Exam 4 Kaplan Review Flashcards by Delia Archer

Breathing accomplished by abdominal muscles and diaphragm; may be used
to increase effectiveness of ventilatory process in certain conditions. What type of breathing pattern is this?

Abdominal respirations

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Produces respiratory alkalosis due to reduction in CO2 tension. What type of breathing pattern is produced by this?

Hyperventilation

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Difficult, labored, or painful breathing (considered “normal” at certain times, e.g., after extreme physical exertion). What type of breathing pattern is this?

Dyspnea

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This contains the voice box and epiglottis, which prevents food from entering the trachea;
cough reflex. This is what structure of the upper respiratory system?

Larynx

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Periodic breathing characterized by rhythmic waxing and waning of the depth of respirations. What type of breathing pattern is this?

Cheyne-Stokes respirations

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Abnormally rapid, deep, and prolonged breathing. What type of breathing pattern is this?

Hyperventilation

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Abnormal breath sounds. What type of breathing pattern is this?

Adventitious lung sounds

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Rate, depth, or tidal volume changes markedly from one interval to the next; pattern of change is periodically reproduced. What type of breathing pattern is this?

Periodic breathing

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Breathing pattern in which a lung (or portion of a lung) deflates during inspiration (acts opposite to normal). What type of breathing pattern is this?

Paradoxical respirations

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Inability to breathe except when trunk is in upright position. What type of breathing pattern is this?

Orthopnea

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Marked increase in depth and rate of breathing. What type of breathing pattern is this?

Kussmaul’s respirations (air hunger)

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Reduced ventilatory efficiency; produces respiratory acidosis due to elevation in CO2 tension. What type of breathing pattern is this?

Hypoventilation

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Gurgling, bubbling, or popping sounds;
heard mostly on inspiration and not
cleared by coughing.
May be high-pitched (fine crackles),
medium-pitched (medium crackles), or
low-pitched (coarse crackles).
May clear with coughing. What adventitious lung sound matches this description?

Crackles (Rales)

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High-pitched, musical sounds similar to
a squeak.
Heard more commonly on expiration, but
may be heard on inspiration.
Auscultated over small airways.
Do not clear with coughing. What adventitious lung sound matches this description?

Wheeze

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Harsh, high-pitched sounds heard over

the trachea. What adventitious lung sound matches this description?

Stridor

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A superficial, low-pitched, coarse
rubbing or grating sound (sounds like
two surfaces rubbing together).
Heard throughout inspiration and
expiration and not cleared by coughing. What adventitious lung sound matches this description?

Pleural Friction Rub

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Needed for blood clotting, skeletal muscle contraction, regulated by the parathyroid hormone and vitamin D, which facilitates reabsorption of calcium from bone and
enhances reabsorption from the GI tract. What electrolyte is required during these processes?

Calcium

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Increased intake of dietary Mg—green vegetables, nuts, bananas, oranges, peanut butter, chocolate
Oral—long-term maintenance with oral magnesium
IV—assess renal function
Monitor for digitalis toxicity
Seizure precautions
6 Safety measures for confusion
Test ability to swallow before PO fluids/food because of dysphagia
These are nursing interventions for what electrolyte imbalance?

Hypomagnesemia

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Malignant neoplastic diseases
Hyperparathyroidism
Prolonged immobilization
Excessive intake
Immobility
Excessive intake of calcium carbonate antacids
These ailments can cause what electrolyte imbalance?

Hypercalcemia

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Acute Pain: Fluid intake reduced
Activation of sympathetic nervous system
Chronic Pain: Stress-induced changes

Pain has this effect on what body system?

Cardiovascular System

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normal ionized serum calcium level:
____-____ mg/dL;
normal total serum calcium level:
____-____ mg/dL

5–5.2 mg/dL

8. 5–10.5 mg/dL

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Lack of coordination
Anorexia, nausea, and vomiting
Confusion, decreased level of consciousness
Personality changes
Dysrhythmias, heart block, cardiac arrest
These are signs and symptoms of what electrolyte imbalance?

