Study questions. Exchange of Oxygen and Carbon Dioxide in the Lungs takes place between the A. Cells and capillaries B. Alveoli and cells C. Alveoli and capillaries 11. Changes in shape and size of the chest cavity is the function of the: A. Respiratory muscles C. Intercostal muscles only B. Lungs D. Diaphragm only 12. During inspiration (breathing in) the diaphragm: A. Contracts and expands D. Relaxes and Flattens B. Contacts and Flattens C. Stays the same 13. During inspiration (breathing in) the chest cavity becomes: A. Shorter from top to bottom B. Longer from top to bottom C. Stays the same 14. As air pressure in the chest cavity and lungs increases: A. Air is pushed out of the lungs B. Air rushes into the lungs 15. When air pressure is greater outside the chest cavity than inside, air: A. Is pushed out B. is pushed in 17. Increased activity/exercise A. Increases heart rate B. Increases respiration C. Increases production of carbon dioxide D. All of the above 18. Breathing patterns may influenced by: A. Exercise/Activity C. Both A & B B. Emotions D. Neither A or B

Thinking skill. Reference: Think Like a Nurse: A Handbook by Linda Caputi

Reflecting step of Tanner’s clinical judgment model:

1. Noticing
2. Interpreting
3. Responding
4. Reflecting

Evaluating data

Describe what this thinking skill means:

Give at least one example of how you use this skill from a clinical experience:

In the example you provided, explain how “evaluating data” helped you analyze the data in your example to determine if your plan of action resulted in the desired outcome.

Evaluating and correcting thinking

Describe what this thinking skill means:

Give at least one example of how you use this skill from a clinical experience:

In the example you provided, explain how “evaluating and correcting thinking” helped you analyze the data in your example to arrive at a clear, accurate understanding of the situation.

Patient teaching. A female patient is admitted to the cardiac floor. Medical history includes hypothyroidism, diabetes, and hypertension. The patient suffered a myocardial infarction due to coronary artery disease 5 years ago. The patient was diagnosed with heart failure 1 year ago and has been managed with hydrochlorothiazide (Microzide) and captopril (Capoten). Over the past 2 months, the patient’s heart failure symptoms have been increasing in severity, with dyspnea and ankle edema occurring at rest or with minimal exertion.

The HCP orders:

1. The HCP adds digoxin (Lanoxin) 0.125mg po daily to the patient’s regimen. The nurse is teaching the patient about digoxin. What should the nurse include in the patient teaching? Be thorough!
2. Does the patient have risk factors for digoxin toxicity?  If so, what are they and why do they put the patient at risk for digoxin toxicity?
3. The patient’s symptoms continue to increase and the patient is diagnosed with acute heart failure and is moved to the ICU. The HCP replaces hydrocholorthiazide (Microzide) with IV furosemide (Lasix) and adds nitroprusside (Nitropress). Discuss some of the nursing considerations related to the addition of furosemide (Lasix) and nitroprusside (Nitropress) with the current medical regimen.