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NUR 325 Exam 3 Gas exchange, Perfusion, Drugs for HTN, Elimination and GI Drugs Questions and Correct Answers
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Define gas exchange The process by which oxygen is transported to cells and carbon dioxide is transported by cells Hypoxemia reduced oxygenation of arterial blood Hypoxia state at which O2 reaching cells is insufficient Anoxia total lack of oxygen in tissues Ischemia Insufficient O2 blood to ti...

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  • September 3, 2024
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  • 2024/2025
  • Exam (elaborations)
  • Questions & answers

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  • nur 325 exam 3 gas exchange perfusion drugs for
  • define gas exchange the process by which oxygen i
  • hypoxemia reduced oxygenation of arterial blood

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NUR 325 Exam 3 Gas exchange,
Perfusion, Drugs for HTN, Elimination
and GI Drugs Questions and Correct
Answers
Define gas exchange ✅The process by which oxygen is transported to cells and
carbon dioxide is transported by cells

Hypoxemia ✅reduced oxygenation of arterial blood

Hypoxia ✅state at which O2 reaching cells is insufficient

Anoxia ✅total lack of oxygen in tissues

Ischemia ✅Insufficient O2 blood to tissues

Physiologic process of gas exchange ✅Atmosphere (21% O2) →chemoreceptors in
medulla sense CO2 levels → transmit to diaphragm and intercostals to contract to
breathe deep → nose (warms & humidifies air) → trachea → bronchi → alveoli (high
pressure causes diffusion to)→pulmonary capillaries with hemoglobin to carry O2 →
perfusion to transport hemoglobin to cells → cell metabolism → process to exhale CO2
begins (reverse path of O2)

Gas exchange: variations and context ✅-Gasses perfuse from high to low
concentration
-CO2 and O2 independent (do not exchange with each other)
-Altered transport: insufficient number or quality of erythrocytes available to carry O2 or
when hemoglobin amount is low
-EX. anemia, SCC
-Infants are obligate nose breathers until 3 months
-Infant respiratory patterns may be irregular

Gas exchange: causes of impairment ✅-Ineffective ventilation (inhale O2 and exhale
CO2)
-EX. Rib fractures, cervical spinal cord injury, muscle weakness

-Reduced capacity for gas transportation (reduced hemoglobin which carries O2 and/or
RBCs)
-EX. Bronchoconstriction (asthma) or obstruction (chronic bronchitis or CF)

,-Inadequate perfusion (hemoglobin to tissues then alveoli)
-EX. Pulmonary edema, acute respiratory distress syndrome, pneumonia

Gas exchange: consequence of impairment ✅-Mild impairment: fatigue, increase HR
and RR (due to compensation)

-More severe impairment: respiratory acidosis (CO2 buildup due to no movement of H+)

-Prolonged or severe: cellular ischemia and necrosis, death

Risk factors for impaired gas exchange ✅-Populations at risk
-Infants: developing, compromised immune systems, fetal hemoglobin for first 5 months
(RBCs do not last as long; reserves very small) which can cause anemia, alveoli and
lung surface area much smaller, narrow branching of peripheral airways that are easily
obstructed
-Older adults: chest muscles weaker, immune system weaker, chest stiffer
-Experience a reduction of erythrocytes, increasing their risk for anemia

-Smoking: damages airways and alveoli, vasoconstriction, bronchoconstriction, damage
to cilia, biggest risk factor to impaired gas exchange

-Risk for aspiration due to altered consciousness
-Being intubated (bypasses protective mechanism for alveoli)

-Prolonged rest: less exercise of chest muscles can cause pneumonia or collapsed lung

-Chronic diseases: increase mucus buildup (COPD), fluid accumulation (HF), etc.

Recognize when an individual has compromised gas exchange ✅-History (problem
based)
-Cough, SOB, chest pain with breathing

-Vital signs: dec in SaO2, inc RR, inc HR, inc temp

-Inspection: clubbing, capillary refill, skin color, lips, 1:2 transverse ratio is normal
(anterior/posterior:lateral), trachea midline, breathe quietly and effortless (not sitting
leaning forward), curvature of vertebrae

-Auscultation: wheezing, stridor, rhonchi, crackles

Gas exchange: optimal vs impaired assessment findings ✅Optimal
-trachea sounds: hars hollow blowing
-bronchiole (1&2 intercostal): high pitched loud hollow blowing
-bronchial vesicular (3&4 intercostal): softer
-vesicular: softest

, Impaired
-wheezing: narrowing of small airways (high pitched whistling)
-stridor: narrowing of trachea and bronchi (emergent)
-rhonchi: sputum or fluid in passages
-crackles: fluid in alveoli
-pleural effusion (hemothorax): no lung sounds

Diagnostic tests for gas exchange (not sure if we have to know these or not) ✅-ABGs,
CBCs (Hgb & Hct), sputum
-Chest x-rays (fluid, object, pneumonia)
-CT (pulmonary embolism)
-Ventilation/perfusion (V/Q) scan (pulmonary emboli)
-PET (pulmonary modules; usually for cancer pt.)
-Skin tests (TB)
-Endoscopy (bronchoscopy, tissue samples, etc.)

Preventions for impaired gas exchange ✅-Primary prevention: infection control,
smoking cessations, immunizations, preventing postoperative complications

-Secondary prevention (screening): flu, pneumonia, TB (Mantoux skin test), COVID

Nursing and collaborative interventions/ interprofessional care for optimizing gas
exchange ✅Smoking cessation, pharmacotherapy, O2 therapy, airway management
and breathing support, chest physiotherapy, nutrition therapy, positioning, invasive
procedures (chest tubes, thoracentesis, bronchoscopy)

-Upper airway drugs: antihistamines (relieve sneezing, rhinorrhea, and nasal itching)
and decongestants (intranasal glucocorticoids have antiinflammatory effect while
sympathomimetics cause vasoconstriction that shrinks edematous membranes)

-Lower airway bronchodilators: glucocorticoids (reduce bronchial hyperreactivity),
sympathomimetics (relieve bronchospasm, stimulate SNS), and anticholinergics (block
PNS so it cannot stimulate constriction of airways)

-Cough suppressants: antitussives act in CNS

-Antimicrobials

-Agents to aid smoking cessation

-Oxygen therapy: nasal cannula (24-44% from 1-6L/min), high flow nasal cannulas
(40L/min), face mask (35-50% from 6-12L/min), partial or non-rebreathing masks (60-
90% from 10-15L/min), venturi masks (24, 28, 31, 35, 40, and 50%)
-COPD patients no greater than 3L

-Chest tubes: remove air or blood from pleura

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