EX3 Module 8B Oxygination

Question 1

Ventilation

Answer 1

Moving of air (02 & CO2) in the lungs

(External Respiration/Breathing)

Question 2

Respiration

Answer 2

• Exchange of 02 & CO2 between the
  atmospheric air in the alveoli and
  blood in the pulmonary capillaries

Question 3

Diffusion

Answer 3

• Movement of solute from higher to
  lower concentration

Alveoli Sac with high of O2
and low CO2 concentration

Red blood cells with high CO2
and low O2 concentration

Question 4

Perfusion

Answer 4

• Tissue perfusion – blood flow from Lt
  side of the heart, through systemic
  circulation; oxygenated capillary blood
  passes through body tissues

Internal Respiration – exchange of oxygen and carbon dioxide
between the circulating blood and the body tissues.

Question 5

Assessment for Patient has panic attack

Answer 5

• Rapid respiration
• Sighing breaths
• Paresthesia
(numbness/tingling sensation)
• Loss of consciousness

Question 6

Patient 68 y.o. diagnosed with
pneumonia couple with COPD
exacerbation.

Assessment

Answer 6

• Lethargic
• Dizziness
• Disorientation
• Cardiac Dysrhythmias
• Electrolytes Imbalances
• Convulsion
• Coma
• Cardiac Arrest

Question 7

Nursing Diagnosis

Answer 7

 Ineffective airway clearance
 Ineffective breathing pattern
 Impaired gas exchange
 Decreased cardiac output
 Impaired tissue perfusion
 Activity intolerance
 Fatigue

Question 8

Implementation

Answer 8

flower position
Nasal cannula 1L/MIN
chest physiotheraphy
ortopenic position
coughing
diaphrem breathing
suctioning
pursed lip breathing
increase fluid if not contraindicated

Question 9

Oral Inhalation

Answer 9

• (Fluticasone/Salmeterol) Advair
  corticosteroid/beta2-adrenergic

Question 10

Nebulization

Answer 10

• (Ipratropium) Atrovent
  anti-cholinergic
• (Albuterol) Proventil
  beta2-adrenergic
• (Acetylcysteine) Mucomyst
  Mucolytic

Question 11

Factors Affecting Oxygenation

Answer 11

• Physiological Factors
- Hyperventilation/Hypoventilation
- Hypovolemia
- Hypoxia
- Decrease H & H
• Conditions Affecting Chest Wall Movement
• Influences of Chronic Disease
- COPD

Question 12

1.Afterload

Answer 12

Resistance of the
ejection of blood from
the left ventricle

Question 13

Stroke Volume

Answer 13

Amount of blood ejected
from the ventricles per
contraction

Question 14

Preload

Answer 14

Amount of blood at
the end of ventricular
diastole

Question 15

Nursing History & Physical Findings

Answer 15

• Patient has history of HTN, HF, hyperlipidemia,
smokes 1 pack/day, truck driver
• S/S include the following
o easily gets tired & confused
o dyspnea & SOB (shortness of breath)
o crackles upon auscultation
o LE pitting edema 3+
o upper right abdominal quadrant pain
o chest pain
o weight gain of 10 lbs in the last 5 days

Question 16

• Patient has history of HTN, HF, hyperlipidemia,
smokes 1 pack/day, truck driver • S/S include the following

Answer 16

o easily gets tired & confused
o dyspnea & SOB (shortness of breath)
o crackles upon auscultation
o LE pitting edema 3+
o upper right abdominal quadrant pain
o chest pain
o weight gain of 10 lbs in the last 5 days

Question 17

With the fluid in the alveoli sac, the diffusion of C02
and O2 is sluggish causing

Answer 17

hypoxemia

Deficiency of
oxygen in the
arterial blood

Question 18

Patient’s left ventricle
Contractility
Preload &
Afterload. what happened

Answer 18

Contractility decrease
Preload &
Afterload increase
Cardiac output
- Easily gets tired, confused,
pale or dusky skin
Deficiency of oxygen in the tissue

Hypoxia

Question 19

CBC ( Complete blood count)

