Podcast
Questions and Answers
Which delivery system would the nurse use when the health care provider prescribes a common low-flow system to deliver continuous oxygen at 2 L/min for a patient with pneumonia?
Which delivery system would the nurse use when the health care provider prescribes a common low-flow system to deliver continuous oxygen at 2 L/min for a patient with pneumonia?
Which alterations of oxygenation and perfusion may require supplemental oxygen therapy?
Select all that apply.
Which alterations of oxygenation and perfusion may require supplemental oxygen therapy? Select all that apply.
Match the type of oxygen mask to its description.
Match the type of oxygen mask to its description.
No reservoir bag; 1 L/min O2 ⇧ = ~5% O2 concentration ⇧ = Simple face mask Reservoir bag present; room air is inspired with O2 delivered = Partial rebreather mask Reservoir bag present; one-way valve prevents entry of exhaled air = Nonrebreather mask No reservoir bag; ensures accuracy of O2 concentration; uses adaptors/dials = Venturi mask
Which device would the nurse apply to a patient who has arrived unconscious and in respiratory arrest (is not breathing)?
Which device would the nurse apply to a patient who has arrived unconscious and in respiratory arrest (is not breathing)?
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Match the artificial airway tube with the correct situation.
Match the artificial airway tube with the correct situation.
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Which guidelines would the nurse recall when inserting a nasopharyngeal tube?
Select all that apply.
Which guidelines would the nurse recall when inserting a nasopharyngeal tube? Select all that apply.
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Which situations would indicate a need for the nurse to consider insertion of a pharyngeal airway?
Select all that apply.
Which situations would indicate a need for the nurse to consider insertion of a pharyngeal airway? Select all that apply.
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Which type of tube would a patient receiving general anesthesia require to maintain oxygenation?
Which type of tube would a patient receiving general anesthesia require to maintain oxygenation?
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For which purpose would a chest tube be inserted in a patient injured in a car crash?
For which purpose would a chest tube be inserted in a patient injured in a car crash?
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Match the type of chest physiotherapy to its description.
Match the type of chest physiotherapy to its description.
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Which actions are the nurse’s responsibilities during a chest tube insertion procedure?
Select all that apply.
Which actions are the nurse’s responsibilities during a chest tube insertion procedure? Select all that apply.
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Match the pulmonary drug classification with the key principle of use.
Match the pulmonary drug classification with the key principle of use.
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Which finding indicates that the prescribed inhaled bronchodilator administered to a patient with chronic obstructive pulmonary disease (COPD) has been effective?
Which finding indicates that the prescribed inhaled bronchodilator administered to a patient with chronic obstructive pulmonary disease (COPD) has been effective?
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Which action describes the primary rationale for administering a corticosteroid (methylprednisolone) to a patient with a pulmonary disease?
Which action describes the primary rationale for administering a corticosteroid (methylprednisolone) to a patient with a pulmonary disease?
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Which patient changes would the nurse expect when medications used to treat pulmonary disease are effective?
Select all that apply.
Which patient changes would the nurse expect when medications used to treat pulmonary disease are effective? Select all that apply.
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Match the drug classification with the key assessment associated with evaluation of treatment.
Match the drug classification with the key assessment associated with evaluation of treatment.
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Which cautions would the nurse include when discussing home oxygen therapy with a patient who has chronic obstructive pulmonary disease (COPD)?
Select all that apply.
Which cautions would the nurse include when discussing home oxygen therapy with a patient who has chronic obstructive pulmonary disease (COPD)? Select all that apply.
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Which potential outcomes for a patient with chronic obstructive pulmonary disease (COPD) are associated with daily extended supplemental oxygen therapy?
Select all that apply.
Which potential outcomes for a patient with chronic obstructive pulmonary disease (COPD) are associated with daily extended supplemental oxygen therapy? Select all that apply.
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Which course of action would the nurse initiate on discovering a recently discharged patient refuses to use a CPAP machine because of claustrophobia?
Which course of action would the nurse initiate on discovering a recently discharged patient refuses to use a CPAP machine because of claustrophobia?
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Which emergency preparedness equipment would the nurse need to confirm is available in the room of a patient with a tracheostomy tube?
Select all that apply.
Which emergency preparedness equipment would the nurse need to confirm is available in the room of a patient with a tracheostomy tube? Select all that apply.
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Which explanation would the nurse give when preparing a patient for placement of an oropharyngeal tube?
