NSG300 / NSG 300 Exam 3
Student Exam 3 Blueprint
Foundations of Nursing - GCU
100% Guarantee Pass
TOPICS FEATURED
Topic 7:
Physiological Integrity I: Oxygenation & Perfusion Respiratory:
Topic 8:
Physiological Integrity II: Oxygenation & Perfusion-Cardiac & Sleep:
Topic 9:
Physiological Integrity III: Neurological and Sensoriperceptual Issues & Pain:
, Student Blueprint for NSG 300 Exam #3
Topic 7: Physiological Integrity I: Oxygenation & Perfusion Respiratory: 30%
Chapter 41: Oxygenation
p. 911 -913 (stop at Cardiovascular Physiology)
p. 914 -936 (begin at Factors Affecting Oxygenation, stop at Suctioning Techniques)
p. 937-938 (Begin at Noninvasive Ventilation, stop at Chest Tubes)
p. 940 -975 (start at Maintenance and Promotion of Oxygenation)
(R) Key Points, Reflective Learning, Review Questions
7.1 Recognize abnormal respiratory assessment findings and their impact on oxygenation and perfusion 2
Scientific base knowledge
● Respiratory gas exchange
○ Oxygen transport
■ 3 things that influence the capacity of the blood to carry oxygen: the amount of dissolved
oxygen in the plasma, the amount of hemoglobin, and the ability of hemoglobin to bind
with oxygen.
● Clients with low hemoglobin have decreased ability to carry oxygen/deliver
oxygen to the tissues
■ Carbon dioxide transport
● Regulation of ventilation
○ Ventilation is the movement of air in and out of the lungs
○ Accessory muscles involved in respiration: intercostal + abd muscles
■ Frequently used by patients with COPD/emphysema due to need to increase lung volume -
prolonged use eventually leads to fatigue
■ Can be seen in assessment if client’s clavicle elevate during inhalation - indicates
ventilatory fatigue, air hunger, or decreased lung expansion
3 steps of oxygenation: ventilation, perfusion, diffusion
● Ventilation: process of moving gasses into and out of the lung via inhalation and exhalation. Requires
the diaphragm.
○ Inhalation is active, and exhalation is passive
● Perfusion: ability of the CV system to pump oxygenated blood to the tissues and return deoxygenated
blood to lungs
● Diffusion: responsible for moving gasses from area to another by concentration gradients
○ Occurs at the alveolar capillary membrane.
○ Thickness of membrane affects the rate of diffusion. How?
■ Increased = impedes diffusion, because gasses take longer to transfer across membrane
■ Patients who may have increased thickness of membrane = pulmonary edema, pulmonary
effusion
■ Also, chronic diseases [emphysema], acute diseases [pneumothorax], and surgical
[lobectomy]
Some conditions that change the structure and function of pulmonary system:
● Chronic obstructive pulmonary disease (COPD), asthma, lung cancer, and cystic fibrosis
● These conditions may cause increased RR, decreased oxygen sat, or adventitious lung sounds [crackles,
, rhonchi, and wheezes]
● COPD = lungs and thorax are unable to recoil = increased work of breathing (WOB)
● Pulmonary edema, interstitial and pleural fibrosis = decreased compliance [lung ability to distend or
expand in response to increased intra-alveolar pressure]
● Airway resistance is the increase in pressure that occurs as the diameter of the airway decreases. It is
increased in clients with asthma, COPD, tracheal edema.
7.2 Describe key physiologic cardiorespiratory processes involved in oxygenation and perfusion of body 3
tissues
Lung volumes (p. 912)
○ Tidal volume: amount of air exhaled following normal inspiration
○ Residual volume: the amount of air left in the alveoli after full expiration
○ Forced vital capacity: maximum amount of air that can be removed from the lungs
during forced expiration
○ Important to note: variations are associated with alterations in health status [pregnancy,
exercise, obesity, obstructive/restrictive conditions of the lungs
Factors affecting oxygenation (p. 914): physiological, developmental, lifestyle, environmental
● Physiological:
○ Respiratory disorders: hyperventilation, hypoventilation, and hypoxia
○ Oxygen-carrying capacity of blood [anemia]
■ Anemic patients will have fatigue, decreased activity tolerance, increased SOB,
increased HR, and pallor (conjunctiva of eye)
■ Increased demand of body [fever]
■ Polycythemia - increased RBCs due to chronic hypoxemia [low level of oxygen in
the blood]
■ CO toxicity symptoms - HA, dizziness, nausea, vomiting, and dyspnea
● Lifestyle modifications:
○ Smoking cessation
■ Cigarette smoking worsens peripheral vascular and coronary artery diseases
○ Weight reduction
○ Low-cholesterol and low-sodium diet, management of HTN, and moderate exercise
○ Nutrition:
■ Chronic lung disease = diet higher in calories
■ Good diet for cardioprotection = rich in fiber, whole grains, fresh fruits and
veggies, nuts, antioxidants, lean meats, fish, chicken, omega-3 fatty acids
■ Fluid volume overload = vascular congestion
■ Dehydration = dizziness, fainting, hypotension, thickening of respiratory
secretions
○ Stress = increased rate/depth of respiration and increased cardiac output. Increased release
of cortisol - affects metabolism and creates risk for CAD and HTN
● Environmental
○ COPD is higher in rural areas versus urban areas
○ Occupational pollutants [asbestos, talcum powder, dust, airborne fibers]
Hypovolemia (p. 915)
● Shock + severe dehydration = loss of ECF, reduced BV
○ Results in hypoxia to body tissues, increasing cardiac output
Decreased inspired oxygen concentration
Student Exam 3 Blueprint
Foundations of Nursing - GCU
100% Guarantee Pass
TOPICS FEATURED
Topic 7:
Physiological Integrity I: Oxygenation & Perfusion Respiratory:
Topic 8:
Physiological Integrity II: Oxygenation & Perfusion-Cardiac & Sleep:
Topic 9:
Physiological Integrity III: Neurological and Sensoriperceptual Issues & Pain:
, Student Blueprint for NSG 300 Exam #3
Topic 7: Physiological Integrity I: Oxygenation & Perfusion Respiratory: 30%
Chapter 41: Oxygenation
p. 911 -913 (stop at Cardiovascular Physiology)
p. 914 -936 (begin at Factors Affecting Oxygenation, stop at Suctioning Techniques)
p. 937-938 (Begin at Noninvasive Ventilation, stop at Chest Tubes)
p. 940 -975 (start at Maintenance and Promotion of Oxygenation)
(R) Key Points, Reflective Learning, Review Questions
7.1 Recognize abnormal respiratory assessment findings and their impact on oxygenation and perfusion 2
Scientific base knowledge
● Respiratory gas exchange
○ Oxygen transport
■ 3 things that influence the capacity of the blood to carry oxygen: the amount of dissolved
oxygen in the plasma, the amount of hemoglobin, and the ability of hemoglobin to bind
with oxygen.
