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NURS 172 Exam 2 Review Notes
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This is a comprehensive and detailed exam 2 review note for Nurs 172. *Essential Study Material!!
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UNIT 2 EXAM REVIWOXYGENATION & PERFUSION
3 major parts for oxygenation and perfusion to occur? Oxygenation LUNGS
respiratory
1. lungs Perfusion HEART
2. circulatory system circulatory
3. heart
PRIMARY FUNCTION: LUNGS oxygenate blood
CIRCULATORY SYSTEM transports blood thought the body
HEART perfuses the blood through out the body and back to
the lungs
ANATOMY OF RESPIRATORY SYSTEM: Airway: air travels through the upper
respiratory system to the lower respiratory system.
UPPER LOWER
Nose Pharynx Trachea
Mouth Larynx Bronchi
Sinuses Bronchioles
WHY IS NASAL BREATHING MORE EFFECTIVE THAN MOUTH
BREATHING?
As air travels it is FILTERED, HUMIDIFIED AND WARMED.
2 PRIMARY FUNCTIONS OF THE RESPIRATORY SYSTEM
VENTILATION – air movement or RESPIRATION- gas exchange
breathing (Mechanical) (TAKES PLACE IN THE ALVEOLI)
Inspiration (in) Physiological dead space- places where
Expiration (out) gas exchange does not occur.
HEALTH OF PRESENT ILLNESS Health History: some ? are best asked in priv.
Factors that exacerbate (makes Current medications Family history
the symptoms wore) of improve Allergies: (environment, pets, food, chemicals)
symptoms Past medical history Previous surgeries
Pain: (assess quality, location,
rate) occupation (carpenter, painter)
Cough: (productive or not: smoking (How much? How long?)
sputum, color) social (drug, alcohol, How much/ long?)
Weight changes (r/t respiratory recent travel
symptoms, elderly)
Dyspnea (subjective complaint)
,Physical assessment: INSPECT
Inspect- skin integrity, symmetry This is your base line
Palpate- feel Nares : pink, free of debris
Percussion Nail beds: clubbing- prolonged oxygen
Auscultation- Bronchial, Bronchovesicular, deprivation… HYPOXIA (pts w. COPD)
Vesicular Color: pink, moist
Mouth: Pink, blue cyanosis signs of
RETRACTIONS and USE OF dehydration
ACCESSOY MUSCLES: Respiratory Rate: 12- 20
NOT NORMAL Pulse OX 95-100%
respiratory distress
**common in newborns
Abnormal Lung Sounds:
Diminished trauma pt.
Adventitious have the pt cough and listen again
CRACKLES: fine/ coarse POPPING
RHONCHI: snoring
WHEEZING: squeaky musical instrument
STRIODOR: high- pitched
PLEURAL FRICTION RUB
DIAGNOSTIC STUDIES
NON INVASIVE INVASIVE
Pulse Oximetry- oxygen saturation Arterial blood gas (ABGs)- drawing blood
-put on index finger (MORE ACCURATE)
- make sure no nail polish/ artificial Radiological (chest x-ray)
Capnometry- no waveform (CO2) Pulmonary function test (evaluate lung
Capnography- waveform (PaCO2) vol. to determine function)
Peak flow (asthma pts) Bronchoscopy (scope down: pt is coughing
Sputum analysis (coughing, thick mucus) up blood)
Thoracentesis (needle is put into the
**NORMAL IS 95% chest/ lung to drain fluid)
**decreased CO2 found in hypothermia Lung biopsy (remove piece of the lung)
Age related changes: everything slows down : lose muscle mass/ lose elasticity
Structural Reactivity or airway
Muscle function Gas exchange (smoker: harder)
, Tissues changes (elasticity) Immunological
QUESTIONS:
1) Which indicated an abnormal assessment finding of the respiratory system?
-Muscle retractions with inhalation
2) You are caring for a pt. who is currently receiving continuous pulse oximetry. Which
finding might indicate an inaccurate reading?
-The hr obtained through pulse oximetry does not correlate with the ECG hr.
3) Which structure(s) is/are located in the lower respiratory tract?
-ALVEOLI, TRACHEA
4) Which diagnostic test/ exam would best measure a pts. Level of hypoxemia?
-ARTERIAL BLOOD GAS
SUCTIONING
Pharyngeal suctioning is preformed to prevent oral and nasal secretions from entering
the lower airway. (If they cant cough it out)
It triggers a cough, which helps loosen and mobilize secretions
deep tracheal suctioning is a sterile procedure
YANKAUER suction catheter: hard suction
Soft tip: goes through nasal cavity
Procedure soft tip sterile
Proper PPE and universal precautions (gloves)
Position pt. (sims or high fowlers)
Opens the suction catheter kit and sterile saline and water-soluble lubricant (if nasal)
Don steril gloves
Oropharyngeal Suctioning (MOUTH)
Measures the distance between the edge of the pts. Mouth and the tip of the pts ear
lobe.
Nasopharyngeal Suctioning (NOSE)
Measures the distance between the tip of the pts nose to the tip of the pts ear lobe.
10-15 seconds .. allowing at least 20 second intervals between suctioning
OXYGEN THERAPY
OXYGEN OXYGEN HAZARDS ADMINISTERING OXYGEN
Oxygen therapy provides -toxicity -oxygen source
oxygen at concentrations -supports combustion -flow meter
greater than the level -under pressure -oxygen tubing
found in room air. -correct oxygen delivery
ROOM AIR – 21% oxygen system
-prefilled humidification
device of required (O2 will
dry out nasal passages)
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