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NR 224 Fundamentals Exam 2 Chamberlain College of Nursing
Latest 2023 / 2024
Exam 2
- Atelectasis
- The collapse of the alveoli that prevents normal exchange of oxygen and
CO2
- how to prevent atelectasis
- deep breathing exercises, coughing after surgery, smoking cessation prior
to surgery
- Respiratory Observations on a patient
- observe nails for clubbing, chest wall retraction and accessory muscle use,
breathing pattern, and assess for paradoxical breathing or asynchronous breathing
- 6 P's of Dyspnea
- P- Pulmonary Bronchial Constriction
- P- Possible Foreign Body
- P- Pulmonary Embolus
- P- Pneumothorax
- P- Pump Failure
- P- Pneumonia
- If patient is at 89% SPO2, do not place pt on oxygen, what do we do instead? 1 / 3
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- Reposition patient to maximize ventilation, ask them to take a few deep
breaths and check equipment is working properly
- Orthopnea
- shortness of breath that occurs when lying flat
- What invention can improve orthopnea?
- use multiple pillows to make it easier for he patient to breathe, have patient
sit forward with arms elevated or patient can sleep in a recliner chair
- Signs and Symptoms of Hypoxia
- Apprehension, restlessness, inability o concentrate, decreased level of
consciousness, dizziness, behavioral changes, inability to lay flat, VS changes (increased pulse and increase in depth of respiration), decline in respiratory rate due to respiratory muscle fatigue.
- First sign of hypoxia
- Elevated BP, unless condition is caused by shock
- Clinical Manifestations of Hypoxia in late stage
- Cyanosis
- Cyanosis
- Blue dis-colorization of the skin and mucous membranes cause by the
presence of desaturated hemoglobin he capillaries
- Central Cyanosis
- observed in the tongue, soft palate, and conjunctiva of the eye-- indicates
hypoxemia
- Peripheral Cyanosis
- seen in the extremities, nail beds, ear lobes- result of vasoconstriction and
stagnant blood flow 2 / 3
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- What do you do if you get an abnormal pulse ox reading?
- Verify that the oximeter probe is intact, ensure hands are not cold, and
check for nail polish
- Who should receive a flu vaccine?
- All people 6 months and older- patients with chronic illnesses, infants,
older adults, and pregnant women.
- Which group of people often require a second flu vaccine?
- HIV- positive patients
- Who should receive the pneumonia vaccine?
- Infants (4 doses), patients with increased risk of developing pneumonia (
65+, patients with chronic illnesses, immunocompromised, adults that smoke or have asthma, and anyone that lives in a nursing home or long term care.
- Nasal Cannula
- 1-6L, low flow, effective for low concentration, oxygen support
- Simple Face Mask
- 6-12L, low flow, used for short periods, oxygen support
- Partial and nonrebreather mask
- 10-15L, low flow, used for short periods, oxygen support
- Oxygen-conserving cannula (Oxymizer)
- 8L/min, low flow, indicated for long term O2 use at home, oxygen support
- Venuri Mask
- L/min varies based on size of he mask (24-50%), high flow, allows for low,
- / 3
constant O2--provides specific amount of oxygen with humidity added, oxygen support