Quiz
Chapter 38: Oxygenation and Perfusion
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Perguntas do quiz (50)
1A nurse caring for a patient with chronic obstructive pulmonary disease (COPD) knows that hypoxia may occur in patients with respiratory problems. What are signs of this serious condition?
- ADyspnea
- BHypotension
- CSmall pulse pressure
- DDecreased respiratory rate
- EPallor
- FIncreased pulse rate
2A nurse is suctioning the nasopharyngeal airway of a patient to maintain a patent airway. For which condition would the nurse anticipate the need for a nasal trumpet?
- AThe patient vomits during suctioning
- BThe secretions appear to be stomach contents
- CThe catheter touches an unsterile surface
- DEpistaxis is noted with continued suctioning.
3The [blank_start]nasal[blank_end] [blank_start]trumpet[blank_end] will protect the nasal mucosa from further trauma related to suctioning.
- Anasal
- Btrumpet
4A nurse is choosing a catheter to use to suction a patient's endotracheal tube via an open system. On which variable would the nurse base the size of the catheter to use?
- AThe age of the patient
- BThe size of the endotracheal tube
- CThe type of secretions to be suctioned
- DThe height and weight of the patient
5A nurse is caring for a 16 year old male patient who has been hospitalized for an acute asthma exacerbation. Which testing methods might the nurse use to measure the patient's oxygen saturation?
- AThoracentesis
- BSpirometry
- CPulse oximetry
- DPeak expiratory flow rate
- EDiffusion capacity
- FMaximal respiratory pressure
6[blank_start]Spirometers[blank_end] are used to monitor the health status of patients with respiratory disorders, such as asthma. [blank_start]Pulse[blank_end] [blank_start]oximetry[blank_end] is used to obtain baseline information about the patient's oxygen saturation level and is also performed for patients with asthma, along with [blank_start]PEFR[blank_end] to monitor airflow. These 3 tests may be administered by the nurse.
- ASpirometers
- BPulse
- Coximetry
- DPEFR
7[blank_start]Diffusion[blank_end] [blank_start]capacity[blank_end] estimates the patient's ability to absorb alveolar gases and determines if a gas exchange problem exists. [blank_start]Maximal[blank_end] [blank_start]respiratory[blank_end] [blank_start]pressures[blank_end] help evaluate neuromuscular causes of respiratory dysfunction. Both tests are usually performed by a respiratory therapist.
- ADiffusion
- Bcapacity
- CMaximal
- Drespiratory
- Epressures
8The physician or other advanced practice professional can perform a [blank_start]thoracentesis[blank_end] at the bedside with the nurse assisting, or in the radiology department.
- Athoracentesis
9[blank_start]Thoracentesis[blank_end] is a procedure in which a needle is inserted into the pleural space between the lungs and the chest wall. This procedure is done to remove excess fluid, known as a pleural effusion, from the pleural space to help you breathe easier.
- AThoracentesis
10A patient with COPD is unable to perform activities of daily living (ADLs) wihtout becoming exhausted. Which nursing diagnosis best describes this alteration to oxygenation as the etiology?
- ADecreased Cardiac Output related to difficulty breathing
- BImpaired Gas Exchange related to use of bronchodialators
- CFatigue related to impaired oxygen transport system
- DIneffective Airway Clearance related to fatigue
11A nurse working in a long-term care facility is providing teaching to patients with altered oxygenation due to conditions such as asthma and COPD. Which measures would the nurse recommend?
- ARefrain from exercise
- BReduce anxiety
- CEat meals 1 to 2 hours prior to breathing treatments
- DEat a high-protein/high calorie diet
- EMaintain a high Fowler's position when possible
- FDrink 2 to 3 pints of clear fluids daily
12A nurse is providing postural drainage for a patient with cystic fibrosis. In which position should the nurse place the patient to drain the right lobe of the lung?
- AHigh Fowler's position
- BLeft side with pillow under chest wall
- CLying position/half on abdomen and half on side
- DTrendelenberg position
13A nurse is teaching a patient how to use a meter-dosed inhaler for her asthma. Which comments from the patient assure the nurse that the teaching has been effective?
