PNR 120 Unit 2 Comprehension Review: Oxygenation, Healthcare Law, Care Coordination, and Math

Comprehensive vocabulary flashcards covering all 100 review topics, comprehension questions, and clinical concepts from PNR 120 Unit 2: Oxygenation and Gas Exchange, Healthcare Law, Care Coordination, and Math.

PNR 120 Unit 2

The nursing course unit focusing on comprehension review questions across Oxygenation and Gas Exchange, Healthcare Law, Care Coordination, and Math.

Primary Function of the Respiratory System

The essential biological role of the respiratory tract in delivering oxygen to systemic tissues and removing metabolic carbon dioxide from the body.

Surfactant

A surface-active lipoprotein complex in the lungs that reduces surface tension across the alveoli, preventing alveolar collapse during expiration.

Surfactant Production

The physiological synthesis and secretion of pulmonary surfactant performed specifically by specialized type 2 alveolar cells.

Alveoli

Microscopic, thin-walled pulmonary air sacs where the primary exchange of oxygen and carbon dioxide takes place between the lungs and bloodstream.

Type 2 Alveolar Cells

Specialized cells within the alveolar epithelium responsible for producing, storing, and secreting pulmonary surfactant.

Inspiration

The active phase of ventilation in which thoracic volume expands and atmospheric air enters the lungs, transporting oxygen into pulmonary capillaries and cells.

Expiration

The phase of breathing during which air is expelled from the lungs, clearing carbon dioxide transported from systemic cells out of the body.

Gas Exchange

The biological process occurring in the alveoli wherein oxygen is loaded into the bloodstream and carbon dioxide is unloaded to be expired.

Primary Gas Transported into Cells during Inspiration

Oxygen ($O_2$), which is drawn into the alveoli during inhalation and transported into the bloodstream to supply cellular metabolism.

Primary Gas Transported from Cells during Expiration

Carbon dioxide ($CO_2$), a metabolic byproduct transported from cellular tissues to the lungs to be eliminated during exhalation.

Hemoglobin

An iron-containing protein in erythrocytes responsible for binding oxygen in pulmonary capillaries and transporting it to peripheral body tissues.

Acid-Base Balance (Respiratory Contribution)

The regulation of systemic pH by the respiratory system through adjusting the rate and depth of ventilation to exhale or retain carbon dioxide ($CO_2$).

Medulla Oblongata

The brainstem structure that functions as the primary autonomic respiratory control center, regulating the rate, rhythm, and depth of breathing.

Hypoxia

A pathological state characterized by an inadequate supply of oxygen at the cellular and tissue level to maintain normal metabolism.

Early Signs of Hypoxia

Initial clinical indicators of tissue oxygen deficiency, including restlessness, anxiety, agitation, tachycardia, tachypnea, and pallor.

Late Signs of Hypoxia

Advanced clinical indicators of severe, prolonged oxygen deprivation, including cyanosis, severe dyspnea, confusion, stupor, and bradycardia.

Anoxia

A severe condition marked by the complete absence of oxygen supply to an organ or tissue.

Ischemia

An insufficient supply of arterial blood to an organ or tissue, resulting in oxygen and nutrient deprivation.

Hypoxemia

An abnormally low concentration or partial pressure of oxygen in arterial blood.

Indications for Oxygen Therapy

Documented clinical needs for administering supplemental oxygen, including hypoxemia, hypoxia, acute respiratory distress, and myocardial ischemia.

Modes of Oxygen Delivery

The specialized delivery apparatuses (such as nasal cannulas, face masks, non-rebreathers, trach masks, and venturi masks) used to administer supplemental oxygen.

Nasal Cannula

A low-flow oxygen apparatus featuring two soft prongs inserted into the nares, typically administered at $1$ to $6\,\text{LPM}$ to deliver approximately $24\%$ to $44\%$ fraction of inspired oxygen.

Simple Face Mask

A low-flow oxygen apparatus covering the nose and mouth, typically set at $6$ to $10\,\text{LPM}$ to prevent carbon dioxide rebreathing and deliver approximately $35\%$ to $50\%$ oxygen.

Non-Rebreather Mask

A high-concentration oxygen delivery device with a reservoir bag and one-way valves, typically set at $10$ to $15\,\text{LPM}$ to deliver $80\%$ to $95\%\text{+}$ oxygen.

