Chapter 40: Respiratory Practice Test Flashcards
(101 cards)
1
Q
What body system controls ventilation regulation?
A
Central nervous system
2
Q
What do these two chemicals control?
O2 transport
C02 transport
A
ventilation regulation
3
Q
What is the purpose of the circulatory system?
A
Deliver oxygen
4
Q
This is regulated by these four factors?
Afterload
Preload
Cardiac output (CO)
Contractility
A
Blood flow
5
Q
These are the four most common defining characteristics of problems with what body system?
Decreased CO
Ischemia
Heart failure
Hypovolemia
A
Circulatory
6
Q
With a patient with COPD receive oxygen via NC ?
A
No because their lungs work on a CO2 drive. Oxygen can cause COPD patient to stop breathing.
7
Q
These four factors affect what part of the respiratory system?
Decrease in O2 carrying capacity of the red blood cell
Decreased inspired O2 concentration in the alveoli
Increased metabolic rate
Chest wall movement
A
Oxygenation
8
Q
These four major factors affect what body system? History Risk factors Fatigue Pain
A
Respiratory
9
Q
What are the four areas you would assess in regards to respiratory during a physical examination?
A
Breathing patterns
Cough
Respiratory infection
Medications
10
Q
Activity intolerance Ineffective breathing pattern Ineffective airway clearance Risk for infection Impaired gas exchange Decreased cardiac output Acute pain Fatigue This is what part of the nursing process?
A
Diagnosis
11
Q
Providing a patent airway Improving oxygenation Increasing level of independence Set priorities based on the patient’s tolerance level Collaborative care
This is what part of the nursing process?
A
Planning
12
Q
Health promotion
Dyspnea management
Safety precautions with oxygen therapy
Mobilization of pulmonary secretions
This is what part of the nursing process?
A
Implementation
13
Q
Common disorders of the upper and lower airway include?
A
Upper Airway: Viruses
Lower Airway: pneumonia, TB, Valley Fever, Aspiration, flu
14
Q
This requires coordination of respiratory, cardiovascular, and hematological systems
A
Oxygenation
15
Q
Ventilation or breathing
Alveolar-capillary gas exchange
Transporting O2 & CO2 between tissues & lungs
Moving O2 & CO2 between systemic capillaries and tissues by diffusion.
This is what process?
A
Oxygenation
16
Q
What defense mechanisms are present in respiratory system to prevent entry of foreign bodies, irritants, microorganisms?
A
Cough
Cillia
17
Q
This includes inspiration & expiration
A
Ventilation
Breathing
18
Q
Adequate ventilation is dependent on?
A
Clear airway
Intact CNS & respiratory centers in medulla and pons of brainstem
Intact thoracic cavity which expands and contracts
Pulmonary compliance (expansion) and recoil
19
Q
O2 & CO2 are exchanged through diffusion at the ______?
A
alveolar capillary membrane
20
Q
Efficient gas exchange depends on balance between?
A
Ventilation (V) or air flow & Perfusion (Q) or blood flow
21
Q
Blood flow to lungs may be normal, but ventilation is reduced ( VQ ratio)
What might reduce airflow, block airway?
A
Check Module 8 Voiceover
22
Q
Areas ventilated, but not perfused (VQ ratio)
What might impair perfusion of oxygenated blood?
A
Check Module 8 Voiceover
23
Q
This type of patients adjust to higher CO2 levels & breathing is may be controlled with hypoxic drive.
Must be kept slightly hypoxic.
Current research shows only a small % of these pts. have depressed CO2 receptors.
A
COPD Patient
24
Q
To control ventilation Keep ____ liter flow & _______ levels as prescribed by physician .
A
O2
Pulse Oximeter
25
Receptors in coratid bodies and aortic arch respond to ___ O2 to control ventilation.
decrease
26
Chemoreceptors in medulla oblongata responds to _____ CO2 or ___ pH to ____ rate/depth of respirations to control ventilation.
increase
decrease
increase
27
6 Lifestyle Factors affecting oxygenation?
Nutrition, exercise, smoking, BP management, drug abuse, stress
28
3 Environmental factors affecting oxygenation?
urban pollution, occupational exposure to toxins, diseases
29
Four physiological factors affecting oxygenation?
Pulmonary or cardiac disease
Musculoskeletal or neuromuscular alterations affecting chest wall movement
Decreased O2 carrying capacity due to anemia or toxins (CO)
Hypovolemia due to blood or fluid loss
30
Developmental factors due to the aging process that affects oxygenation?
Stiffening of elastin and collagen connective tissue supporting lungs leads to chest wall stiffness.
Decreased Elastic recoil
Osteoporosis alters shape of thorax
Altered alveolar shape decreased surface area
Cilia function decreases
cough reflex
31
Decreased immune function. Increased risk of pneumonia, flu, TB.
This is an example of what type of body system change that could affect pulmonary function?
Cardiovascular
32
Does pt. c/o chest pain or difficulty breathing? Possible causes? Is airway patent?
