Deck 34: Determinants and Assessment of Oxygenation

Question 1

Arterial blood gases were drawn when a patient was discovered in cardiopulmonary arrest.Which results would the nurse evaluate as indicating global lactic acidosis? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)pH 7.21
B)HCO₃ 24 mEq/L
C)Base excess -12 mmol/L
D)PaO₂ 82 mm Hg
E)PaCO₂ 37 mm Hg

Answer 1

pH 7.21
Base excess -12 mmol/L

Question 2

A patient's mixed venous oxygen saturation level is 56%.What evaluation would the nurse make of this reading?

A)The cells are producing oxygen to meet needs.
B)The cells are not receiving enough oxygen.
C)The cells are releasing more carbon dioxide.
D)There isn't enough oxyhemoglobin to meet the patient's needs.

Answer 2

The cells are not receiving enough oxygen.

Question 3

A patient is diagnosed with lactic acidosis.The nurse plans to provide care to a patient whose energy is being produced through which process?

A)Affinity
B)Aerobic metabolism
C)Extraction
D)Anaerobic metabolism

Answer 3

Anaerobic metabolism

Question 4

The nurse is planning essential activities for a critically ill patient.In order to provide the least impact on oxygen consumption,the nurse would be certain the patient rests before and after which activity?

A)Abdominal wound dressing change
B)Bed bath
C)Daily weight using bed sling scale
D)Turning and repositioning

Question 5

A patient is diagnosed with iron deficiency anemia.The nurse plans interventions for a patient with which most likely complication?

A)Impaired oxygen delivery
B)Bleeding
C)Multisystem organ failure
D)Reduced lung function

Question 6

A patient's PaO₂ level is 56 mm Hg.The nurse would plan care to prevent development of which condition?

A)Hypoxemia
B)Intrapulmonary shunt
C)Hypoxia
D)Hyperventilation

Question 7

The nurse,caring for a patient with hypovolemic shock,is primarily concerned that which change could occur in this patient's pulmonary gas exchange?

A)Insufficient distribution of oxygen
B)Buildup of electrolytes in the blood
C)Over-oxygenation
D)Oxygen delivery shift to osmosis

Question 8

The nurse is caring for a patient with impaired diffusion of oxygen secondary to pneumonia.Assessment findings related to this impairment are similar to those the nurse would see in patients with which other disease states?

A)Spinal cord injuries
B)Flail chest
C)Atelectasis
D)Carbon monoxide poisoning

Question 9

The nurse assessing a patient with multiple injuries is concerned about the patient's ability to maintain adequate oxygenation.Which explanation would the nurse provide for this increased concern?

A)The patient's bowel sounds are hypoactive.
B)The patient has a hemoglobin level of 14 mg/dL.
C)The patient suffered a cervical neck injury and slight concussion.
D)The patient had an arm injury from flying glass.

Question 10

A patient who is receiving chemotherapy is anemic and has low CaO₂ levels.Which nursing interventions offer the best support for this patient? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Monitor the administration of blood products.
B)Administer diuretics as ordered.
C)Keep the patient's oxygen cannula in place.
D)Keep the patient on bedrest.
E)Monitor the patient's pulmonary artery wedge pressure (PAWP).

Question 11

A patient injured in an explosion has a flail chest and crushing injuries to her left arm and leg.She is unconscious and is losing blood rapidly.Laboratory testing reveals impaired oxygenation.Nursing interventions should be implemented to improve which components of oxygenation disrupted by this injury? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)Ventilation
B)Thickness of the alveolar-capillary membrane
C)Oxygen affinity
D)Hemoglobin concentration
E)Blood flow to the lungs

Question 12

A patient is being started on oxygen therapy for an oxygen saturation level of 84% on room air.The nurse expects that this therapy will be effective if oxygen enters the blood through which physiological process?

A)Osmosis
B)Fluid shift
C)Diffusion
D)Concentration gradient

Question 13

A nurse reviewing arterial blood gas results identifies the oxygen saturation level as low.The nurse interprets this information to reflect changes in which process?

A)Ratio of oxygenated hemoglobin to total hemoglobin
B)Percentage of cardiac output
C)Content of oxygen in arterial blood
D)Autoregulation

Question 14

A patient with chronic obstructive pulmonary disease (COPD)says,"I have to rest a lot.It just wears me out trying to breathe." The nurse interprets this statement to mean the patient has difficulty with which respiratory process?

A)Perfusion
B)Diffusion
C)Ventilation
D)Consumption

Question 15

A patient is going to be assessed for oxygen consumption level.Which parameter will the nurse identify for this assessment?

A)Serum potassium level
B)Hemoglobin level
C)Creatinine level
D)Serum lactate level

Question 16

A patient has a hemoglobin level of 8.6 mg/dL.The nurse is concerned that which oxygenation component will be affected in this patient?

A)Oxygen delivery
B)Diffusion of oxygen
C)Pulmonary gas exchange
D)Oxygen consumption

Question 17

The nurse is caring for a patient diagnosed with uncontrolled asthma.The nurse implements interventions to help control the effects of asthma on which element of the patient's pulmonary gas exchange?

A)Removal
B)Diffusion
C)Ventilation
D)Perfusion

Question 18

A nurse is monitoring trends of a patient's SvO2 as a measure of oxygen delivery to tissues.The nurse would be concerned about the accuracy of this trending if which patient condition develops? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)The patient's heart rate drops.
B)The patient develops a high fever.
C)The patient develops gastrointestinal bleeding.
D)The patient's SaO2 improves with antibiotic therapy.
E)The patient is receiving multivitamins in intravenous infusions.

Question 19

A patient tells the nurse that he feels more energetic when he wears oxygen.What would the nurse consider prior to responding to this statement?

A)The patient's ability to extract oxygen is increased by wearing oxygen.
B)Increasing oxygen availability has shifted the oxyhemoglobin dissociation curve to the left.
C)Increasing availability of oxygen has produced more adenosine triphosphate.
D)Increased oxygen increases energy by breaking down carbohydrates.

Question 20

A nurse is preparing a patient for pulmonary functioning testing (PFT).Which nursing statements will help to reinforce teaching about the purposes of these tests? Note: Credit will be given only if all correct choices and no incorrect choices are selected.
Select all that apply.

A)"These tests can help in the diagnosis of any pulmonary diseases you may have."
B)"We can monitor how well therapies are working by comparing the results of your tests."
C)"Insurance companies require these tests be done before you can be discharged from the hospital."
D)"By testing you frequently we can identify changes occurring in your pulmonary health before they become severe."
E)"The tests give us numbers so we can make accurate assessments of your pulmonary health."