Answer 19

RBC 4.1 x 1012/L L Male: 4.7 – 6.1 x 1012 /L
WBC 10 x 109/L 5.0 – 10.0 x 109/L
Hgb 12g/dL L Male: 14 – 18 g/dL
Hct 37% L Male : 42 – 52%
Platelets 156 x 109/L
Neutrophils 67% 55 – 70%
Lymphocytes 25% 20 – 40%
Basophils 1% 0.5 – 1%
Eosinophils 1% 1 – 4%
Monocytes 4% 2 – 8%

Question 20

BASIC METABOLIC PANEL (BMP)

Answer 20

• *SODIUM** 132 mEq/L L 136 – 145 mEq/L
• *POTASSIUM** 5.3 mEq/L H 3.5 – 5.0 mEq/L
• *CHLORIDE** 101 mEq/L 98 – 106 mEq/L
• *CO2** 31 mEq/L H 23 – 30 mEq/L
• *BUN** 32 mg/dL H 10 – 20 mg/dL
• *CREATININE** 2 mg/dL H 0.5 – 1.1 mg/dL
• *GLUCOSE** 200 mg/dL H 70 – 110 mg/dL
• *CALCIUM** 9.6 mg/dL 9 – 10.5 mg/dLBASIC METABOLIC PANEL (BMP)
• *SODIUM** 132 mEq/L L 136 – 145 mEq/L
• *POTASSIUM** 5.3 mEq/L H 3.5 – 5.0 mEq/L
• *CHLORIDE** 101 mEq/L 98 – 106 mEq/L

Question 21

LIPID PROFILE

Answer 21

• *CHOLESTEROL** 300 mg/dL H < 200 mg/dL
• *HDL** 26 mg/dL L Male > 45 mg/dL
• *LDL** 120 mg/dL < 130 mg/dL
• *TRIGLYCERIDES** 290 mg/dL H 40 – 160 mg/dL

BNP (B-type Natriuretic Peptides)
BNP 500 pg/ml H < 100 pg/ml

Question 22

Nursing Diagnosis with Ineffective airway clearance

Answer 22

Nursing Diagnosis

 Ineffective airway clearance
 Ineffective breathing pattern
 Impaired gas exchange
 Decreased cardiac output
 Impaired tissue perfusion
 Activity intolerance
 Fatigue

Question 23

who Increase preload and
contractility?

Furosemide

Answer 23

Furosemide
- Decrease preload

Lisinopril
- Decrease preload and
afterload

Digoxin
- Increase preload and
contractility

Question 24

Right Side -Deoxygenated Blood

Answer 24

Superior/Inferior Vena Cava Right Atrium Tricuspid Valve Right Ventricle Pulmonic Valve Pulmonary Artery *Deoxygenated blood goes to the lungs*

Question 25

* Left Side-Oxygenated Blood *

Answer 25

* Pulmonary Vein * Left Atrium * Bicuspid/Mitral Valve * Left Ventricle * Aortic Valve * Aorta \*Oxygenated Blood goes to the body\*

Question 26

Ventilation is the moving of air in the lungs

Answer 26

* * External respiration: inhale oxygen and exhale carbon dioxide leading to an exchange of O2 and CO2 * Example: chest expansion

Question 27

Respiration

Answer 27

* is the exchange of o2 and Co2 between the atmospheric air in the alveoli and blood in the pulmonary capillaries

Question 28

* Diffusion is

Answer 28

* the movement of solute from higher to lower concentration

Question 29

* Perfusion

Answer 29

* is the blood from the left side of the heart, through systemic circulation, oxygenated cappliary blood passes through body tissue * Example: capillary refill \>3 seconds

Question 30

Internal respiration is

Answer 30

the exchange of oxygen and carbon dioxide between the circulating blood and body tissues

Question 31

* Describe common alterations in cardiopulmonary function and oxygenation

Answer 31

* Arrhythmia * P and T waves abnormal * Hypoxia

Question 32

* Identify factors affecting cardiopulmonary function and oxygenation

Answer 32

* Hyperventilation * Hypoventilation * Hypoxia * Decrease H&H * Conditions affecting chest wall movement COPD