- AI will be careful not to shake up the canister before using it
- BI will hold the canister upside down when using it
- CI will inhale the medication through my nose
- DI will continue to inhale when the cold propellant is in my throat
- EI will only inhale one spray with one breath
- FI will activate the device while continuing to inhale
14When planning care for a patient with chronic lung disease who is receiving oxygen through a nasal cannula, what does the nurse expect?
- AThe oxygen must be humidified
- BThe rate will be no more than 2 to 3 L/min or less
- CArterial blood gases will be drawn every 4 hours to assess flow rate
- DThe rate will be 6 L/min or more
15A rate higher than [blank_start]3[blank_end]L/min may destroy the hypoxic drive that stimulates respirations in the medulla in a patient with chronic lung disease.
- A3
16A nurse is securing a patient's endotracheal tube with tape and observes that the tube depth changed during the retaping. Which action would be appropriate related to this incident?
- AInstruct assistant to notify the primary care provider
- BAssess the patient's vital signs
- CRemove the tape, adjust the depth to ordered depth and reapply the tape
- DNo action is required as depth will adjust automatically
17What action does the nurse perform to follow the safe technique when using a portable oxygen cylinder?
- AChecking the amount of oxygen in the cylinder before using it
- BUsing a cylinder for a patient transfer that indicates available oxygen is 500 psi
- CPlacing the oxygen cylinder on the stretcher next to the patient
- DDiscontinuing oxygen flow by turning cylinder key counterclockwise until tight
18A nurse providing care of a patient's chest drainage system observes that the chest tube has become separated from the drainage device. What would be the first action that should be taken by the nurse in this situation?
- ANotify the physician
- BApply an occlusive dressing on the site
- CAssess the patient for signs of respiratory distress
- DPut on gloves and insert the chest tube in a bottle of sterile saline
19An emergency department nurse is using a manual resuscitation bag (Ambu bag) to assist ventilation in a patient with lung cancer who has stopped breathing on his own. What is an appropriate step in this procedure?
- ATilt the patient's head forward
- BHold the mask tightly over the patient's nose and mouth
- CPull the patient's jaw backward
- DCompress the bag twice the normal respiratory rate for the patient
20Which assessments and interventions should the nurse consider when performing tracheal suctioning?
- AClosely assess the patient before, during and after the procedure.
- BHyperoxigenate the patient before and after suctioning
- CLimit the application of suction to 20 to 30 seconds
- DMonitor the patient's pulse frequently to detect potential effects of hypoxia and stimulation of the vagus nerve
- EUse an appropriate suction measure (80-150 mm Hg)
- FInsert the suction catheter to further than 1cm past the length of the trachea or endotracheal tube
21Risks of tracheal suctioning include: [blank_start]atelactasis[blank_end], [blank_start]dysrythmias[blank_end], [blank_start]hypoxia[blank_end], [blank_start]infection[blank_end], and [blank_start]trachial[blank_end] [blank_start]tissue[blank_end] [blank_start]damage[blank_end].
- Aatelactasis
- Bdysrythmias
- Chypoxia
- Dinfection
- Etrachial
- Ftissue
- Gdamage
22The airway begins at the [blank_start]nose[blank_end] and ends at the [blank_start]terminal[blank_end] [blank_start]bronchioles[blank_end].
- Anose
- Bterminal
- Cbronchioles
23Each lung is divided into two [blank_start]lobes[blank_end]. Each lobe is subdivided into [blank_start]segments[blank_end] or [blank_start]lobules[blank_end].
- Alobes
- Bsegments
- Clobules
24The main [blank_start]bronchus[blank_end] branches to each lung from the [blank_start]trachea[blank_end]. It subdivides into [blank_start]secondary[blank_end] [blank_start]bronchi[blank_end], they subdivide again and again becoming smaller and smaller. The smallest of these branches are the [blank_start]bronchioles[blank_end], ending at the [blank_start]terminal[blank_end] [blank_start]bronchioles[blank_end].
- Abronchus
- Btrachea
- Csecondary
- Dbronchi
- Ebronchioles
- Fterminal
- Gbronchioles
25The [blank_start]visceral[blank_end] pleura covers the lung, and the [blank_start]parietal[blank_end] pleura lines the thoracic cavity.
