Oxygen Therapy ATI - Flashcards

Q: face tent

a soft, oxygen-delivery mask that fits under the patient\'s chin, loosely covers the mouth and nose, and is held in place by an adjustable elastic strap

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atelectasis

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airlessness or collapse of a lung, usually as a result of hypoventilation or obstruction

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bi-level positive airway pressure (BiPAP)

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a noninvasive, ventilation-assistance modality that provides higher airway pressure during inspiration and lower pressure during expiration, usually delivered by a face mask

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continuous positive airway pressure (CPAP)

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a noninvasive, ventilation-assistance modality that provides a set positive airway pressure throughout the patient's respiratory cycle

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cyanosis

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a bluish discoloration, especially of the skin and mucous membranes, due to excessive concentration of deoxyhemoglobin (hemoglobin not combined with oxygen) in the blood

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dyspnea

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difficult or labored breathing

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face tent

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a soft, oxygen-delivery mask that fits under the patient's chin, loosely covers the mouth and nose, and is held in place by an adjustable elastic strap

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flow meter

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a device used to control the rate of oxygen being delivered in liters per minute

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flow rate

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the quantity of oxygen delivered in liters per minute

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fraction of inspired oxygen (FiO2)

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the oxygen level inhaled by or delivered to the patient, expressed in a percentage of atmospheric air

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hypercapnia

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an excess of carbon dioxide in the blood

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hypoxemia

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a diminished amount (reduced saturation) of oxygen in arterial blood

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hypoxia

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a reduced supply of oxygen to tissues below physiological levels despite adequate perfusion of the tissue by blood

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incentive spirometer

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a resistive breathing device that helps patients exercise their breathing muscles, provides visual reference for deep breathing; educate patient: 1. exhale normally 2. place spirometer in mouth 3. inhale as deeply as possible through mouth & hold breath to count of 3 4. remove mouth from spirometer and exhale normally 5. perform 10x/ hour

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manual resuscitation bag

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a hand-held device consisting of a flexible air chamber attached to a face mask via a shutter valve and used to provide ventilation to a patient who is not breathing or who is breathing inadequately; often referred to by the common brand name, Ambu bag

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mechanical ventilator

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breathing assistance provided by a ventilator, one of various types of devices that support and maintain respiratory function

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naris

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one of the two external orifices of the nose; nostril (plural: nares)

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noninvasive ventilation

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a type of breathing assistance used to maintain positive airway pressure and improve alveolar ventilation without the need for an artificial airway

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oxygen

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a tasteless, odorless gas that comprises 21% of atmospheric air and is used by the body to maintain adequate cellular function

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oxygen mask

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a device that fits over the patient's nose and mouth and delivers oxygen, humidity, and/or heated humidity

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oxygen tent

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a canopy that surrounds the patient, providing oxygen, humidification, and a cool environment to help control body temperature

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oxygen therapy

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the delivery of oxygen for therapeutic purposes

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partial nonrebreather mask

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an oxygen-delivery apparatus similar to a nonrebreather mask, but with a two-way valve allowing the patient to rebreathe exhaled air

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positive-pressure ventilation

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a technique that uses a mechanism such as a mechanical ventilator to force air into the lungs to provide breathing assistance

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pulse oximeter

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a noninvasive device that measures oxygen saturation indirectly via a finger or ear probe with a light-emitting diode (LED) and a photo detector attached by a cable to the device

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pulse oximetry

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the measurement of oxygen saturation indirectly via a finger or ear probe with a light-emitting diode (LED) and a photo detector attached by a cable to the oximeter device

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simple face mask

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an oxygen-delivery apparatus used for patients who require a moderate flow rate for a short period of time via a plastic mask that fits snugly over the mouth and nose

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t-tube

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a t-shaped conduit with a piece that connects an oxygen source to the patient's artificial airway

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tidal volume

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the amount of air normally breathed in and out with each respiratory cycle either spontaneously or delivered via mechanical ventilation

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tracheostomy

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an opening created by a surgical incision into the trachea for the purpose of establishing and maintaining an airway

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tracheostomy collar

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a small oxygen-delivery apparatus that fits over a tracheostomy site and is held in place by an adjustable elastic strap that fits around the patient's neck; also called a tracheostomy mask

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tracheostomy mask

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a small oxygen-delivery apparatus that fits over a tracheostomy site and is held in place by an adjustable elastic strap that fits around the patient's neck; also called a tracheostomy collar

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ventilation

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inspiration and expiration, the process of the exchange of air between the lungs and the environment

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compliance

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stretchability

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airway resistance

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how hard it is to pull air into lungs

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Ventilation is stimulated by....