Question 33

* Discuss changes in cardiopulmonary function and oxygenation related to older adults

Answer 33

* Previous smoker * Other conditions * Decrease mobility

Question 34

* Create a care plan for a patient with ineffective airway clearance, ineffective breathing pattern and impaired gas exchange

Answer 34

* Ineffective airway clearance * Elevate head of bed during and after meals * Encourage coughing and deep breathing * Possible aspiration precautions * Monitor sputum * Assess and monitor respiratory status * Perform chest physiotherapy if needed * Provide exercise and activity * Suction pt airway as needed * Monitor ABG * Ineffective breathing pattern * Impaired gas exchange * Assist ADLs * Auscultate breath sounds * Monitor respiratory status * Monitor signs of respiratory problems * Perform chest physiotherapy * Limit agitation * Encourage incentive spirometry * Monitor ABG * Maintain airway

Question 35

* Afterload, Preload, Stroke Volume *

Answer 35

* Afterload- resistance of blood from L. ventricle * Inversely proportional * Increase in resistance is in aorta, vasoconstriction * Decrease in resistance, vasodilation * Increase in afterload causes decrease in stroke volume * Decrease in afterload causes increase in stroke volume * Preload- amount of blood at end of ventricular diastole * Increase in preload causes increase in stroke volume * Directly proportional to stroke volume * Stroke volume- amount of blood pumped out ventricle w each beat/contraction * Directly proportional * If contractility increase stroke volume increase or vice versa

Question 36

* Heart Failure * Left Sided HF * Backward flow * Related to lungs & Cardiac output * Examples: SOB, dyspnea, crackles, easily tired, confusion and chest pain r/t cardiac output * Right Sided HF * Symptoms related to systematic except cardiac output * Edema * Pain not r/t cardiac output decrease * Weight gain

Answer 36

* Left Sided HF * Backward flow * Related to lungs & Cardiac output * Examples: SOB, dyspnea, crackles, easily tired, confusion and chest pain r/t cardiac output *

Question 37

* Right Sided HF *

Answer 37

* Symptoms related to systematic except cardiac output * Edema * Pain not r/t cardiac output decrease * Weight gain

Question 38

* Differentiate types of oxygen delivery systems

Answer 38

* Regular nasal cannula * mustache/ pendant cannula * Simple face mask * Partial rebreather with reservoir bag * Non rebreather with reservoir bag * High flow nasal cannula * Venturi mask

Question 39

* Regular nasal cannula O2

Answer 39

* 1-6 L/min * 24%-44% *

Question 40

* Mustache or Pendent cannula o2 * 3x-4x more than regular cannula with same flow rate * No humidifier * Simple face mask o2 * 5-8 L/min * 40%-60% * Partial rebreather with reservoir bag 02 * 8-11 L/min * 50%-75% * Non Rebreather with reservoir bag o2 * 10-15 L/min * 80%-95% * High flow nasal cannula o2 * Max flow 60 L/min * 10 L/min-65% * 15 L/min-90% * Humidifier * Venturi mask o2 * Deliver precise, high flow rates * Masks available of 24%, 28%, 31%, 35%, 40%, 60% * Which o2 methods are low flow? * Regular cannula * Mustache or pendant cannula * Simple face mask * Partial rebreather * Non Rebreather * Which o2 methods are high flow? * High flow nasal cannula * Venturi mask * Which o2 methods are used with a humidifier? * Regular nasal cannula * Simple face mask * High flow nasal cannula

Answer 40

* 3x-4x more than regular cannula with same flow rate * No humidifier *

Question 41

* Simple face mask o2 * 5-8 L/min * 40%-60% * Partial rebreather with reservoir bag 02 * 8-11 L/min * 50%-75% * Non Rebreather with reservoir bag o2 * 10-15 L/min * 80%-95% * High flow nasal cannula o2 * Max flow 60 L/min * 10 L/min-65% * 15 L/min-90% * Humidifier * Venturi mask o2 * Deliver precise, high flow rates * Masks available of 24%, 28%, 31%, 35%, 40%, 60% * Which o2 methods are low flow? * Regular cannula * Mustache or pendant cannula * Simple face mask * Partial rebreather * Non Rebreather * Which o2 methods are high flow? * High flow nasal cannula * Venturi mask * Which o2 methods are used with a humidifier? * Regular nasal cannula * Simple face mask * High flow nasal cannula

