QUESTIONS AND CORRECT DETAILED ANSWERS
(VERIFIED ANSWERS) |ALREADY GRADED
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COPD and oxygenation - CORRECT ANSWER- -these pts have adapted to a high level of CO2, so
the CO2 sensitive receptors do not function
-COPD pts stimulus to breathe is low O2, while normally it is high CO2
-receptors in the aortic arch and carotid bodies are sensitive to low O2 level causing increased
ventilation when low O2
-SO, administering high levels of O2 to these pts prevents their O2 level from falling and
stimulating the receptors, which REMOVES THEIR STIMULUS TO BREATHE
hyper and hypo ventilation - CORRECT ANSWER- hyper- breathing in excess of what is required
to remove CO2
hypo- inadequate breathing to meet bodys O2 demands or needs to eliminate CO2
nursing notes on oxygenation - developmental factors - CORRECT ANSWER- -mental status
changes are 1st sign of respiratory problem
-may not complain of dyspea until it affects ADLs
- changes in coughing mechanism may lead to retention of secretions and atelectasis (when
using cough suppressants)
,-diminshed respiratory muscles from changes in thorax lead to issues w chest expansion
nursing note on oxygenation - lifestyle - CORRECT ANSWER- smoking (heart disease, COPD,
lung cancer), substance abuse (impairs tissue perfusion), stress (increases metabolic rate and
oxygen demand of the body)
nursing note on oxygenation - environmental factors - CORRECT ANSWER- the incidence of
pulmonary disease is higher in smoggy, urban areas
-work place risks include asbestosis, coccidiodomycosis
thorough assessment of oxygenation and systems - CORRECT ANSWER- past impairments of
circulatory or respiratory function, methods pt uses to optimize oxygenation, review of
allergies, physical examination, lab and diagnostic tests.
-HX of chest pain, dyspnea, wheezing, resp. infections, meds, fatigue, cough, smoking,
exposures
-EXAMINE skin and mucous membranes, LOC, breathing patterns, chest wall movement,
palpate chest, feet, legs, pulses, auscultate heart and lung sounds
how to assess breath sounds - CORRECT ANSWER- rate, volume (shallow or deep), rhythm
(regular or irregular), effort, AP:LAT diameter (1:2), cough (productive or not) - amt., color,
consistency, odor
what causes decreased or absent breath sounds - CORRECT ANSWER- pneumothorax,
emphysema, removed lung lobes, obstruction, atelectasis
difference between hypoxia and hypoxemia - CORRECT ANSWER- hypoxia - inadequate tissue
oxygenation at cell level
hypoxemia - low level of oxygen in arterial blood
,what is a more invasive way than pulse oximetry of determining level of oxygenation -
CORRECT ANSWER- arterial blood gases (ABGs) - invasive way to measure partial pressure of
O2 in blood. NORMAL 80-100
what does the use of accessory muscles indicate - CORRECT ANSWER- an attempt to increase
lung volume that results in fatigue is not effective ventilation. indicates ventilatory fatigue, air
hunger, or decreased lung expansion
how does oxygenation of tissues take place - CORRECT ANSWER- ventilation; the process of
moving gases into and out of the lungs
perfusion; the cardiovascular system pumping oxygenated blood to the tissues and return
deoxygenated blood to the lungs
diffusion; exchange of respiratory gases in the alveoli and capillaries
how are respirations regulated (chemical and neural) - CORRECT ANSWER- neural regulation-
CNS controls the respiratory rate, depth, and rhythm and cerbral cortex control voluntary
respirations
chemical regulation - maintains the rate and depth of respirations based on changes in the
blood concentrations of CO2 and O2 and in pH, SO the chemoreceptors sense these changes in
chemicals and stimulate the nervous system to adjust
Factors affecting oxygenation - physiology - CORRECT ANSWER- decreased o2 carrying
capacity, hypovolemia (low blood volume, less hemoglobin to carry O2 through vessels),
decreased inspired O2 conc., increased metabolic rate (infection, sepsis),
factors affecting oxygenation - chest wall movement - CORRECT ANSWER- prgnancy, obesity,
neuromuscular disease, musculoskeletal deformities, trauma, alterations to CNS
, acute hypoxia - CORRECT ANSWER- SUDDEN - causes? - obstructed airway, pulmonary
embolism, impaired ventilation (asthma, pneumonia)
SX- anxious, sitting up, increased RR and HR, confusion, behavior changes, nasal flaring -
cyanosis is a late sign
chronic hypoxia - CORRECT ANSWER- long term - Causes? - COPD, anemia, impaired
ventilation, cardiac abnormalities
SX- fatigue, lethargy, clubbed fingers, barrel chest, SOA, paroxysmal nocturnal dyspnea,
orthopnea, activity intolerance
define orthopnea - CORRECT ANSWER- shortness of breath that occurs when lying flat
an H+H diagnostic blood test - CORRECT ANSWER- hematocrit - % of total blood volume made
up by RBCs
MALE - 42-52% FEMALE - 37-47%
= decreased levels are called anemia
hemoglobin - iron containing pigment of RBC
MALE - 14-18 FEMALE 12-16
ways to promote oxygenation - CORRECT ANSWER- monitor hydration, humidification,
administer inhalant medications (expectorants, mucolytics, bronchodilators, anti inflammatory
agents), teach coughing and breathing, perform chest physiotherapy, suction airway, artificial
airways
what is a method that a nurse can teach the pt to do to increase air to lower lungs - CORRECT
ANSWER- diaphragmatic breathing - belly breathing