Podcast
Questions and Answers
Which patterns did the nurse observe in a client with diabetic ketoacidosis experiencing Kussmaul's respirations? (Select all that apply)
Which patterns did the nurse observe in a client with diabetic ketoacidosis experiencing Kussmaul's respirations? (Select all that apply)
The client with several broken ribs is most likely to experience which type of acid-base imbalance?
The client with several broken ribs is most likely to experience which type of acid-base imbalance?
The nurse should assess a client at risk for respiratory acidosis for which signs and symptoms?
The nurse should assess a client at risk for respiratory acidosis for which signs and symptoms?
What other extrapulmonary causes can lead to respiratory failure in a client with Guillain-Barré syndrome? (Select all that apply)
What other extrapulmonary causes can lead to respiratory failure in a client with Guillain-Barré syndrome? (Select all that apply)
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If Guillain-Barré syndrome is severe enough, the client will be at risk for which acid-base imbalance?
If Guillain-Barré syndrome is severe enough, the client will be at risk for which acid-base imbalance?
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Which type of adventitious lung sounds should the nurse expect to hear from a client with asthma?
Which type of adventitious lung sounds should the nurse expect to hear from a client with asthma?
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Which statement is most appropriate for the nurse to make to the client about coughing and deep-breathing techniques?
Which statement is most appropriate for the nurse to make to the client about coughing and deep-breathing techniques?
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What piece of information should the nurse include when teaching a client about the use of an incentive spirometer?
What piece of information should the nurse include when teaching a client about the use of an incentive spirometer?
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What action is most appropriate if continuous gentle bubbling is noted in the water seal chamber of a client with a pneumothorax?
What action is most appropriate if continuous gentle bubbling is noted in the water seal chamber of a client with a pneumothorax?
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What is the most appropriate action when a 12-month-old infant's respiratory rate is 35 breaths/minute?
What is the most appropriate action when a 12-month-old infant's respiratory rate is 35 breaths/minute?
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Limit the length of suctioning to ______ seconds.
Limit the length of suctioning to ______ seconds.
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Which finding would the nurse expect when assessing a patient with a right pneumothorax?
Which finding would the nurse expect when assessing a patient with a right pneumothorax?
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A closed suction device would be most appropriate for which patient?
A closed suction device would be most appropriate for which patient?
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Which patient should the nurse see first?
Which patient should the nurse see first?
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Which statement by the patient indicates an understanding of atelectasis?
Which statement by the patient indicates an understanding of atelectasis?
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In which order will the nurse perform the steps for nasotracheal suctioning, beginning with the first step?
In which order will the nurse perform the steps for nasotracheal suctioning, beginning with the first step?
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Which type of diet will the nurse most likely suggest for a patient with carbon dioxide retention?
Which type of diet will the nurse most likely suggest for a patient with carbon dioxide retention?
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Which condition will the nurse assess for in a patient taking warfarin (Coumadin) and garlic for hypertension?
Which condition will the nurse assess for in a patient taking warfarin (Coumadin) and garlic for hypertension?
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What does a whooshing sound at the fifth intercostal space indicate?
What does a whooshing sound at the fifth intercostal space indicate?
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Which oxygen delivery device is most appropriate for a patient with COPD receiving 2 L/min of oxygen?
Which oxygen delivery device is most appropriate for a patient with COPD receiving 2 L/min of oxygen?
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Which age-related change requires close monitoring of oxygen status during anesthesia for older adults?
Which age-related change requires close monitoring of oxygen status during anesthesia for older adults?
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Which assessment finding does the nurse expect when conducting a history and physical examination for a patient experiencing angina pectoris?
Which assessment finding does the nurse expect when conducting a history and physical examination for a patient experiencing angina pectoris?
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Which risk factor for cardiopulmonary disease is modifiable?
Which risk factor for cardiopulmonary disease is modifiable?
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Which intervention best addresses a short-term goal for an obese patient suffering from fatigue related to ineffective breathing?
