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ISB: Gas Exchange
Nightingale BSN 205 Week 9, Gas Exchange ISB (Airway Management)
| Question | Answer |
|---|---|
| You are reviewing the signs, symptoms, and prevention of hypoxia with the family of a patient who requires frequent suctioning at home. Choose the information that you should cover. (Select all that apply.) | Restlessness & anxiety are indications of hypoxia. Confusion, disorientation, & altered consciousness are indications of hypoxia. Increase in pulse, respiration, and BP are indications of hypoxia. Having difficulty breathing and looking blue |
| Elder woman hospitalized w/ pneumonia & anemia, hx of heart failure. Weak w/ poor cough effort. T 100.2 °F, p 114, r 26, bp 106/58. O2 ordered 2L, nasal cannula. O2 88%, 93% w/ oxygen. SOB w/ activity & poor appetite Risk factors for developing hypoxia? | Anemia. Increased secretions with weak cough. Impaired cardiac function. Pneumonia. |
| Which of the following patients would have the greatest potential for an alteration in respiration? | A 44-year-old woman with anemia. |
| Which of the following, if exhibited by the patient, is a late sign of hypoxia? | Cyanosis |
| Which of the following would lead to an increase in oxygen demand? | A fever |
| What nursing intervention is appropriate for the patient with a large amount of sputum? | Encourage the patient to cough every hour while awake. |
| Pt underwent abdominal surgery 24 hrs ago. The 72 yr male is weak and lethargic from large doses of pain meds. After noting audible gurgling on inspiration/expiration, respiratory assessment completed. Which parameters indicate need for oral suction? | Unusual restlessness. Gagging. Gurgling and adventitious lung sounds. Evidence of eyes is in the mouth. Persistent coughing that fails to clear airway. weakness and lethargy accompanied by drooling. |
| The nurse is performing routine assessments of the patients on the unit. The nurse notes audible gurgling on inspiration and expiration of the stable postoperative patient. Which of the following tasks can be delegated to competent NAP? | Performing oral suctioning |
| The nurse is preparing to perform oropharyngeal suctioning. Which of the following steps in the sequence is incorrect? | Assist the patient into a supine position. Prepare supplies. Turn the suction unit on and set the suction control gauge to high. Connect the suction tubing to the suction machine and to the Yankauer suction catheter. |
| The nurse is teaching the spouse of a patient how to perform oral suctioning for when they return home. Which of the following statements, if made by the spouse, indicates further instruction is needed | “Because oral secretions are thick, suction settings should always be set on high.” |
| Which of the following patients is most likely to experience some difficulty with effective coughing? | The patient who is postoperative for abdominal surgery. |
| Which of the following patients should be assessed for a worsening clinical situation? | The patient with presence of blood in the secretions. |
| Which of the following patients may likely require oropharyngeal suctioning? (Select all that apply | A patient who had maxillofacial surgery. A patient who had trauma to the mouth. A patient with impaired swallowing from neurological injury. A patient with an artificial airway who requires oral hygiene. |
| Which of the following should NOT be delegated to nursing assistive personnel (NAP)? | Nasotracheal suctioning |
| The nurse desires to suction the patient’s left main-stem bronchus. In what position should the patient be placed? | Turn the patient’s head to the right |
| The nurse is orienting a new graduate nurse to common procedures performed on the unit. Which statement, if made by the graduate nurse, indicates understanding of nasotracheal suctioning? | A 1- to 2- minute interval should be allowed between suctioning passes." |
| A discussion is taking place on the unit regarding the application of lubricant to the suction catheter before passing it through the nasal passage. Which statement is accurate? | Correct! “Water-soluble lubricant should be used because oil based lubricants increase the risk for aspiration and pneumonia.” |
| The nurse performs nasotracheal suctioning. Which of the following is an incorrect sequence for this procedure? | Apply sterile gloves, pick up the suction catheter with dominant hand, secure the catheter to the tubing, connect the tubing to the suction machine, and turn the suction on. |
| Which of the following is a potential complication for a patient who is having nasotracheal suctioning? (Select all that apply.) | A significant drop in oxygen concentration. A decrease in heart rate. Dysrythmias |
| 73yr old pt admitted w/ severe respiratory distress secondary to pneumonia. Long hx of smoking, recently quit. On arrival, placed on continuous O2, & trachel tube inserted for mechanical ventilation. Heavily sedated. Pt is at risk for airway occlusion. | True |
| 73yr old pt admitted w/ severe respiratory distress secondary to pneumonia. Long hx of smoking, recently quit. On arrival, placed on continuous O2, & trachel tube inserted for mechanical ventilation. Heavily sedated. Risk factors smoking, illness and age | True |
| 73yr old pt admitted w/ severe respiratory distress secondary to pneumonia. Long hx of smoking, recently quit. Placed on continuous O2, & trachel tube inserted for mechanical ventilation. Receiving IV 100mL per hr. Fluids may affects resp rate. | True |
| For a patient with an endotracheal tube on mechanical ventilation, preoxygenation is unnecessary before suctioning because the ventilator will maintain the patient's oxygen levels. | False |
| Which of the following statements regarding nasotracheal suctioning are true? (Select all that apply.) | Sterile technique is required. Suction should be applied intermittently as the catheter is removed. The suction catheter should be rotated as it is withdrawn. |
| The nurse is preparing to perform nasotracheal suctioning on a patient. Which of the following actions would indicate a break in sterile technique? (Select all that apply.) | Nurse places the sterile basin on the bedside table, they touche the inside of the basin with the nonsterile glove. uses the same catheter to suction the oral cavity followed bytrache tube and then discards the catheter inside the gloves |
| Before performing endotracheal suctioning, the nurse presses the sigh mechanism on the mechanical ventilator. Why does the nurse do this? The nurse is: (Select all that apply.) | preoxygenating the patient. offsetting the volume of oxygen lost during the suction procedure. compensating for the interruption in mechanical ventilation. |
Created by:
alishalynne93
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