Trach Mask

A specialized oxygen delivery collar or mask placed directly over a tracheostomy tube to administer humidified oxygen at prescribed flow rates.

Venturi Mask

A high-flow oxygen delivery device that uses calibrated entrainment adapters to deliver precise, specific concentrations of oxygen ($24\%$ to $50\%$).

Complications of Oxygen Therapy

Adverse effects associated with supplemental oxygen use, including oxygen toxicity, absorption atelectasis, mucous membrane drying, skin breakdown, and fire hazards.

Nursing Interventions for Nasal Cannula

Nursing care actions that include assessing skin integrity behind the ears and nares, verifying flow meter settings, adding humidification for flow rates exceeding $4\,\text{LPM}$, and monitoring oxygen saturation.

Respiratory Distress

An acute physiological state marked by difficulty breathing, tachypnea, accessory muscle use, retractions, and abnormal lung sounds.

Nursing Interventions for Respiratory Distress

Immediate clinical interventions including positioning the patient in high-Fowler's, initiating or titrating supplemental oxygen, assessing vital signs and lung sounds, and notifying the provider.

Assessing Effectiveness of Oxygen Therapy

Evaluating clinical response through continuous pulse oximetry ($SpO_2$), arterial blood gas values, respiratory rate, ease of breathing, and resolution of cyanosis.

Effective Breathing Techniques

Instructional breathing exercises, such as pursed-lip breathing and diaphragmatic breathing, promoted by the nurse to increase alveolar ventilation and reduce the work of breathing.

Airway Clearance Techniques

Therapeutic maneuvers, including deep breathing, effective coughing, chest physiotherapy, and incentive spirometry, promoted by the nurse to mobilize pulmonary secretions.

Frequency of Airway Clearance Techniques

The clinical schedule for performing airway clearance exercises, commonly recommended every $1$ to $2\,\text{hours}$ while awake.

Hospital and Home Oxygen Safety Education

Patient education regarding fire risks, avoiding open flames or smoking, keeping cylinders upright and secure, avoiding petroleum-based lubricants, and verifying functional electrical equipment.

Smoking Cessation Promotion

Nursing guidance and supportive interventions providing education, counseling, and cessation resources to reduce airway irritation and improve respiratory health.

Trach Suctioning Steps

The ordered clinical procedure for clearing tracheostomy secretions: pre-oxygenate, insert catheter without suction until resistance is met, apply intermittent suction while rotating and withdrawing the catheter, and hyperoxygenate.

Trach Suctioning Duration per Pass

The maximum permissible time for applying suction during a single pass, strictly limited to no more than $10$ to $15\,\text{seconds}$ to prevent hypoxemia.

Healthcare Law

The curricular area comprising legal standards, state statutes, scope of practice limits, ethical theories, confidentiality, and patient rights in nursing.

Nurse Practice Act

State-specific legislation governing nursing practice that defines educational requirements, scope of practice boundaries, and standards to protect public health and safety.

Informed Consent

A legal and ethical process where a patient voluntarily authorizes a procedure after receiving full disclosure of risks, benefits, alternatives, and anticipated outcomes.

Individual Authorized to Obtain Informed Consent

The healthcare provider or physician performing the procedure, who is the only individual legally responsible for explaining and obtaining informed consent.

Nurse's Role in Informed Consent

The nursing responsibility to witness the client's signature, confirm the client is competent and giving consent voluntarily, and ensure the provider is notified if the patient has unanswered questions.

Patient Confidentiality

The legal and ethical obligation to protect private health information and medical records from unauthorized access or disclosure.

Autonomy

The fundamental ethical principle that recognizes and respects a patient's right to make independent, self-determined decisions regarding their own healthcare.

Beneficence

The ethical principle requiring nurses and healthcare providers to take positive actions to promote good, well-being, and the best interests of the patient.

Fidelity

The ethical principle that obligates nurses to be loyal, truthful, keep promises, and maintain professional commitments made to patients.

Justice

The ethical principle that demands fairness, equity, and impartiality in the distribution of healthcare resources and patient care.

Patient Advocacy

The nurse's ethical obligation to actively speak on behalf of, defend, and protect the rights, safety, and individual wishes of patients.