Which intervention best addresses a short-term goal for an obese patient suffering from fatigue related to ineffective breathing?
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Which nursing diagnosis is a priority for a patient with left-sided hemiparesis who has developed bronchitis?
Which nursing diagnosis is a priority for a patient with left-sided hemiparesis who has developed bronchitis?
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Which response by the nurse is most therapeutic when a patient with COPD asks why clubbing occurs?
Which response by the nurse is most therapeutic when a patient with COPD asks why clubbing occurs?
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Which finding requires immediate action by the nurse for a patient with a chest tube inserted on low constant suction?
Which finding requires immediate action by the nurse for a patient with a chest tube inserted on low constant suction?
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Which nursing intervention is most effective in promoting effective airway clearance for a patient with a tracheostomy?
Which nursing intervention is most effective in promoting effective airway clearance for a patient with a tracheostomy?
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Which patient is most appropriate for a closed suction device?
Which patient is most appropriate for a closed suction device?
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Which information should be included in a teaching session about the flu vaccine?
Which information should be included in a teaching session about the flu vaccine?
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Which types of ventilator support should the nurse be prepared to administer for a patient with sleep apnea?
Which types of ventilator support should the nurse be prepared to administer for a patient with sleep apnea?
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What electrolyte imbalance does profuse diaphoresis, dry sticky mucous membranes, weakness, disorientation, and decreased levels of consciousness support?
What electrolyte imbalance does profuse diaphoresis, dry sticky mucous membranes, weakness, disorientation, and decreased levels of consciousness support?
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Which oxygen-delivery system should the nurse select for a patient with a precise oxygen level prescribed?
Which oxygen-delivery system should the nurse select for a patient with a precise oxygen level prescribed?
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Which nursing intervention is appropriate for preventing atelectasis in the postoperative patient?
Which nursing intervention is appropriate for preventing atelectasis in the postoperative patient?
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What is the appropriate action for the nurse when there is 200 mL of dark-red drainage in the chest tube two hours post-surgery?
What is the appropriate action for the nurse when there is 200 mL of dark-red drainage in the chest tube two hours post-surgery?
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Which priority assessments should the nurse perform for a patient exhibiting labored breathing and using accessory muscles?
Which priority assessments should the nurse perform for a patient exhibiting labored breathing and using accessory muscles?
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What action should the nurse perform first for a patient feeling short of breath while lying supine?
What action should the nurse perform first for a patient feeling short of breath while lying supine?
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Which statement indicates a need for further education in a patient with emphysema?
Which statement indicates a need for further education in a patient with emphysema?
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What are the signs/symptoms of secondary pneumothorax?
What are the signs/symptoms of secondary pneumothorax?
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Which assessment finding indicates a patient with pneumonia needs airway suctioning?
Which assessment finding indicates a patient with pneumonia needs airway suctioning?
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Which intervention is a simple method for reducing the risks of stasis of pulmonary secretions?
Which intervention is a simple method for reducing the risks of stasis of pulmonary secretions?
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Which adventitious lung sounds should the nurse expect to auscultate in a patient with severe left-sided heart failure?
Which adventitious lung sounds should the nurse expect to auscultate in a patient with severe left-sided heart failure?
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What physiological process explains why a child with a fever is at risk for developing dyspnea?
What physiological process explains why a child with a fever is at risk for developing dyspnea?
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What symptoms should the nurse assess for to determine the oxygen status of a patient diagnosed with severe iron deficiency anemia?
What symptoms should the nurse assess for to determine the oxygen status of a patient diagnosed with severe iron deficiency anemia?
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What disorder is a patient at increased risk for if they have smoked since adolescence?
What disorder is a patient at increased risk for if they have smoked since adolescence?
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Do you use a clean or sterile technique with nasopharyngeal suctioning?
Do you use a clean or sterile technique with nasopharyngeal suctioning?
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Do you use a clean or sterile technique with oropharyngeal suctioning?
Do you use a clean or sterile technique with oropharyngeal suctioning?