Which explanation would the nurse give when preparing a patient for placement of an oropharyngeal tube?
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Which alteration resulting from improper tube placement and found by palpating the skin around the stoma site during tracheostomy care would prompt the nurse to call the primary health care provider?
Which alteration resulting from improper tube placement and found by palpating the skin around the stoma site during tracheostomy care would prompt the nurse to call the primary health care provider?
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Which information would the nurse give to a postsurgical patient who states that performing incentive spirometry is uncomfortable and wants to know why it is necessary?
Which information would the nurse give to a postsurgical patient who states that performing incentive spirometry is uncomfortable and wants to know why it is necessary?
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Which type of chest physiotherapy involves percussion?
Which type of chest physiotherapy involves percussion?
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The nurse would instruct a patient to hold each breath for __ seconds when explaining coughing/deep breathing chest physiotherapy? Record your answer as two whole numbers separated by a hyphen.
The nurse would instruct a patient to hold each breath for __ seconds when explaining coughing/deep breathing chest physiotherapy? Record your answer as two whole numbers separated by a hyphen.
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Which route would the nurse use when administering medication to a patient with non–life-threatening lower airway inflammation?
Which route would the nurse use when administering medication to a patient with non–life-threatening lower airway inflammation?
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The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) and administers a bronchodilator. Which primary action would the nurse conclude is relieving the wheezing?
The nurse is caring for a patient with chronic obstructive pulmonary disease (COPD) and administers a bronchodilator. Which primary action would the nurse conclude is relieving the wheezing?
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Which medications would the nurse expect to be added to the patient’s drug regimen when a patient with infectious bronchitis (inflammation of the bronchi) is admitted to the hospital?
Select all that apply
Which medications would the nurse expect to be added to the patient’s drug regimen when a patient with infectious bronchitis (inflammation of the bronchi) is admitted to the hospital? Select all that apply
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Which explanation would the nurse give to a patient experiencing an abnormally rapid heartbeat who asks about the purpose of an antiarrhythmic medication?
Which explanation would the nurse give to a patient experiencing an abnormally rapid heartbeat who asks about the purpose of an antiarrhythmic medication?
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Which interventions would the nurse implement when providing care for a patient prescribed a diuretic?
Select all that apply
Which interventions would the nurse implement when providing care for a patient prescribed a diuretic? Select all that apply
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Which benefit is important for the nurse to include when educating a patient about antihypertensive medications?
Which benefit is important for the nurse to include when educating a patient about antihypertensive medications?
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Which medications would the nurse expect to be on the medication administration record for a patient with chronic cardiovascular disease?
Select all that apply
Which medications would the nurse expect to be on the medication administration record for a patient with chronic cardiovascular disease? Select all that apply
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Which discharge instruction would be included during patient education of a patient prescribed anticoagulant therapy?
Which discharge instruction would be included during patient education of a patient prescribed anticoagulant therapy?
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Study Notes
Oxygen Delivery Systems
- Nasal cannula: delivers low flow oxygen (1-6 L/min)
- Simple face mask: delivers moderate flow oxygen (6-10 L/min)
- Partial rebreather mask: delivers moderate flow oxygen (6-10 L/min), with a reservoir bag to collect expired air
- Non-rebreather mask: delivers highest concentration of oxygen (10-15 L/min) for critical patients, with a one-way valve that prevents rebreathing expired air
Oxygenation and Perfusion
- Hypoxemia: low blood oxygen levels
- Hypoxia: deficient oxygen supply to the tissues, leading to tissue damage
- Pneumonia: inflammation of the lungs, often leading to impaired oxygen exchange
- Acute respiratory distress syndrome (ARDS): severe lung inflammation, causing fluid buildup and decreased lung capacity
