NRSG 2500 Unit 6 Exam Questions and Answers Graded A+
PaO2 in ARF - Answers Less than 50
PaCO2 in ARF - Answers Greater than 50
S/S of ARF - Answers Mismatch V/Q, restlessness, fatigue, headache, air hunger, tachycardia, increased
BP
Example of Absolute Shunting - Answers ARDS
Example of High Ratio - Answers Cardiogenic Shock
Acute Respiratory Distress Syndrome (ARDS) definition - Answers Syndrome characterized by sudden,
progressive pulmonary edema, increasing bilateral infiltrates on CXR, hypoxemia refractory to oxygen
therapy, decreased lung compliance
S/S of ARDS - Answers Rapid onset of severe dyspnea, restlessness, tachycardia, hypoxemia that does
not respond to supplemental oxygen, BNP less than 100
Management of ARDS - Answers Intubate and Ventilate!
PEEP
Positioning- frequent position changes (prone is best)
Nutritional support- enteral or TPN
Oral care
Skin care
ROM
Flail Chest - Answers Chest wall moves paradoxically with respiration as a result of multiple fractures of
the ribs
Venturi Mask - Answers The most accurate way to deliver oxygen and is primarily used for patients with
COPD. It provides appropriate levels, thus avoiding the risk of suppressing the hypoxic drive.
Nonrebreathing Mask - Answers A face mask and reservoir bag device that delivers high concentrations
of oxygen. The patient's exhaled air escapes through a valve and is not rebreathed.
Partial Rebreathing Mask - Answers A mask similar to the nonrebreathing mask but without a one-way
valve between the mask and the reservoir; room air is not drawn in with inspiration; residual expired air
is mixed in the mask and rebreathed.
Concentration of Oxygen in Room Air - Answers 20-21%
, Oxygen Toxicity Cause - Answers Oxygen concentrations greater than 50% for extended periods of time
(longer than 24 hours) can cause an overproduction of free radicals that severely damage cells.
S/S of Oxygen Toxicity - Answers Substernal discomfort
Parasthesias
Dyspnea
Restlessness
Fatigue
Malaise
Progressive respiratory difficulty
Refractory hypoxemia
Alveolar atelectasis
Alveolar infiltrates on X-ray
Prevention of Oxygen Toxicity - Answers Use lowest effective concentrations of oxygen:
PEEP or CPAP prevent or reverse atelectasis and allow lower oxygen percentages to be used
Complication of Oxygen Toxicity in preemies - Answers Retinopathy
Endotracheal Intubation - Answers Placement of a tube through the nose or mouth into the trachea to
provide a patent airway for mechanical ventilation and removal of secretions
Things that should be done immediately after intubation - Answers Check symmetry of chest expansion
Auscultate breath sounds
Verify placement with a chest x-ray
Endotracheal Intubation Position - Answers 2cm above the carina
Head of Bed positioning for Intubated Patients - Answers 30-45 degrees
This will help prevent ventilator acquired pneumonia (VAP).
Complications of Inadvertent Removal of an Endotracheal Tube - Answers Laryngeal swelling
Hypoxemia
Bradycardia
PaO2 in ARF - Answers Less than 50
PaCO2 in ARF - Answers Greater than 50
S/S of ARF - Answers Mismatch V/Q, restlessness, fatigue, headache, air hunger, tachycardia, increased
BP
Example of Absolute Shunting - Answers ARDS
Example of High Ratio - Answers Cardiogenic Shock
Acute Respiratory Distress Syndrome (ARDS) definition - Answers Syndrome characterized by sudden,
progressive pulmonary edema, increasing bilateral infiltrates on CXR, hypoxemia refractory to oxygen
therapy, decreased lung compliance
S/S of ARDS - Answers Rapid onset of severe dyspnea, restlessness, tachycardia, hypoxemia that does
not respond to supplemental oxygen, BNP less than 100
Management of ARDS - Answers Intubate and Ventilate!
PEEP
Positioning- frequent position changes (prone is best)
Nutritional support- enteral or TPN
Oral care
Skin care
ROM
Flail Chest - Answers Chest wall moves paradoxically with respiration as a result of multiple fractures of
the ribs
Venturi Mask - Answers The most accurate way to deliver oxygen and is primarily used for patients with
COPD. It provides appropriate levels, thus avoiding the risk of suppressing the hypoxic drive.
Nonrebreathing Mask - Answers A face mask and reservoir bag device that delivers high concentrations
of oxygen. The patient's exhaled air escapes through a valve and is not rebreathed.
Partial Rebreathing Mask - Answers A mask similar to the nonrebreathing mask but without a one-way
valve between the mask and the reservoir; room air is not drawn in with inspiration; residual expired air
is mixed in the mask and rebreathed.
Concentration of Oxygen in Room Air - Answers 20-21%
, Oxygen Toxicity Cause - Answers Oxygen concentrations greater than 50% for extended periods of time
(longer than 24 hours) can cause an overproduction of free radicals that severely damage cells.
S/S of Oxygen Toxicity - Answers Substernal discomfort
Parasthesias
Dyspnea
Restlessness
Fatigue
Malaise
Progressive respiratory difficulty
Refractory hypoxemia
Alveolar atelectasis
Alveolar infiltrates on X-ray
Prevention of Oxygen Toxicity - Answers Use lowest effective concentrations of oxygen:
PEEP or CPAP prevent or reverse atelectasis and allow lower oxygen percentages to be used
Complication of Oxygen Toxicity in preemies - Answers Retinopathy
Endotracheal Intubation - Answers Placement of a tube through the nose or mouth into the trachea to
provide a patent airway for mechanical ventilation and removal of secretions
Things that should be done immediately after intubation - Answers Check symmetry of chest expansion
Auscultate breath sounds
Verify placement with a chest x-ray
Endotracheal Intubation Position - Answers 2cm above the carina
Head of Bed positioning for Intubated Patients - Answers 30-45 degrees
This will help prevent ventilator acquired pneumonia (VAP).
Complications of Inadvertent Removal of an Endotracheal Tube - Answers Laryngeal swelling
Hypoxemia
Bradycardia