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increased CO2 in arterial blood (PaCO2) stimulates inspiration, decreased PaO2 also influences inspiration to a lesser degree.

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diffusion

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movement of O2 and CO2 between alveoli and capillaries (from higher pressure to lower pressure)

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perfusion

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delivery of oxygenated blood to body tissues

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O2 Transport affected by:

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1. the amount of O2 entering lungs (ventilation) 2. pulmonary circulation 3. adequacy of diffusion 4. amount of hemoglobin to carry O2 5. cardiac output to transport blood to body tissues 6. peripheral circulation

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Problems with ventilation, diffusion, or perfusion lead to...

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hypoxia.

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acute hypoxia

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a sudden difficulty breathing; leading to symptoms such as anxiety, restlessness, dyspnea, high BP, small pulse pressure, pallor, cyanosis

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chronic hypoxia

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someone used to living with lower oxygen levels, see long term affects i.e.clubbing, decreased urinary output, systemic issues

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CO=

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SV X HR

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cardiac output is affected by...

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1. preload (volume) 2. afterload (resistance) 3. myocardial contractility

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The primary purpose of surfactant is A. to propel sheet of mucus toward the upper airway B. to warm inspired air C. to produce watery mucous D. to reduce surface tension of the fluid lining of the alveoli

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D (often an issue for premature babies)

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birth

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have to switch to breathing air

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infants

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small chests, short airways; breath much more rapidly then later on

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pre-school/ school-age

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lots of upper respiratory infections

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older adult

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decreased muscle tone leading to more difficulty using muscles, sometimes see kyphosis, at risk for respiratory disease

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COPD

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Chronic Obstructive Pulmonary Disease; drive to breathe shifts, depends on oxygen levels not CO2

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emphysema

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a disease that progressively destroys the walls of the alveoli

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Abdominal breathing at 30-60 breaths/min with an irregular pattern of rate and depth would closely describe the breathing pattern of what age group? A. Older adult B. Infant C. Children D. Adolescents

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B (nervous system isn't mature)

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A patient with a fractured rib is breathing less often and with less depth because of the pain. The nurse would document this finding using which term? A. fremitus B. hyperventilation C. pleural friction rub D. hypoventilation

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D

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A patient who has difficulty breathing, increased respiratory and pulse rates, and pale skin with some cyanosis may be suffering from which of the following? A. hyperventilation B. hypoxia C. perfusion D. atelectasis

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D (acute)

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The nurse assesses an adult patient's SpO2 as 82%. The nurse would expect to see which of the following assessment findings? A. cyanosis B. capillary refill < 2 sec. C. unlabored breathing D. respiratory rate 16 breath/min.

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A

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Pulse Oximetry

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Measures amount of Hgb saturated with O2 in arterial blood (SaO2 or Sp02)

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Examples of Nursing Diagnoses:

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1. ineffective Airway Clearance r/t secretions 2. impaired Gas Exchange r/t history of smoking 3. ineffective Breathing Pattern r/t anxiety 4. acute pain r/t pleural inflammation 5. acute confusion r/t impaired ventilation 6. anxiety r/t feeling of suffocation 7. fatigue r/t impaired oxygen transport 8. disturbed sleep pattern r/t orthopnea

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Examples of Nursing Interventions:

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1. promoting Comfort (patient positioning, hydration) 2. patient Education (breathing exercise i.e. deep breathing, pursed lip breathing, diaphragmatic breathing; incentive spirometry) 3. chest PT & Postural Drainage 4. administering Medications 5. administration of Oxygen

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normal SpO2=

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95-100% (<85%= inadequate tissue oxygenation)

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pursed lip breathing

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to gain control of rate & depth of respiration, goal is to prolong exhalation; educate to patient: 1. sit or stand upright 2. onhale through nose- count to 3 3. exhale through pursed lips, tighten abdomen- count to 7

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diaphragmatic breathing

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Used for COPD patients who breathe shallow, rapid breaths- exhausting! Reduces respiratory rate, increases tidal volume, reduces functional residual capacity Educate patient: Place one hand on stomach & one hand on middle of chest Inhale slowly through nose while protruding abdomen Exhale through pursed lips while contracting abdominal muscles press in and up on abdomen Perform x 1 min followed by 2 min rest Practice several times/day so eventually becomes automatic

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chest physiotherapy (CPT)

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percussion and vibration

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percussion

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sounds like a horse clopping, cupping motion on back of lungs

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vibration

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Use rhythmic contraction and relaxation of arm and shoulder muscles while holding hands flat on chest wall as patient exhales

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postural drainage

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force of gravity assists drainage of secretions

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bronchodilators

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open up bronchioles

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mucolytics

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thin out secretions

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A patient with dyspnea should be placed in which of the following positions? A. prone B. lateral C. supine D. Fowler's

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D

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Mr. Parks has COPD. The nurse has taught him that pursed-lip breathing helps him by A. increasing carbon dioxide, which stimulates breathing. B. prolonging inspiration and shortening expiration. C. liquefying his secretions. D. decreasing the amount of air trapping and resistance.

