NSB336 Exam Questions With Complete Solutions
a reduction in oxygenation Correct Answers - the most
common reasons for a reduction in SaO2 is an imbalance
between the amount of ventilation compared to the amount of
circulation taking place in the alveoli (VQ mismatch)
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: cardiovascular Correct Answers - increased
mortality post-cardiac arrest with hyperoxia
- systematic vasoconstriction leading to increase SVR, increased
BP, decreased HR and decreased CO
- normobaric hyperoxia reducing coronary blood flow in patients
with coronary artery disease or chronic heart failure
- increased myocardial infarct size
- impairs endothelium-mediated vasodilation
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: cellular injury due to increase reactive oxygen
species Correct Answers - increased ROS (e.g. superoxide
anion, hydroxyl radical, hydrogen peroxide)
- ROS leads to inflammation and secondary tissue
injury/apoptosis
- can deplete cellular antioxidant defences
- reacts/impairs function of intracellular macromolecules
- can cause cell death
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: haematological Correct Answers - prolonged
exposure to 100% O2 impairs erythropoiesis
,adverse physiological effects secondary to hyperoxia and
oxygen toxicity: immune effects Correct Answers increased
risk of secondary lung infection due to impaired mucociliary
clearance and decreased bactericidal capacity of immune cells
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: neurological Correct Answers - acute toxicity
with hyperbaric 100% O2 causing altered moods and vertigo
and LOC and convulsions
- retinopathy of prematurity
- increased mortality with stroke and TBI
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: respiratory effects Correct Answers -
pulmonary vasodilation, resulting in VQ mismatch and CO2
retention in COPD
- haldane effect leading to decreased affinity of Hb for CO2, and
contributes to CO2 retention in COPD
- increased mortality in CO2 retainers from high flow O2
compared with titrated O2
- increased RR
- de-nitrogenation of the lungs, causing reabsorption atelectasis
- bronchopulmonary dysplasia
- O2 causing tracheal irritation, sore throat, substernal pain,
pulmonary congestion, decreased VC
- dry nose and mouth and increased susceptibility to mucous
plugging
aerobic vials for cultures (green) Correct Answers - fill this vial
first
,- air can be pulled into the aerobic vial first without
compromising the anaerobic vial
aerobic vs. anaerobic respiration Correct Answers - aerobic
respiration requires oxygen in order for ATP to be generated -
this is preffered as O2 is necessary to produce ATP which is
central for energy processes
- anaerobic respiration can occur in the absence of oxygen, but is
a less efficient form of metabolism that increases lactic acid in
the body
- anaerobic respiration occurs when oxygen access is
compromised or demand exceeds supply
- anaerobic respiration can use alternative energy sources (e.g.
fats, proteins)
- ABGs indicate the change from aerobic to anaerobic oxygen
- increased lectic acid decreases pH and thus the cells cannot
function optimally
- the brain cannot cope in anaerobic state
after initiating a MET call Correct Answers - ensure someone
can direct the MET team to the patient's location
- be ready to provide a handover (the patient, their reason for
admission, medical hx, what happened, treatments,
interventions, how they have been going, what happened today,
their current vitals, what interventions have been done, resus
status if known)
- who will contact family or support family if present
afterload Correct Answers - afterload is a measure of vascular
resistance, essentially providing an assessment of how
vasodilated or vasoconstricted the patient is
, - can be assessed non-invasively by consideration assessment
findings of capillary refill time, colour and warmth of
peripheries, urinary output, decreased quality of periphal pulses,
and reduced blood pressure
- vasoconstriction is an attempt to preserve blood pressure and
thus cardiac output
anaerobic vial for cultures (orange) Correct Answers - need to
not contaminate top of vial
- FILL THIS ONE SECOND, after adding blood sample to
aerobic vial
- air in the tubing or syringe can be pulled into anaerobic vial,
compromising the vial
- most bacteria leading to sepsis opt for aerobic environments
anatomy of a tracheostomy Correct Answers - flange: sits
against the skin and is where the tapes securing it in place are
tied to
- cuff: inflatable cushion filled by inserting air into the balloon,
sealing side of tracheal wall and limiting movement of air into
and out of lungs around it and micro-aspirations of saliva; cuff
pressure should be checked at least once a shift (~20-25cm)
- inner cannula: serves as safety device to limit impact and
potential for tracheostomy to become occluded; check to ensure
not blocked with sputum, and change to a clean one
- balloon: access port to inflate and deflate tracheostomy cuff,
where you need to attach device to monitor/assess cuff pressure
assessing response to IVF administration: blood pathology
Correct Answers - increased fluid administration should
