Respiratory System (Exam Two) Flashcards
(184 cards)
1
Q
The cilia are responsible for what?
A
The movement of different substances in and out of the nasal cavity
2
Q
Where does gas exchange occur?
A
Alveolar sacs
3
Q
The left lung has how many lobes?
A
2 lobes
4
Q
The right lung has how many lobes?
A
3 lobes
5
Q
A child’s airway is ______ and ______.
A
Shorter and narrower
6
Q
Which sinuses are present at birth?
A
- Ethmoid sinus
- Maxillary sinus
7
Q
Are periods of apnea normal or abnormal in the newborn?
A
Normal
8
Q
Because a child’s metabolic rate is higher, they require what?
A
Higher oxygen demand
9
Q
Newborns are obligatory ____ _____.
A
Nose breathers
10
Q
How big is a child’s airway?
A
4mm
11
Q
How big is an adult’s airway?
A
20mm
12
Q
How do a child’s eustachian tubes differ from an adults?
A
- Shorter
- More horizontal
13
Q
How do you position a child’s ear when assessing the eustachian tube?
A
Pull down and back
14
Q
What is the normal blood pH and normal oxygen pH?
A
7.35 - 7.45
15
Q
A low pH is referred to as what?
A
Acidosis
16
Q
A high pH is referred to as what?
A
Alkalosis
17
Q
What is the normal range for PCO2?
A
35 - 45 mmHg
18
Q
What is the normal range for HCO3?
A
22 - 26 mEq/L
19
Q
What does PCO2 measure?
A
Partial pressure of CO2
20
Q
What does HCO3 measure?
A
Waste from metabolic processes
21
Q
In uncompensated respiratory acidosis, what is the pH, PCO2, and HCO3?
A
pH: Low
PCO2: High
HCO3: Normal
22
Q
In uncompensated metabolic acidosis, what is the pH, PCO2, and HCO3?
A
pH: Low
PCO2: Normal
HCO3: Low
23
Q
In uncompensated respiratory alkalosis, what is the pH, PCO2, and HCO3?
A
pH: High
PCO2: Low
HCO3: Normal
24
Q
In uncompensated metabolic alkalosis, what is the pH, PCO2, and HCO3?
A
pH: High
PCO2: Normal
HCO3: High
25
Respiratory alkalosis is associated with what?
- Hyperventilation
| - Keeping in excess PCO2
26
Respiratory acidosis is associated with what?
- Hypoventilation
| - Giving off excess PCO2
27
Metabolic acidosis is associated with what?
- DKA
| - Kidney disease
28
Metabolic alkalosis is associated with what?
- Antacid medications
| - Loss of gastric contents (i.e. vomiting)
29
Complete the acid-base balance example:
pH = 7.3
CO2 = 50
HCO3 = 25
Respiratory acidosis
30
Complete the acid-base balance example:
pH = 7.5
CO2 = 40
HCO3 = 35
Metabolic alkalosis
31
Complete the acid-base balance example:
pH = 7.47
CO2 = 30
HCO3 = 22
Respiratory alkalosis
32
Complete the acid-base balance example:
pH = 7.27
CO2 = 38
HCO3 = 20
Metabolic acidosis
33
If the pH in an ABG returns to normal, what does this indicate?
Compensation
34
What are the effects of aging on the respiratory system?
- Decreased force of cough
- Air trapping
- Decreased gas exchange
- Increased risk for respiratory infections
35
What is included in inspection of the respiratory system?
- Symmetry
- Dyspnea
- Accessory muscle use
- Color
- Cough
36
What are retractions?
Area between the ribs and in the neck will sink in during inhalation
37
What is Cheyne-Stokes breathing?
Respirations that gradually become faster and deeper, then slower with alternating periods of apnea
38
What are Kussmaul's respirations?
Faster and deeper respirations without pauses
39
What is crepitus?
Rattling or creaking noise of the lungs
40
What are coarse crackles? Coarse crackles are most commonly found in what disease(s)?
- Fluid in airway
- Bubbling sound
- Pulmonary edema
41
What are fine crackles? Fine crackles are most commonly found in what disease(s)?
