Respiratory Nursing Interventions Quiz

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Questions and Answers

Which technique is primarily used to counteract the effects of hypoventilation?

Pursed-lip breathing

Chest physiotherapy

Diaphragmatic breathing

Incentive spirometry (correct)

What is the primary goal of using abdominal (diaphragmatic) breathing techniques?

To increase tidal volume and enhance oxygenation (correct)

To develop muscle strength in the upper chest

To promote relaxation and reduce anxiety

To improve oxygen saturation levels through medication

What is the purpose of promoting a pollution-free environment in respiratory nursing interventions?

To increase the effectiveness of cough management

To prevent airway irritation and improve respiratory health (correct)

To enhance lung capacity through exercise

To reduce the need for oxygen delivery systems

What aspect of incentive spirometry provides visual reinforcement?

The flow of air inhaled through the mouthpiece Signup and view all the answers

Frequent position changes every two hours are implemented to support which nursing goal?

Prevent pressure ulcers and promote comfort Signup and view all the answers

What differentiates peripheral cyanosis from central cyanosis?

Peripheral cyanosis results from stagnant blood flow, whereas central cyanosis is a life-threatening condition. Signup and view all the answers

Which characteristic is common in older adults affecting respiratory function?

Increased prominence of bony landmarks due to loss of subcutaneous fat. Signup and view all the answers

What is a late sign of hypoxia that indicates potential life-threatening issues?

Cerebral cortex can tolerate hypoxia for a maximum of 3-5 minutes. Signup and view all the answers

What distinguishes rales from wheezes in respiratory assessment?

Rales occur when air moves through fluid-filled airways, while wheezes are caused by constricted airways. Signup and view all the answers

In assessing for cyanosis in individuals with dark skin, where should a nurse primarily check?

The nail beds, conjunctiva, and mucous membranes. Signup and view all the answers

Which of the following is NOT a contraindication for oxygen therapy?

Patients with renal failure Signup and view all the answers

What is the primary goal of oxygen therapy?

To maintain the lowest fraction of inspired oxygen for acceptable blood oxygen levels Signup and view all the answers

Which oxygen delivery system provides a flow rate that meets the entire inspiratory demands?

High flow systems Signup and view all the answers

What is the duration of action for oxygen when administered as a medication?

Less than 2 minutes Signup and view all the answers

Which of the following statements about oxygen safety is false?

Oxygen tanks can be stored without precautions in a patient's home Signup and view all the answers

Which adverse reaction can occur in patients receiving oxygen therapy?

Respiratory depression due to chronic CO2 retention Signup and view all the answers

What kind of therapy is consistent with providing humidified air and performing chest physiotherapy?

Oxygen therapy support Signup and view all the answers

What distinguishes low flow oxygen delivery systems from high flow systems?

Low flow systems provide a flow rate insufficient for total inspiratory needs Signup and view all the answers

What is the maximum oxygen concentration delivered by a nonrebreather mask?

80-95% Signup and view all the answers

At what liter flow does a Venturi mask typically deliver oxygen concentrations of 24-40%?

4-6L/min Signup and view all the answers

Which patient safety precaution is NOT recommended when administering oxygen?

Avoid using cotton fabrics. Signup and view all the answers

How much oxygen does a nasal cannula deliver at a flow rate of 5L/min?

36-40% Signup and view all the answers

What type of oxygen delivery device uses one-way valves?

Nonrebreather mask Signup and view all the answers

What is the FiO2 range for a nasal cannula at a flow rate of 4L/min?

32-36% Signup and view all the answers

Which device is characterized by wide-bore tubing and color-coded jet adapters?

Venturi mask Signup and view all the answers

Which oxygen delivery device provides variable oxygen concentrations with flow rates of 10-15L/min?

Nonrebreather mask Signup and view all the answers

What is the primary function of BI-PAP in respiratory care?

To improve gas exchange without intubation Signup and view all the answers

Which condition does Continuous Nasal Positive Airway Pressure primarily address?

Atelectasis post-surgery Signup and view all the answers

Which inhalation device relies on the patient's effort to activate the medication delivery?

Dry powder inhaler Signup and view all the answers

Which of the following is NOT one of the main components of asthma-related inflammation?

Bronchial dilation Signup and view all the answers

What triggers asthma attacks according to identified triggers?

Viral respiratory infections Signup and view all the answers

Which statement accurately describes Chronic Obstructive Pulmonary Disease (COPD)?