Hypercalcemia

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Acute Pain: Nausea and vomiting
Chronic Pain: Constipation, anorexia

Pain has this effect on what body system?

Digestive system

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Tap facial nerve 2 cm anterior to the earlobe just below the zygomatic arch;
twitching of facial muscles indicates tetany in hypocalcemia. What is this sign to indicate tetany called?

Chvostek’s Sign

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This is the main intracellular ion; involved in cardiac rhythm, nerve transmission. What electrolyte is required during these processes?

Potassium

Potassium Normal level ___-___ mEq/L

3.5–5.0 mEq/L

Inflate BP cuff on upper arm to 20 mm Hg above systolic pressure, carpal spasms within 2–5 min indicate tetany in hypocalcemia. What is this sign to indicate tetany called?

Trousseau’s Sign

1. EKG changes–peaked T waves, wide QRS complexes 2. Dysrhythmias, ventricular fibrillation, heart block 3. Cardiac arrest 4. Muscle twitching and weakness 5. Numbness in hands and feet and around mouth 6. Nausea 7. Diarrhea These are signs and symptoms of what electrolyte imbalance?

Hyperkalemia

1. Restrict dietary potassium and potassium-containing medications or IV solutions 2. Sodium polystyrene sulfonate (Kayexalate)—cation-exchange resin (causes diarrhea) a. Orally—dilute to make more palatable b. Rectally—give in conjunction with sorbitol to avoid fecal impaction 3. Peritoneal or hemodialysis 4. Diuretics These are nursing interventions for what electrolyte imbalance?

Hyperkalemia

1. Vomiting 2. Gastric suction 3. Prolonged diarrhea 4. Diuretics and steroids 5. Inadequate intake These ailments can cause what electrolyte imbalance?

Hypokalemia

1. Anorexia, nausea, vomiting 2. Weak peripheral pulses 3. Muscle weakness, paresthesias; decreased deep tendon reflexes 4. Impaired urine concentration 5. Ventricular dysrhythmias 6. Potential for digitalis toxicity 7. Shallow respirations These are signs and symptoms of what electrolyte imbalance?

Hypocalcemia

1. Administration of oral potassium supplements—dilute in juice and give with meals to avoid gastric irritation 2. Increase dietary intake—raisins, bananas, apricots, oranges, beans, potatoes, carrots, celery 3. Assess renal function prior to administration of IV supplements 4. Risk for digitalis toxicity These are nursing interventions for what electrolyte imbalance?

Hypokalemia

This is the main extracellular ion; responsible for water balance. What electrolyte is required during these processes?

Sodium

1. Renal failure 2. Use of potassium supplements 3. Burns 4. Crushing injuries 5. Severe infection 6. Potassium-sparing diuretics 7. ACE inhibitors These ailments can cause what electrolyte imbalance?

Hyperkalemia

1. Nervous system becomes increasingly excitable 2. Tetany 3. Hyperactive reflexes 4. Confusion 5. Paresthesias 6. Irritability 7. Seizures These are signs and symptoms of what electrolyte imbalance?

Hypocalcemia

What three nursing interventions would you implement to prevent development of renal calculi?

a. Increase fluid intake b. Maintain acidic urine c. Prevent urinary tract infection

What nursing intervention would you implement for hypocalcemia and what would it be administered with?

Orally—calcium gluconate (less concentrated) or calcium chloride; administer with orange juice to maximize absorption

1. Elevated temperature 2. Weakness 3. Disorientation 4. Irritability and restlessness 5. Thirst 6. Dry, swollen tongue 7. Sticky mucous membranes 8. Postural hypotension with ↓ ECF Hypertension with normal or ↑ ECF 9. Tachycardia 10. Elderly—mental status changes, coma These are signs and symptoms of what electrolyte imbalance?

Hypernatremia

1. Vomiting 2. Diuretics 3. Excessive administration of dextrose and water IVs 4. Burns, wound drainage 5. Excessive water intake 6. Syndrome of inappropriate antidiuretic hormone secretion (SIADH) 7. Elderly—kidneys unable to excrete free water These ailments can cause what electrolyte imbalance?