● Clients with low hemoglobin have decreased ability to carry oxygen/deliver
oxygen to the tissues
■ Carbon dioxide transport
● Regulation of ventilation
○ Ventilation is the movement of air in and out of the lungs
○ Accessory muscles involved in respiration: intercostal + abd muscles
■ Frequently used by patients with COPD/emphysema due to need to increase lung volume -
prolonged use eventually leads to fatigue
■ Can be seen in assessment if client’s clavicle elevate during inhalation - indicates
ventilatory fatigue, air hunger, or decreased lung expansion
3 steps of oxygenation: ventilation, perfusion, diffusion
● Ventilation: process of moving gasses into and out of the lung via inhalation and exhalation. Requires
the diaphragm.
○ Inhalation is active, and exhalation is passive
● Perfusion: ability of the CV system to pump oxygenated blood to the tissues and return deoxygenated
blood to lungs
● Diffusion: responsible for moving gasses from area to another by concentration gradients
○ Occurs at the alveolar capillary membrane.
○ Thickness of membrane affects the rate of diffusion. How?
■ Increased = impedes diffusion, because gasses take longer to transfer across membrane
■ Patients who may have increased thickness of membrane = pulmonary edema, pulmonary
effusion
■ Also, chronic diseases [emphysema], acute diseases [pneumothorax], and surgical
[lobectomy]
Some conditions that change the structure and function of pulmonary system:
● Chronic obstructive pulmonary disease (COPD), asthma, lung cancer, and cystic fibrosis
● These conditions may cause increased RR, decreased oxygen sat, or adventitious lung sounds [crackles,
, rhonchi, and wheezes]
● COPD = lungs and thorax are unable to recoil = increased work of breathing (WOB)
● Pulmonary edema, interstitial and pleural fibrosis = decreased compliance [lung ability to distend or
expand in response to increased intra-alveolar pressure]
● Airway resistance is the increase in pressure that occurs as the diameter of the airway decreases. It is
increased in clients with asthma, COPD, tracheal edema.
7.2 Describe key physiologic cardiorespiratory processes involved in oxygenation and perfusion of body 3
tissues
Lung volumes (p. 912)
○ Tidal volume: amount of air exhaled following normal inspiration
○ Residual volume: the amount of air left in the alveoli after full expiration
○ Forced vital capacity: maximum amount of air that can be removed from the lungs
during forced expiration
○ Important to note: variations are associated with alterations in health status [pregnancy,
exercise, obesity, obstructive/restrictive conditions of the lungs
Factors affecting oxygenation (p. 914): physiological, developmental, lifestyle, environmental
● Physiological:
○ Respiratory disorders: hyperventilation, hypoventilation, and hypoxia
○ Oxygen-carrying capacity of blood [anemia]
■ Anemic patients will have fatigue, decreased activity tolerance, increased SOB,
increased HR, and pallor (conjunctiva of eye)
■ Increased demand of body [fever]
■ Polycythemia - increased RBCs due to chronic hypoxemia [low level of oxygen in
the blood]
■ CO toxicity symptoms - HA, dizziness, nausea, vomiting, and dyspnea
● Lifestyle modifications:
○ Smoking cessation
■ Cigarette smoking worsens peripheral vascular and coronary artery diseases
○ Weight reduction
○ Low-cholesterol and low-sodium diet, management of HTN, and moderate exercise
○ Nutrition:
■ Chronic lung disease = diet higher in calories
■ Good diet for cardioprotection = rich in fiber, whole grains, fresh fruits and
veggies, nuts, antioxidants, lean meats, fish, chicken, omega-3 fatty acids
■ Fluid volume overload = vascular congestion
■ Dehydration = dizziness, fainting, hypotension, thickening of respiratory
secretions
○ Stress = increased rate/depth of respiration and increased cardiac output. Increased release
of cortisol - affects metabolism and creates risk for CAD and HTN
● Environmental
○ COPD is higher in rural areas versus urban areas
○ Occupational pollutants [asbestos, talcum powder, dust, airborne fibers]
Hypovolemia (p. 915)
● Shock + severe dehydration = loss of ECF, reduced BV
○ Results in hypoxia to body tissues, increasing cardiac output
Decreased inspired oxygen concentration
