Medical Surgical Nursing Test 2
Questions and Correct Answers the
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Hypoxemia
✓ low levels of oxygen in the blood
Hypoxia
✓ decreased tissue oxygenation
Indications of Hypoxia
✓ Dyspnea
✓ Nasal flaring
✓ Use of accessory muscles
✓ Purse lipped or diaphragmatic breathing
✓ Decreased endurance
✓ Skin, mucous membrane changes (pallor, cyanosis)
ABG analysis
✓ best way to determine oxygen needs
O2 Hazards
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✓ Combustion
✓ Oxygen-induced hypoventilation
✓ Hypercarbia—retention of CO2
✓ CO2 narcosis—loss of sensitivity to high levels of CO2
✓ Oxygen toxicity
✓ Absorption atelectasis—new onset of crackles/decreased breath sounds
✓ Drying of mucous membranes
✓ Infection
Hypercarbia
✓ retention of CO2
CO2 narcosis
✓ loss of sensitivity to high levels of CO2
Absorption atelectasis
✓ new onset of crackles/decreased breath sounds
Home oxygen requirements
✓ Importance of accuracy and control of oxygen concentration-compressed gas tank, liquid
O2 in reservoir, O2 concentrator
Home oxygen needs
✓ Patient comfort
✓ Importance of humidity
✓ Patient mobility
Low flow O2 delivery methods
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✓ nasal cannula, face mask, simple and nonrebreather
Nasal cannula
✓ Flow rates of 1-6 L/min
✓ O2 concentration of 24%-44% (1-6 L/min)
✓ Flow rate >6 L/min does not increase O2 because anatomical dead space is full
✓ Assess patency of nostrils
✓ Assess for changes in respiratory rate and depth
✓ May need humidification for >3L/min flow rate
Face mask
✓ Delivers O2 up to 40%-60%
✓ Minimum of 5 L/min
✓ Monitor closely for risk of aspiration
Partial nonrebreather
✓ Provides 60%-75% with flow rate of 6-11 L/min
✓ One-third exhaled tidal volume with each breath
✓ Adjust flow rate to keep reservoir bag inflated
Nonrebreather mask
✓ Highest O2 level
✓ Can deliver FIO2 greater than 90%
✓ Used for unstable patients requiring intubation
✓ Ensure valves are patent and functional
Priority problems with oxygenation
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✓ • Reduced oxygenation
✓ • Inadequate communication
✓ • Inadequate nutrition
✓ • Potential for infection
Tracheostomy types
✓ Cuffed or non-cuffed, fenestrated
Tracheostomy complications
✓ Tube obstruction/dislodgement
✓ Pneumothorax, Subcutaneous emphysema, bleeding, infection
Complications of suctioning
✓ Hypoxia, tissue trauma, infection, vagal stimulation, bronchospasm, Cardiac dysrhythmias
from induced hypoxia
Nutrition with Tracheostomy
✓ • Swallowing can be a major problem for patients with tracheostomy tube
Tracheostomy positioning
✓ • Elevate head of bed for at least 30 min after eating to prevent aspiration during
swallowing
Passey Muir
✓ swallowing speaking valves
Tracheostomy tube weaning
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