Non-Maleficence

The foundational ethical principle directing healthcare professionals to do no harm, prevent harm, and minimize potential injury to patients.

Patient Self-Determination

The ethical standard and legal right allowing patients to direct their own medical care, choose among treatment options, or refuse interventions.

Negligence

A legal tort defined as the failure of a healthcare professional to exercise the level of care that a reasonably prudent nurse would provide under similar circumstances, resulting in harm.

Four Elements of Negligence

The four required legal criteria to establish nursing negligence: duty of care, breach of duty, causation (direct link), and actual damages or injury.

Legal Consequences of Negligence

Potential legal outcomes including civil liability lawsuits, monetary damages, disciplinary action by the state board of nursing, and suspension or revocation of licensure.

Proper Documentation

The timely, accurate, complete, objective, and factual recording of all nursing assessments, interventions, and client responses to establish a legal record of care.

Established Policies and Procedures

Institutional healthcare protocols that define clinical standards of care, guide nursing actions, ensure quality, and minimize liability.

Reducing the Risk of Negligence

Proactive clinical habits such as adhering to institutional policies, clarifying unclear orders, maintaining technical competence, communicating changes, and documenting care thoroughly.

Scope of Practice Adherence

The ongoing practice of verifying that clinical skills, delegated duties, and medication administrations fall strictly within the limits defined by the state Nurse Practice Act.

Reporting Suspected Abuse or Neglect

The mandatory legal and ethical responsibility of nurses to immediately report any suspected physical, emotional, sexual abuse, or neglect of vulnerable individuals.

Abandonment

The illegal and unethical termination of the established nurse-patient relationship without giving reasonable notice or ensuring an appropriate transfer of care.

Legal Implications of Abandonment

Severe consequences including disciplinary action by the state licensing board, loss of nursing license, and civil tort claims for resulting patient injury.

End-of-Life Care Ethical Principles

Ethical frameworks emphasizing autonomy, beneficence, non-maleficence, and human dignity when guiding clinical decision-making during terminal illness.

Advanced Directives

Legally executed documents (such as living wills and durable powers of attorney for healthcare) that outline an individual's medical preferences if they become incapacitated.

Nurse's Responsibility in Honoring Advanced Directives

The professional duty of the nurse to verify the presence of advance directives in the medical record, advocate for their execution, and ensure the care team follows the patient's documented wishes.

Restraints (Legal and Ethical Considerations)

Physical or chemical restrictive measures permitted only as an emergency last resort, requiring valid provider orders, ongoing clinical checks, frequent release, and documented justification.

LPN Response to Out-of-Scope Requests

The required action when an LPN is asked to perform a task outside their statutory scope: refuse the task, inform the supervisor or requester of the scope limitation, and seek appropriate assignment re-allocation.

Legal Consequences of Medication Errors

Potential legal ramifications resulting from improper drug administration, including patient malpractice claims, institutional disciplinary reviews, and state board licensing investigations.

Professional Boundaries

The established therapeutic limits in the nurse-patient relationship that protect the patient's vulnerability and prevent overinvolvement, conflicts of interest, or exploitation.

Care Coordination

The organized collaboration and synchronization of healthcare services, personnel, and information to meet a patient's ongoing health needs across settings.

Discharge Planning

A systematic, centralized process of multidisciplinary planning that prepares a patient for transition from an acute health facility to home or a post-acute facility.

Continuity of Care

The unbroken, consistent delivery of healthcare services across time, healthcare settings, and multiple providers during transitions of care.

Primary Purpose of Discharge Planning

To ensure patient safety, promote continued recovery, maintain continuity of care, empower self-management, and prevent unnecessary hospital readmission.

Timing of Discharge Planning

The standard healthcare timeline establishing that discharge planning should ideally begin upon the patient's admission to a healthcare facility.

Patient Education in Discharge Planning

Structured instruction regarding medication regimens, physical activity limits, dietary guidelines, warning symptoms, wound care, and follow-up schedules prior to leaving the facility.

Nurse's Role in Coordinating Discharge Planning

Leading the assessment of transition needs, liaising with multidisciplinary teams, facilitating patient education, and coordinating post-discharge referrals and equipment.

