NUR 321L Final Exam
Oxygen & Oxygen Delivery - ANS-
What percentage of oxygen is the air around us? (FiO2) - ANS-21%
How does oxygen get into the blood? - ANS-- air enters the alveolus and the O2 moves
across the capillary membrane into the hemoglobin
What is the appropriate range for SpO2? - ANS-mid to upper 90%
When is the 21% - ANS-- COPD: alveoli get overinflated and destroyed
- pulmonary edema: water in the alveoli
- pneumonia: pus gets into the alveoli, leading to infected consolidation/hardness
- pleural effusion: space-occupying, alveoli can't expand
- atelectasis: completely deflated alveoli
- obstruction (asthma & bronchial obstruction) can cause little air to get inside
What are the signs of hypoxemia? - ANS-- cyanosis (blue or gray tone to skin), SOB,
cough, sputum production
What is a nasal cannula? - ANS-- oxygen delivery device that can administer up to
6L/min of O2; needs to be humidified in order to not dry out the nostril
- 6LPM can deliver FiO2 of around 40-44%
- Not very exact and hard to control
Why is humidification important? - ANS-- prevents drying of the mucous membranes;
used if flow > 2L/min
What is a simple face mask? - ANS-- oxygen delivery device that must administer
greater than 5LPM (flushes out accumulated CO2)
- can go up to 8-10L (about 60% FiO2)
- best for mouth breathers or those with clogged nose/sinuses
What is a venturi device? - ANS-- delivers the most precise amount of FiO2
- Ex: order for O2 at 40% - this is the best noninvasive way to achieve (because it is
most precise when it comes to FiO2)
, What is a non-rebreather mask? - ANS-- a one-way valve that delivers the highest
concentration of O2 (about 100%)
- reservoir bag must be inflated (takes about 10-15 LPM)
What is TCDB and when could it be used? - ANS-- turn, cough, deep breathe can help
open airways and mobilize secretions (O2 is no help if patient has mucus blocking the
airway)
What is an incentive spirometer and how is it used? - ANS-- can help keep the lungs
strong by deep breathing, which allows the piston to rise
- patient usually has a goal to meet (the incentive)
- usually told to do it 10x/hr (can tell them to do it 2-3x every time a commercial comes
on)
What positioning can help facilitate breathing? - ANS-- fowlers allows gravity to pull
abdomen and lower body off the diaphragm to help lung expansion
- tripod position can do the same
- pursed-lip breathing: slow breathing and allows the patient to feel some more control
How do you prepare a new inhaler to be used? - ANS-- place the canister into the
inhaler and press down to lock
- shake and press down 3-4 times to ensure the medication has moved into the inhaler
(primed)
How do you used an inhaler? - ANS-- shake before every use
- remove the cap
- exhale deeply and blow out all the air
- place the inhaler into your mouth and create a seal with your lips
- depress the canister and slowly breathe in
- hold your breath to let gravity pull meds to the lungs
- wait a minute or so before the next puff
How do you use a spacer? - ANS-- a spacer helps slow the time between pressing the
canister and breathing in, helping more medication reach the lungs
- shake the whole set
- use the same process except you should allow the medication to be held in the
chamber for a moment before breathing in
What should be done after using an inhaler? - ANS-- rinse after
- reduces the risk of thrush and other side effects
Oxygen & Oxygen Delivery - ANS-
What percentage of oxygen is the air around us? (FiO2) - ANS-21%
How does oxygen get into the blood? - ANS-- air enters the alveolus and the O2 moves
across the capillary membrane into the hemoglobin
What is the appropriate range for SpO2? - ANS-mid to upper 90%
When is the 21% - ANS-- COPD: alveoli get overinflated and destroyed
- pulmonary edema: water in the alveoli
- pneumonia: pus gets into the alveoli, leading to infected consolidation/hardness
- pleural effusion: space-occupying, alveoli can't expand
- atelectasis: completely deflated alveoli
- obstruction (asthma & bronchial obstruction) can cause little air to get inside
What are the signs of hypoxemia? - ANS-- cyanosis (blue or gray tone to skin), SOB,
cough, sputum production
What is a nasal cannula? - ANS-- oxygen delivery device that can administer up to
6L/min of O2; needs to be humidified in order to not dry out the nostril
- 6LPM can deliver FiO2 of around 40-44%
- Not very exact and hard to control
Why is humidification important? - ANS-- prevents drying of the mucous membranes;
used if flow > 2L/min
What is a simple face mask? - ANS-- oxygen delivery device that must administer
greater than 5LPM (flushes out accumulated CO2)
- can go up to 8-10L (about 60% FiO2)
- best for mouth breathers or those with clogged nose/sinuses
What is a venturi device? - ANS-- delivers the most precise amount of FiO2
- Ex: order for O2 at 40% - this is the best noninvasive way to achieve (because it is
most precise when it comes to FiO2)
, What is a non-rebreather mask? - ANS-- a one-way valve that delivers the highest
concentration of O2 (about 100%)
- reservoir bag must be inflated (takes about 10-15 LPM)
What is TCDB and when could it be used? - ANS-- turn, cough, deep breathe can help
open airways and mobilize secretions (O2 is no help if patient has mucus blocking the
airway)
What is an incentive spirometer and how is it used? - ANS-- can help keep the lungs
strong by deep breathing, which allows the piston to rise
- patient usually has a goal to meet (the incentive)
- usually told to do it 10x/hr (can tell them to do it 2-3x every time a commercial comes
on)
What positioning can help facilitate breathing? - ANS-- fowlers allows gravity to pull
abdomen and lower body off the diaphragm to help lung expansion
- tripod position can do the same
- pursed-lip breathing: slow breathing and allows the patient to feel some more control
How do you prepare a new inhaler to be used? - ANS-- place the canister into the
inhaler and press down to lock
- shake and press down 3-4 times to ensure the medication has moved into the inhaler
(primed)
How do you used an inhaler? - ANS-- shake before every use
- remove the cap
- exhale deeply and blow out all the air
- place the inhaler into your mouth and create a seal with your lips
- depress the canister and slowly breathe in
- hold your breath to let gravity pull meds to the lungs
- wait a minute or so before the next puff
How do you use a spacer? - ANS-- a spacer helps slow the time between pressing the
canister and breathing in, helping more medication reach the lungs
- shake the whole set
- use the same process except you should allow the medication to be held in the
chamber for a moment before breathing in
What should be done after using an inhaler? - ANS-- rinse after
- reduces the risk of thrush and other side effects