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Which assessment finding indicates a patient with severe lobar pneumonia needs airway suctioning?
Which assessment finding indicates a patient with severe lobar pneumonia needs airway suctioning?
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Which of the following results falls within expected or normal limits?
Which of the following results falls within expected or normal limits?
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What is the primary function of the alveoli?
What is the primary function of the alveoli?
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What condition will anemia result in?
What condition will anemia result in?
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What is the process of exchanging gases through the alveolar capillary membrane called?
What is the process of exchanging gases through the alveolar capillary membrane called?
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What would a nurse expect to find in a patient with a C4 injury?
What would a nurse expect to find in a patient with a C4 injury?
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In which situation would a nurse expect to see increased ventilation?
In which situation would a nurse expect to see increased ventilation?
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Why should a patient install a carbon monoxide detector at home?
Why should a patient install a carbon monoxide detector at home?
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What does crackles in lung fields and a patient sleeping on three pillows most likely indicate?
What does crackles in lung fields and a patient sleeping on three pillows most likely indicate?
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What would a nurse expect in a patient with ischemia to the left coronary artery?
What would a nurse expect in a patient with ischemia to the left coronary artery?
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What formula should be used to calculate normal cardiac output?
What formula should be used to calculate normal cardiac output?
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If a patient's heart rate increased from 80 bpm to 160 bpm, what is expected to follow?
If a patient's heart rate increased from 80 bpm to 160 bpm, what is expected to follow?
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Why does a nurse monitor a patient's cardiac output?
Why does a nurse monitor a patient's cardiac output?
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What should a nurse's first priority be for a patient complaining of sharp chest pain and shortness of breath?
What should a nurse's first priority be for a patient complaining of sharp chest pain and shortness of breath?
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If a patient has inadequate stroke volume related to decreased preload, what should the nurse anticipate?
If a patient has inadequate stroke volume related to decreased preload, what should the nurse anticipate?
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Which vital sign is a nurse most concerned with when caring for a patient with atrial fibrillation?
Which vital sign is a nurse most concerned with when caring for a patient with atrial fibrillation?
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What would a nurse expect to find in a patient with right-sided heart failure?
What would a nurse expect to find in a patient with right-sided heart failure?
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Which part of the conduction system represents the P wave?
Which part of the conduction system represents the P wave?
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Which statement by a patient indicates understanding of atelectasis?
Which statement by a patient indicates understanding of atelectasis?
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Where is the best location to assess for hypoxia in an African American patient with COPD?
Where is the best location to assess for hypoxia in an African American patient with COPD?
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Why should a nurse expect a patient with a temperature of 100.2 F to hyperventilate?
Why should a nurse expect a patient with a temperature of 100.2 F to hyperventilate?
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What is the earliest sign of hypoxia?
What is the earliest sign of hypoxia?
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What change in respiratory pattern should a nurse expect in a 5-year-old with strep throat given aspirin?
What change in respiratory pattern should a nurse expect in a 5-year-old with strep throat given aspirin?
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What would a nurse anticipate finding in a patient who suffered a myocardial infarction to the left coronary artery?
What would a nurse anticipate finding in a patient who suffered a myocardial infarction to the left coronary artery?
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What should a nurse recommend for breakfast to a patient managing hypertension?
What should a nurse recommend for breakfast to a patient managing hypertension?
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What does a whooshing sound at the fifth intercostal space indicate?
What does a whooshing sound at the fifth intercostal space indicate?
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Which oxygen delivery device is most appropriate for a patient with COPD?
Which oxygen delivery device is most appropriate for a patient with COPD?
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What age-related change requires monitoring of oxygen status during anesthesia in the elderly?
What age-related change requires monitoring of oxygen status during anesthesia in the elderly?
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What is the best plan of care for an elderly patient at risk for infection due to decreased immunity?
What is the best plan of care for an elderly patient at risk for infection due to decreased immunity?
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What change in cardiac output is expected in a patient with fluid volume overload?