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D

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Effective use of a metered-dose inhaler requires the patient to do which of the following? A. Breathe in through nose B. Inhale 2 sprays with 1 breath C. Hold breath for 5-10 seconds after inspiration D. Exhale quickly through open mouth

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C

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To drain the apical section of the upper lobes of the lungs, the nurse should place the patient in which position? A. left side with a pillow under the chest wall B. side-lying, half on abdomen and half on side C. High Fowler's D. Trendelenberg

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C

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nasal cannula

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1-6 L/min, a common oxygen-delivery device consisting of a length of tubing with two small prongs that are inserted into the patient's nares

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simple mask

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6-12 L/min

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partial rebreather mask

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6-15 L/min

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nonrebreather mask

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highest concentration of O2, 6-15 L/min, an oxygen-delivery apparatus used to deliver high flow rates and high concentrations of oxygen via a mask that fits snugly over the patient's mouth and nose

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venturi mask

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an oxygen-delivery apparatus consisting of a mask with holes on each side that allow exhaled air to escape and color-coded entrainment ports that are adjustable to allow regulation of the concentration of oxygen delivered, MOST PRECISE, 4-10 L/min (24%-55% FiO2)

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oxygen tents

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provides cool, highly humidified airflow

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oropharyngeal airways

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when muscles relax, tongue falls back and occludes the airway, used to keep tongue clear of airway, used during recovery from anesthesia, comatose patients, to prevent biting ET tubes; do not tape airway in place- patient should be able to spit it out when alert

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Which oxygen delivery device would the nurse expect to use to provide the highest concentration of oxygen to a patient who is breathing spontaneously? A. partial rebreather mask B. nonrebreather mask C. simple mask D. venturi mask

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B

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When planning care for a patient with chronic lung disease (COPD) who is receiving oxygen through a nasal cannula, the nurse expects that A. the oxygen must be humidified B. the rate will be 2 L/min or less C. arterial blood gases will be drawn every 4 hours to assess flow rate D. the rate will be 6 L/min or more

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B

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David White is in the hospital with a medical diagnosis of viral pneumonia. He is receiving oxygen through a simple face mask. The nurse ensure that the mask fits snugly over the patient's face for which reason? A. To prevent mask movement and consequent skin breakdown B. To help the patient feel secure C. To maintain carbon dioxide retention D. To aid in maintaining expected oxygen delivery

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D

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To prevent a common complications of continuous enternal tube feedings ,a nurse should

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limit the time the formula hangs to 4hr (if it hangs longer it is at risk fro bacterial contamination)

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A nurse inserting a nasogastric tube asks the patient to flex her head toward her chest after the tube passes through the nasopharynx. This action facilitates proper insertion of the tube by

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closing off the glottis

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To prevent aspiration during the administration of an enternal tube feeding, a nurse should

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place the patient in fowlers position

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A patient with a gastric ileus postoperatively requires nutritional support for approximately 2 weeks. Which of the following types of feeding tubes is appropriate for this patient

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Nasointestinal tube

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To determine how much of the length of a nasogastric tube to insert, a nurse should measure the distance from the tip of the patients nose to the earlobe to the

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xiphoid process plus 20 to 30 cm more

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Which of the following formulas is appropriate to administer to a patient who has dysfunctional gastrointestinal tract

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elemental

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An older adult patient in a long term care facility is receiving intermittent enternal feedings in his room. His affect is flat, and the nurse suspects that he is feeling isolated. which of the following interventions is appropriate for this patient

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Encourage him to go to the dining room at meal times to talk with other patients

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The most reliable method for verifying initial placement of a small-bore feeding tube is by

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obtaining an abdominal x-ray

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A nurse is providing teaching to a patient who is receiving intermittent nasogastric feedings. Which of the following should the nurse instruct the patient to report immediately

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persistant coughing

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A nurse is caring fro a patient who has a tracheostromy. Which of the following must the nurse use when administering oxygen to the patient

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tracheostomy collar

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A nurse is caring for a patient who is dyspenic and slightly cyanotic, with a respiratory rate of 28/min. The nurse determines that the patient has impaired gas exchange during which of the following phases of the nursing process

