NURS 244 GAS EXCHANGE BD EXAM WITH
CORRECT SOLUTIONS
What is acute respiratory failure? - ANSWER Failure of gas exchange. Meaning it isn't
adequately providing oxygen to body and not removing CO2 well. Impaired lungs
What causes acute respiratory failure? - ANSWER Neuromuscular disorders, stroke,
pulomnary edema or emboli, chest trauma, pneumonia, ARDS, drug overdoses
Purpose for a V/Q scan - ANSWER Determining if a PE is present
What is a ventilation-perfusion mismatch? - ANSWER Imbalance between the air that
reaches alveoli (ventilation) and blood flow to alveoli (perfusion). Can be cardiac
disorder, PE, tension pneumo. Pneumonia.
Normal ventilation (V) - ANSWER 4L/min
Normal perfusion (Q) - ANSWER 5L/min
Normal V/Q ratio - ANSWER 4:5 or 0.8
What is Type 1 ARF? - ANSWER Hypoxemia normocapnic (normal CO2)
What is Type 2 ARF? - ANSWER Hypoxemia hypercapnic (Elevated CO2)
s/s of acute respiratory failure - ANSWER altered mental status (eg, confusion, agitation,
somnolence), paresthesias, dyspnea, tachypnea, hypoxemia, restlessness, fatigue,
hypertension, tachycardia
S/S of respiratory failure - ANSWER dyspnea, orthopedic, ABGs: hypoxia and
hypercapnia, restlessness, irritability, agitation, accessory muscle use, decreased
breath sounds
early s/s of respiratory distress - ANSWER SOB, tachycardia, LOC change, restless,
tachypnea, hypertension, headache
Late S/S of Respiratory Distress - ANSWER Confusion, lethargy, central cyanosis,
diaphoresis, respiratory arrest
How do you assess hypoxemia? - ANSWER ABGs and VBGs show the level of oxygen in
blood to determine hypoxemia
Interventions to clear secretions - ANSWER 1. Maintain open airway
2. Endotracheal suctioning
3. Assess and medicate for pain
, 4. Monitor sputum
5. Administer humidification
6. Perform postural drainage, chest physiotherapy
7. Auscultate lungs for changes in breaths sounds
What is the first sign of respiratory distress or hypoxia? - ANSWER Neurological
changes
What is the best position for patients with pneumonia? - ANSWER High fowlers HOB 30
How do you diagnose a PE? - ANSWER D-Dimer, Pulmonary angiogram or V/Q scan
What are s/s of PE? - ANSWER SOB, tachypnea, chest pain, anxiety, apprehension,
sweat, fever, tachycardia, cough, syncope
How do you diagnose pneumonia? - ANSWER CXR, blood cultures, sputum examination
What are the early signs of ARF? - ANSWER Restlessness, tachycardia, hypertension,
fatigue, headache
Indications for endotracheal intubation - ANSWER 1. Failure to oxygenate: inadequate
exchange of gases at the alveolar level, as seen in ARDS
2. Failure to ventilate: decreased mental status or decreased lung compliance
3. Combination of both
4. Airway protection
Goals for patient receiving mechanical ventilation - ANSWER -Maintenance of patent
airway
-Optimal gas exchange
-Absence of trauma or infection
-Attainment of optimal mobility
-Adjustment to nonverbal methods of communication
-Successful coping measures
What do you do if the ventilator fails? - ANSWER Use ambu bag to provide respiratory
support
what are the S&S of oxygen toxicity? - ANSWER substernal discomfort, paresthesias,
dyspnea, restlessness, fatigue, malaise, progressive respiratory difficulty, refractory
hypoxemia, alveolar atelectasis, and alveolar infiltrates evident on chest x-rays.
CORRECT SOLUTIONS
What is acute respiratory failure? - ANSWER Failure of gas exchange. Meaning it isn't
adequately providing oxygen to body and not removing CO2 well. Impaired lungs
What causes acute respiratory failure? - ANSWER Neuromuscular disorders, stroke,
pulomnary edema or emboli, chest trauma, pneumonia, ARDS, drug overdoses
Purpose for a V/Q scan - ANSWER Determining if a PE is present
What is a ventilation-perfusion mismatch? - ANSWER Imbalance between the air that
reaches alveoli (ventilation) and blood flow to alveoli (perfusion). Can be cardiac
disorder, PE, tension pneumo. Pneumonia.
Normal ventilation (V) - ANSWER 4L/min
Normal perfusion (Q) - ANSWER 5L/min
Normal V/Q ratio - ANSWER 4:5 or 0.8
What is Type 1 ARF? - ANSWER Hypoxemia normocapnic (normal CO2)
What is Type 2 ARF? - ANSWER Hypoxemia hypercapnic (Elevated CO2)
s/s of acute respiratory failure - ANSWER altered mental status (eg, confusion, agitation,
somnolence), paresthesias, dyspnea, tachypnea, hypoxemia, restlessness, fatigue,
hypertension, tachycardia
S/S of respiratory failure - ANSWER dyspnea, orthopedic, ABGs: hypoxia and
hypercapnia, restlessness, irritability, agitation, accessory muscle use, decreased
breath sounds
early s/s of respiratory distress - ANSWER SOB, tachycardia, LOC change, restless,
tachypnea, hypertension, headache
Late S/S of Respiratory Distress - ANSWER Confusion, lethargy, central cyanosis,
diaphoresis, respiratory arrest
How do you assess hypoxemia? - ANSWER ABGs and VBGs show the level of oxygen in
blood to determine hypoxemia
Interventions to clear secretions - ANSWER 1. Maintain open airway
2. Endotracheal suctioning
3. Assess and medicate for pain
, 4. Monitor sputum
5. Administer humidification
6. Perform postural drainage, chest physiotherapy
7. Auscultate lungs for changes in breaths sounds
What is the first sign of respiratory distress or hypoxia? - ANSWER Neurological
changes
What is the best position for patients with pneumonia? - ANSWER High fowlers HOB 30
How do you diagnose a PE? - ANSWER D-Dimer, Pulmonary angiogram or V/Q scan
What are s/s of PE? - ANSWER SOB, tachypnea, chest pain, anxiety, apprehension,
sweat, fever, tachycardia, cough, syncope
How do you diagnose pneumonia? - ANSWER CXR, blood cultures, sputum examination
What are the early signs of ARF? - ANSWER Restlessness, tachycardia, hypertension,
fatigue, headache
Indications for endotracheal intubation - ANSWER 1. Failure to oxygenate: inadequate
exchange of gases at the alveolar level, as seen in ARDS
2. Failure to ventilate: decreased mental status or decreased lung compliance
3. Combination of both
4. Airway protection
Goals for patient receiving mechanical ventilation - ANSWER -Maintenance of patent
airway
-Optimal gas exchange
-Absence of trauma or infection
-Attainment of optimal mobility
-Adjustment to nonverbal methods of communication
-Successful coping measures
What do you do if the ventilator fails? - ANSWER Use ambu bag to provide respiratory
support
what are the S&S of oxygen toxicity? - ANSWER substernal discomfort, paresthesias,
dyspnea, restlessness, fatigue, malaise, progressive respiratory difficulty, refractory
hypoxemia, alveolar atelectasis, and alveolar infiltrates evident on chest x-rays.
