enation

PRELIMINARY READING
Chapter 41, pp. 87 1-933
~------------
fCQOM~PR~E~H~E~NS~IV~E~U~N~D~E~R~ST.~'A~N~D~IN~G!.------------

Scientific Knowledge Base iratory physiology. fi one area to another according to con.
Match the followin~ k~y tenns that relate t~ r~ves the respiratory gases rom
I. , Ventilation . · trarion gradients
2 - ~ - Work of breath mg cen lobin
3: - - - Inspiration b. Reduced he~og led after normal inspiration .. .
4 __ _ _ Expiration c. Amount o~ air exha tween the mouth and the alveoh m relation to the
5 - ___ Compliance d. Pressure difference be
6.· _ _ _ Airway resistance rate offlow of inspire
· · d gas . d ut of the lungs
. • · f · ases mto an o
7. _ _ _ Respiration . e. Process o movmg g d bon dioxide during cellular metab r
8. - ~-Deoxyhemoglobm f. ls the exchange of oxygen an car ism °
9. ' \ Diffusion Effort required to expand and contract the 1~ngs .
Jo. C Tidal volume : : Ability of the lungs to distend or to expand m response to mcreased
intraalveolar pressure .
1. Active process stimulated by chemical. recept~rs m the_ aorta
J. Passive process dependent on the elastic rec01l properties of the lungs

Match the following cardiopulmonary physiology terms. .

11. _ _ _ Frank-Starling law a. Reflects the electrical activity of the conduction system
12. _ _ _ Cardiac output b. End-diastolic volume
13. _ _ _ S1 and S2 c. As the myocardium stretches, the strength of the contraction increases
14. _ _ _ Stroke volume d. Normal sequence on the electrocardiogram (ECG)
15. _ _ _ Preload e. Amount of blood ejected from the left ventricle each minute
16. ----'---Afterload f. Affected by preload, afterload, and contractility
17. _ _ _ ECG g. The resistance to left ventricular ejection
18. \) Normal sinus rhythm h. Closure of heart valves
Explain what the following waves in the conduction system represent and the normal values for each.

19. P wave: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

20. PRinterval: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

21. QRScomplex: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

22. QTinterval: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

23. Identify the factors that affect oxygenation.

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 Chap\er 41
Ox-,ge11a11on
179

d.
t' fy conditions that affect chest wall
1dell I . movemerlt and
Z· provide an e __/
n. ------------- --- xamp\e.

b,

c.
d.
e.
f.
g.
£)(P Jain the following alterations in respiratory functionmg.
. .

25_Hyperventilation:======~-----------------

26 . Hypoventilation: = = = = = = = ~ - - - - - - - - - - - - - - - - - - ~

27. Hypoxia:

28. Cyanosis: - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
I

29. Briefly describe the following dysrhythmias. \

a. T a c h y c a r d i a : - - - - - - - - - - - - - - - - - - - - - - - - - - - - -
b. Bradycardia: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __
c. Atrial fibrillation: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

30. Explain the difference between the following types of heart failure.
a. Left s i d e d : - - - - - - - - - - - - - - - - - - - - - - - - - ~ - - - -
b. Rightsided: _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ __

Describe the following disorders.

31. Myocardial ischemia: - - - - - - - - - - - - - - - - - - - - - - - - - - - -

32. Angina pectoris: ------------------------~====

33 . Myocardial infarction:
 180 Chapter 41 Oxygenotlon

• .c: nces between the following t

1 in the d1fiere :Yp~s,
41. Expa .
of chest pain.
Nursing Knowledge Base ti follow-
ldenti fy the cardiopulmonary risk factors for ,e a. Cardiac pain:
ing developmental levels.