What change in cardiac output is expected in a patient with fluid volume overload?
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What is the priority nursing action for a patient with COPD recovering from a myocardial infarction?
What is the priority nursing action for a patient with COPD recovering from a myocardial infarction?
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What should the nurse expect a patient with angina pectoris to experience?
What should the nurse expect a patient with angina pectoris to experience?
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What is a nonmodifiable risk factor for lung disease?
What is a nonmodifiable risk factor for lung disease?
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What short-term goal could be achieved by an obese patient suffering from fatigue related to ineffective breathing?
What short-term goal could be achieved by an obese patient suffering from fatigue related to ineffective breathing?
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What nursing diagnosis is the priority for a patient with left-sided hemiparesis who developed bronchitis?
What nursing diagnosis is the priority for a patient with left-sided hemiparesis who developed bronchitis?
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What nursing intervention is most effective in preventing hospital-acquired pneumonia in an elderly patient?
What nursing intervention is most effective in preventing hospital-acquired pneumonia in an elderly patient?
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Which assessment finding requires further follow-up in a patient with emphysema?
Which assessment finding requires further follow-up in a patient with emphysema?
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What response is most therapeutic for a patient with COPD asking about difficulty with fine motor skills?
What response is most therapeutic for a patient with COPD asking about difficulty with fine motor skills?
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Which nursing intervention is most effective for promoting effective airway clearance in a patient with a tracheostomy tube?
Which nursing intervention is most effective for promoting effective airway clearance in a patient with a tracheostomy tube?
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What statement indicates that teaching has been effective regarding caring for a patient with a chest tube?
What statement indicates that teaching has been effective regarding caring for a patient with a chest tube?
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What is the priority nursing diagnosis for a patient with a tracheostomy post-traumatic brain injury?
What is the priority nursing diagnosis for a patient with a tracheostomy post-traumatic brain injury?
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Study Notes
Gas Exchange and Respiratory Physiology
- Alveoli primarily function in gas exchange, allowing oxygen and carbon dioxide to move between the air and bloodstream.
- Anemia decreases oxygen-carrying capacity, leading to hypoxemia due to inadequate tissue oxygenation.
- Diffusion is the process where gases are exchanged through the alveolar capillary membrane.
Neuromuscular Impact on Breathing
- A C4 spinal cord injury can lead to decreased tidal volume due to impaired diaphragm function.
- Decreased pH from CO2 retention signals increased ventilation, while normal or increased oxygen saturation may not reflect respiratory issues.
Heart and Circulation
- Cardiac output in healthy adults ranges from 4 to 6 L/min and can be calculated using stroke volume multiplied by heart rate.
- An increase in heart rate often results in decreased cardiac output due to reduced diastolic filling time.
- Left-sided heart failure manifests as pulmonary congestion and is indicated by crackles in lung fields.
Patient Monitoring and Interventions
- Continuous cardiac monitoring is essential for patients post-myocardial infarction, especially those with comorbidities like COPD.
- Inadequate stroke volume due to decreased preload requires verification of blood consent before transfusion.
- Patients with COPD may have altered mental status affecting their awareness of breathing difficulties.
Infection Prevention and Respiratory Care
- Vaccination is vital for elderly patients to prevent infections due to decreased immunity.
- Effective coughing and deep breathing exercises can help prevent hospital-acquired pneumonia.
- Administering humidified oxygen through a tracheostomy collar improves airway clearance.
Diagnosis and Signs of Hypoxia
- Restlessness is typically the first sign of hypoxia, leading to more severe symptoms as condition worsens.
- A patient with COPD and bronchitis may be assessed for impaired gas exchange, especially if displaying increased respiratory rates.
Surgical and Emergency Responses
- In cases of pneumothorax, absence of breath sounds on the affected side is expected.
- A closed suction device is most suitable for patients with aspiration pneumonia, particularly in the elderly.