- Avisceral
- Bparietal
- Cparietal
- Dvisceral
26Pressure w/in the pleural space ([blank_start]intrapleural[blank_end] [blank_start]pressure[blank_end]) is always [blank_start]subatmospheric[blank_end] (a negative pressure).
- Aintrapleural
- Bpressure
- Csubatmospheric
27[blank_start]Inspiration[blank_end] is the active phase, [blank_start]expiration[blank_end] is the passive phase.
- AInspiration
- BExpiration
- Cexpiration
- Dinspiration
28During [blank_start]inspiration[blank_end]: the [blank_start]diaphragm[blank_end] contracts and descends, lengthening the throracic cavity; the [blank_start]external[blank_end] [blank_start]intercostal[blank_end] muscles contract, lifting the ribs upward and outward; and the [blank_start]sternum[blank_end] is pushed forward enlarging the chest. This combination of an increased lung volume and decrease of [blank_start]intrapulmonic[blank_end] pressure allows air to move in from an area of greater pressure (outside air) into an area of lesser pressure (w/in the lungs). The relaxation or [blank_start]recoil[blank_end] of these structures then results in [blank_start]expiration[blank_end]. This causes a [blank_start]decreased[blank_end] volume in the lungs and an increased in [blank_start]intrapulmonic[blank_end] pressure.
- Ainspiration
- Bdiaphragm
- Cexternal
- Dintercostal
- Esternum
- Fintrapulmonic
- Gexpiration
- Hrecoil
- Idecreased
- Jintrapulmonic
29The respiratory center is located in the [blank_start]medulla[blank_end] in the [blank_start]brainstem[blank_end]. It is stimulated by an increased concentration of [blank_start]carbon[blank_end] [blank_start]dioxide[blank_end] and [blank_start]hydrogen[blank_end] [blank_start]ions[blank_end], and to a lesser degree, by the decreased amount of [blank_start]oxygen[blank_end] in the arterial blood. In addition chemoreceptors in the [blank_start]aortic[blank_end] [blank_start]arch[blank_end] and [blank_start]carotid[blank_end] bodies are also sensitive to the same [blank_start]arterial[blank_end] [blank_start]blood[blank_end] [blank_start]gas[blank_end] and can activate the medulla.
- Amedulla
- Bbrainstem
- Ccarbon
- Ddioxide
- Ehydrogen
- Fions
- Goxygen
- Haortic
- Iarch
- Jcarotid
- Karterial
- Lblood
- Mgas
30Atria receive blood from the veins: superior/inferior [blank_start]vena[blank_end] [blank_start]cav[blank_end] and the left/right [blank_start]pulmonary[blank_end] [blank_start]veins[blank_end].
- Avena
- Bcava
- Cpulmonary
- Dveins
31Contractions of the heart start in the [blank_start]atria[blank_end], followed by contraction of the [blank_start]ventricles[blank_end], with a subsequent resting of the [blank_start]heart[blank_end].
- Aatria
- Bventricles
- Cheart
32Deoxygenated blood flows from the [blank_start]right[blank_end] side of the heart to the lungs.
- Aright
- Bleft
33Oxygenated blood is returned to the [blank_start]left[blank_end] side of the heart and pumped out to all other parts of the body.
- Aleft
- Bright
34[blank_start]97[blank_end]% of oxygen is carried by red blood cells as part of [blank_start]hemoglobin[blank_end] in the form of [blank_start]oxyhemoglobin[blank_end]. Hemoglobin also carries [blank_start]carbon[blank_end] [blank_start]dioxide[blank_end] in the form of carboxyhemoglobin.
- A97
- Bhemoglobin
- Coxyhemoglobin
- Dcarbon
- Edioxide
35Be alert for the possibility of [blank_start]respiratory[blank_end] [blank_start]depression[blank_end] or [blank_start]arrest[blank_end] when administering any narcotic or sedative.
- Arespiratory
- Bdepression
- Carrest
36Generalized [blank_start]anxiety[blank_end] has been show to cause enough bronchospasm to produce an episode of bronchial asthma.