Answer 41

* 5-8 L/min * 40%-60% *

Question 42

* Partial rebreather with reservoir bag 02 * 8-11 L/min * 50%-75% * Non Rebreather with reservoir bag o2 * 10-15 L/min * 80%-95% * High flow nasal cannula o2 * Max flow 60 L/min * 10 L/min-65% * 15 L/min-90% * Humidifier * Venturi mask o2 * Deliver precise, high flow rates * Masks available of 24%, 28%, 31%, 35%, 40%, 60% * Which o2 methods are low flow? * Regular cannula * Mustache or pendant cannula * Simple face mask * Partial rebreather * Non Rebreather * Which o2 methods are high flow? * High flow nasal cannula * Venturi mask * Which o2 methods are used with a humidifier? * Regular nasal cannula * Simple face mask * High flow nasal cannula

Answer 42

* 8-11 L/min * 50%-75% *

Question 43

* Non Rebreather with reservoir bag o2 * 10-15 L/min * 80%-95% * High flow nasal cannula o2 * Max flow 60 L/min * 10 L/min-65% * 15 L/min-90% * Humidifier * Venturi mask o2 * Deliver precise, high flow rates * Masks available of 24%, 28%, 31%, 35%, 40%, 60% * Which o2 methods are low flow? * Regular cannula * Mustache or pendant cannula * Simple face mask * Partial rebreather * Non Rebreather * Which o2 methods are high flow? * High flow nasal cannula * Venturi mask * Which o2 methods are used with a humidifier? * Regular nasal cannula * Simple face mask * High flow nasal cannula

Answer 43

* 10-15 L/min * 80%-95% *

Question 44

* High flow nasal cannula o2 * Max flow 60 L/min * 10 L/min-65% * 15 L/min-90% * Humidifier * Venturi mask o2 * Deliver precise, high flow rates * Masks available of 24%, 28%, 31%, 35%, 40%, 60% * Which o2 methods are low flow? * Regular cannula * Mustache or pendant cannula * Simple face mask * Partial rebreather * Non Rebreather * Which o2 methods are high flow? * High flow nasal cannula * Venturi mask * Which o2 methods are used with a humidifier? * Regular nasal cannula * Simple face mask * High flow nasal cannula

Answer 44

* Max flow 60 L/min * 10 L/min-65% * 15 L/min-90% * Humidifier *

Question 45

* Venturi mask o2 * Deliver precise, high flow rates * Masks available of 24%, 28%, 31%, 35%, 40%, 60% * Which o2 methods are low flow? * Regular cannula * Mustache or pendant cannula * Simple face mask * Partial rebreather * Non Rebreather * Which o2 methods are high flow? * High flow nasal cannula * Venturi mask * Which o2 methods are used with a humidifier? * Regular nasal cannula * Simple face mask * High flow nasal cannula

Answer 45

* Deliver precise, high flow rates * Masks available of 24%, 28%, 31%, 35%, 40%, 60% *

Question 46

* Which o2 methods are low flow? * Regular cannula * Mustache or pendant cannula * Simple face mask * Partial rebreather * Non Rebreather * Which o2 methods are high flow? * High flow nasal cannula * Venturi mask * Which o2 methods are used with a humidifier? * Regular nasal cannula * Simple face mask * High flow nasal cannula

Answer 46

* Regular cannula * Mustache or pendant cannula * Simple face mask * Partial rebreather * Non Rebreather *

Question 47

* Which o2 methods are high flow? *

Answer 47

* High flow nasal cannula * Venturi mask * Which o2 methods are used with a humidifier? * Regular nasal cannula * Simple face mask * High flow nasal cannula

Question 48

* Which o2 methods are used with a humidifier? *

Answer 48

* Regular nasal cannula * Simple face mask * High flow nasal cannula