NUR 123 Exam 3 Practice Notes: Oxygenation,
Perfusion, Gastrointestinal, Hydration, Nutrition,
Neurological-Musculoskeletal Assessment, and
Pain Management
NUR 123 Exam 3 Practice Notes: Oxygenation,
Perfusion, Gastrointestinal, Hydration, Nutrition,
Neurological-Musculoskeletal Assessment, and
Pain Management
Oxygenation and Perfusion
Respiratory Anatomy & Physiology: The alveoli are the primary site of gas exchange within the
respiratory system.
Chronic Obstructive Pulmonary Disease (COPD): Characteristic physical findings include a
barrel chest due to hyperinflation of the lungs.
Asthma Management: Using a spacer with a metered dose inhaler (MDI) improves medication
delivery by increasing the amount of drug reaching the lungs.
Hypoxemia Assessment: Arterial blood gas (ABG) analysis is the most precise diagnostic tool to
measure oxygen levels in the blood.
Carotid Artery Assessment: Proper technique involves auscultation with the bell of the stetho-
scope to listen for bruits and palpation for thrills, avoiding simultaneous bilateral palpation to prevent
vagal stimulation.
Prevention of Clot Formation in Bedridden Patients: Encourage frequent position changes or
turning to enhance circulation and reduce clot risks.
Inspiratory Wheezing: This may be auscultated in conditions such as asthma, especially in the
lower posterior thorax.
Continuous Positive Airway Pressure (CPAP): Primarily used for patients diagnosed with sleep
apnea to maintain airway patency during sleep.
Oxygen Delivery Systems: For mouth breathers, a Venturi mask is appropriate as it provides
controlled oxygen delivery at a minimum concentration to prevent carbon dioxide retention.
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, Oxygenation Quality Confirmation for Pneumonia Patients: Objective indicators include mon-
itoring mental status, vital signs, and auscultating lung sounds critically.
Cardiopulmonary Assessment Areas: The five heart auscultation sites include Aortic, Pulmonic,
Tricuspid, Mitral, and the Angle of Louis as a landmark.
Normal Breath Sounds: Bronchial, vesicular, and bronchovesicular are normal. Crackles, rhonchi,
stridor, and wheeze typically indicate pathology.
Sensory Perception and Neurological Assessment
Sensory Receptor Function: Proprioceptors convey body position and response to stimuli; loss
may result in inability to identify limb position.
Anxiety Management in Patients: Strategies include dimming lights, reducing noise, and en-
gaging patients about comfort measures rather than distractions or immediate pharmacological
intervention.
Glasgow Coma Scale (GCS): Essential for assessing and planning care for patients with altered
levels of consciousness.
Highest Priority Nursing Diagnoses: Among multiple diagnoses, "Risk for injury" takes prece-
dence, especially in patients with altered neurological status.
Environmental Safety for Sensory Impairment: For patients with reduced olfaction, installing
smoke detectors on all levels is critical for safety.
Sensory Deprivation Signs: Depression and increased agitation in older adults with visual and
hearing loss point towards sensory deprivation effects.
Communication with Hearing Impaired Patients: Use visual cues and approach the patient from
the front quietly; shouting is discouraged as it can distort speech clarity.
Gastrointestinal System and Bowel Elimination
Dietary Recommendations for Constipation in Older Adults: Encourage intake of fruits, which
are rich in fiber.
Colon Cancer Screening: Colonoscopy is the most recommended direct visualization gastroin-
testinal study.
Promoting Peristalsis Post-Surgery: Early ambulation is encouraged to stimulate bowel motility.
Bowel Patterns: Dry, hard stools are indicative of constipation.
Types of Enemas and Uses:
• Medicated enemas deliver medication absorbed via the rectal mucosa.
• Cleansing enemas stimulate peristalsis and aid in evacuation.
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Perfusion, Gastrointestinal, Hydration, Nutrition,
Neurological-Musculoskeletal Assessment, and
Pain Management
NUR 123 Exam 3 Practice Notes: Oxygenation,
Perfusion, Gastrointestinal, Hydration, Nutrition,
Neurological-Musculoskeletal Assessment, and
Pain Management
Oxygenation and Perfusion
Respiratory Anatomy & Physiology: The alveoli are the primary site of gas exchange within the
respiratory system.
Chronic Obstructive Pulmonary Disease (COPD): Characteristic physical findings include a
barrel chest due to hyperinflation of the lungs.
Asthma Management: Using a spacer with a metered dose inhaler (MDI) improves medication
delivery by increasing the amount of drug reaching the lungs.
Hypoxemia Assessment: Arterial blood gas (ABG) analysis is the most precise diagnostic tool to
measure oxygen levels in the blood.
Carotid Artery Assessment: Proper technique involves auscultation with the bell of the stetho-
scope to listen for bruits and palpation for thrills, avoiding simultaneous bilateral palpation to prevent
vagal stimulation.
Prevention of Clot Formation in Bedridden Patients: Encourage frequent position changes or
turning to enhance circulation and reduce clot risks.
Inspiratory Wheezing: This may be auscultated in conditions such as asthma, especially in the
lower posterior thorax.
Continuous Positive Airway Pressure (CPAP): Primarily used for patients diagnosed with sleep
apnea to maintain airway patency during sleep.
Oxygen Delivery Systems: For mouth breathers, a Venturi mask is appropriate as it provides
controlled oxygen delivery at a minimum concentration to prevent carbon dioxide retention.
1/6
, Oxygenation Quality Confirmation for Pneumonia Patients: Objective indicators include mon-
itoring mental status, vital signs, and auscultating lung sounds critically.
Cardiopulmonary Assessment Areas: The five heart auscultation sites include Aortic, Pulmonic,
Tricuspid, Mitral, and the Angle of Louis as a landmark.
Normal Breath Sounds: Bronchial, vesicular, and bronchovesicular are normal. Crackles, rhonchi,
stridor, and wheeze typically indicate pathology.
Sensory Perception and Neurological Assessment
Sensory Receptor Function: Proprioceptors convey body position and response to stimuli; loss
may result in inability to identify limb position.
Anxiety Management in Patients: Strategies include dimming lights, reducing noise, and en-
gaging patients about comfort measures rather than distractions or immediate pharmacological
intervention.
Glasgow Coma Scale (GCS): Essential for assessing and planning care for patients with altered
levels of consciousness.
Highest Priority Nursing Diagnoses: Among multiple diagnoses, "Risk for injury" takes prece-
dence, especially in patients with altered neurological status.
Environmental Safety for Sensory Impairment: For patients with reduced olfaction, installing
smoke detectors on all levels is critical for safety.
Sensory Deprivation Signs: Depression and increased agitation in older adults with visual and
hearing loss point towards sensory deprivation effects.
Communication with Hearing Impaired Patients: Use visual cues and approach the patient from
the front quietly; shouting is discouraged as it can distort speech clarity.
Gastrointestinal System and Bowel Elimination
Dietary Recommendations for Constipation in Older Adults: Encourage intake of fruits, which
are rich in fiber.
Colon Cancer Screening: Colonoscopy is the most recommended direct visualization gastroin-
testinal study.
Promoting Peristalsis Post-Surgery: Early ambulation is encouraged to stimulate bowel motility.
Bowel Patterns: Dry, hard stools are indicative of constipation.
Types of Enemas and Uses:
• Medicated enemas deliver medication absorbed via the rectal mucosa.
• Cleansing enemas stimulate peristalsis and aid in evacuation.
2/6
