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NUR195 COTAC Exam 2 (Semester 4) – Questions & A+ Solutions
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NUR195 COTAC Exam 2 (Semester 4) – Questions & A+ Solutions
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NUR195 COTAC Exam 2 (Semester 4) – Questions & A+ Solutions What are the pulmonary physiology processes? Right Ans - • Movement of air into and out of the lungs• Distribution of air throughout the lungs
• Diffusion of oxygen across the alveolar-capillary membrane
• Attachment of oxygen to hemoglobin molecules
• Transportation of oxyhemoglobin to the cells for production of ATP
PaCO2 reflects __________ while PaO2 reflects diffusion of _____________. Right Ans - ventilation, oxygenation
If the PaO2 is decreased, must the PaCO2 be increased? Right Ans - No. Carbon dioxide is much more diffusible than oxygen so when the pulmonary condition causes a diffusion defect, the PaO2 will be decreased but the PaCO2 will not be increased until ventilation is also affected. This is why early ARDS causes a decrease in PaO2 while late ARDS causes an increase in PaCO2 and a profound decrease in PaO2.
Hypoxemia= Right Ans - Decreased O2 in the blood= decreased SaO2
Hypoxia= Right Ans - Decreased O2 in the tissue=systemic symptoms
___% of oxygen is carried on the hemoglobin molecule and __% is dissolved in the plasma. Right Ans - 97, 3
Look at the SaO2 for Right Ans - hypoxemia
What are clinical manifestations of hypoxia? Right Ans - • Restlessness --
confusion -- lethargy -- coma
• Tachycardia-- dysrhythmias
• Tachypnea
• Dyspnea
• Use of accessory muscles
• Mild hypertension--hypotension • Cyanosis (depending on Hgb level so present early in polycythemia and late in anemia because 5 gm of hemoglobin must be desaturated for cyanosis to be present)
Can you have hypoxia without having hypoxemia? Right Ans - Yes, even if the blood oxygen level is normal, a decrease in Hgb or CO will still cause hypoxia.
What delivers oxygen to the tissues? Right Ans - PaO2, SaO2, Hemoglobin, Cardiac Output
Hypoxemia is decreased oxygen in the ______. Right Ans - blood
What shows evidence of Hypoxemia? Right Ans - Low PaO2, SaO2, SpO2.
Hypoxia is decreased oxygen in the ________. Right Ans - Tissues.
What shows evidence of Hypoxia? Right Ans - Clinical indications and increased lactic acid levels.
Because tissues can increase extraction when blood oxygen is low, hypoxia doesn't occur until: Right Ans - SaO2<88-90%. This is why the goal of Oxygen therapy is to keep SaO2>88-90%.
Disorders decreasing lung and chest wall compliance are referred to as: Right Ans - Restrictive Disorders
Disorders Increasing airway resistance are referred to as: Right Ans - Obstructive disorders
Blood in the pleural cavity is referred to as: Right Ans - Hemothorax
What is a hemothorax typically caused by?? Right Ans - From high force trauma to chest causing a lung injury and often rib fractures.
What are clinical manifestations of a Hemothorax? Right Ans - - Dyspnea - Chest pain - Diminished breath sounds on affected side - Dullness to percussion on affected side - Decreased SpO2 - Chest X-ray: pleural fluid collection noted
What is the treatment for a Hemothorax? Right Ans - - Chest tube to drain the blood; often need local anesthesia plus an opioid and a benzodiazepine for the procedure
At least 2 rib fractures at 2 sites on the rib refers to: Right Ans - Flail Chest
What are the causes of a flail chest? Right Ans - Paradoxical rib movements.
What are the clinical manifestations of flail chest? Right Ans - - Tachycardia, hypotension - Dyspnea, respiratory distress - Chest pain - Asymmetrical chest expansion - Paradoxical chest wall movement
What is the treatment for Flail chest? Right Ans - - Monitoring SpO2 and oxygen as needed - Frequent vital signs, lung assessments, incentive spirometer - Pain control with opioids - Intubation and ventilation may be required
What are the causes of a Simple (Closed) Pneumothorax? Right Ans - - Spontaneous: tall, thin young person - Blunt chest trauma - COPD
What are the clinical manifestations of a Simple (Closed) Pneumothorax? Right Ans - - Tachycardia, tachypnea - Dyspnea - Chest pain - Decreased breath sounds on affected side - Hyperresonance to percussion on affected side - May have subcutaneous emphysema - Decreased SpO2
What is the treatment for a Simple (Closed) Pneumothorax? Right Ans - Chest tube
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