NSG 3130 EXAM 4 PREP – COMPLETE STUDY
GUIDE & PRACTICE EXAM
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NSG 3130 – FUNDAMENTAL CONCEPTS AND SKILLS FOR NURSING PRACTICE II
EXAM 4 PREP: CARDIOPULMONARY NURSING CARE
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=======
This comprehensive study guide and practice exam covers acute and chronic
cardiopulmonary nursing care, with an emphasis on oxygenation, circulation, respiratory
disorders, cardiac conditions, and advanced clinical management. All content is aligned
with the NCSBN Clinical Judgment Measurement Model (CJMM).
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PART 1: COMPREHENSIVE STUDY GUIDE
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SECTION 1: OXYGENATION & RESPIRATORY CARE
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=======
1.1 ASSESSING OXYGENATION STATUS
KEY VITAL SIGNS TO MONITOR:
,- Oxygen saturation (SpO2): Normal is 95–100%; below 90% is abnormal and requires
intervention
- Respiratory rate: Normal is 12–20 breaths/min
- Heart rate: Tachycardia may indicate hypoxia
- Blood pressure: May decrease in late-stage hypoxia
EARLY SIGNS OF HYPOXIA (FIRST SIGNS):
- Restlessness (often the FIRST sign)
- Anxiety
- Confusion
- Tachycardia
- Tachypnea
- Hypertension (early)
LATE SIGNS OF HYPOXIA:
- Cyanosis (bluish discoloration of skin/mucous membranes)
- Bradypnea (slow breathing)
- Decreased blood pressure
- Bradycardia
- Cardiac dysrhythmias
DEFINITIONS:
- Hypoxia = Decreased oxygen at the tissue level
- Hypoxemia = Decreased oxygen in the blood (low PaO2 or SpO2)
1.2 ARTERIAL BLOOD GASES (ABGs)
,ABGs are the gold standard for assessing gas exchange.
NORMAL ABG VALUES:
- pH: 7.35–7.45
- PaO2: 80–100 mmHg
- PaCO2: 35–45 mmHg
- HCO3 (Bicarbonate): 22–26 mEq/L
- Base Excess: -2 to +2 mEq/L
INTERPRETATION:
- Respiratory Acidosis: pH low, PaCO2 high (hypoventilation)
- Respiratory Alkalosis: pH high, PaCO2 low (hyperventilation)
- Metabolic Acidosis: pH low, HCO3 low (DKA, renal failure)
- Metabolic Alkalosis: pH high, HCO3 high (vomiting, diuretics)
1.3 OXYGEN DELIVERY DEVICES
NASAL CANNULA:
- Flow Rate: 1–6 L/min
- FiO2: 24–44%
- Best Used For: Mild hypoxemia, chronic lung disease
- Nursing Considerations: Provide humidification for flow >4 L/min
SIMPLE FACE MASK:
- Flow Rate: 5–8 L/min
, - FiO2: 40–60%
- Best Used For: Short-term therapy
- Nursing Considerations: Ensure 5 L/min minimum to prevent CO2 rebreathing
PARTIAL REBREATHER MASK:
- Flow Rate: 6–10 L/min
- FiO2: 60–75%
- Best Used For: Moderate hypoxemia
- Nursing Considerations: Reservoir bag should remain 1/3 to 1/2 full
NON-REBREATHER MASK:
- Flow Rate: 10–15 L/min
- FiO2: 80–95%
- Best Used For: Severe hypoxemia
- Nursing Considerations: Highest FiO2 without intubation; ensure bag does not deflate
completely
VENTURI MASK:
- Flow Rate: 4–10 L/min
- FiO2: 24–50%
- Best Used For: Precise O2 delivery (COPD patients at risk for CO2 retention)
- Nursing Considerations: Provides most precise FiO2; color-coded adapters
HIGH-FLOW NASAL CANNULA:
- Flow Rate: Up to 60 L/min
- FiO2: Up to 100%
GUIDE & PRACTICE EXAM
=========================================================================
=======
NSG 3130 – FUNDAMENTAL CONCEPTS AND SKILLS FOR NURSING PRACTICE II
EXAM 4 PREP: CARDIOPULMONARY NURSING CARE
=========================================================================
=======
This comprehensive study guide and practice exam covers acute and chronic
cardiopulmonary nursing care, with an emphasis on oxygenation, circulation, respiratory
disorders, cardiac conditions, and advanced clinical management. All content is aligned
with the NCSBN Clinical Judgment Measurement Model (CJMM).