Is skin pale, diaphoretic, dusky, or cyanotic?
This is what part of the nursing process?
Respiratory Assessment
33
What are VS & pulse oximetry readings?
Is the patient using accessory muscles to breathe? Such as?
This is what part of the nursing process?
Respiratory Assessment
34
Has the patient’s LOC changed?
Is the patient confused, anxious, or agitated?
Does the patient change position to facilitate breathing? E.g. tripod position
Are they orthopneac?
This is what part of the nursing process?
Respiratory Assessment
35
Chief Complaint – onset, course, duration of respiratory sx.
Current symptoms possibly R/T Respiratory problem such as?
Respiratory Assessment
36
Patient/Family History of Lung/Heart Problems
Asthma Emphysema Bronchitis
PE
COPD
TB
Bronchiectasis Allergy hx, exposure
Infections
Lifestyle, med use.
This is what part of the nursing process?
Respiratory Assessment
37
What conditions may cause this type ofpain?
Can you differentiate between cardiac, pulmonary, & muscular chest pain?
What lung conditions may cause this type of pain?
Chest Pain Assessment
38
```
Pulmonary (pleuritic) pain may be
Sharp, stabbing, and intermittent
May increase with breathing, coughing
Dull, aching, and persistent
Usually felt on affected side, may be referred
May radiate to scapula.
```
This is what part of the nursing process?
Chest Pain Assessment
39
What is a cough? Dry? Productive?
Purpose of cough?
What do you want to document about a cough?
Check module 8 Respiratory Voiceover
40
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Present and past work experiences (Why?)
Smoking habits
Activities of daily living tolerance
Cardiac risk factors
Stress level
Dietary habits
Relationship with significant others
Recreational habits
```
This is what part of the nursing process?
Respiratory Assessment
41
Respiratory effort
How can you tell if a patient is having trouble breathing?
What are S/Sx hypoxia?
Note: Cyanosis doesn’t occur until later hypoxia
This is what part of the nursing process?
Physical Assessment
42
Lung sounds – adventitious
Crackles, wheezing, rhonchi, stridor
What do these indicate?
This is what part of the nursing process?
Physical Assessment
43
Fluid status – s/sx dehydration, over-hydration
Why is this significant?
This is what part of the nursing process?
Physical Assessment
44
Observe facial expression & LOC
Note respiratory rate, rhythm, pattern, depth
This is what part of the nursing process?
Assessment:
| Inspection
45
Inspect anterior and posterior thorax for symmetry
What might it indicate if one side larger or smaller than the other?
This is what part of the nursing process?
Assessment:
| Inspection
46
Observe general condition and musculoskeletal development.
This is what part of the nursing process?
Assessment:
| Inspection
47
This has an elliptical shape and causes the ribs to slope down?
Normal Chest Shape
48
This occurs when width & depth equal, and causes the ribs to become horizontal.
This can be R/T chronic lung hyperinflation (emphysema)
This is normal w/aging and in infants
Barrel chest Shape
49
What questions do you ask to assess ventilatory patterns?
What are these breathing patterns & what may cause?
50
```
Eupnea
Dyspnea
Orthopnea
Bradypnea
Tachypnea
Hypoventilation
Hyperventilation
Apnea
These are examples of what?
```
Irregular breathing patterns
51
Regular pattern of increased respirations followed by progressively more shallow respirations until apnea occurs.
This is defined as?
Cheyne-Stokes
52
3-4 normal breaths with irregular periods of apnea.
This is defined as?
Biot's
53
This is a symptom of chronic hypoxia due to pulmonary or cardiac disease. what is this defined as?
Clubbing nails
54
This is a late sign of hypoxia. PO2<40 (norm 80-100) What is this defined as?
Cyanosis
55
Central: tongue, soft palate, conjunctiva most indicative.
Peripheral: (nailbeds, earlobes) often sign of vasoconstriction.
Use these locations to check for?
Cyanosis
56
Besides hypoxia, what conditions may increase respiratory rate?
Check Module 8 Respiratory voiceover
57
When you assess a patient you are checking for skin that is dusky, cool & clammy – why?
Check Module 8 Respiratory voiceover
58
Splinting of respirations can occur due to?
Pain
59
Abnormal sounds that are superimposed on underlying breath sounds.
What is this defined as?
Adventitious Sounds
60
Name three examples of adventitious blood sounds?
Crackles (Rales)
Wheezes
Rhonchi (Gurgles)
61
COPD, chronic bronchitis occur with what kind of crackles? what disease process is this common in?
Early inspiratory crackles in obstructive disease
62
pneumonia, CHF occur with what kind of crackles? what disease process is this common in?
Late inspiratory in restrictive disease
63
This type of abnormal breath sound occurs due to narrow airways?
Wheezes
64
This type of abnormal breath sound occurs primarily during expiration.
Coughing may clear.
Ronchi (Gurgles)
65
10 types of diagnostic tests for respiratory issues?
