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NRSG 421 Exam 2 Questions And Accurate Answers
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NRSG 421 Exam 2 Questions And Accurate AnswersPlacental abruption can cause - ANSWER Post-partum hemorrhage
Hypovolemic Respiratory Failure (Type 1) - ANSWER PAO2 < 60, despite increasing
FIO2
* refractory hypoxemia
hypercapnic respiratory failure (type 2) - ANSWER PaCO2> 50 with PH < 7.35.
Acidosis
Ventilation - ANSWER movement of air in and out of lungs
Perfusion - ANSWER Blood flow through pulmonary circulatory system
Diffusion - ANSWER Exchange of 02 and CO2 within alveoli
Ventilation perfusion ration V/Q - ANSWER Normal = 4/5
High V/Q = air reaches lung, but no blood flow (PE, low CO)
Low V/Q= airflow decreased, blood flowing (pneumonia, ARDS, pulm edema)
ARF risk factors - ANSWER Hypoventilation (airway, obstruction, muscle weakness,
injury, anesthesia, opioid)
,V/Q mismatch diseases - ANSWER COPD, atelectasis, restrictive, lung diseases, PE,
ARDS, pneumothorax, pulmonary edema
ARF Early S/S - ANSWER Dyspnea, restlessness, anxiety, fatigue, tachycardia,
increased, BP, low CO2 (hyperventilating)
ARF Intermediate S/S - ANSWER Confusion, pinker, skin, tone, lethargy due to increase
CO2
ARF Late S/S - ANSWER Cyanosis/unresponsiveness
ARF diagnosis - ANSWER -ABGs
-CXR
*hypercapnia=late sign
ARF treatment - ANSWER treat underlying condition
NPPV: CPAP/BiPAP
Mechanical ventilation
ARDS - ANSWER Inflammatory condition secondary to another problem
Non-cardiogenic pulmonary edema
Onset: <7 days
Diagnosis: chest X-ray (white out), PAO2/FiO2=<200
, Direct Causes of ARDS - ANSWER Aspiration of the chest, trauma, pneumonia,
pulmonary contusion, inhalation injury, pulmonary embolus
InDirect Causes of ARDS - ANSWER Sepsis/shock, pancreatitis, Burns, blood
Transfusions, transfusion related acute lung injury, cardiopulmonary bypass,
Drug/alcohol overdose
ARDS P/F ratio - ANSWER Mild= 200-300
Moderate= 100-200
Severe=<100
Exudative - Injury phase - ANSWER 24-48 hours following injury damage to capillary
membrane align fluid that is protein, rich to leak into interstitium> Alveolar sac> Causing
edema
Damaged surfactant cells, decrease ability to keep sac open*
Blood shunting past alveoli w/o being oxygenated *
Proliferative (repair) phase - 14 days after injury, cells reproducing quickly, trying to
repair, causing noncompliant, lung tissue, causes pulmonary hypertension and right
sided heart failure*
Fibrotic: fibrosis/scarring, severe tissue hypoxia, lactic acidosis*
Treatment for ARDS - Ventilation: ventilation uses lower tidal volume to prevent alveoli
rupture * PEEP used to keep alveoli open
Position: prone, relieve pressure on lungs *16-20 hrs/day
Medication: infection-antibiotics, neuromuscular blocking agents= Reduced pulmonary
resistance
Oral cares, suctioning, >30° bed
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