=========================================================================
=======
PART 1: COMPREHENSIVE STUDY GUIDE
=========================================================================
=======
SECTION 1: OXYGENATION & RESPIRATORY CARE
=========================================================================
=======
1.1 ASSESSING OXYGENATION STATUS
KEY VITAL SIGNS TO MONITOR:
,- Oxygen saturation (SpO2): Normal is 95–100%; below 90% is abnormal and requires
intervention
- Respiratory rate: Normal is 12–20 breaths/min
- Heart rate: Tachycardia may indicate hypoxia
- Blood pressure: May decrease in late-stage hypoxia
EARLY SIGNS OF HYPOXIA (FIRST SIGNS):
- Restlessness (often the FIRST sign)
- Anxiety
- Confusion
- Tachycardia
- Tachypnea
- Hypertension (early)
LATE SIGNS OF HYPOXIA:
- Cyanosis (bluish discoloration of skin/mucous membranes)
- Bradypnea (slow breathing)
- Decreased blood pressure
- Bradycardia
- Cardiac dysrhythmias
DEFINITIONS:
- Hypoxia = Decreased oxygen at the tissue level
- Hypoxemia = Decreased oxygen in the blood (low PaO2 or SpO2)
1.2 ARTERIAL BLOOD GASES (ABGs)
,ABGs are the gold standard for assessing gas exchange.
NORMAL ABG VALUES:
- pH: 7.35–7.45
- PaO2: 80–100 mmHg
- PaCO2: 35–45 mmHg
- HCO3 (Bicarbonate): 22–26 mEq/L
- Base Excess: -2 to +2 mEq/L
INTERPRETATION:
- Respiratory Acidosis: pH low, PaCO2 high (hypoventilation)
- Respiratory Alkalosis: pH high, PaCO2 low (hyperventilation)
- Metabolic Acidosis: pH low, HCO3 low (DKA, renal failure)
- Metabolic Alkalosis: pH high, HCO3 high (vomiting, diuretics)
1.3 OXYGEN DELIVERY DEVICES
NASAL CANNULA:
- Flow Rate: 1–6 L/min
- FiO2: 24–44%
- Best Used For: Mild hypoxemia, chronic lung disease
- Nursing Considerations: Provide humidification for flow >4 L/min
SIMPLE FACE MASK:
- Flow Rate: 5–8 L/min
, - FiO2: 40–60%
- Best Used For: Short-term therapy
- Nursing Considerations: Ensure 5 L/min minimum to prevent CO2 rebreathing
PARTIAL REBREATHER MASK:
- Flow Rate: 6–10 L/min
- FiO2: 60–75%
- Best Used For: Moderate hypoxemia
- Nursing Considerations: Reservoir bag should remain 1/3 to 1/2 full
NON-REBREATHER MASK:
- Flow Rate: 10–15 L/min
- FiO2: 80–95%
- Best Used For: Severe hypoxemia
- Nursing Considerations: Highest FiO2 without intubation; ensure bag does not deflate
completely
VENTURI MASK:
- Flow Rate: 4–10 L/min
- FiO2: 24–50%
- Best Used For: Precise O2 delivery (COPD patients at risk for CO2 retention)
- Nursing Considerations: Provides most precise FiO2; color-coded adapters
HIGH-FLOW NASAL CANNULA:
- Flow Rate: Up to 60 L/min
- FiO2: Up to 100%