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diagnosis

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A nurse should recognize that which of the following is an indication fro oxygen therapy

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Tachypnea; SaO2 90%

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A nurse is caring for a critically ill patient with COPD who requires delivery of a precise concentration of oxygen. Which of the following types of oxygen-delivery device is indicated fro this patient

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venturi mask

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A home health nurse is instruction a patient who has just started receiving oxygen therapy via mask. The nurse should emphasize that the patient must

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reposition the elastic band frequently

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A patient has been receiving oxygen PRN via nasal cannula fro 4 hr. Which of the following assessment findings helps indicate that oxygen therapy has been effective

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Respiratory rate 14/min

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A patient admitted with community-acquired pneumonia has been receiving oxygen therapy for several days. Which of the following assessment findings indicates an adverse effect of oxygen therapy

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cracks in the oral mucosa

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Administering oxygen therapy with a nonbreather mask has which of the following advantages

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offers the highest oxygen concentration of the low-flow systems

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A patient who is prescribed oxygen therapy 24hr/day is concerned about being confined to bed. Which of the following would the nurse do to provide mobility fro this patient

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make sure the patient has up to 50ft of connection tubing

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Oxygen therapy is prescribed fro a patient who is brought to an emergency department in the early stages of hypoxia. When assessing this patient, the nurse should expect to find which of the following clinical indicators

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elevated blood pressure

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A nurse is providing discharge teaching to a patient who will continue oxygen therapy at home. The nurse should instruct the patient that turning the knob on the oxygen flow meter all the way to the right

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stops the oxygen flow

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Nasogastric tube feedings are an appropriate choice for patients who

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is postoperative following laryngectomy

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A nurse should recognize that nasogastric intubation is indicated to relieve gastric distention for which patient

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40 year old patient w/ a postoperative bowel obstruction

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A nurse is caring for a patient who has a newly inserted nasogastric tube. Which method is appropriate for verifying the initial placement

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X-Ray examination of the chest and abdomen (it's the gold standard)

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A nurse is performing a nasogastric intubation. Which of the following actions should the nurse take immediately after inserting the tube to the predetermined length

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Inspect the oropharynx with a penlight and a tongue blade

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During report, a nurse is informed that a patient has a nasogastric tube connected to continuous suction. The nurse should recognize that this patient must have which types of tube

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Salem sump

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A patient recovering from gastric surgery remains NPO and has a nasogastric tube connected to suction. Which of the following actions should the nurse take to prevent dry mucous membranes

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Provide frequent mouth care

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What should not be used for a patient who is NPO status and just underwent gastric surgery

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Throat lozenges

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When using chilled normal saline solution during gastric lavage, nurse should watch for which of the following complications

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Hypothermia

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Iced normal saline can cause a rapid loss of what

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Electrolytes

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A nurse is caring for an unconscious patient. Which of the following statements by the nurse indicates an understanding of providing good oral hygiene for the patient

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"I'll swab the patient's mouth with diluted hydrogen peroxide."

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What is not appropriate for oral hygiene for a patient that removes moisture from the oral cavity and that damages tooth enamel

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Lemon-glycerin swabs

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When planning morning hygiene care for a postoperative patient, which of the following actions should the nurse include

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Ask the patient in what order she typically performs her morning routine

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A nurse is caring for an adult patient who is NPO. The patient is refusing oral care. Which of the following is appropriate by the nurse

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"Oral care is still important even though you are not eating."

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Why is it important to perform oral care

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To help reduce oral bacteria and keep the oral cavity moist

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A nurse is caring for a patient who is on long-term bed rest and requires frequent linen changes due to excess diaphoresis. Which of the following is the priority rationale for frequent linen changes

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Moisture from excessive diaphoresis can cause skin breakdown

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A nurse observes an assistive personnel (AP) make a client's bed while the client is out of the room. Which of the following actions by the AP is appropriate for this task

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The AP reuses the patient's blanket and spread

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Making a clients bed does not require what

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Documentation

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While performing a complete bed bath for a patient, the nurse should

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Raise the room temperature

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Why should soap not be added to the water in the basin when giving a bed bath

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Irritation to the eyes can occur

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What is the nurse going to do when giving a patient a tub bath

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First, nurse will gather all necessary supplies. Second, prepare the room by placing a rubber mat on the rub floor to prevent the patient from slipping and falling. Third, nurse will assist patient into the bathroom and give instructions regarding the use of bars to prevent slipping and falling when entering or exiting the bathtub. Lastly, nurse will instruct patient to remain in tub for no longer than 20 min due to possibility of vasodilation from warm water, which can cause light-headedness or dizziness.