- Chronic obstructive pulmonary disease (COPD): airflow obstruction impacting airflow in and out of the lungs
- Asthma: chronic inflammatory airway disease with frequent bronchospasms
- Cardiac disease: can lead to decreased oxygen transport to the tissues
- Anemia: decreased red blood cell count impairs oxygen carrying capacity
Artificial Airways
- Oropharyngeal airway: inserted through the mouth, prevents blockage of the airway by the tongue
- Nasopharyngeal airway: inserted through the nose, keeps the airway open
- Endotracheal tube: inserted into the trachea, secures the airway and allows for mechanical ventilation
- Tracheostomy tube: inserted surgically directly into the trachea, provides long-term airway management
Chest Tubes
- Pneumothorax: air in the pleural space, collapsing the lung
- Hemothorax: blood in the pleural space, putting pressure on the lung
- Pleural effusion: fluid buildup in the pleural space can restrict lung expansion
Chest Physiotherapy
- Postural drainage: positioning the patient to drain secretions from their lungs
- Percussion: striking specific areas of the chest with cupped hands to loosen secretions
- Vibration: gentle shaking or vibrations applied to the chest to dislodge secretions
Pulmonary Medications
- Bronchodilators: relax smooth muscle in the airway to open airways (albuterol, ipratropium)
- Corticosteroids: reduce inflammation in the airway to improve airflow (fluticasone, budesonide)
- Antibiotics: used to manage bacterial pneumonia or other infections
Patient Education: Home Oxygen Therapy
- *Important Considerations:
- Avoid open flames and sources of heat (cigarettes, stoves, candles)
- Do not use oxygen-producing medical devices or equipment as the source for home oxygen
Patient Education: Incentive Spirometry
- Purpose: To encourage deep breaths and improve lung capacity
Chest Physiotherapy: Percussion
- Purpose: To loosen mucus in the airways to make it easier to cough up
Medications: Antiarrhythmics
- Purpose: To regulate the heart rhythm and prevent arrhythmias
Medications: Diuretics
- Purpose: To reduce fluid retention by promoting urination
Medications: Antihypertensives
- Purpose: To lower high blood pressure
Medications: Anticoagulant Therapy
-
Important Considerations:
- Avoid taking aspirin or NSAIDs unless directed by the doctor
- Report any signs of bleeding immediately, such as blood in the urine, stools, gums, or nosebleeds
-
Discharge Instructions:
- It is important to take anticoagulants as prescribed to prevent blood clots
Emergency Preparedness Equipment
- Suction device: to remove airway obstructions
- Ambu bag: to provide manual ventilation
- Oxygen source: to ensure adequate oxygen supply
Tracheostomy Care
- Palpation of stoma site: identifies any air leaks, excessive swelling, or obstruction.
- Tracheostomy tube placement: a slight shift in the tube could obstruct the airway.
Considerations For Patients With COPD
-
Daily Extended Supplemental Oxygen Therapy:
- Can improve exercise tolerance and quality of life
- Can slow the progression of the disease and reduce hospitalizations
Patient Refusal: CPAP
-
Options:
- Explore alternative treatment options with the patient
- Involve respiratory therapy and physician to discuss alternatives
- Provide patient education and address anxieties
Respiratory Infections
-
Infectious Bronchitis (inflammation of the bronchi):
- Medications likely ordered:
- Bronchodilators to help relieve airway narrowing
- Antiviral medications to fight the virus
- Antibiotics if a bacterial infection is suspected
- Corticosteroids to reduce inflammation
- Medications likely ordered:
Cardiac Care
-
Antiarrhythmic Medication:
- Purpose: To regulate the heartbeat and prevent abnormal heart rhythms
Medication Administration
-
Inhaled Medications:
- Used for non–life-threatening lower airway inflammation
Wheezing
-
Primary Action of Bronchodilator:
- Relaxing the muscles in the airway to open up the airway, reducing wheezing
Interventions for Patients Prescribed Diuretics
- Monitor weight: To check for fluid retention.
- Monitor blood pressure: To check for sudden drops in blood pressure.
- Encourage fluids: To prevent dehydration.
Medications for Chronic Cardiovascular Disease
- Medications likely ordered:
- Diuretics to reduce fluid buildup
- Beta-blockers to reduce heart rate and workload
- ACE inhibitors to relax blood vessels
- Aspirin to prevent blood clots
- Nitrates to dilate blood vessels
- Statins to help lower cholesterol levels
Discharge Instructions: Anticoagulant Therapy
-
Purpose:
- To help prevent blood clots in the legs, lungs, or brain.
- Important Considerations:
- Report any unusual bleeding.
- Avoid taking aspirin or other NSAIDs unless directed by the doctor.
- Maintain a healthy lifestyle with a balanced diet and regular exercise.
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Description
This quiz assesses your knowledge of oxygen delivery systems, specifically for low-flow scenarios. You will encounter a question regarding the appropriate system to deliver continuous oxygen for a patient with pneumonia at a specified flow rate. Test your understanding of respiratory care in nursing.