Discharge Plan Components for Chronic Conditions

Targeted planning elements for illnesses such as diabetes, COPD, and heart failure, emphasizing symptom recognition, daily monitoring, dietary restrictions, and medication adherence.

Barriers to Effective Discharge Planning

Challenges including low health literacy, financial limitations, lack of caregiver support, cognitive deficits, and fragmented interprofessional communication.

Patient Self-Management and Adherence Promotion

Equipping patients with the knowledge, skills, confidence, and tools necessary to manage their chronic conditions and adhere to post-discharge care plans.

Key Components of a Comprehensive Discharge Plan

A formalized plan outlining discharge medications, specific treatment schedules, durable medical equipment, follow-up appointments, dietary guidance, and emergency contact numbers.

Interventions for Complex Chronic Conditions

Care coordination interventions including multidisciplinary case conferences, tailored multi-disease education, polypharmacy reconciliation, and coordinated outpatient scheduling.

Patient and Family Involvement in Discharge Planning

The collaborative practice of engaging the patient and family caregivers in setting care goals, learning hands-on clinical skills, and evaluating home readiness.

Priority Interventions for Discharging High-Risk Patients

Targeted transition actions for vulnerable patients, such as initiating home health referrals, early post-discharge telephone follow-ups, and rapid primary care visits.

Hospital Readmission Prevention Interventions

Critical transition safeguards including teach-back patient education, complete medication reconciliation, timely outpatient follow-up, and 24-hour access to care providers.

Actions Promoting Continuity of Care (Facility to Home)

Four essential transition actions: conducting a comprehensive discharge summary handoff, completing medication reconciliation, confirming outpatient appointments, and coordinating follow-up communication.

Home Health Services and Equipment Considerations

Arranging skilled in-home nursing or therapy services and confirming the delivery and functional training of durable medical equipment before patient discharge.

Care Coordination for High-Risk Pregnancy

Specialized coordination focusing on maternal-fetal monitoring, frequent obstetric surveillance, management of maternal comorbidities, and education on obstetric warning signs.

Care Coordination for Premature Infants

Targeted coordination addressing neonatal growth, specialized infant nutrition, apnea monitoring, temperature regulation, and specialized pediatric follow-up.

Care Coordination for Children with Disabilities/Special Needs

Comprehensive pediatric management coordinating physical/occupational/speech therapy, adaptive equipment, specialized medical services, and school-based support.

Care Coordination for the Elderly

Geriatric-focused care coordination managing polypharmacy, fall prevention, cognitive support, functional assistance with daily activities, and community resources.

Follow-Up Appointments and Monitoring

Scheduled post-discharge visits and remote clinical check-ins that evaluate healing progress, assess treatment compliance, and identify early complications.

Medication Reconciliation in Discharge Planning

The formal clinical comparison of a patient's pre-admission, inpatient, and post-discharge medication orders to eliminate duplications, omissions, and dosing errors.

Ethical Considerations in Discharge Planning

Balancing patient autonomy and self-determination with safety concerns when patients refuse recommended post-acute services, placements, or care plans.

Evaluating and Improving Discharge Planning Processes

Organizational quality improvement efforts that assess readmission metrics, patient satisfaction surveys, and care transition audits to enhance discharge effectiveness.

Math Review (PNR 120 Unit 2)

Mathematical nursing calculations evaluated across ratio and proportion, systems of measurement, metric system conversions, and time and temperature problems.

Ratio and Proportion

A mathematical method used in nursing dosage calculation where two equivalent ratios or fractions are set equal to solve for an unknown quantity ($\frac{a}{b} = \frac{c}{d}$).

Systems of Measurement

The clinical measurement systems utilized in medication administration, comprising the metric system, the household system, and the apothecary system.

Metric System

The decimal-based system of measurement used as the standard in healthcare for measuring weight ($\text{grams}$, $\text{milligrams}$), volume ($\text{liters}$, $\text{milliliters}$), and length ($\text{meters}$).

Time Calculations in Healthcare

The clinical scheduling and charting conversion between standard $12\text{-hour}$ civilian time and military $24\text{-hour}$ time to avoid medication administration errors.

Temperature Conversions in Healthcare

The mathematical conversion between degrees Fahrenheit ($^\circ\text{F}$) and degrees Celsius ($^\circ\text{C}$) used in patient vital sign assessment.