Oxygenation & Perfusion
What is the purpose of incentive spirometry in patient care, and how does it help prevent respiratory complications?
Incentive spirometry encourages deep breathing and lung expansion, which helps prevent respiratory complications such as atelectasis, pneumonia, and hypoxemia, in patients recovering from surgery, pneumonia... or a cracked rib....
By promoting sustained inhalation, it helps keep alveoli open, improves ventilation, which enhances oxygenation.
What is BMR, and what factors may increase it?
Basal Metabolic Rate (BMR) is the amount of energy (in calories) the body requires to maintain basic, vital functions at rest, things like breathing, temperature regulation, and metabolism.
It represents the minimum energy needed to keep the body alive while at complete rest.
Urinary output measuring 400mL or less in a 24 hour period is known as what?
Oliguria!
DAILY DOUBLE: Name 5 things that are assessed with a urinalysis
What are some nursing interventions you would implement to prevent respiratory complications in a postoperative patient?
Interventions include assisting the patient with deep breathing and coughing exercises, use of incentive spirometry, turning as ordered, encouraging ambulation as soon as it is safe, assessing respiratory function, and promoting hydration.
What are contraindications for an enema?
Enemas should be avoided in patients with thrombocytopenia, leukopenia, or who are otherwise immunocompromised. Patients with a paralytic ileus or bowel obstruction should also avoid their use.
Even without these factors, enemas should only be used occasionally.
DAILY DOUBLE! T/F: Enema administration is a sterile procedure.
This mask delivers 60–100% oxygen at flow rates of 10–15 L/min and uses a reservoir bag with one-way valves to prevent rebreathing exhaled air.
Your patient, who is recovering from major abdominal surgery, asks you what foods they should eat to help support the healing of the incision. What do you suggest to them?
After major abdominal surgery, promote incision healing with a high-protein, high-calorie diet plus adequate vitamins and minerals. Protein supports tissue repair, calories provide energy. Vitamins C and A and zinc aid immune function and wound healing. Encourage fluids unless contraindicated.
DAILY DOUBLE: What if it was a patient with iron deficiency anemia?
A patient expresses embarrassment and frustration about using adult briefs for incontinence. What nursing interventions could you utilize to maintain the patient’s dignity, promote continence, and involve the patient in care planning?
Above all, acknowledge and validate the patient's feelings. Reassure them that incontinence is common, treatable and not an inevitable part of aging. Discuss alternatives, such as scheduled toileting, etc. Educate on exercises and lifestyle changes such as Kegels, reducing bladder irritants, and managing fluid intake. If briefs are still needed, ensure they are used in a way that reduces discomfort and risk of skin breakdown.
What is cultural imposition? Give a potential example that could be seen in a healthcare setting? How can nurses avoid cultural imposition when planning and delivering care to patients from diverse backgrounds?
Cultural imposition occurs when the nurse imposes their own beliefs/practices/values onto a patient from a different background, assuming that their way is better. Ex: insisting that a terminally ill patient sees a chaplain, even if the patient does not share spiritual beliefs.
To avoid cultural imposition, nurses should develop self-awareness of their own values and biases and recognize that they aren't likely to be shared with every patient. Nurses should assess the patient's beliefs and adapt their care to respect them.
What does Vitamin K do for the human body?
Vitamin K is essential for the production of certain clotting factors, giving it a major role in stopping bleeds.
DAILY DOUBLE: Is vitamin K fat or water soluable?
What is the initial device and flow rate range for treating mild hypoxemia?
Nasal cannula, up to 6 liters.
What nursing interventions help prevent aspiration during meals?
- Ensure patient is sitting upright, at 90 degrees if possible, maintaining this position for 30 minutes after eating.
- Don't rush or force feeding, allow ample time for meals.
- Reduce distractions so the patient can focus on chewing/swallowing.
- Collab with speech therapy for swallow evals.
- Collab with nutrition to make diet modifications (like chopping or pureeing food)
DAILY DOUBLE: What signs would you see in a patient that has potentially aspirated on a meal?
A school-age child presents with constipation and reports withholding stool during school hours. What developmental and environmental factors should the nurse consider when planning interventions to promote regular bowel elimination?
A school aged child may avoid public restrooms due to embarrassment, lack of privacy, or limited time. They may also ignore the urge to go because they are focused on school activities. Repeated withholding leads to harder stools, pain when defecating and chronic constipation.
Interventions include assessing routines and school conditions, and educating both the child and family on responding promptly to urges and using positive reinforcement.
Describe a clinical scenario where Sim’s position would be indicated. What are the key considerations for patient safety and comfort when placing a patient in this position?