- Aanxiety
37Be aware of the patient's [blank_start]hemoglobin[blank_end] level before evaluating oxygen saturation because the test measures only the percentage of oxygen carried by the available hemoglobin. Thus even a patient with a [blank_start]low[blank_end] hemoglobin level could appear to have a [blank_start]normal[blank_end] SpO2, because most of that hemoglobin is saturated. However the patient may not have enough oxygen to meet body needs. A range of [blank_start]95[blank_end]% to [blank_start]100[blank_end]% is considered normal SpO2; values <= [blank_start]90[blank_end]% are abnormal.
- Ahemoglobin
- Blow
- Cnormal
- D95
- E100
- F90
38The max amt of fluid removed with Thoracentesis is generally [blank_start]1,000[blank_end] mL.
- A1,000
39People who work hard at breathing often do not have much energy for [blank_start]eating[blank_end]. Many of the medications used for treatment can cause [blank_start]anorexia[blank_end] and [blank_start]nausea[blank_end].
- Aeating
- Banorexia
- Cnausea
40Research has demonstrated that, in patients with pulmonary disease who are acutely ill, turning to the [blank_start]prone[blank_end] position on a regular basis promotes oxygenation. In this position the posterior dependent sections of the lungs are better ventilated and perfused.
- Aprone
41Patients can help keep their secretions thin by drinking [blank_start]2[blank_end] to [blank_start]3[blank_end] quarts ([blank_start]1.9[blank_end] L - [blank_start]2.9[blank_end] L) of clear fluids daily. However, encourage patients with heart failure and low sodium levels to limit their fluid intake to [blank_start]1.5[blank_end] L / day.
- A2
- B3
- C1.9
- D2.9
- E1.5
42Some health care providers consider adequate [blank_start]fluid[blank_end] intake and air [blank_start]humidification[blank_end] as effective expectorants.
- Afluid
- Bhumidification
43Suctioning irritates the mucosa and removes [blank_start]oxygen[blank_end] from the respiratory tract, possibly causing hypoxemia. Thus it is important to [blank_start]preoxygenate[blank_end] the patient before suctioning.
- Aoxygen
- Bpreoxygenate
44In an [blank_start]emergency[blank_end] situation the absence of a [blank_start]prescription[blank_end] should not delay the administration of oxygen to the patient.
- Aemergency
- Bprescription
45Removal of chest tubes can be a painful and stressful process for patients. Whenever possible, administer [blank_start]analgesics[blank_end] prior to the tube removal and apply [blank_start]cold[blank_end] to the chest.
- Aanalgesics
- Bcold
46The [blank_start]oropharyngeal[blank_end] airway is used to keep the tongue clear of the airway.
- Aoropharyngeal
47A [blank_start]nasopharyngeal[blank_end] airway is inserted through the nare and protrudes into the back of the pharynx. The [blank_start]nasal[blank_end] [blank_start]trumpet[blank_end] allows for frequent [blank_start]nasotracheal[blank_end] suctioning without trauma to the nasal passageway.
- Anasopharyngeal
- Bnasal
- Ctrumpet
- Dnasotracheal
48Patients w/tracheostomies frequently have an infective [blank_start]cough[blank_end] mechanism and copious [blank_start]secretions[blank_end].
- Acough
- Bsecretions
49Exercise care when changing the [blank_start]tracheostomy[blank_end] ties to prevent accidental decannulation or [blank_start]expulsion[blank_end] of the tube.
- Atracheostomy
- Bexpulsion
50During tracheal suctioning: to prevent hypoxia, [blank_start]hyperoxigenate[blank_end] before/after suctioning and limit the application of suction [blank_start]10[blank_end] to [blank_start]20[blank_end] seconds. Suction catheter should be limited to no further than [blank_start]1[blank_end] [blank_start]cm[blank_end] past the length of the tracheal/endotrachel tube to avoid damage.
- Ahyperoxigenate
- B10
- C20
- D1
- Ecm
Informações
- Descrição
- Unit VII: Promoting Healthy Physiologic Responses Chapter 38: Oxygenation and Perfusion
- Autor
- Alexandra Bozan
- Idioma
- English
- Visualizações
- 589
- Etiquetas
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