34. Infants and toddlers:

b. Pleuritic chest pain:

35. School-age children and adolescents:

c. Musculoskeletal pain:

36. Young and middle-aged adults:

. h following affect oxygenation.
Explam how t e

37. Older adults: 42. Fatigue:

38. List the lifestyle modifications to decrease cardio- 43. Dyspnea: - - - - - - - - - - - -

pulmonary risks.

a.---------------
b. - - - - - - - - - - - - - -
44. Orthopnea: - - - - - - - - - - - -
c. - - - - - - - - - - - - - - -
d. - - - - - - - - - - - - -
e. - - - - - - - - - - - - - - -
39. List four occupational pollutants. 45. Cough: - - - - - - - - - - - - -

a. - - - - - - - - - - - - - - - -

b. - - - - - - - - - - - - - - -
c. - - - - - - - - - - - - - - - - 46. Wheezing:

d. - - - - - - - - - - - - - - - -
Nursing Process
Assessment
Briefly explain what information is gained from the fol-
40. Explain the focus of the nursing history to meet oxy-
gen needs for the following. lowing techniques used during the physical examination
to assess tissue oxygenation.
a. Cardiac function: 47. Inspection: _ _ _ _ _ _ _ _ _ _ _ __

b. Respiratory function:
48. Palpation:
-------------
f rcussion: - - - - - - - - - - -
Chapter 41 Oxygenation 181

~9- r e
c. Bronchoscopy:
I,,

Auscultation:
50. d. Lung scan:

pescribe the following diagnostic t

5I. determine the adequacy of the cardiaests used . to e. Thoracentesis:
c conduction
5ystern.
a. Bolter monitor:
Nursing Diagnosis
· ct·iagnoses that are appropriate for the
53 · List. the n~smg
patient with alterations in oxygenation.
b. Exercise stress test:
a. - - - - - - - - - - - - - - - -

b. - - - - - - - - - - - - -
c. - - - - - - - - - - - - - - - - -
c. Thallium stress test:
d. - - - - - - - - - - - - - -
e. - - - - - - - - - - - - - - - - -
f. - - - - - - - - - - - - - -
d. Electrophysiologic study (EPS): g. - - - - - - - - - - - - - - - -
h. - - - - - - - - - - - - - - -
Planning
54. List the specific outcomes for maintaining a patent
e. Echocardiography: airway.
a. - - - - - - - - - - - - - - - - -
b. - - - - - - - - - - - - - - - - -
f. Scintigraphy: c. - - - - - - - - - - - - - - - - - -
d. - - - - - - - - - - - - - - - - - -
Implementation
g. Cardiac catheterization and angiography: 55. List patient and family teaching strategies to promote
cardiopulmonary health.
a. - - - - - - - - - - - - - - - - - -
b. - - - - - - - - - - - - - - -
52. Describe the following tests used to measure the c. - - - - - - - - - - - - - - - - - -
adequacy of ventilation and oxygenation.
d. - - - - - - - - - - - - - - - -
a. Pulmonary function tests:
e. - - - - - - - - - - - - - - - - -
f.

b. Peak expiratory flow rate (PEFR):

2.o&irgi10 2017 by Elsevier, Inc. All rights reserved.

 182 Chapter 41 Oxygenation

. a·
63. Positionino·
.
56. List the intcrven~1ons that promote mobilization or
pulmonary secrct1ons.
a. _ __ _ _ __

· 0 metry:
· sptr
b. - - -- - - 64. Incentive
c. _ __ __ __

d. - - -- - - -
57. Describe the following types of cough. . . d' ations for invasive mechanical
65 . L .IS t the. clinical m ic
a. Cascade: ventilat10n.
a.
b.
b. Huff: c.
d.
e.
c. Quad:
f.
g.

66. Identify
. the most commonly used modes available
58. Postural drainage is a component of pulmonary
hygiene and consists of: on all ventilators.

a.-----------
b. - - - - - - - - - -
59. Percussion is contraindicated in: C. - - - - - - - - - - - -- - - - -

a.------------- 67_ Identify the complications of invasive mechanical

ventilation.
b. - - - - - - - - - - -
C. - - - - - - - - - - - - - -

60. Suctioning techniques include:

a. - - - - - - - - - - - - - - - 68. Noninvasive ventilatory support can be achieved

b. - - - - - - - - - - - - using a variety of modes. List two of them.
C. - - - - - - - - - - - - - - - - - - - -
a. - - - - - - - - - - - - - - - -
61. Define the types of artificial airways.