It involves progressive airflow obstruction that is not fully reversible. Signup and view all the answers

Among the following, which inhaled medication is known primarily for opening narrowed airways?

Bronchodilators Signup and view all the answers

What is a common characteristic of obstructive lung diseases?

Difficulty with exhaling air Signup and view all the answers

Study Notes

Respiratory Function & Hypoxia

Cyanosis is a bluish discoloration of tissues due to reduced oxygen saturation in the blood.
Assess nail beds, conjunctiva, and mucous membranes for cyanosis in dark-skinned individuals.
Cyanosis is a late sign of hypoxia and can lead to permanent brain damage if untreated.
Skin color is not a reliable indicator of oxygenation status.
Peripheral cyanosis occurs due to vasoconstriction and may be normal.
Central cyanosis is never normal.

Abnormal Lung Sounds

Rales are intermittent sounds heard during inspiration due to air moving through airways containing fluid.
Wheezes are continuous sounds heard during expiration or inspiration as air passes through constricted airways.
Sibilant wheezes are high-pitched whistling sounds.
Sonorous wheezes are low-pitched, rumbling sounds.

Respiratory Function in the Older Adult

Bony landmarks are more prominent due to loss of subcutaneous fat in older adults.
Kyphosis is common, giving the appearance of leaning forward.
Barrel chest deformity can occur, increasing the anteroposterior diameter of the chest.
Tissues and airways become more rigid in older adults, making breathing less efficient.
Risk of respiratory diseases, particularly pneumonia, increases with age.

Promoting Proper Breathing

Deep breathing helps to improve lung function.
Incentive spirometry encourages deep breathing and measures air volume.
Pursed-lip breathing helps to slow expiration and improve air flow.
Diaphragmatic breathing utilizes the diaphragm to increase lung capacity.

Nursing Interventions for Adequate Respiratory Functioning

Teach about pollution-free environments to prevent exposure to irritants.
Promote optimal function by encouraging deep breathing and regular exercise.
Maintain comfort and manage pain to reduce respiratory effort.
Monitor vital signs regularly to assess respiratory status.
Promote effective coughing to clear airways.
Suction airway to remove secretions as needed.
Administer oxygen therapy as prescribed to maintain adequate blood oxygen levels.

Deep Breathing & Coughing

Diaphragmatic breathing focuses on deep, controlled inhalations using the diaphragm.
Pursed-lip breathing involves slow exhalation through pursed lips to prevent airway collapse.
Controlled/huff cough is a technique that helps to clear airways without strain.

Incentive Spirometry

Visual reinforcement for deep breathing, encouraging patients to inhale deeply.
Improves ventilation by promoting deep breathing.
Prevents hypoventilation after surgery or illness.
Loosens respiratory secretions, facilitating their expulsion.
Facilitates gas exchange by keeping alveoli open.
Expands collapsed alveoli, improving lung function.

Promoting Comfort

Frequent position changes every 2 hours help to improve lung expansion.
Adequate fluid intake helps to thin secretions and facilitate their removal.
Humidified air can reduce irritation and ease breathing.
Chest physiotherapy can help to loosen secretions and improve airway drainage.

Oxygen Therapy

Oxygen is a medication, requiring a healthcare provider's order for administration.
Reverses hypoxemia by providing supplemental oxygen.
Onset of action is immediate, providing rapid relief.
Duration of action is short, requiring continuous administration.
Contraindications include COPD patients who may not tolerate high oxygen concentrations.
Adverse reactions can include decreased level of consciousness and respiratory depression in patients with chronic CO2 retention.

Oxygen Delivery Systems

Nasal cannula is a low-flow system with a flexible prongs inserted into the nostrils.
Nasopharyngeal catheter is a soft tube inserted into the nose and pharynx to deliver oxygen.
Transtracheal catheter is a tube inserted through the neck into the trachea for long-term oxygen delivery.
Simple mask is a low-flow system that covers the nose and mouth delivering oxygen.
Partial rebreather mask is a low-flow system that has a reservoir bag to allow for rebreathing of some exhaled air, enriching the oxygen concentration.
Nonrebreather mask is a high-flow system that delivers the highest oxygen concentration, preventing rebreathing of exhaled air.
Venturi mask is a high-flow system that delivers precise oxygen concentrations at variable flow rates, using color-coded jets.

