Nur 195 Test 1; Questions and Answers %
Correct
Respiratory: What is the nurse's priority? Correct answer-A
Airway:
upper
respiratory tract
natural or artificial airway
B
Breathing:
lower
respiratory tract
respiration: ventilation, perfusion, diffusion
Nur 195 Test 1; Questions and Answers %
Correct
Respiratory: What is the nurse's priority? Correct answer-A
Airway:
upper
respiratory tract
natural or artificial airway
B
Breathing:
lower
respiratory tract
respiration: ventilation, perfusion, diffusion
C
Circulation: adequate BP and Hemoglobin (Hg)
Morbidly obese Correct answer-increase risk for airway and breathing issues, increased
respiratory rate, circulatory issues, etc, DVT- can change into a pulmonary embolism
Head of the bed must be up for Correct answer-respiratory patients and the elderly
If patient is unconscious Correct answer-keep them on their side in case they vomit
, Nur 195 Test 1; Questions and Answers %
Correct
Anything below the trachea is Correct answer-sterile
If someone aspirates, what lung will most likely be affected? Correct answer-Right lung
PLEURAL EFFUSION Correct answer-Addtl fluid in the lung (pleural space)
diaphragm Correct answer-the major muscle of respiration located at the base of the
thoracic cavity
use of accessory muscles Correct answer-Scalenes, intercostal, flaring of nostrils
Surfactant Correct answer-keeps the alveoli open and decreases surface
Atelectasis Correct answer-unable to keep the alveoli open (collapsed alveoli), low grade
temp and may have crackles, leads to hospital acquired pneumonia, important to use incentive
spirometer
anatomic dead space Correct answer-Nose to bronchioles
, Nur 195 Test 1; Questions and Answers %
Correct
What Controls Respiratory Rate and Depth? Correct answer-Chemoreceptors in the Brain,
Peripheral receptors -Carotid and Aortic Bodies, Mechanical receptors in the Lungs
Chemoreceptors in the Brain Correct answer---Chemical changes in H+ ion concentration
or pH
--Changes in carbon dioxide concentration
Peripheral receptors -Carotid and Aortic Bodies Correct answer-respond to oxygen levels,
carbon dioxide and pH
Mechanical receptors in the Lungs Correct answer-Physiologic factors: pulmonary muscle
stretching, alveolar wall distortion, irritants and fluid build up.
Why must COPD patients be conscious of the amt of oxygen that they get? Correct
answer-they have higher levels of carbon dioxide
What is a focused respiratory assessment? Correct answer-Subjective Assessments:
•Dyspnea: (rated on a scale of 1-10)
•Chest pain: pulmonary v.s. cardiac origin
Objective assessments:
•Cough: describe characteristics
•Sputum: quantity, consistency, color
, Nur 195 Test 1; Questions and Answers %
Correct
Physical Assessments:
Inspection, Palpation, Percussion, Auscultation
Arterial Blood Gas (ABG) Correct answer-ABG analysis is used to evaluate respiratory
function and provides accurate information about oxygenation, ventilation and acid-base
balance. The measurements reported are the pH, PaCO2, PaO2, HCO3 and SaO2.
An arterial puncture is done from the radial, brachial or femoral artery or the blood is obtained
from an indwelling arterial catheter. Perform the Allen test before using the radial artery. Use a
heparinized syringe and immediately place blood sample on ice and send to the lab.
Nursing Implications:
Explain the procedure to the patient. Make no changes with the patient for twenty minutes
prior to test. Indicate whether oxygen was in use at the time blood was drawn. Once the needle
is removed, firm, direct pressure is applied for 5 minutes to the arterial site, until the site is no
longer bleeding.
M.H. 72 y/o female admitted with diagnosis of Pneumonia , shortness of breath, fever, chest
pain with coughing, fatigue.
Health History: smoker, Influenza PTA, productive cough
Labs: Blood and Sputum cultures pending, WBC: Leukocytosis
Proceed with data collection and the Nursing Process: Correct answer-Physical Exam
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