- Alveoli popping
- Velcro sound
- Heart failure or atelectasis
42
What adventitious breath sound may dissipate with a cough?
Ronchi
43
What diagnostic test is most common regarding the respiratory system?
Chest x-ray
44
What is the nursing priority following a bronchoscopy?
Assess for bronchospasms
45
What is the most important intervention for preventing and treating respiratory diseases?
Smoking cessation
46
What are therapeutic measures for the respiratory system?
- Deep breathing and coughing
- Huff coughing
- Breathing exercises
- Positioning
47
Huff coughing is a common therapeutic measure for patients with what disease?
COPD
48
When is pursed-lip breathing encouraged?
During shortness of breath
49
When are Venturi masks used?
When a precise oxygen percentage is needed
50
A child cannot be administered a metered dose inhaler without what?
Spacer
51
An incentive spirometer is used to prevent what two diseases?
- Atelectasis
| - Pneumonia
52
What is an alternative to chest physiotherapy?
Posey vest
53
What is a posey vest?
Inflatable vest placed over the patient to vibrate and remove secretions
54
Drainage systems always need to be what?
- Upright
| - Below the chest
55
How often should the patient and the lungs be assessed in a patient with a tracheotomy?
Every four hours
56
______ technique is utilized during cleaning of a tracheostomy?
Sterile technique
57
What is the nursing priority if mechanical ventilation fails?
Bag the patient
58
What is epistaxis?
Nose bleed
59
What are the causes of epistaxis?
- Dry mucous membranes
- Trauma
- Hypertension
- Hemophilia
60
What is the proper positioning for a patient with epistaxis?
-Sitting up and leaning slightly forward
61
Nasal polyps occur most often with what?
Allergies
62
Patients with a deviated septum is at an increased risk for what?
Sinus infections
63
What should be monitored following a nasoseptoplasty?
- Bleeding
- Vital signs
- Dressing
64
What is the most common misdiagnosed disease in children?
Otitis media
65
What is the most common reason a child receives antibiotics?
Otitis media
66
What is one of the most common childhood illnesses?
Otitis media
67
What can cause reflux into the eustachian tube?
Bottle feeding/propping
68
What are the signs and symptoms of otitis media?
- Absence of landmarks
- Yellow/green purulent drainage
- Fever
- Anorexia
- Sleep disturbances
69
What is otitis media with effusion (OME)?
Collection of fluid in middle ear with or without signs and symptoms of infection
70
What is otitis externa (OE)?
- Inflammation of the external ear canal
| - "Swimmer's ear"
71
What is the hallmark sign of otitis externa (OE)?
Tenderness
72
What is the priority education that the nurse should teach parents for a child with otitis media?
Avoid bottle propping
73
Sinusitis is only diagnosed in a child after they have had persistent drainage for how many days?
10 consecutive days
74
What are the risk factors for obstructive sleep apnea?
- Obesity
- High palate
- Receded mandible
- Smoking
75
What are the signs and symptoms of obstructive sleep apnea?
- Snoring
- Daytime sleepiness
- Headache
- Memory and attention problems
- Childhood behavior problems
76
What is viral rhinitis?
Common cold
77
What is rhinitis?
Inflammation of the nasal mucous membranes
78
Bacterial pharyngitis is also known as what?
Strep throat
79
Pharyngitis may be _____ or _____.
Bacterial or viral
80
What is associated with strep throat?
Vomiting
81
What are the common signs and symptoms of laryngitis? Which of these is the most common
- Hoarse voice is the most common
- Cough
- Dysphagia
- Fever
82
What is the common therapeutic measure for laryngitis?
Rest
83
Spasmodic croup can only be diagnosed during what ages?
3 months to 3 years
84
What does croup sound like? When does it appear to be the worst?
- Seal-like cough/barking seal
| - Worse at night
85
What are the three main viruses that cause croup?
- Parainfluenza
- RSV
- Influenza
86
Croup is CAUSED by a _____.
Virus
87
Multiple diagnosis of croup in a child may be indicative of what disease?
