
PaO2 normal range - ANSWER 80-100 mm Hg
A healthy adults peak inspiratory flowrate is - ANSWER 35-40L/min
Which oxygen delivery systems are considered low flow? - ANSWER -
NP/NC (nasal cannula)
- SM (simple mask)
- NRM (non-rebreather mask)
- O2 tents (face tents)
What is the FiO2 with low flow oxygen devices? - ANSWER •With low
flow devices, air is also inhaled along with supplemental O2, therefore
the FiO2 will vary depending on the respiratory rate, tidal volume, and
litre flow
When documenting low flow O2, what unit do you document in? -
ANSWER L/min
What % O2 is room air? - ANSWER 21%
How much does the FiO2 (fraction of inspired O2) increase for every L of
oxygen delivered? - ANSWER 3%-4%
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