health alterations - week 3 Flashcards
(14 cards)
What is the pathophysiology of emphysema?
Cigarette smoke and air pollution lead to inflammation and destruction of alveolar septa
Alveolar destruction creates large air spaces not active in diffusion of gasses
Loss of elastic recoil and passive expiration of air
What is alveolar dead space?
An area of the lung where the alveoli is ventilated but not perfused
The nurse is admitting a patient diagnosed with an acute exacerbation of chronic obstructive pulmonary disease (COPD). How should the nurse determine the appropriate Oxygen flow rate?
Maintain the pulse oximetry level at 90% or greater.
What is the pathophysiology of chronic bronchitis?
Airway inflammation, mucous hypersecretion and airway remodelling (narrowing)
Postural drainage with percussion and vibration is ordered twice daily for a patient with chronic bronchitis. Which intervention should the nurse include in the plan of care?
Give the prescribed salbutamol (Ventolin) before the therapy.
Bronchodilators are administered before chest physiotherapy.
Chronic obstructive pulmonary disease is the result of what two conditions?
Emphysema and chronic bronchitis
What is ventilation perfusion (V/Q) mismatch?
The adequate ventilation of an area of the lung without adequate perfusion, or inadequate ventilation of an area of the lung with adequate perfusion.
The nurse interviews a patient with a new diagnosis of chronic obstructive pulmonary disease (COPD). Which information is most specific in confirming a diagnosis of chronic bronchitis?
The patient reports a productive cough for 3 months every winter.
Although smoking is the major risk factor for chronic bronchitis, a smoking history does not confirm the diagnosis.
The nurse provides dietary teaching for a patient with chronic obstructive pulmonary disease (COPD) who has a low body mass index (BMI). Which patient statement indicates that the teaching has been effective?
The nurse provides dietary teaching for a patient with chronic obstructive pulmonary disease (COPD) who has a low body mass index (BMI). Which patient statement indicates that the teaching has been effective?
I can have ice cream as a snack every day.
A patient with chronic obstructive pulmonary disease (COPD) has poor gas exchange. Which action by the nurse would support the patient’s ventilation?
Encourage the patient to sit up at the bedside in a chair and lean forward.
Patients with COPD improve the mechanics of breathing by sitting up in the “tripod” position.
What is the impact of a thickened alveolar-capillary membrane?
Delayed diffusion of gasses between the alveoli and the capillaries
Hypoxaemia
Hypercapnia
The nurse in the emergency department receives arterial blood gas results for four recently admitted patients with obstructive pulmonary disease. The results for which patient will require the most rapid action by the nurse?
pH 7.28, PaCO2 50 mm Hg, and PaO2 58 mm Hg
NOT
pH 7.34, PaCO2 33 mm Hg, and PaO2 80 mm Hg
pH 7.31, PaCO2 58 mm Hg, and PaO2 64 mm Hg
pH 7.48, PaCO2 30 mm Hg, and PaO2 65 mm Hg
What is the impact of chronic bronchitis on respiration?
Airways collapse early in expiration
Gas is trapped in distal portions of the lungs leading to thoracic cavity expansion
Gas exchange is decreased increasing the ventilation-perfusion (V/Q) mismatch
A patient is receiving 35% O2 via a Venturi mask. To ensure the correct amount of O2 delivery, which action by the nurse is important?
Keep the air entrainment ports clean and unobstructed.
The air entrainment ports regulate the O2 percentage delivered to the patient, so they must be unobstructed.