a reduction in oxygenation Correct Answers - the most
common reasons for a reduction in SaO2 is an imbalance
between the amount of ventilation compared to the amount of
circulation taking place in the alveoli (VQ mismatch)
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: cardiovascular Correct Answers - increased
mortality post-cardiac arrest with hyperoxia
- systematic vasoconstriction leading to increase SVR, increased
BP, decreased HR and decreased CO
- normobaric hyperoxia reducing coronary blood flow in patients
with coronary artery disease or chronic heart failure
- increased myocardial infarct size
- impairs endothelium-mediated vasodilation
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: cellular injury due to increase reactive oxygen
species Correct Answers - increased ROS (e.g. superoxide
anion, hydroxyl radical, hydrogen peroxide)
- ROS leads to inflammation and secondary tissue
injury/apoptosis
- can deplete cellular antioxidant defences
- reacts/impairs function of intracellular macromolecules
- can cause cell death
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: haematological Correct Answers - prolonged
exposure to 100% O2 impairs erythropoiesis
,adverse physiological effects secondary to hyperoxia and
oxygen toxicity: immune effects Correct Answers increased
risk of secondary lung infection due to impaired mucociliary
clearance and decreased bactericidal capacity of immune cells
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: neurological Correct Answers - acute toxicity
with hyperbaric 100% O2 causing altered moods and vertigo
and LOC and convulsions
- retinopathy of prematurity
- increased mortality with stroke and TBI
adverse physiological effects secondary to hyperoxia and
oxygen toxicity: respiratory effects Correct Answers -
pulmonary vasodilation, resulting in VQ mismatch and CO2
retention in COPD
- haldane effect leading to decreased affinity of Hb for CO2, and
contributes to CO2 retention in COPD
- increased mortality in CO2 retainers from high flow O2
compared with titrated O2
- increased RR
- de-nitrogenation of the lungs, causing reabsorption atelectasis
- bronchopulmonary dysplasia
- O2 causing tracheal irritation, sore throat, substernal pain,
pulmonary congestion, decreased VC
- dry nose and mouth and increased susceptibility to mucous
plugging
aerobic vials for cultures (green) Correct Answers - fill this vial
first
,- air can be pulled into the aerobic vial first without
compromising the anaerobic vial
aerobic vs. anaerobic respiration Correct Answers - aerobic
respiration requires oxygen in order for ATP to be generated -
this is preffered as O2 is necessary to produce ATP which is
central for energy processes
- anaerobic respiration can occur in the absence of oxygen, but is
a less efficient form of metabolism that increases lactic acid in
the body
- anaerobic respiration occurs when oxygen access is
compromised or demand exceeds supply
- anaerobic respiration can use alternative energy sources (e.g.
fats, proteins)
- ABGs indicate the change from aerobic to anaerobic oxygen
- increased lectic acid decreases pH and thus the cells cannot
function optimally
- the brain cannot cope in anaerobic state
after initiating a MET call Correct Answers - ensure someone
can direct the MET team to the patient's location
- be ready to provide a handover (the patient, their reason for
admission, medical hx, what happened, treatments,
interventions, how they have been going, what happened today,
their current vitals, what interventions have been done, resus
status if known)
- who will contact family or support family if present
afterload Correct Answers - afterload is a measure of vascular
resistance, essentially providing an assessment of how
vasodilated or vasoconstricted the patient is
, - can be assessed non-invasively by consideration assessment
findings of capillary refill time, colour and warmth of
peripheries, urinary output, decreased quality of periphal pulses,
and reduced blood pressure
- vasoconstriction is an attempt to preserve blood pressure and
thus cardiac output
anaerobic vial for cultures (orange) Correct Answers - need to
not contaminate top of vial
- FILL THIS ONE SECOND, after adding blood sample to
aerobic vial
- air in the tubing or syringe can be pulled into anaerobic vial,
compromising the vial
- most bacteria leading to sepsis opt for aerobic environments
anatomy of a tracheostomy Correct Answers - flange: sits
against the skin and is where the tapes securing it in place are
tied to
- cuff: inflatable cushion filled by inserting air into the balloon,
sealing side of tracheal wall and limiting movement of air into
and out of lungs around it and micro-aspirations of saliva; cuff
pressure should be checked at least once a shift (~20-25cm)
- inner cannula: serves as safety device to limit impact and
potential for tracheostomy to become occluded; check to ensure
not blocked with sputum, and change to a clean one
- balloon: access port to inflate and deflate tracheostomy cuff,
where you need to attach device to monitor/assess cuff pressure
assessing response to IVF administration: blood pathology
Correct Answers - increased fluid administration should