```
EKG
Chest X-Ray
CBC
Sputum
Skin Tests
ABGs
Pulmonary Function Tests (PFTs)
Computerized Tomography (CT scan)
Bronchoscopy
Lung Scan
```
66
Why would you order an EKG in a patient with respiratory issues?
to rule out cardiac etiology.
67
Why would you order an Chest X-Ray in a patient with respiratory issues?
to diagnose emphysema, tumors,
| valley fever, TB
68
Why would you order a CBC in a patient with respiratory issues?
anemia, polycythemia, infection, allergies
69
Why would you order a sputum sample in a patient with respiratory issues?
C&S to ID organism
70
Why would you order an ABG in a patient with respiratory issues?
measure oxygenation, CO2 levels, ventilation, acid-base balance
71
Why would you order a skin test in a patient with respiratory issues?
TB (PPD) & Valley fever (coccidiomycosis)
72
Why would you order a Pulmonary Function Test in a patient with respiratory issues?
Measures lung volumes, airspeed & ease of airflow.
Strength of respiratory muscles.
73
Why would you order a Computerized Tomography (CT Scan) in a patient with respiratory issues?
To diagnose COPD, PE, lung cancer,
74
What is the difference between a CT scan and a spherical CT scan?
CT: 2D
| Spherical CT: 3D
75
Why would you order a Bronchoscopy in a patient with respiratory issues?
examine tissue, biopsy, remove mucous plugs, collect sputum
76
What is important to remember when performing a bronchoscopy ?
NPO until gag reflex returns
77
Why would you order a Lung Scan (Nuclear Medicine) in a patient with respiratory issues?
Measure VPS or V/Q (Ventilation/Perfusion)
| Diagnose or Rule Out Pulmonary Embolism
78
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Ineffective airway clearance
Ineffective Breathing Pattern
Impaired Gas Exchange
Activity Intolerance, Self-care deficit
Anxiety
Fatigue
Powerlessness, Social Isolation
This is what part of the nursing process?
```
Diagnosis
79
Maintain patent airway.
Improve comfort and ease of breathing.
This is what part of the nursing process?
Goals (Outcomes)
80
Maintain or improve ventilation and oxygenation.
Reduce/prevent risks associated with oxygenation problems such as skin and tissue breakdown, syncope, acid-base imbalance, hopelessness, isolation.
This is what part of the nursing process?
Goals (Outcomes)
81
Assessment
Therapeutic
Educational
Referral
Interventions for respiratory patients?
See Module 8 Respiratory Voiceover
82
What are possible complications of URI?
See Module 8 Respiratory Voiceover
83
Examples of Upper Respiratory Infection includes?
Common cold
| Acute Viral rhinitis
84
Upper Respiratory Infection commonly occur because of these two reasons?
Bacteria/virus invades upper airway.
Immune/inflammatory Response
85
Immune/inflammatory Response occurs due to?
Swelling of infected tissue, increased mucous.
86
What are s/sx that a Bacteria/virus has invaded a patient's upper airway?
See Module 8 Respiratory Voiceover
87
What are three common interventions for all URIs?
Rest
Fluid & nutrition
Meds
88
What should be documented & reported when using interventions for URIs?
See Module 8 Respiratory Voiceover
89
Why is rest an important intervention for a URI?
See Module 8 Respiratory Voiceover
90
Influenza Virus:
What are S/Sx?
How long do sx last if uncomplicated?
What complications may occur?
See Module 8 Respiratory Voiceover
91
Who should get a yearly flu shot?
| What type of treatment is needed for Influenza Virus?
See Module 8 Respiratory Voiceover
92
This illness has a significant morbidity and mortality with most deaths occurring in people over 60.
36,000 deaths per year in 2008.
Influenza Virus
93
_________ results from beta-hemolytic streptococcal invasion.
Strep throat
94
What are s/sx strep throat (pharyngitis) ?
| What are possible complications if untreated?
See Module 8 Respiratory Voiceover
95
For URI's:
Warm salt water gargles, lozenges
Throat culture, antibiotics if bacterial only (Why?)
This is what part of the nursing process?
Intervention
See Module 8 Respiratory Voiceover
96
Acute inflammation of pharynx (pharyngitis)
| Cause & signs and symptoms?
See Module 8 Respiratory Voiceover
97
Laryngitis is caused by?
Virus
98
S/S: Hoarseness, Sore throat, Nasal congestion.
Self limiting without long-term harm.
Treat symptoms with voice rest, fluids, and humidified air
This is common is what illness?
Laryngitis
99
May also be caused by bacteria: Streptococcus pneumoniae, Haemophilus influenzae, Staphylococcus aureus, or dental infections.
If not treated may cause meningitis, brain abscess and/or osteomyelitis
This occurs in what illness?
Acute Sinusitis
100
Frequently develops as a result of an URI (particularly viral)
What are common s/sx?
Acute Sinusitis
See Module 8 Respiratory Voiceover
101
This is what part of the nursing process?
Finished at Page 36 on Module 8 Respiratory