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A nurse is assisting a patient with personal hygiene care. Which of the following actions by the nurse will reduce the risk of infection

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Cleaning the lease-soiled areas prior to cleaning the most-soiled areas

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How should a bed bath be given

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Using long, firm strokes and proceeding from the distal to the proximal areas

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A nurse is caring for a patient who has impaired swallowing due to a cerebralvascular accident. Which of the following interventions should the nurse use to assist the patient with feeding

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elevate the head of the bed 45 to 90 degrees

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A nurse should recognize that which of the following is correct regarding albumin levels as a diagnostic marker for nutritional status

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Albumin level is a poor short-term indicator poor short-term indicator of protein status

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Which of the following strategies for enhancing the intake of healthful foods is appropriate for an adolescent

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Making healthful food choices more convenient and available for the adolescent

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Which of the following is appropriate fro a full liquid diet

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plain yogurt, custard, pureed vegetables, gelatin

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A nurse caring for a patient who has sustained a head injury and whose level of consciousness fluctuates. The provider prescribes a full liquid diet progressing to a pureed diet as tolerated. Before initiating feedings, it is essential that this patient undergo which of following

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swallowing exam

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When teaching the parents of a toddler about feeding and eating, the nurse should include which of the following safety measures

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do not offer the child raw vegetables

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A nurse is performing a nutritional assessment. When obtaining and interpreting anthropometric values, the nurse should recognize which of the following

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the patient should be weighed on that same scale at the same time each day

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To assess a patient fro adequate swallowing, the nurse should do which of the following-

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Place the fingers on the patients throat at the level of the larynx and ask him to swallow

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Which of the following interventions should a nurse use at mealtimes for a patient who has visual deficits

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identify the food location as though the plate were a clock

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Which of the following dietary modifications should an adolescent engaging in sports implement

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drink water before and after sports activates

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Which of the following is the primary purpose fro asking a patient to keep a 3-7 day food diary

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to assess the pattern of intake and compare with daily reference intakes

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Which of the following techniques is appropriate when obtaining a blood pressure on a child

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Use a cuff with bladder covering 80 to 100% of the arm circumference

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Which of the following communication techniques is most appropriate fro a nurse to employ during the physical examination of a 10 year ol

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Use books and other visual aids to advance the interview

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A nurse is testing a child for strabismus. Which of the following is the correct technique fro performing this examination

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perform the cover-uncover test

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When performing an otoscopy examination on a 2-year old child, the nurse should pull the pinna

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down and back

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A nurse is performing an abortion examination on a preschooler. Which of the following instructions should the nurse give to the child when performing abdominal palpitation

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place your hand under mine

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A nurse is performing an annual physical examination on an adolescent. Which of the following should be included in the general survey

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the patient makes good eye contact

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When assessing a school age child for scoliosis, it is important to have the child

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bend forward with the knees straight and the arms dangling

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A nurse is examining an 18-month-old child ears during a well child visit. Which of the following techniques should the nurse use

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have the parent hold the child securely in their lap

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A nurse is documenting findings from a physical examination. Which of the following statements indicates correct charting

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Regular heart rate and rhythm: S1, S2 heard.

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A nurse is obtaining a problem-oriented history from a preschool-aged child. The nurse should consider that children form this age group typically can

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describe the symptoms

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latex and latex free equipment

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main source of concern with regards to medical equipment because a large majority contains latex material. Client should be assessed for latex allergy during initial assessment

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hand hygeine

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hand hygeine refers to both the actual process of washing the hands with soap and water as well as the use of an antimicrobial agent. The use of antimicrobial agent is acceptable except when the hands are visibly soiled or coming into contact with specific bateria's that could potentially become harmful

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waste managment

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handle sharps and dispose of them in a "sharps container"; dispose of blood or bodily fluids in the agencies "flush system"; and always transport linen in a closed liquid-containable bag NEVER A KNIT OR DRAWSTRING BACK THAT COULD SPREAD BODILY FLUID

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proper cough etiquette involves what 5 things...

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1. covering mouth and nose during coughing or sneezing 2. wear a surgical mask when coughing 3. using facial tissues to contain secretions 4. turn the head when coughing away from others atleast 3 feet 5. disinfecting hands after sneezing or coughing

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a nurse preparing a sterile field knows that the field has been contaminated when

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1. a cotton ball dampened with normal saline touches the field 2. the nurse turns to answer the clients question 3. the procedure is post poned for 30min

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when opening a sterile pack, which of the following would compromise sterility

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holding the sterile contents below the waist when opening

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