Chapter 27

Question 1

Intrinsic risk factors

Answer 1

Risk factors within or influenced by the patient: i.e. Genetic predisposition

Question 2

What disease types allow blood to pool in the large veins of the pelvis and lower extremities causing pulmonary emboli?

Answer 2

Cardiac and circulatory diseases

Question 3

Extrinsic risk factors

Answer 3

Factors that are external to the patient, I.e. Cigarette smoking

Question 4

What are diseases commonly found among cigarette smokers?

Answer 4

Lung carcinoma, COPD, Pneumonia, Pulmonary emboli, and other cardiac diseases.

Question 5

What are the three steps of gas exchange?

Answer 5

Ventilation, Diffusion, perfusion

Question 6

Ventilation

Answer 6

Mechanical process of moving air in and out of the lungs.

Question 7

Diffusion

Answer 7

The movement of molecules through the membrane from an area of greater concentration to an area of lesser concentration.

Question 8

Perfusion

Answer 8

The circulation of blood through the capillaries

Question 9

For ventilation to occur, What three body structures must be intact?

Answer 9

Chest wall, nerve pathways, diaphragm

Question 10

What is the normal concentration of oxygen in the alveoli?

Answer 10

104 mmHg

Question 11

What is a normal concentration of oxygen in the pulmonary arterial circulation?

Answer 11

40 mmHg

Question 12

What is the concentration of carbon dioxide in the pulmonary capillaries?

Answer 12

45 mmHg

Question 13

What is the concentration of carbon dioxide in the alveoli?

Answer 13

40 mmHg

Question 14

For diffusion to occur, what three body structures must be intact?

Answer 14

Respiratory membrane, interstitial space, and endothelial lining.

Question 15

What types of medications can be used to treat a patient suffering from fluid accumulation or inflammation?

Answer 15

Diuretic agent or anti-inflammatory drugs (corticosteroids, Antibiotics)

Question 16

How does the oxygen disassociation curve work?

Answer 16

As oxygen molecules bind to hemoglobin other oxygen molecules more readily binds to that hemoglobin. Similarly, as oxygen bound hemoglobin begins to release oxygen, it more readily releases more oxygen.

Question 17

For perfusion to occur, what four things must be in place?

Answer 17

Adequate volume of blood, pulmonary capillaries must be able to transport blood, vessels must not be occluded, and the heart must pump efficiently.

Question 18

What three things can alter the oxygen disassociation curve?

Answer 18

Body temperature, blood pH, and PCO2.

Question 19

In patients with acute pulmonary edema, what type of drug would be helpful?

Answer 19

A diuretic, because that reduces blood return to an inefficiently pumping heart and improves cardiac efficiency.

Question 20

Respiration

Answer 20

The exchange of gases between a living organism and its environment.

Question 21

Pulmonary respiration

Answer 21

Occurs in the lungs when the respiratory gases are exchanged between the alveoli and the red blood cells.

Question 22

Cellular respiration

Answer 22

Involves the exchange of respiratory gases between the red blood cells and the various tissues.

Question 23

What injuries cause loss of negative pressure with in the plural space?

Answer 23

Pneumothorax, hemothorax

Question 24

Cheyne– Stokes respirations

What does it look like, and what does it indicate?

Answer 24

Progressively increasing title volume followed by a declining title volume, separated by periods of apnea
–Indicates brain injury and/ or often found older patients.

Question 25

Kussmaul Respirations | What does it look like, and what does it indicate?

Answer 25

Deep, rapid breaths | --Indicates diabetic ketoacidosis which produces metabolic ketoacidosis

Question 26

Central Neurogenic Hyperventilations | What does it look like, and what does it indicate?

Answer 26

Deep, rapid respirations | -- Indicates strokes or injury to the brainstem.

Question 27

Ataxic (Biot's) Respiratons | What does it look like, and what does it indicate?

Answer 27

Repeated episodes of gasping ventilation separated by periods of apnea. -- Indicates increased intracranial pressure.

Question 28

Apneustic Respirations | What does it look like, and what does it indicate?

Answer 28

Characterized by long, deep breaths that are stopped during the inspiratory phase and separated by periods of apnea. -- Indicates stroke or severe central nervous system disease.

Question 29

Anemia

Answer 29

A condition in which the number of red blood cells or amounted in hemoglobin in them is below normal.

Question 30

What are the five parts of getting a general impression of respiratory status?

Answer 30

Position, color, mental status, ability to speak, respiratory effort.

Question 31

Asphyxia

Answer 31

A decrease in the amount of oxygen and an increase in the amount of carbon dioxide as a result of some interference with respiration.

Question 32

Orthopnea

Answer 32

Dyspnea while lying supine

Question 33

Paroxysmal nocturnal dyspnea

Answer 33

Short attacks of dyspnea that occur at night and interrupt sleep.

Question 34

Ronchi

Answer 34

Rattling sounds in the larger airways associated excessive mucus or other material.

Question 35

Wheezing

Answer 35

Whistling sound due to narrowing of the airways by edema, bronchoconstriction, or foreign materials.

Question 36

Pulsus paradoxes

Answer 36

A drop in the systolic blood pressure of 10 mmHg or more with each respiratory cycle. Associated with COPD and cardiac tamponade.

Question 37

Capnometry

Answer 37

The measurement of expired CO2

Question 38

Capnography

Answer 38

A graphic recording or display of the capnometry reading over time

Question 39

Capnograph

Answer 39

A device that measures expired CO2 levels

Question 40

Capnogram

Answer 40

The visual representation of the expired CO2 waveform

Question 41

End title CO2

Answer 41

The measurement of CO2 concentration at the end of expiration

Question 42

PETCO2

Answer 42

The partial pressure of and title CO2 in a mixed gas solution

Question 43

PaCO2

Answer 43

The partial pressure of CO2 in the arterial blood

Question 44

What are common ailments associated with decreased ETCO2?

Answer 44

Shock, cardiac arrest, pulmonary embolism, bronchospasm, and incomplete airway occlusion.

Question 45

What is phase one of a wave form?

Answer 45

Late inspiration phase

Question 46

What is phase two of the waveform?

Answer 46

Appearance of CO2 in the exhaled gas.

Question 47

What is the phase three of the waveform?

Answer 47

Plateau (Constant CO2)

Question 48

What is phase four of the waveform?

Answer 48

rapid descent during inspiration

Question 49

What part of the patient's body is not functioning correctly in cardiogenic pulmonary edema?

Answer 49

The left ventricle of the heart

Question 50

What are some obstructive lung diseases?

Answer 50

Asthma, emphysema, chronic bronchitis

Question 51

Cor Pulmonale

Answer 51

Hypertrophy of the right ventricle resulting from disorders of the lung.

Question 52

Blebs

Answer 52

Destroyed lung tissue

Question 53

Polycythemia

Answer 53

Increased red blood cell production/ an excess of red blood cells

Question 54

When do medical problems related to smoking usually develop?

Answer 54

When patients surpass a 20 pack/year history.

Question 55

How do you calculate the pack per year history?

Answer 55

Multiply the number of packs smoked per day by the number of years the patient smoked

Question 56

What does an asthmatic waveform look like?

Answer 56

Shark fin

Question 57

Status Asthmaticus

Answer 57

Severe, prolonged asthma attack that cannot be broken by repeated doses of bronchodilators. Under this condition, recognize that respiratory arrest is imminent and be prepared for endotracheal intubation.

Question 58

Pleuritic

Answer 58

Sharp or tearing, as a description of pain

Question 59

Carboxyhemoglobin

Answer 59

Hemoglobin with carbon monoxide bound to it.