Sim’s position is used for rectal & vaginal exams, enemas, suppositories, as it provides access to the rectal area while promoting comfort and dignity.
Place the patient on their left side. The left arm rests behind or alongside the body, and the right arm is bent in front. The left leg is slightly flexed, and the right leg is flexed more sharply and brought forward to expose the rectal area.
Ensure privacy, use pillows for support and alignment, assist with positioning to prevent injury, and monitor for discomfort, especially in older adults or those with joint issues.
Explain why humidifying oxygen is important for patients receiving supplemental oxygen therapy.
Humidifying oxygen prevents airway dryness and irritation caused by dry supplemental oxygen. It helps maintain mucosal integrity, supports ciliary function, and keeps secretions thin. This is especially important for patients on high-flow oxygen, or those with artificial airways to prevent thickened secretions and difficulty clearing mucus.
What is the purpose of having a patient do pursed lip breathing?
Pursed-lip breathing helps slow exhalation, improve oxygenation, and keep airways open longer, which reduces shortness of breath and prevents airway collapse, especially in patients with obstructive lung conditions, like COPD.
What are the main reasons a nurse might insert a nasogastric tube for a patient?
An NG tube can be used to provide short term nutritional support, to decompress/lavage the stomach and to administer medications.
What factors contribute to stress urinary incontinence and what may trigger it?
Stress urinary incontinence is caused by weak pelvic floor muscles and urethral sphincter. Triggers include: coughing, sneezing, laughing, lifting heavy objects, jumping/running, etc
How can a nurse assess whether a patient truly understands information provided through an interpreter? What techniques can be used to confirm comprehension and support patient safety?
To verify understanding through an interpreter, the nurse should use the teach-back method by asking the patient to explain the information in their own words. This confirms comprehension beyond a simple “yes.” The interpreter must translate the patient’s exact response so the nurse can assess understanding accurately.
Your patient, a 28 year old woman, has come to the clinic for her yearly checkup. She mentions that she has recently started exercising more and wants to ensure that her vegetarian diet is supporting her overall health. Explain to her:
- The difference between complete and incomplete proteins, and why this matters for vegetarians.
- Which vitamins and minerals vegetarians may have difficulty obtaining, and how to address these needs.
Complete proteins contain all nine essential amino acids needed by the body. These are typically found in animal products such as meat, eggs, and dairy. Most plant proteins are considered incomplete because they lack one or more of the essential amino acids. There are some exceptions, soy and quinoa are plant sources that are complete proteins. For vegetarians, this matters because relying solely on single plant protein sources may not provide all the essential amino acids. To address this, vegetarians should eat a variety of plant-based proteins throughout the day.
Vegetarians and especially vegans may have difficulty getting enough vitamin B-12, iron, calcium and vitamin D. These patients should be encouraged to eat a varied and balanced diet and to take supplements as needed to meet all nutritional needs.
How might the risk for respiratory problems change as a person ages?
The risk of respiratory problems increases with age due to less elastic lungs, weaker respiratory muscles, stiffer chest walls, and easily collapsing airways, which make clearing secretions harder. Older adults also have reduced cough and gag reflexes and may be less mobile, increasing the risk of infections and subsequent complications
A patient with suspected malnutrition has experienced recent weight loss and poor oral intake.
Which laboratory values would the nurse review to assess the patient’s nutritional status?
Common labs include (but are not limited to):
-Hemoglobin and hematocrit
-Serum albumin
-BUN/Creatinine
-Blood glucose/A1C
-Cholesterol/Triglycerides
-Electrolytes
A patient with a Foley catheter requires a urinalysis for culture/sensitivity. What steps should the nurse take to ensure the specimen is collected properly, and what errors must be avoided to prevent contamination?
The urine specimen should be taken directly from the catheter, using the port, not the bag (unless the cath was just placed). If necessary, the tubing can be clamped below the port for no more than 30 minutes to allow urine to accumulate.
If a patient is experiencing constipation, what foods would you recommend they include in their diet, and what foods should they avoid?
Foods that can help with constipation include fiber rich foods like fresh fruit and vegetables and whole grains. Foods to avoid include low fiber and highly processed foods, as well as cheese and high fat meats.
Why is checking the pH of aspirate important when confirming nasogastric tube placement. What pH values indicate correct placement?
Checking the pH of aspirate is important for confirming nasogastric tube placement because it helps determine if the tube is in the stomach, where gastric secretions are acidic. A pH of 5 or less suggests correct placement, whereas higher pH levels should indicate the need for further assessment of placement.