Solution 2024/2025
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NUR 211 Final Exam Questions and Answers
Latest Update 2024-2025
what does the use of accessory muscles indicate ANS✔✔ an attempt to
increase lung volume that results in fatigue is not effective ventilation.
indicates ventilatory fatigue, air hunger, or decreased lung expansion
how does oxygenation of tissues take place ANS✔✔ ventilation; the process
of moving gases into and out of the lungs
perfusion; the cardiovascular system pumping oxygenated blood to the
tissues and return deoxygenated blood to the lungs
diffusion; exchange of respiratory gases in the alveoli and capillaries
how are respirations regulated (chemical and neural) ANS✔✔ neural
regulation- CNS controls the respiratory rate, depth, and rhythm and cerbral
cortex control voluntary respirations
chemical regulation - maintains the rate and depth of respirations based on
changes in the blood concentrations of CO2 and O2 and in pH, SO the
chemoreceptors sense these changes in chemicals and stimulate the
nervous system to adjust
Factors affecting oxygenation - physiology ANS✔✔ decreased o2 carrying
capacity, hypovolemia (low blood volume, less hemoglobin to carry O2
through vessels), decreased inspired O2 conc., increased metabolic rate
(infection, sepsis),
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factors affecting oxygenation - chest wall movement ANS✔✔ prgnancy,
obesity, neuromuscular disease, musculoskeletal deformities, trauma,
alterations to CNS
COPD and oxygenation ANS✔✔ -these pts have adapted to a high level of
CO2, so the CO2 sensitive receptors do not function
-COPD pts stimulus to breathe is low O2, while normally it is high CO2
-receptors in the aortic arch and carotid bodies are sensitive to low O2 level
causing increased ventilation when low O2
-SO, administering high levels of O2 to these pts prevents their O2 level
from falling and stimulating the receptors, which REMOVES THEIR STIMULUS
TO BREATHE
hyper and hypo ventilation ANS✔✔ hyper- breathing in excess of what is
required to remove CO2
hypo- inadequate breathing to meet bodys O2 demands or needs to
eliminate CO2
nursing notes on oxygenation - developmental factors ANS✔✔ -mental
status changes are 1st sign of respiratory problem
-may not complain of dyspea until it affects ADLs
- changes in coughing mechanism may lead to retention of secretions and
atelectasis (when using cough suppressants)
-diminshed respiratory muscles from changes in thorax lead to issues w
chest expansion
nursing note on oxygenation - lifestyle ANS✔✔ smoking (heart disease,
COPD, lung cancer), substance abuse (impairs tissue perfusion), stress
(increases metabolic rate and oxygen demand of the body)
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nursing note on oxygenation - environmental factors ANS✔✔ the incidence
of pulmonary disease is higher in smoggy, urban areas
-work place risks include asbestosis, coccidiodomycosis
thorough assessment of oxygenation and systems ANS✔✔ past impairments
of circulatory or respiratory function, methods pt uses to optimize
oxygenation, review of allergies, physical examination, lab and diagnostic
tests.
-HX of chest pain, dyspnea, wheezing, resp. infections, meds, fatigue,
cough, smoking, exposures
-EXAMINE skin and mucous membranes, LOC, breathing patterns, chest wall
movement, palpate chest, feet, legs, pulses, auscultate heart and lung
sounds
how to assess breath sounds ANS✔✔ rate, volume (shallow or deep), rhythm
(regular or irregular), effort, AP:LAT diameter (1:2), cough (productive or
not) - amt., color, consistency, odor
what causes decreased or absent breath sounds ANS✔✔ pneumothorax,
emphysema, removed lung lobes, obstruction, atelectasis
difference between hypoxia and hypoxemia ANS✔✔ hypoxia - inadequate
tissue oxygenation at cell level
hypoxemia - low level of oxygen in arterial blood
what is a more invasive way than pulse oximetry of determining level of
oxygenation ANS✔✔ arterial blood gases (ABGs) - invasive way to measure
partial pressure of O2 in blood. NORMAL 80-100
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acute hypoxia ANS✔✔ SUDDEN - causes? - obstructed airway, pulmonary
embolism, impaired ventilation (asthma, pneumonia)
SX- anxious, sitting up, increased RR and HR, confusion, behavior changes,
nasal flaring - cyanosis is a late sign
chronic hypoxia ANS✔✔ long term - Causes? - COPD, anemia, impaired
ventilation, cardiac abnormalities
SX- fatigue, lethargy, clubbed fingers, barrel chest, SOA, paroxysmal
nocturnal dyspnea, orthopnea, activity intolerance
define orthopnea ANS✔✔ shortness of breath that occurs when lying flat
an H+H diagnostic blood test ANS✔✔ hematocrit - % of total blood volume
made up by RBCs
MALE - 42-52% FEMALE - 37-47%
= decreased levels are called anemia
hemoglobin - iron containing pigment of RBC
MALE - 14-18 FEMALE 12-16
ways to promote oxygenation ANS✔✔ monitor hydration, humidification,
administer inhalant medications (expectorants, mucolytics, bronchodilators,
anti inflammatory agents), teach coughing and breathing, perform chest
physiotherapy, suction airway, artificial airways
what is a method that a nurse can teach the pt to do to increase air to lower
lungs ANS✔✔ diaphragmatic breathing - belly breathing