Hyponatremia

Sodium Normal level ___-___ mEq/L

135–145 mEq/L

This ion is interdependent with calcium. What electrolyte is required during this process?

Magnesium

This is the relationship between airflow and pleural pressure. What is this defined as?

Airway resistance

Magnesium Normal level ___-___ mEq/L

1.5–3.0 mEq/L

1. Increased neuromuscular irritability 2. Tremors 3. Tetany 4. Hyperactive deep tendon reflexes 5. Seizures 6. Dysrhythmias especially if hypokalemia present 7. Disorientation 8. Confusion These are signs and symptoms of what electrolyte imbalance?

Hypomagnesemia

1. Renal failure 2. Excessive magnesium administration (antacids, cathartics) These ailments can cause what electrolyte imbalance?

Hypermagnesemia

1. Hypertonic tube feedings without water supplements 2. Hyperventilation 3. Diabetes insipidus 4. Ingestion of OTC drugs such as Alka-Seltzer 5. Inhaling large amounts of saltwater (near drowning) 6. Inadequate water ingestion These ailments can cause what electrolyte imbalance?

Hypernatremia

1. Oral administration of sodium-rich foods—beef broth, tomato juice 2. IV lactated Ringer’s or high concentrations of NaCl (0.9%) 3. Water restriction (safer method) 4. I and O 5. Daily weight These are nursing interventions for what electrolyte imbalance?

Hyponatremia

1. Discontinue oral and IV Mg 3. Hemodialysis 4. Monitor reflexes 5. Teach regarding over-the-counter drugs containing Mg 6. Monitor respiratory status 7. Monitor cardiac rhythm; have calcium preparations available to antagonize cardiac depressant These are nursing interventions for what electrolyte imbalance?

Hypermagnesemia

This population is at a greater risk of adverse reactions and toxicity, greater risk of drug interaction between analgesics and medications, e.g., analgesics, anti-epileptics, and antidepressants; start with lower dose and increase gradually

Elderly

This moves air into and out of lungs and along bronchial airways to bring oxygen into the lungs and removes CO2. What is this function of the respiratory system?

Ventilation

Change: Increased blood pressure and heart rate lead to increased blood flow to brain and muscles. Rapid, irregular respiration leads to increased O2 supply to brain and muscles. Result: Enhanced alertness to threats This is what body system response to pain and result?

Cardiovascular

Change: Increased muscle tension or activity leads to neuromuscular responsiveness. Result: Ready for rapid motor activity. This is what body system response to pain and result?

Musculoskeletal

1) This is the contraction of inspiratory muscles 2) Enlargement of thoracic cage 3) Reduction in intrapleural and intrapulmonic pressures 4) Inflow of air until intrapulmonic pressure equals atmospheric pressure What is this function of the respiratory system?

Inspiration

1. IV administration of 0.45% NaCl or 0.9% NaCl 2. Encourage fluids 3. Lasix - Excretes fluid through the urinary tract 4. Calcitonin—decreases calcium level 5. Mobilizing the patient 6. Dietary calcium restriction 7. Injury prevention 8. Limit intake of calcium carbonate antacids These are nursing interventions for what electrolyte imbalance?

Hypercalcemia

This filters, warms, and humidifies inspired air; contains olfactory receptors for sense of smell; older adults have restricted air flow. This is what structure of the upper respiratory system?

Nose

These air-filled cavities provide resonance during speech. This is what structure of the upper respiratory system?

Sinuses

This contains adenoids and tonsils; defense mechanisms against infection; gag-reflex. This is what structure of the upper respiratory system?

Pharynx (throat)

This is the smallest subdivisions of bronchi, conducting air from secondary bronchi into alveoli. This is what structure of the lower respiratory system?

Bronchioles

1. Alcoholism 2. GI suction 3. Diarrhea 4. Intestinal fistulas 5. Poorly controlled diabetes mellitus 6. Malabsorption syndrome These ailments can cause what electrolyte imbalance?

Hypomagnesemia

Delicate, thin-walled, minute hollow chambers within the lungs surrounded by networks of capillaries; contain surfactant that keeps these expanded. This is what structure of the lower respiratory system?