Oxygen Safety

Oxygen supports combustion, requiring precautions to prevent fire hazards.
"Oxygen in Use" and "No Smoking" signs are essential for safety.
Educate clients on home safety measures for oxygen use.

Oxygen Delivery Systems: Low vs High Flow

Low flow systems do not provide enough oxygen to meet the entire inspiratory demand.
High flow systems supply sufficient oxygen for the entire inspiratory demand.

Low Flow Systems

Nasal cannula: delivers low-flow oxygen via prongs inserted into the nostrils.
Simple face mask: covers the nose and mouth, delivering low-flow oxygen.
Partial rebreather mask: allows for rebreathing of some exhaled air to enrich the oxygen concentration.

High Flow Systems

Venturi mask: provides a precise oxygen concentration with variable flow rates, using color-coded jets.
Aerosol mask: delivers humidified oxygen through a mask.
Non-rebreather mask: delivers the highest oxygen concentration by preventing exhalation rebreathing.
Tracheostomy collar and T-piece: delivers oxygen directly into the trachea.
Bag-valve mask: provides manual ventilation with oxygen supplementation.

Nasal Cannula Oxygen Flow Rates

1L/min: provides 21-24% FiO2.
2L/min: provides 25-28% FiO2.
3L/min: provides 28-32% FiO2.
4L/min: provides 32-36% FiO2.
5L/min: provides 36-40% FiO2.
6L/min: provides 40-44% FiO2.

Precautions for Oxygen Administration

Avoid open flames in the patient's room to prevent fire hazards.
Place "No Smoking" signs in conspicuous locations to alert others.
Check electrical equipment for proper working order to prevent fire hazards.
Avoid wearing synthetic fabrics as they can build up static electricity.
Avoid using oils in the area as they can ignite spontaneously in the presence of oxygen.

Noninvasive Positive-Pressure Ventilation (NPPV)

Bi-PAP (Bilevel positive airway pressure) uses two different pressure settings to improve ventilation.
Inspiratory positive airway pressure (IPAP) increases pressure during inhalation, keeping alveoli open.
Expiratory positive airway pressure (EPAP) maintains a lower pressure during exhalation to assist with airflow.
BiPAP machine delivers set IPAP and EPAP pressures with each breath.
Benefits of BiPAP include improved tidal volume, better gas exchange, and reduced airway resistance.

Continuous Nasal Positive Airway Pressure (CPAP)

Delivers a constant positive airway pressure with each breath (both inspiration and expiration).
Keeps alveoli open and improves gas exchange.
Benefits of CPAP include improving ventilation in patients with sleep apnea, atelectasis, and pulmonary edema.

Administering Inhaled Medications

Bronchodilators open narrowed airways by relaxing muscle spasms.
Nebulizers disperse medication into a fine mist for inhalation, allowing for deep lung access.
Metered-dose inhalers (MDIs) deliver a precise dose of medication with each actuation.
Dry powder inhalers (DPIs) deliver medication through a dry powder that is activated by the patient's breath.

Obstructive Lung Disease

Characterized by chronic airflow limitation that is not fully reversible.
Asthma is a condition characterized by airway inflammation and bronchospasm.
COPD (Chronic Obstructive Pulmonary Disease) is a progressive lung disease that includes:
- Emphysema: destruction of alveolar walls, leading to air trapping and decreased gas exchange.
- Chronic bronchitis: excessive mucus production and inflammation of the bronchi.

Asthma

Airway obstruction occurs after initial insult from an allergen that binds to IgE.
Inflammation leads to:
- Bronchial constriction
- Airway edema
- Mucus hypersecretion
- Air trapping
- Hyperinflation
- Epithelial desquamation
- Fibrosis

Asthma Triggers

Viral respiratory infections can trigger bronchospasm.
Allergens such as dust mites, pollen, and pet dander can trigger asthma attacks.
Exercise can trigger exercise-induced bronchospasm.
Cold air can trigger bronchospasm.
Emotional stress can trigger asthma attacks.
Environmental exposure to smoke, pollutants, or fumes can trigger asthma attacks.

Chronic Obstructive Pulmonary Disease (COPD)

Progressive airflow obstruction that is not fully reversible.
Fourth leading cause of death in the U.S.
Includes emphysema and chronic bronchitis.

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Description

Test your knowledge on key concepts related to respiratory nursing interventions. This quiz covers techniques such as abdominal breathing, incentive spirometry, and the signs of hypoxia. Understand how to differentiate between types of cyanosis and the specific needs of older adults in respiratory care.