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NUR 3310 Exam Questions And Answers
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NUR 3310 Exam Questions And Answers...
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NUR 3310 Exam Questions And AnswersDefinition of APO - ANSWER abnormal collection of fluid in the lung interstitium, the
alveolar space or both, affect gas exchange and reduce lung compliance
4 Causes of APO(cardiogenic) - ANSWER 1. heart failure
2. AMI
3. acute arrhythmia
4. acute valvular dysfunction
Clinical Manifestations of APO (4) - ANSWER - crackles
- tachycardia
- tachypnoea/ dyspnoea
- sudden onset of SOB
Pathophysiology of Cardiogenic APO - ANSWER Pressure increases within the heart >
decrease in CO despite increase in SVR; more blood returning to the left atrium, yet
failed to pump out from the left ventricle, results in an increased pulmonary venous
pressure thus increasing the pulmonary hydrostatic pressure --> pushing fluid into the
interstitial space
Clinical Manifestation of PE - ANSWER 1. Sudden onset of pleuritic Chest pain
2. Dyspnoea
3. Haemoptysis (coughing Blood)
4. Hypoxaemia
Identify 3 risk factors for PE (give 1 example each) - ANSWER 1. endothelial injury
(atherosclerosis, trauma)
,2. hypercoagulability (cancer, oral contraceptives )
3. venous stasis (immobility)
What is PE? - ANSWER A partial or complete obstruction in the pulmonary arteries
which can resulted from blood clot, fat, tumor or air
Why does PE develops hypoxaemia? - ANSWER The blockage in the pulmonary arteries
causes V/Q mismatch that increased in dead space as perfusion decrease. Less gas
exchange
Why does PE develops pleuritic chest pain? - ANSWER Prolonged deprivation of oxygen
causes infarction of lung tissue and the release of inflammatory mediators causes
irritation in the lung
Priority nursing considerations for PE (3) - ANSWER 1. anticoagulation
2. thrombolysis
3. pain relief
Indication of anticoagulation of PE - ANSWER prevent the formation of new thrombi and
allow endogenous fibrinolysis to take effect on the thrombus
Indication of thrombolysis of PE - ANSWER - used in massive PE/ hemodynamically
unstable PE
- time critical (within 4hours, useful for current PE)
Describe NIPPV (non-invasive positive pressure ventilation) - ANSWER Provide
ventilation for spontaneously breathing patient under positive pressure
High flow oxygen delivery system- A device that provides an oxygen flow rate higher
than the peak inspiratory flow demand of a patient. This allows a fixed FiO2 to be
delivered to the patient irrespective of the patient's RR and tidal volume
, Common indications for use of NIPPV- APO (cardiogenic)
-moderate to severe resp. distress
-COPD (acute exacerbation)
-SpO2 <90%
Two types of NIPPV 1. continuous positive airway pressure (CPAP)
2. BiPAP
Contraindications of using NIPPV (5) - ANSWER - uncooperative/ extreme anxiety/
depressed LOC
- unable to secure patent airway
- MI/ unable angina
- copious resp. secretions
- pneumothorax
Complications of NIPPV - ANSWER - hypotension
- myocardial ischaemia
- altered conscious state
- gastric distension
Why does NIPPV can cause hypotension? - ANSWER Increase in intrathoracic pressure,
decrease venous return and decrease CO
Why does NIPPV may worsen myocardial ischaemia? - ANSWER increase intrathoracic
pressure, decrease coronary perfusion
Why does NIPPV may cause altered conscious state? - ANSWER Increase intrathoracic
pressure, decrease CO, decrease cerebral perfusion
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