Alveoli

This population has a loss of elastic recoil; increased residual volume; and increased use of accessory muscles in the lungs.

Elderly

Change: Increased papillary diameter leads to increased eye accommodation to light. Result: Visual perception of threat. This is what body system response to pain and result?

Neurological

1) Relaxation of inspiratory muscles 2) Reduction in size of thoracic cage 3) Increase in intrapleural and intrapulmonic pressures 4) Outflow of air until intrapulmonic pressure equals atmospheric pressure What is this function of the respiratory system?

Expiration

1) Rate in adult is 12 to 20 breaths per minute 2) Smooth with an even respiratory depth 3) Easy, relaxed; requiring minimal effort 4) Symmetric chest wall movement 5) May be abdominal (commonly seen in men) or thoracic (common in women) What type of breathing pattern is this a desciption of?

Eupnea | Normal Breathing Pattern

This causes an increase in intrapleural and intrapulmonic pressures; gases in the pleural cavity are expelled until intrapulmonic and atmospheric pressures equalize. What is this defined as?

Expiration

The right lung has __ lobes; the left lung has __ lobes.

1. Depresses the CNS 2. Depresses cardiac impulse transmission 3. Cardiac arrest 4. Facial flushing 5. Muscle weakness 6. Absent deep tendon reflexes 7. Paralysis 8. Shallow respirations These are signs and symptoms of what electrolyte imbalance?

Hypermagnesemia

a. Patent airway b. Elastic, expansive lungs and tracheobronchial tree c. Adequate musculoskeletal apparatus of chest wall This is required for what type of ventilation?

Effective Ventilation

Diaphragm and Intercostal ______ enhance inspiration and expiration.

Muscles

Contraction of diaphragm and intercostal muscles, resulting in downward expansion of the thoracic cavity and elevation of the rib cage. What is this defined as?

Inspiration

Passive action involving deflation of lungs, relaxation of thoracic musculature, and reduction in the size of the thoracic cavity. What is this defined as?

Expiration

__________ muscles may be used in pathological states or after exercise when additional expansion is needed; abdominal muscles may be used during coughing

Accessory

This pressure in the lungs is normally negative (below atmospheric pressures). What is this defined as?

Intrapleural pressure

When lung compliance is lowered, the respiratory effort is __________.

Increased

This causes a reduction in intrapleural and intrapulmonic pressures; air enters the lungs until the intrapulmonic and atmospheric pressures equalize. What is this defined as? equalize

Inspiration

``` Low-pitched, coarse, loud, moaning/ snoring sounds heard primarily on expiration, but may be present on inspiration, arise from large airways. Coughing may clear. What adventitious lung sound matches this description? ```

Sonorous Wheeze (Ronchi)

1) Highest airway resistance is in the _____. 2) Lowest resistance in the _________. 3) Airway problems (e.g., emphysema) _____ airway resistance.

Nose Bronchioles Increase

1. IV administration of hypotonic solution —0.3% NaCl or 0.45% NaCl; 5% dextrose in water 2. Offer fluids at regular intervals 3. Decrease sodium in diet 4. Daily weight These are nursing interventions for what electrolyte imbalance?

Hypernatremia

FINISH RESPIRATORY OVERVIEW

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Caused by central nervous system disorders, drugs that increase sensitivity of respiratory centers, or acute anxiety. What type of breathing pattern is caused by this?

Hyperventilation

Temporary cessation of breathing. What type of breathing pattern is this?

Apnea

1. Nausea 2. Muscle cramps 3. Confusion 4. Muscular twitching, coma 5. Seizures 6. Headache 7. Delirium in older adults These are signs and symptoms of what electrolyte imbalance?

Hyponatremia

1. Hypoparathyroidism 2. Pancreatitis 3. Renal failure 4. Steroids and loop diuretics 5. Inadequate intake 6. Post-thyroid surgery These ailments can cause what electrolyte imbalance?

Hypocalcemia

Abnormally deep breathing. What type of breathing pattern is this?

Hyperpnea

Exam 4 Kaplan Review Flashcards

(84 cards)