Gas Exchange & ABGs
What is gas exchange?
The process of oxygen entering the blood and carbon dioxide leaving the lungs. (Rationale: Occurs at the alveolar-capillary membrane.)
What is the mechanism of action for albuterol?
Activates beta₂ receptors to cause bronchodilation. (Rationale: Relieves airway constriction.)
What is cardiac output and how is it calculated?
CO = HR × SV. (Rationale: Indicates blood flow from heart per minute.)
Hold digoxin if HR is below ___ bpm.
60 bpm. (Rationale: Prevent bradycardia/toxicity.)
Symptoms of hyponatremia?
Confusion, headache, seizures. (Rationale: Swelling of brain cells.)
identify the primary acid-base imbalance: pH 7.30, PaCO₂ 50, HCO₃ 25.
Respiratory acidosis. (Rationale: Low pH + high CO₂ = respiratory acidosis.)
Teaching for an inhaled corticosteroid (ICS)?
Rinse mouth after use to prevent thrush. (Rationale: Steroids suppress local immunity.)
Signs of left-sided vs right-sided heart failure?
eft = crackles, dyspnea; Right = edema, JVD. (Rationale: Left = lungs; Right = body.)
Common adverse effect of ACE inhibitors?
Dry cough. (Rationale: Due to bradykinin buildup.)
Priority treatment for severe hyperkalemia with ECG changes?
IV calcium gluconate. (Rationale: Protects cardiac muscle from K⁺ effects.)
Name two causes of respiratory acidosis.
Name two causes of respiratory acidosis.
What are common adverse effects of ipratropium?
Dry mouth, urinary retention, constipation. (Rationale: Anticholinergic effects.)
Which ECG change is most consistent with hyperkalemia?
Peaked T waves. (Rationale: Indicates elevated serum potassium.)
Beta-blocker nursing considerations?
Hold for HR <60, taper off slowly, monitor BP. (Rationale: Prevent rebound tachycardia.)
Safety teaching for a patient on warfarin?
Report bruising, avoid NSAIDs, monitor INR. (Rationale: Prevent bleeding complications.)
The nurse’s priority for a patient with PaO₂ of 55 mm Hg is to?
Apply oxygen and assess breath sounds. (Rationale: ABCs—oxygenation first.)
A client using acetylcysteine starts coughing and wheezing — priority action?
Stop treatment and assess airway; prepare bronchodilator. (Rationale: NAC may trigger bronchospasm.)
First nursing action for a patient with chest pain and diaphoresis?
Stop activity, sit down, apply oxygen. (Rationale: Decrease myocardial workload.)
Teaching for sublingual nitroglycerin?
Take at chest pain onset; may repeat every 5 min ×3. (Rationale: Relieves angina by vasodilation.)
Which patient should the nurse see first?
Post-op thyroidectomy patient with stridor. (Rationale: Airway obstruction = ABC priority.)
Select all that apply — signs of hypoxia.
Restlessness, confusion, cyanosis. (Rationale: Early = restlessness; late = cyanosis.)
Correct inhaler sequence when prescribed both albuterol and steroid inhaler?
Use albuterol first, wait 5 min, then steroid. (Rationale: Opens airways for steroid absorption.)
Explain how decreased perfusion leads to organ dysfunction.
Low CO → low tissue oxygen → cell death. (Rationale: Hypoxia impairs ATP production.)
Select all that apply — signs of digoxin toxicity.
Nausea, bradycardia, yellow halos. (Rationale: Toxicity causes GI, visual, and cardiac effects.)
Select all that apply — nursing interventions for hypokalemia.
Give oral/IV K⁺, monitor ECG, encourage potassium-rich foods. (Rationale: Prevent dysrhythmias.)