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NR224 FUNDAMENTALS FINAL EXAM WITH CORRECT ANSWERS

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NR224 FUNDAMENTALS FINAL EXAM WITH CORRECT ANSWERS. What intervention may prevent clinical decline and promote optimal oxygenation? Cardiopulmonary rehabilitation -physical exercise, nutrition counseling, relaxation and stress-management techniques, and prescribed medications and oxygen Respiratory muscle training -incentive spirometer, resistive breathing device Breathing exercises -Pursed lip breathing, deep breathing and coughing, diaphragmatic breathing What is pneumothorax? collection of air in the pleural space -loss of negative intrapleural pressure causes the lung to collapse What is spontaneous (primary) pneumothorax? is a genetic condition that occurs unexpectedly in healthy individuals who develop blisterlike formations (blebs) on the visceral pleura, usually on the apex of the lungs. -bleb can rupture during sleep or exercise Clinical findings with pneumothorax Dyspnea Pain (sharp and pleuritic and worsens on inspiration) Interventions associated with pneumothorax Chest tube (drain air or excess fluid) Chest tube chambers Chamber 1: collects fluid draining from patient Chamber 2: water seal prevents air from re-entering patient's pleural space Chamber 3: suction control of system In which chamber of

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What intervention may prevent clinical decline and promote optimal
oxygenation?

Cardiopulmonary rehabilitation



-physical exercise, nutrition counseling, relaxation and stress-management
techniques, and prescribed medications and oxygen



Respiratory muscle training



-incentive spirometer, resistive breathing device



Breathing exercises



-Pursed lip breathing, deep breathing and coughing, diaphragmatic breathing




What is pneumothorax?

collection of air in the pleural space

-loss of negative intrapleural pressure causes the lung to collapse




What is spontaneous (primary) pneumothorax?

is a genetic condition that occurs unexpectedly in healthy individuals who
develop blisterlike formations (blebs) on the visceral pleura, usually on the
apex of the lungs.

-bleb can rupture during sleep or exercise

,Clinical findings with pneumothorax

Dyspnea



Pain (sharp and pleuritic and worsens on inspiration)




Interventions associated with pneumothorax

Chest tube (drain air or excess fluid)




Chest tube chambers

Chamber 1: collects fluid draining from patient

Chamber 2: water seal prevents air from re-entering patient's pleural space

Chamber 3: suction control of system




In which chamber of the chest tube can you expect bubbling?

Suction control chamber

-be sure to keep it filled with sterile water




A constant or intermittent bubbling in the water-seal chamber indicates .....

a leak in the drainage system, and the health care provider must be notified
immediately.

,CPAP

treats patients with obstructive sleep apnea, patients with heart failure, and
preterm infants with underdeveloped lungs. In obstructive sleep apnea,
airways collapse, causing shallow or absent breathing. Any air moving past
the obstruction results in loud snoring




How do we teach a patient to use an incentive spirometer?

Sitting up atleast 45 degrees

Used every 1-2 hours

Inhale slowly with an even flow to eleyate the balls and keep them floating
as long as possible




How do we assess oxygenation status?

Respiratory rate

Observation of nails for clubbing

Accessory muscle use

SpO2

Arterial blood gas (ABG)

Position change

LOC

Breathing patterns




Late signs of low oxygenation assessment

LOC

, Blood gas

Clubbing

Capillary refil




How can we promote adequate oxygenation?

Raise head of bed

Provide oxygen

Breathing exercise

Turning, coughing, deep breathing

Mobility

Incentive spirometer




What are some considerations for patients with a tracheostomy?

Have oxygen

Sterile water near by

Extra canula

Suction

Humidified oxygen




What are some conditions that required the use of a chest tube?

Hemothroax

Pneumothorax

Chest surgery/trauma

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