a. - - - - - - - - - - b. - - - - - - - - - - - - -
69. List the complications of noninvasive ventilation.
b. - - - - - - - -

C. - - - - - - - - - - - - - - - -------

Nursing interventions that maintain or promote lung

expansion include the following noninvasive tech- 7
niques. Briefly explain each one. o. Identify the three reasons for inserting chest tubes.
a.
62. Ambulation:
b.
C.
 Cl1op10r 41 oxygenallon 183

. , rhc rollowing.
l)~•I//\C 74 · Identify the indicnlions for u putienl to receive home
71.
~. 111 0 11tornx:
11, 11 oxygen therapy.

pncuinothorax:
Ii, 75. In cardiopulmonary resuscitation, CAB stands for:
C:
----------------
~. Tho gonl of oxygen therapy is:
A:
----------------
B:
1 ----------------
76. The goal of cardiopulmonary rehabilitation for the
patient to maintain an optimal level of health focuses
on:
_ Describe the following methods of oxygen delivery. a.
73
n. Nasal cannula: - - - - - - - - - -- b. - - - - - - - - - -- - - - -
c. - - - - - - - - - - - - - - - -

d. - - - - - - - - - - - - - - -
b. face mask: - - - - - - - - - - - - Briefly explain the following breathing techniques used
to improve ventilation and oxygenation.
77. Pursed-lip breathing:

c. Venturi m a s k : - - - - - - - - - - - -
78. Diaphragmatic breathing:

REVIEW QUESTIONS
80. Afterload refers to:
Select the appropriate answer and cite the rationale for 1. The resistance to left ventricular ejection
choosing that particular answer. 2. The amount of blood in the left ventricle at the end
of diastole
79. Ventilation, perfusion, and exchange of gases are the 3. The amount of blood ejected from the left ven-
tricle each minute
major purposes of: 4. The amount of blood ejected from the left ven-
1. Respiration tricle with each contraction
2. Circulation
3. Aerobic metabolism Rationale: _ _ _ _ __
Answer: _ _ _ _ __
4. Anaerobic metabolism
Rationale: _ _ _ _ __
Answer: - - - - - -

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 '· ...
..
_

. ·. ,

... ·.r.
,,
.

184 Chapter 41 Oxygenation t•UNt<IIIIG MODEL FOR NURSING c

,;R;NeFF£CTIVE JJflWAV CLEAllANct"·
8 I. The movement of gases into and out of the lungs gine that you are the student nurse in the
· rnl a on P· 889 of your text. Complete the A care
depends on: 84 p1 an . . I th ' nki' sses.
model by w .. s-
I. 50% oxygen content in the atmospheric air me hase of the cnuca I. ng b ntin
2. The pressure gradient between the atmosphere yournt P
answers in the appropriate oxes of the g
and the alveoli shown. Think about the following. model
3. The use of accessory muscles of respiration dur- • What knowledge base . h was applied .to Mr. Edwards?
ing expiration • In what . way. ro1g t your previous exp enenc . •
4. The amount of carbon dioxide dissolved in the
apply m this case? e
fluid of the alveoli • What intellectual or professional standard 5
Rationale: _ _ _ _ __ applied to Mr. Edwards? were
Answer: - - - - - - • What critical thinking attitudes did you use ·
assessing Mr. Edwards? tn
• As you review your assessment, what ke
did you cover? Y areas
82. Mr: l~aac comes to the emergency department com-
plam1_ng of difficulty breathing. An objective finding
assoc1a~ed with his dyspnea might include:
1· Feeling~ of heaviness in the chest
. Comp lam ts of shortness of breath
~- ~se of accessory muscles of respiration
. tatements about a sense of impending doom

Answer: - - - - - - Rationale: - - - - - -

83. The use of chest physiother ..

nary secretions involves th apy to mobthze pulmo-
1. Hydration e use of:
2. Percussion
3- Nebulization
4· Humidification

Answer: Rationale:
 Chapter 41 Oxygenation 185

8. KNOWLEDGE

C. EXPERIENCE

A. ASSESSMENT

D. STANDARDS E. ATTITUDES

Cl 2017 Dy Elsevier, Inc. All rights reserved.