Nutritional Guidance and Lifestyle Considerations
- Dietary recommendations for patients managing hypertension should emphasize low-fat, high-potassium, and high-fiber foods.
- Making small adjustments, like sleeping with elevated pillows, can alleviate breathing difficulties in obese patients experiencing fatigue.
Atrial Fibrillation and Monitoring
- In patients with atrial fibrillation, oxygen saturation is the most critical vital sign due to the risk of emboli formation.
- Hemoptysis in a patient with emphysema necessitates further evaluation, as it may indicate serious complications.
Patient Education
- Understanding the importance of regular breathing exercises can help prevent atelectasis in at-risk patients.
- During evaluation of a new tracheostomy, awareness of suctioning techniques and signs of airway obstruction is vital for patient safety.### Breathing Exercises
- Performing breathing exercises every hour is critical to prevent atelectasis.
Nasotracheal Suctioning Steps
- Correct sequence for nasotracheal suctioning:
Attach catheter to suction system → Have patient deep breathe → Insert catheter → Apply suction and remove → Encourage patient to cough → Rinse catheter and connecting tubing.
Carbon Dioxide Retention Diet
- A low-carbohydrate diet is recommended for patients with carbon dioxide retention due to lung issues.
Anticoagulant Interaction
- Monitor for bleeding in patients taking warfarin (Coumadin) who also use garlic for hypertension management.
Heart Auscultation Findings
- A whooshing sound at the fifth intercostal space indicates mitral valve regurgitation.
Oxygen Delivery for COPD
- A nasal cannula is the most appropriate oxygen delivery device for COPD patients receiving 2 L/min of oxygen.
Anesthesia Monitoring in Older Adults
- Diminished respiratory muscle strength can lead to inadequate chest expansion in older adults undergoing anesthesia.
Angina Pectoris Symptoms
- Patients often report chest pain after consuming heavy meals when experiencing angina pectoris.
Modifiable Risk Factors
- Stress is identified as a modifiable risk factor for cardiopulmonary disease.
Short-term Goal for Fatigue
- Using two to three pillows at night can help alleviate fatigue related to ineffective breathing for obese patients.
Prioritizing Nursing Diagnoses
- Impaired gas exchange is the priority nursing diagnosis for patients with chronic bronchitis and abnormal vital signs.
Clubbing in Lung Disease
- Clubbing occurs due to insufficient oxygen supply to peripheral areas, commonly seen in lung disease.
Chest Tube Care
- Absence of bubbling in the suction control chamber after chest tube insertion indicates potential blockage needing immediate evaluation.
Promoting Airway Clearance
- Administering humidified oxygen via a tracheostomy collar effectively promotes airway clearance for patients with tracheostomy tubes.
Closed Suction Device Use
- The most suitable patients for closed suction devices include those on mechanical ventilation, such as a 24-year-old with ARDS.
Flu Vaccine Teaching
- Important points about the flu vaccine include its yearly administration and its safety for children allergic to eggs.
Ventilator Support for Sleep Apnea
- CPAP and BiPAP are effective ventilator support options for patients with sleep apnea.
Hypernatremia Indicator
- Indicators of hypernatremia include symptoms like profuse diaphoresis and dry mucous membranes alongside decreased consciousness.
Precise Oxygen Delivery
- A Venturi mask is the ideal system for administering precise oxygen levels to patients.
Incentive Spirometer in Postoperative Care
- Incentive spirometry is essential for preventing atelectasis in postoperative patients.
Chest Tube Drainage Monitoring
- A chest tube with dark-red drainage post-surgery should be monitored and documented without immediate action unless excessive.
Priority Assessments for Dyspnea
- When assessing a patient with breathing difficulties, prioritize measuring SpO2 levels, sputum production, and changes in respiratory patterns.
Initial Action for Dyspnea
- Elevating the head of the bed to 45 degrees is the first action for a patient reporting shortness of breath.
Education on Emphysema
- Statements indicating a need for further education include misconceptions about increasing oxygen flow when experiencing dyspnea.
