Quiz On Lungs and Respiratory System

The range for "normal" levels of HCO3 in the blood is typically 22 - 26. HCO3, also known as bicarbonate, is an important electrolyte that helps maintain the acid-base balance in the body. Levels outside of this range may indicate an imbalance in the body's pH levels and can be a sign of certain medical conditions.

The correct "normal" range for PCO2 in the blood is 35 - 45. PCO2 refers to the partial pressure of carbon dioxide in the blood, and this range represents the typical levels of carbon dioxide that are considered normal in the bloodstream. Levels below 35 or above 45 may indicate an imbalance in the body's respiratory system.

The Venturi Mask is best for the patient with chronic lung disease because it delivers a more precise oxygen concentration.

CPAP stands for Continuous Positive Airway Pressure. It delivers a set positive airway pressure throughout each cycle of inhalation and exhalation. This helps to open collapsed alveoli, making it beneficial for patients with atelectasis after surgery or cardiac-induced pulmonary edema. CPAP is also used for sleep apnea, as it holds open the upper airways, allowing for better breathing during sleep.

The face tent is a high flow system mask that is not tight fitting, which makes it suitable for patients with facial trauma or burns. The loose fit of the mask allows for better comfort and less pressure on the affected areas, while still delivering a high flow of oxygen or aerosol therapy to the patient. This helps to ensure adequate oxygenation and healing while minimizing discomfort and potential damage to the injured facial tissues.

Initial symptoms include nonproductive cough, substernal chest pain, GI upset, and dyspnea. As exposure to high levels of oxygen continues, the symptoms become more severe with decreased vital capacity, decreased compliance (which results in more dyspnea), crackles, and hypoxemia. Prolonged exposure to high oxygen levels damages lung tissues. Atelectasis, pulmonary edema, hemorrhage, and hyaline membrane formation result.

The correct "normal range" levels for PaO2 are 80 to 100. This range indicates the normal partial pressure of oxygen in arterial blood, which is typically measured in millimeters of mercury (mmHg). PaO2 levels outside of this range may indicate a respiratory or circulatory issue.

The total level of oxygen inspired in a Low Flow System for oxygen therapy is dependent upon the respiratory rate and tidal volume. The respiratory rate refers to the number of breaths taken per minute, while tidal volume refers to the volume of air inhaled and exhaled with each breath. By adjusting the respiratory rate and tidal volume, the amount of oxygen delivered to the client can be controlled.

The nasal cannula, or nasal prongs, is used at flow rates of 1 to 6 L/min. Oxygen concentrations of 24% (at 1 L/min) to 44% (at 6 L/min) can be achieved. Flow rates greater than 6 L/min do not increase oxygenation because the anatomic dead space (places where air flows but the structures are too thick for gas exchange) is full. In addition, high flow rates increase mucosal irritation.

The patient who retains carbon dioxide rarely is prescribed to receive oxygen at a rate higher than 2 to 3 L/min because of the risk for losing the drive to breathe, thereby increasing the risk for apnea or respiratory arrest.

Make sure that the reservoir does not twist or kink, which results in a deflated bag. Deflation results in decreased oxygen delivered and rebreathing of exhaled air.

When a client's main respiratory drive is hypoxia (hypoxic drive), providing supplemental oxygen can suppress their respiratory drive and cause hypoventilation. This is known as oxygen-induced hypoventilation. In clients with chronic lung disease and carbon monoxide retention, their hypoxic drive is already compromised, and providing too much oxygen can further decrease their respiratory effort. Therefore, assessing for oxygen-induced hypoventilation is important in these clients to prevent respiratory complications.

When an oxygen flow rate higher than 4 L/min is needed, humidity is added to the delivery system.

The proper way to cleanse the cannula or mask of a client receiving oxygen therapy is to cleanse it with clear, warm water every 4 to 8 hours or as needed. This helps to remove any dirt, debris, or secretions that may have accumulated on the cannula or mask, ensuring that the client receives clean and effective oxygen therapy. Using sterile saline or clear, cool water is not necessary for routine cleansing of the cannula or mask.

The toxic effects of oxygen are difficult to treat, making prevention a priority. The lowest level of oxygen needed to maintain oxygenation and prevent oxygen toxicity is prescribed. Closely monitor arterial blood gases (ABGs) during oxygen therapy, and notify the physician of PaO2 levels greater than 90 mm Hg. Also monitor the prescribed oxygen level and length of therapy to identify the patient at higher risk. High oxygen levels are avoided unless absolutely necessary.

A minimum flow rate of 5 L/min is needed to prevent the rebreathing of exhaled air.

Nitrogen in the air normally helps maintain patent airways and alveoli. Making up 79% of room air, nitrogen prevents alveolar collapse. When high oxygen levels are delivered, nitrogen is diluted, oxygen diffuses from the alveoli into the circulation, and the alveoli collapse. Collapsed alveoli cause atelectasis (called absorption atelectasis), which is detected by auscultation. Monitor the patient closely for crackles and decreased breath sounds every 1 to 2 hours when oxygen therapy is started and as often as needed thereafter.

The type of oxygen delivery system used for a client is determined by several factors. First, the oxygen concentration required by the patient is important in determining the appropriate delivery system. Some patients may require a higher concentration of oxygen, which may necessitate the use of a different system. The importance of accuracy and control of the oxygen concentration is also a factor, as some delivery systems may offer more precise control over the oxygen levels. Patient comfort is another consideration, as certain delivery systems may be more comfortable for the patient to use. Patient mobility is also important, as some systems may be more portable and allow for greater freedom of movement. Finally, the importance of humidity may also play a role, as certain systems may offer options for adding humidity to the delivered oxygen.

Humidification is not needed in a Venturi Mask because this type of oxygen delivery system provides a precise and fixed concentration of oxygen to the patient. It works by mixing oxygen with room air through a series of small ports, creating a specific oxygen concentration. Since the oxygen is not delivered at a high flow rate, there is no need for humidification to prevent drying of the airways. In contrast, the other options (Aerosol Mask, Face Tent, Tracheostomy Collar) deliver oxygen at high flow rates, which can cause drying of the airways, and therefore require humidification to add moisture to the delivered oxygen.

If the patient's color improves from ashen or gray to pink, it indicates that the oxygen therapy is effective and the client's oxygen saturation levels are increasing. This suggests that the client's respiratory drive is not solely dependent on the hypoxic drive, which is the backup mechanism that stimulates breathing in individuals with chronic respiratory conditions. Therefore, this manifestation indicates that the client is not at risk for apnea or respiratory arrest from loss of Hypoxic Drive.