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NUR151-Oxygenation

Oxygenation

Question	Answer
CO is the most common toxic inhalant and decreases the oxygen-carrying capacity of blood. In CO toxicity, hemoglobin	strongly binds with carbon monoxide, creating a functional anemia. Because of the strength of the bond, carbon monoxide does not easily dissociate from hemoglobin, which makes hemoglobin unavailable for oxygen transport.
Conditions such as shock and severe dehydration cause	extracellular fluid loss and reduced circulating blood volume (hypovolemia).
Fever increases the tissues' need for oxygen, and as a result, carbon dioxide production	increases. When fever persists, the metabolic rate remains high and the body begins to break down protein stores, which results in muscle wasting and decreased muscle mass.
Left-sided heart failure is an abnormal condition characterized by decreased functioning of the	left ventricle. If left ventricular failure is significant, the amount of blood ejected from the left ventricle drops greatly, which results in decreased cardiac output.
A simple and cost-effective method for reducing the risks of stasis of pulmonary secretions and decreased chest wall expansion is?	Changing the client's position -reduces the risk of pneumonia associated with stasis of pulmonary secretions and decreased chest wall expansion. Oxygen humidification, chest physiotherapy, and use of antiinfectives are all helpful, but are not cost effect
The nurse is concerned when a client's heart rate, which is normally 95 beats per minute, rises to 220 beats per minute, because a rate this high will	Reduce coronary artery perfusion - Coronary arteries fill and perfuse the myocardium (heart muscle) during diastole. When the heart rate is elevated, more time is spent in systole and less in diastole; hence, the myocardium may not be perfused adequately.
Spinal cord injury at the level of C5 or above often results in damage to the	phrenic nerve, which innervates the diaphragm and permits breathing. Cardiac output is not usually affected by spinal cord injury; however, cardiac output may be reduced as a result of trauma and blood loss.
A bubbling chest tube (in the water-seal portion) should	never be clamped because it provides the only exit for air accumulating in the pleural space. If the tube is clamped, tension pneumothorax could occur, which could be fatal.
A client is receiving oxygen via a nonrebreathing mask. A crucial nursing assessment the nurse performs is to be sure that	The bag attached to the mask is inflated at all times - If the bag attached to a nonrebreathing mask is deflated, the client is at risk for breathing in large amounts of exhaled carbon dioxide.
For a nonrebreathing mask 2 L/min is	far too low a flow setting - The oxygen flow should be set at 10 L/min or more. Otherwise, the bag will collapse.
The normal cardiac output for an adult is	4 to 6 L/min.
Nicotine decreases	the oxygen-carrying capacity of hemoglobin
Clients with anemia have	fatigue, decreased activity tolerance, and increased breathlessness, as well as pallor (especially seen in the conjunctiva of the eye) and an increased heart rate.
Left-sided heart failure results in	ineffective ejection of blood from the left ventricle. This causes a backup of blood into the lungs. Thus, symptoms of left-sided heart failure are usually related to the lungs.
Blood is oxygenated through	ventilation, perfusion, and transport of respiratory gases
Neural and chemical regulators control the ___of respiration.	rate and depth
Deoxignated blood is returned to the heart through	superior and inferior vena cava and dumps into the right atrium. It is high in CO2 and low in Oxygen.
The right ventricle pumps blood through the	pulmonary circulation.
The left ventricle pumps blood through the	systemic circulation.
As the left ventricle continues to fail, blood begins to pool	in the pulmonary circulation, causing pulmonary congestion.
Right-sided heart failure more commonly results from	pulmonary disease or as a result of long-term left-sided failure.
___ are life-threatening rhythms that require immediate intervention.	Ventricular tachycardia and ventricular fibrillation.
Ventricular tachycardia is a life-threatening dysrhythmia because	the decreased cardiac output and the potential to deteriorate into ventricular fibrillation.
If left heart failure	pulmonary congestion
If right failure	systemic congestion
As the myocardium stretches, the strength of the subsequent contraction increases; this is known as	the Frank-Starling (Starling's) law of the heart.
In the diseased heart, Starling's law does not apply because	the stretch of the myocardium is beyond the heart's physiological limits.
S1	mitral and tricuspid open
S2	aortic and pulmonic close
The coronary arteries fill during	ventricular diastole
Coronary arteries supply	the myocardium with nutrients and remove wastes
Cardiac Output	Amount of blood ejected from the left ventricle each minute – about 4-6 or 5 liters.
Stroke Volume	Amount of blood ejected from the left ventricle with each contraction – Is affected by preload and afterload.
Preload	End diastolic pressure (volume) - In clinical situations the preload and subsequent SV are manipulated by changing the amount of circulating blood volume – ex: hemorrhage is present, fluid therapy and replacement of blood increases circulating volume and
Preload would __ if person is bleeding out.	decrease
Afterload	Resistance to left ventricular ejection - The diastolic aortic pressure is a good clinical measure of afterload.
In hypertension, afterload	increases, which makes cardiac workload increase.
In hypertension, afterload is manipulated by reducing	systemic blood pressure.
Heart rate affects blood flow because of the relationship between	rate and diastolic filling time. With a sustained heart rate greater than 160 beats per minute, diastolic filling time decreases, decreasing stroke volume and cardiac output.
Gases move in and out of the lung through	pressure changes.
Interplural pressure is	negative.
Ventilation	The process of moving gases into and out of the lungs – diaphragm helps this occur – innervated by phrenic nerve.
Perfusion	ability of circulatory system to move blood around the body and get it to the tissues.
Inspiration/expiration	An active process stimulated by chemical receptors in the aorta and a passive process for expiration
Pulmonary circulation	Moves blood to and from the alveolar capillary membranes for gas exchange
Diffusion	Exchange of respiratory gases in the alveoli and capillaries
Oxygen transport	Lungs and cardiovascular system
Carbon dioxide transport	Diffuses into red blood cells and is hydrated into carbonic acid
Decreased oxygen-carrying capacity	Anemia and inhalation of toxic substances decrease the oxygen-carrying capacity of blood by reducing the amount of available hemoglobin to transport oxygen.
Decreased inspired oxygen	caused by an upper or lower airway obstruction limiting delivery of inspired oxygen to alveoli; decreased environmental oxygen, such as at high altitudes; or decreased inspiration, which occurs in drug overdoses.

Created by: Ladystorm

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