Symptoms of Pneumothorax
- Sharp pleuritic pain worsening on inspiration is a symptom indicative of a pneumothorax.
Indicators for Airway Suctioning
- A decreased ability to clear airways through coughing suggests a need for airway suctioning.
Reducing Risks of Pulmonary Secretions
- Regular position changes are a straightforward, cost-effective method to mitigate the risk of pulmonary secretions and enhance chest wall expansion.
Adventitious Lung Sounds in Heart Failure
- Inspiratory crackles in lung bases are expected in patients with severe left-sided heart failure.
Dyspnea in Febrile Children
- Increased metabolic demands due to fever significantly raise the oxygen requirement, elevating the risk of dyspnea in children.
Iron Deficiency Anemia Symptoms
- Patients may demonstrate decreased activity tolerance and increased breathlessness as indicators of oxygen status.
Smoking Risks
- Long-term smokers face heightened risks for developing cardiopulmonary diseases and lung cancer.
Nasopharyngeal vs. Oropharyngeal Suctioning Techniques
- Nasopharyngeal suctioning requires a sterile technique; oropharyngeal suctioning involves a clean technique.
Diagnostic Testing Normal Limits
- Arterial oxygen tension of 95 mmHg falls within normal limits for oxygen status; other tuberculosis-related tests indicate abnormal results.
Kussmaul's Respirations
- Characteristics of Kussmaul's respirations include increased rate and abnormally deep breaths.
Respiratory Acidosis from Rib Fractures
- Patients with multiple rib fractures are at risk of respiratory acidosis due to inadequate ventilation.
Signs of Respiratory Acidosis
- Symptoms characteristic of respiratory acidosis include headaches, restlessness, and confusion.
Causes of Respiratory Failure
- Potential extrapulmonary causes of respiratory failure include strokes, sleep apnea, myasthenia gravis, and effects of opioids or sedatives.
Guillain-Barré Syndrome Risks
- Patients with Guillain-Barré syndrome are susceptible to respiratory acidosis due to potential respiratory muscle paralysis.
Asthma Assessment Findings
- Wheezes are the typical adventitious lung sounds a nurse would expect in an asthmatic patient during respiratory assessment.
Teaching Coughing and Deep Breathing
- Use of an incentive spirometer is vital in preventing pneumonia and should be emphasized in patient education regarding respiratory post-operative care.### Pulmonary Embolus
- Blockage of the pulmonary artery affects blood flow to one or more lung lobes.
- Most common cause is clot formation.
- Early ambulation and blood thinners help prevent this complication.
- Coughing and deep-breathing techniques are not related to prevention.
Incentive Spirometer Use
- Optimal results achieved while sitting up or at a 45 to 90-degree angle.
- Inhale slowly with a tight seal around the mouthpiece.
- Maximum inspiration should be held for 5 seconds before exhaling.
- Client should assume a semi Fowler's or high Fowler's position for lung expansion.
Continuous Bubbling in Water Seal Chamber
- Continuous gentle bubbling indicates a potential air leak; should be intermittent.
- Fluctuation may occur with inspiration/expiration, diminishing as pneumothorax resolves.
- Bubbling observed in the suction control chamber of a wet drainage system, not the water seal chamber.
- Increasing suction pressure is not typically advised unless prescribed, as it can be harmful.
- Chest tubes should only be clamped with a healthcare provider's order.
Vital Signs in Infants
- Normal respiratory rate for a 12-month-old is 20 to 40 breaths/minute.
- A recorded respiratory rate of 35 breaths/minute falls within normal limits.
- Other normal vital signs: apical heart rate of 90 to 130 beats/minute, and average blood pressure of 90/56 mm Hg.
- Appropriate action is to document the findings.
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Description
Test your knowledge with these practice questions focusing on Chapter 41 related to oxygenation. Each question offers multiple-choice options, requiring you to identify the correct answers related to gas exchange and the impact of anemia. Perfect for nursing students looking to reinforce their understanding of respiratory health.
