NCM 112 Pretest: Chronic Lung Disorders

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Questions and Answers

What is the primary purpose of using a non-rebreather mask?

To maintain a constant flow of oxygen regardless of inhalation

To provide the highest concentrations of oxygen to the patient (correct)

To deliver low concentrations of oxygen to the patient

To allow the patient to rebreathe their exhaled air

What complication can arise from the suctioning process?

Hypoxemia (correct)

Enhanced airway patency

Reduced respiratory effort

Increased oxygen saturation

At what liter flow should a simple face mask not be used beyond, to avoid complications?

6 liters per minute (correct)

4 liters per minute

10 liters per minute

2 liters per minute

Which type of mask delivers oxygen concentrations that can range from 24%-40%?

Venturi mask Signup and view all the answers

What is a characteristic feature of the partial rebreather mask?

It allows the patient to rebreathe exhaled air Signup and view all the answers

What percentage of oxygen is transported as oxyhemoglobin in red blood cells?

97% Signup and view all the answers

Which of the following is a consequence of exposure to traffic pollutants?

Coughing and sneezing Signup and view all the answers

What is the primary method of carbon dioxide transport in red blood cells?

As bicarbonate Signup and view all the answers

Which lifestyle factor is associated with decreased lung function?

Tobacco smoking Signup and view all the answers

What effect does stress have on respiration?

Leads to panic attacks Signup and view all the answers

What condition is most commonly associated with obesity regarding respiration?

Respiratory failure Signup and view all the answers

What role does physical inactivity play in respiratory health?

Causes respiratory deconditioning Signup and view all the answers

What percentage of carbon dioxide combines with hemoglobin as carbhemoglobin?

30% Signup and view all the answers

What is a characteristic feature of Kussmaul’s breathing?

Deep and labored breathing pattern Signup and view all the answers

Which of the following best describes Cheyne-Stokes respirations?

Crescendo-decrescendo breathing patterns Signup and view all the answers

What is the primary purpose of using incentive spirometry?

Counteract effects of anesthesia or hypoventilation Signup and view all the answers

What is indicated by partial airway obstruction?

Low-pitched snoring during inhalation Signup and view all the answers

Which of the following nursing measures is NOT appropriate for promoting respiratory function?

Reducing fluid intake Signup and view all the answers

Which breathing alteration is characterized by an abnormal slow breathing rate?

Bradypnea Signup and view all the answers

What respiratory pattern is likely associated with increased intracranial pressure (IICP)?

Biot’s respirations Signup and view all the answers

What physical sign is commonly associated with cyanosis in respiratory distress?

Intercostal retractions Signup and view all the answers

What is the best method for a client with a chronic lung disorder to maintain consistent and safe oxygen delivery?

2 L/min per nasal cannula Signup and view all the answers

Which practice is recommended for deep breathing and coughing in clients?

Huff coughing every 2 hours or as needed. Signup and view all the answers

What is a reason why forceful coughing should be avoided in these clients?

It can lead to excessive fatigue. Signup and view all the answers

What is the recommended approach for coughing and deep breathing exercises for optimal effectiveness?

Incorporate both actions simultaneously. Signup and view all the answers

What potential complication could arise while assisting a client with chest tubes who is ambulating?

Dislodging of the connection between the tube and water seal. Signup and view all the answers

When a client's chest tube becomes dislodged while ambulating, what is the most appropriate action for the nurse to take?

Reconnect the tube to the water seal. Signup and view all the answers

What breathing techniques are particularly useful for clients with obstructive airway disease?

Combined diaphragmatic and pursed-lip breathing. Signup and view all the answers

Which of the following statements accurately describes huff coughing?

It is a technique to help clear secretions from the airways. Signup and view all the answers

What should be done with tissue specimens to ensure safe handling?

Put specimens in a specimen bottle or basin. Signup and view all the answers

What is a key responsibility of the circulating nurse during surgery?

Wash hands and arms before entering the operating room without wearing gloves. Signup and view all the answers

What is essential to do with sponges and instruments when the surgeon begins closing a wound?

Count them to ensure all are accounted for and notify the scrub nurse. Signup and view all the answers

How should instruments be passed to the surgeon?

Slap them firmly into the surgeon's palm. Signup and view all the answers

What should be done if a sterile package drops to the floor?

Discard it immediately, as it is no longer considered sterile. Signup and view all the answers

What materials should be prepared and ready for the closing of the incision?

Betadine, dressing materials, and plaster. Signup and view all the answers

What is the proper method for cleaning instruments during surgery?

Wipe them with a moist sponge to remove blood. Signup and view all the answers

When assisting the scrub nurse, what should the circulating nurse do?

Provide sterile supplies as needed throughout the procedure. Signup and view all the answers

Study Notes

Postoperative Care and Respiratory Management

Patients with chronic lung disorders typically receive oxygen at low levels, usually not exceeding 2 L/min to prevent complications.
Coughing and deep breathing exercises aid in lung expansion and secretion clearance. These should be performed together, rather than separately.
Huff coughing is effective for mobilizing secretions and maintaining airway patency.

Oxygen Transport and Diffusion

Approximately 97% of oxygen is transported from the lungs to tissues by hemoglobin as oxyhemoglobin.
The remaining oxygen is dissolved in plasma and cells.
Carbon dioxide, produced by cellular metabolism, is mainly transported as bicarbonate within red blood cells (65%) or combined with hemoglobin (30%).

Breathing Patterns and Airway Management

Various abnormal breathing patterns include tachypnea (rapid), bradypnea (slow), apnea (cessation), Kussmaul’s (deep and labored), and Cheyne-Stokes (alternating deep/slow breaths).
Signs of an obstructed airway may include low-pitched snoring, extreme inspiratory effort without movement, or retractions of the chest muscles.

Nursing Interventions for Respiratory Function

Key nursing interventions include ensuring a patent airway, proper positioning, adequate hydration, and teaching deep breathing and coughing techniques.
Incentive spirometry promotes pulmonary ventilation, loosens secretions, and helps expand collapsed alveoli, counteracting the effects of anesthesia.

Oxygen Delivery Systems

Nasal Cannula: Delivers 1-6 L/min (24%-45% oxygen) but is not advisable beyond 6 L/min due to air swallowing.
Simple Face Mask: Delivers 40%-60% oxygen at 5-8 L/min flow rates.
Partial Rebreather Mask: Delivers 60%-90% oxygen at 6-10 L/min, utilizing an oxygen reservoir bag for rebreathing exhaled air.
Non-Rebreather Mask: Provides 95%-100% oxygen at 10-15 L/min, equipped with a one-way valve to prevent air re-entry.
Venturi Mask: Delivers specified oxygen concentrations (24%-50%) based on flow rates (4-10 L/min) through an interchangeable jet adapter.

Complications and Risks in Respiratory Care

Potential complications of suctioning include hypoxemia and airway trauma.
Maintaining a patent airway and preventing secretions accumulation are crucial to avoid respiratory distress.

Circulating Nurse Responsibilities in OR

The circulating nurse facilitates surgeries by counting instruments and supplies, keeping the operating area organized, and preparing sterile supplies.
They should wash hands thoroughly at the beginning of the day and maintain cleanliness throughout the procedure.
Correct handling of specimens is essential, ensuring that small specimens are not crushed and that any contaminated materials are discarded properly.

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Description

This quiz focuses on managing patients with chronic lung conditions, specifically regarding the administration of supplemental oxygen. It highlights nursing interventions that prevent postoperative complications, including breathing exercises and oxygen delivery safety. Test your knowledge on critical nursing practices in respiratory care.