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fdn-oxy-05

Oxygenation

Course: Foundations

Practice Questions

Fundamentals: Oxygenation Matrix 1 — Definitions

Match each description with the correct oxygenation concept.

Description Oxygenation Ventilation Perfusion Hypoxemia Dyspnea Result
Process of getting oxygen into the blood so it can be delivered to body tissues.
Movement of air in and out of the lungs through breathing.
Movement of blood through the lungs and body so oxygen can be delivered to tissues.
Low oxygen level in the blood, often reflected by decreased oxygen saturation or abnormal ABG findings.
Subjective feeling of difficult, labored, uncomfortable, or short breathing.
Respiratory rate, depth, rhythm, and effort help the nurse evaluate this process.
Results will appear here.

Fundamentals: Oxygenation Matrix 2 — Assessment Cues

Match each assessment cue with the correct oxygenation concern.

Assessment Cue Hypoxia Ineffective Airway Clearance Increased Work of Breathing Poor Perfusion Respiratory Depression Result
Client has restlessness, confusion, cyanosis, low SpO₂, or worsening shortness of breath.
Client has thick secretions, weak cough, coarse crackles, gurgling, or inability to clear mucus.
Client is using accessory muscles, nasal flaring, tripod position, retractions, or has labored breathing.
Client has cool clammy skin, weak pulses, delayed capillary refill, hypotension, or signs of shock.
Client has slow respirations, excessive sedation, shallow breathing, or decreased arousal after opioids or sedatives.
Client is sitting upright, leaning forward, and struggling to speak in full sentences.
Results will appear here.

Fundamentals: Oxygenation Matrix 3 — Oxygen Devices

Match each situation with the correct oxygen delivery device or support.

Situation Nasal Cannula Simple Face Mask Nonrebreather Mask Venturi Mask Bag-Valve-Mask Result
Client needs low-flow oxygen and can still eat, talk, and tolerate tubing in the nares.
Client needs moderate oxygen support and can tolerate a mask covering the nose and mouth.
Client needs high-concentration oxygen quickly while awaiting provider, respiratory therapy, or emergency response.
Client needs a precise oxygen concentration, commonly used when oxygen must be carefully controlled.
Client is not breathing adequately and needs manual ventilation support.
Client’s SpO₂ is 82% with severe respiratory distress; high-flow emergency oxygen is needed now.
Results will appear here.

Fundamentals: Oxygenation Matrix 4 — Intervention Matching

Match each oxygenation problem with the best nursing intervention focus.

Oxygenation Problem High Fowler’s Position Cough / Deep Breathe Incentive Spirometry Suctioning Notify Provider / RT Result
Client is short of breath and needs chest expansion improved immediately.
Client needs help mobilizing secretions and expanding lungs after immobility or surgery.
Postoperative client needs to prevent atelectasis and practice slow, sustained inhalation.
Client cannot clear secretions, has gurgling, visible mucus, or ineffective cough causing airway compromise.
Client’s respiratory status worsens despite positioning, oxygen, and basic nursing interventions.
Client has a tracheostomy with noisy breathing and thick secretions that are not cleared by coughing.
Results will appear here.

Fundamentals: Oxygenation Matrix 5 — Priority and Safety

Match each situation with the best oxygenation priority.

Situation Airway First Oxygen Safety Assess Before Oxygen Monitor Response Escalate Care Result
Client has choking, obstruction, gurgling, absent breath sounds, or inability to clear secretions.
Oxygen is in use, so smoking, open flames, petroleum products, and unsafe electrical equipment must be avoided.
Before starting or changing oxygen, the nurse checks respiratory rate, effort, lung sounds, SpO₂, skin color, and mental status.
After oxygen or positioning, the nurse reassesses SpO₂, breathing effort, lung sounds, color, and comfort.
Client remains hypoxic, becomes confused, has worsening distress, or cannot maintain airway despite intervention.
Before focusing on oxygen saturation numbers, the nurse makes sure the airway is open and breathing is adequate.
Results will appear here.
Practice questions coming soon.

Welcome to your fdn Oxygenation

Definition

Oxygenation is the process of taking in oxygen, moving it through the lungs into the bloodstream, and delivering it to body tissues. Adequate oxygenation is essential for cellular function, tissue perfusion, and organ survival.

When oxygenation is impaired, the nurse must recognize the problem early and intervene quickly to prevent deterioration.

Assessment
  • Respiratory rate: normal is about 12 to 20/min.
  • SpO₂: normal is usually about 95% to 100%, unless otherwise expected for the client.
  • Assess depth, rhythm, and effort of breathing.
  • Observe for use of accessory muscles, retractions, nasal flaring, or tripod position.
  • Assess lung sounds: clear, diminished, crackles, wheezes, or rhonchi.
  • Observe skin color, mental status, ability to speak, and activity tolerance.
  • Check cough, sputum, chest pain, and any signs of distress.
Diagnostic Thinking

The nurse combines respiratory assessment findings, oxygen saturation, labs, and diagnostics to determine if the client is oxygenating adequately or showing signs of respiratory compromise.

  • Low SpO₂ + increased respiratory rate + accessory muscle use may suggest hypoxia or respiratory distress.
  • Crackles + low oxygen saturation may suggest fluid in the lungs or pneumonia.
  • Wheezing may suggest bronchoconstriction or airway narrowing.
  • Diminished breath sounds may suggest poor air movement, collapse, or obstruction.
  • Restlessness and confusion may be early signs of hypoxia.

Labs and diagnostics that help support the picture:

  • ABGs: evaluate oxygenation, ventilation, and acid-base status.
  • PaO₂: normal is about 80 to 100 mm Hg.
  • PaCO₂: normal is about 35 to 45 mm Hg.
  • pH: normal is about 7.35 to 7.45.
  • HCO₃⁻: normal is about 22 to 26 mEq/L.
  • CBC: WBC normal is about 5,000 to 10,000/mm³; elevated WBC may suggest infection.
  • Hemoglobin: normal is about 12 to 18 g/dL; low Hgb can reduce oxygen-carrying capacity.
  • Chest x-ray: may show pneumonia, atelectasis, or fluid overload.
Interventions
  • Position the client to maximize lung expansion, such as High Fowler’s if tolerated.
  • Apply oxygen as ordered and monitor response.
  • Encourage coughing, deep breathing, and incentive spirometry when appropriate.
  • Promote mobility and repositioning to improve ventilation.
  • Monitor oxygen saturation, respiratory effort, and lung sounds closely.
  • Report worsening respiratory status promptly.
  • Document findings and interventions clearly.
Skills to Master
  • Focused respiratory assessment
  • Counting respiratory rate accurately
  • Using pulse oximetry correctly
  • Applying oxygen devices safely
  • Positioning the client to improve breathing
  • Encouraging coughing, deep breathing, and incentive spirometry
Clinical Pearls
  • Respiratory rate often changes before oxygen saturation drops.
  • Restlessness may be an early sign of hypoxia.
  • Clients can look “okay” while still compensating hard.
  • Low hemoglobin can impair oxygen delivery even if the lungs are working.
  • Students often focus only on SpO₂ and forget the full respiratory picture.
Notes / Resources

Oxygen devices, ABG review, and respiratory assessment reminders coming soon.

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