MED SURG NURS120L Exam 5 Review Oxygenation- West Coast University

2/22/202




1 Oxygenationrzd6ty
• Upper Respiratory Problems
• Lower Respiratory Problems
• Obstructive Pulmonary Diseases
• Acid Base Balance and ABGs
2 Week 5 Objectives
Oxygenation
Summarize the nursing process in care of patients with alterations in oxygenation.
Classify priorities in the care of patients with alterations in oxygenation using the following
applicable concepts: oxygenation, nutrition, perfusion, fluid/electrolyte regulation,
infection/inflammation, tissue integrity, pain, metabolism, elimination, safety, and intracranial
regulation.
Identify interprofessional collaboration/team management for needs of the patient with
alterations in oxygenation.
Examine the pharmacologic, nutritional, developmental, and teaching needs of the patient with
alterations in oxygenation.

3 Topics Covered
Lewis Ch. 25: Assessment: Respiratory System
Lewis Ch. 26: Upper Respiratory Problems
Lewis Ch. 27: Lower Respiratory Problems
ATI Ch. 17: Respiratory Diagnostic Procedures
ATI Ch. 19: Respiratory Management and Mechanical Ventilation
ATI Ch. 20: Acute Respiratory Disorders
*ATI Ch. 21: Asthma
*ATI Ch. 22: Chronic Obstructive Pulmonary Disease
ATI Ch. 23: Tuberculosis
ATI Ch. 45: Acid-Base Imbalances

4 Upper Respiratory Problems
Disorders of:
Nose
Sinuses
Hollow cavities in the skull
Pharynx
Cavity behind the nose and mouth
Larynx
Hollow organ that holds the vocal cords
5 Upper Respiratory Problems
Acute Viral Rhinitis
The common cold
200 different rhinoviruses
Most prevalent infectious disease

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Average adult: 1 – 3 colds each year
Spread by airborne droplets and direct hand contact
Can survive 3 days on inanimate objects
Symptoms begin 2 – 3 days after infection and last 2 – 14 days
Typical recovery 7 – 10 days
Runny nose, watery eyes, nasal congestion, sneezing, cough, sore throat, fever, headache, and
fatigue

6 Acute Viral Rhinitis
Nursing Management
Sore Throat
Warm salt water gargles, ice chips, lozenges
Raw Nose
Petroleum jelly
Nasal Congestion
Saline nasal spray
Postnasal Drip/Cough
Antihistamine and decongestant therapy
Intranasal decongestant sprays: 3 days only
Prevent rebound congestion
Cough suppressants (dextromethorphan)
Expectorants (guaifenesin)

7 Drug Therapy

8 Drug Therapy

9 Which of the following would be an expected outcome for a client recovering from an upper
respiratory tract infection? The client will:
Maintain a fluid intake of 800 mL every 24 hours
Experience chills only once per day
Cough productively without chest discomfort
Experience less nasal obstruction and discharge
10 The nurse teaches the client how to instill nasal drops. Which of the following techniques is
correct?
The client uses sterile technique when handling the dropper.
The client blow the nose gently before instilling drops.
The client uses a new dropper for each installation
The client sits in a semi-Fowler’s position with the head tilted forward after the administration of
the drops

11 Upper Respiratory Problems
Influenza
Flu season: September – April

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20,000 deaths annually
Flu A
Most common and most virulent
Infects humans and animals
Can cause epidemics and pandemics
Flu B
Only infects humans
Can cause epidemics but disease is milder
Flu C
Mild illness in humans only
No epidemics or pandemics
12 Upper Respiratory Problems
Influenza
Can be transmitted from animals to humans by direct or indirect contact
Transmitted between humans:
Infected droplets and inhalation of aerosolized particles
To a lesser extent, direct contact with contaminated surfaces
Incubation period: 1 – 4 days
Peak transmission risk:
 1 day before onset of symptoms and continuing for 5 – 7 days
13 Common Cold vs. Flu

14 Common Cold vs. Flu

15 Nursing Management
Influenza
Vaccination
Changed on a yearly basis
Best time to receive is in September
Takes 2 weeks for full protection
Most frequent adverse effect: soreness at injection site
Alternatives available for people who are allergic to eggs
Treatment: antiviral medication
Relenza (zanamivir)
Oral inhalation, q12 hours for 5 days
Tamiflu (oseltamivir)
Oral capsule, BID for 5 days
Rapivab (peramivir)
Intravenous, one dose
16 Upper Airway Problems
Acute Pharyngitis
Inflammation of the pharyngeal walls
Gargle with warm salt water (0.5 tsp in 8 oz. H20)
Caused by viral, bacterial, or fungal infection