patho quiz 5 3

Question 1

How does the body control ventilation?

Answer 1

Neurologic control (respiratory center- medulla & pons), Chemical ( changes in PO O2 CO2), Mechanical (stretch receptors in bronchi & irritant receptors throughout the epithelium)

Question 2

How do you control breathing?

Answer 2

Medullary Center, Pons, chemoreceptors, peripheral receptors, stretch receptors, irritant receptors, pain, stress, muscles, and joints

Question 3

What is ventilation?

Answer 3

Process of moving air into the lungs and distributing air within the lungs to alveoli for maintaining of O2 and removal CO2

Question 4

What is perfusion?

Answer 4

The second process of respiration which blood flow and distribution of blood flow at the alveolar level to allow exchange of O2 and CO2

Question 5

What is the ventilation / perfusion ratio?

Answer 5

4L/min of alveoli ventilation to 5L/min of capillary blood flow in the lungs. V/Q 80%, 0.8

Question 6

What is respiratory insufficiency?

Answer 6

Gas exchange is maintained at an acceptable level with much increased work of the cardiopulmonary system

Question 7

What is respiratory failure?

Answer 7

Cardiopulmonary system inability to maintain adequate gas exchange at the pulmonary level

Question 8

What is the etiology of respiratory failure?

Answer 8

Decreased CNS drive to breath, impaired ventilation d/t obstruction, and impaired ventilation/perfusion

Question 9

What is hypoxemia?

Answer 9

Abnormally low O2 in the blood as a direct consequence of resp. failure

Question 10

What effects does Hypoxemia have on CNS?

Answer 10

Restlessness, agitation, incordination, and coma and death

Question 11

What are the clinical presentations of resp insufficiency vs. failure?

Answer 11

tachycardia, coolness, diaphoresis, pallor-cyanosis, initial increase in BP/HR, failure : hypotension and bradycardia

Question 12

What is hypercapnea?

Answer 12

increased level of CO2 in blood. It is a direct vasodilator ( cerebral vessels > headache, flushed skin, and conjunctiva - hyperemia)

Question 13

What does acidosis mean?

Answer 13

pH low, too much H+ ion. Resp: CO2 elevated. Metabolic: HCO3 decreased

Question 14

What is the normal arterial pH?

Answer 14

7.35-7.45

Question 15

What is the normal value of arterial PaCO2?

Answer 15

35-45 mm Hg

Question 16

What is the normal value of arterial Bicarb (HCO2-)

Answer 16

22-26 mEq/L ( mmol/L)

Question 17

What does alkalosis mean?

Answer 17

pH high, low level of H+ ion in blood, Resp: low, Metabolic: high

Question 18

What are the manifestations of metabolic acidosis?

Answer 18

Causes HYPERKALEMIA. Drowsiness, confusion, coma, decrease Bp, dysrhythmia (K+), dilations, NVD, and pain, increased resp. (comp).

Question 19

What are the manifestations of metabolic alkalosis?

Answer 19

HYPOKALEMIA, dizziness, irritability, nervous, confusion, Increase HR, NV, anorexia, tetany, tremor, paresthesia, seizures, decreased resp. (comp)

Question 20

What is complete compensation?

Answer 20

both CO2 and HCO3 are abnormal in the same direction and pH is within normal range

Question 21

What is partial compensation?

Answer 21

Both CO2 & HCO3 are abnormal in the same direction, and pH is still outside the normal range

Question 23

What is combined Acidosis?

Answer 23

CO2 is high and HCO3 is low

Question 24

What is combined Alkalosis?

Answer 24

CO2 is low and HCO3 is high

Question 25

What are the 6 steps in diagnosis of metabolic vs. resp. acidosis or alkalosis?

Answer 25

Evaluate pH, analyze PaCO2, analyze HCo3, determine if balanced or unbalanced, determine if CO2 or HCO3 matches the alteration, and decide if the body is attempting to compensate

Question 26

What are the values of resp. failure?

Answer 26

PaO2 less than or equal to 50 mmHg (hypoxemia) or PaCO2 greater than or equal to 50 mmHg with pH less than or equal to 7.25

Question 27

What causes respiratory failure?

Answer 27

pneumonia, COPD, atelectasis, CHF, sepsis, drugs, neuro disorders

Question 28

What is the treatment of resp. failure?

Answer 28

O2 and ventilator support

Question 29

What is hemoptysis?

Answer 29

coughing up blood

Question 30

What is clubbing a sign of?

Answer 30

chronic resp. disease

Question 31

What is paroxysmal nocturnal dyspnea?

Answer 31

awakening from deep sleep with severe shortness of breath

Question 32

What is orthopnea?

Answer 32

unable to lie flat because of breathing

Question 33

What is obstructive lung disease?

Answer 33

difficulty exhaling, decreased FEV1 and FEV1/FVC, increase in breathing, use of accessory muscles of exhalation, and intrapulmonary problem

Question 34

What is restrictive lung disease?

Answer 34

difficulty inhaling, decreased FVC? Caused by stiff lung (fibrosis), neuro, muscular, skeletal, normal ventilation during sleep

Question 35

What is Chronic Obstructive Pulmonary Disease?

Answer 35

obstruct pathway of normal alveolar ventilation either by spasm of the airways, mucus secretions, or changes in airway and/or alveoli

Question 36

COPD is a comb of what 3 diseases?

Answer 36

chronic bronchitis, emphysema, and asthma

Question 37

What is chronic bronchitis?

Answer 37

bronchial inflammation with hypertrophy and hypersecretion of bronchial mucous glands

Question 38

What causes chronic bronchitis?

Answer 38

inhalation of chemical or physical irritants, such as tobacco smoke, smog, viral or bact. Infections

Question 39

How is chronic bronchitis dx?

Answer 39

productive cough for 3 months of each year for 2 consecutive years

Question 40

What are the signs and symptoms of chronic bronchitis?

Answer 40

productive cough, increased work of breathing, dyspnea

Question 41

What is pts. With chronic bronchitis called?

Answer 41

blue bloater

Question 42

What is emphysema?

Answer 42

nonreversible obstructive disease characterized by the destruction of alveolar walls and connective tissue. Terminal airways collapse during expiration. Secretions are retained.

Question 43

What are the causes of Emphysema?

Answer 43

inhalation of irritants (tobacco smoke) and genetic (rare)

Question 44

What are the s/s of emphysema?

Answer 44

dyspnea, barrel chest, non-productive cough

Question 45

What are pts. With emphysema called?

Answer 45

pink puffers

Question 46

What is barrel chest?

Answer 46

A & P diameter is equal to transverse diameter

Question 47

How do you treat emphysema?

Answer 47

improve ventilation (bronchodilators & breathing exercises), Promote secretion removal (hydration & humidification), and prevent complications

Question 48

What is asthma?

Answer 48

intermittent airway obstruction d/t bronchospasm and increase mucous secretions. Hyper-responsiveness of airways after exposure to irritating stimuli (exercise, change in temp., emotional stress, animal dander, fumes)

Question 49

What are the s/s of asthma?

Answer 49

wheezing, cough, hyperventilate, dyspnea, and anxiety