Asthma
88
What part of the airway is affected with croup?
Upper airway
89
What is the priority nursing intervention associated with croup?
- Cool mist
| - Cold air
90
What medication is commonly prescribed for croup?
Dexamethasone
91
Epiglottitis is most commonly due to what?
Type B influenza
92
What are the signs and symptoms of epiglottitis?
- Tripod position
- Drooling
- Dysphagia
- Dysphonia
- Distressed air movement (stridor)
93
If the nurse believes a child to have epiglottitis, what should they NOT do? What should the nurse do instead?
- Should NOT look in the mouth or attempt to assess the airway
- Notify the health care provider ASAP
94
Epiglottitis is considered what?
Life-threatening, EMERGENCY!!
95
What are the primary nursing interventions for a patient with epiglottitis?
- Prepare to intubate
- Encourage child not to cry
- Medications
- Hydrate
- Emotional support for parents
96
What family education should be provided regarding epiglottitis?
- Proper administration of antibiotics
- Encourage oral hydration
- Encourage vaccines
97
Why are vaccines encouraged with epiglottitis?
Routine vaccines prevent epiglottitis
98
Describe grade 1+ tonsillitis.
Tonsils extend to arches
99
Describe grade 2+ tonsillitis.
Tonsils extend to just beyond arches
100
Describe grade 3+ tonsillitis.
Tonsils approximate the uvula
101
Describe grade 4+ tonsillitis.
Tonsils meet midline
102
Grade 4+ tonsillitis is also referred to as what?
Kissing tonsils
103
What nursing management is provided to a patient who has undergone a tonsillectomy?
- Suction at bedside!
- No red drinks!
- Semi-fowlers
- Hydration/cool fluids
- Humidifier
104
What nursing management is priority for a tonsillectomy?
Suction at bedside!
105
How is influenza prevented?
- Yearly vaccination
- Handwashing
- Avoidance of infected people
- Do not share drinks/food
106
Can the patient get the flu from the flu vaccine?
No
107
What is the most common complication of influenza?
Pneumonia
108
How is influenza differentiated from a normal virus?
Body aches are indicative of flu
109
Sore throat is more common in what types of viruses?
Regular viruses
110
What is the primary nursing diagnosis for upper respiratory infections?
-Risk for secondary infection! (i.e. pneumonia, ear infection)
111
Cancer of the larynx can spread to what other parts of the body?
- Lungs
- Liver
- Lymph nodes
112
Where will the tumor develop if a patient has cancer of the larynx?
Mucosal epithelium
113
What is the most common symptom of cancer of the larynx?
- Hoarseness of the voice
| - Change in voice
114
What is the main postoperative nursing diagnosis for larynx cancer?
Ineffective airway clearance
115
How long does chronic bronchitis occur? How long can it last?
- More than 3 months out of the year
| - Up to 2 years
116
Bronchiolitis is diagnosed in what age group?
Children under 2 years of age
117
What is the most common cause of bronchiolitis?
-RSV
118
What is atelectasis?
- Reduced lung compliance
- Hypoxemia/hypercapnia
- Risk for pneumonia
119
Patients are only hospitalized for RSV if it is accompanied by what?
Bronchiolitis
120
What are the signs and symptoms of bronchiolitis? What must the nurse specifically assess for?
- Wheezing
- Crackles
- Apnea
- Must assess for retractions
121
What does a PCR assay diagnose?
RSV
122
What is the number one cause of death from infection?
Pneumonia
123
What is the most common cause of pneumonia?
- Bacteria
| - Streptococcus pneumoniae
124
What diagnostic test should be done if pneumonia is suspected?
Culture and sensitivity
125
Yellow, rusty, or blood-tinged sputum is indicative of what illness?
Pneumonia
126
List the signs and symptoms of pneumonia in the elderly?
- Confusion
- Lethargy
- Fever
- Dyspnea
127
What diagnostic tests should be monitored in a patient with pneumonia?
- CBC
| - ABG's
128
What is pertussis? What is it known as?
- Highly contagious, bacterial infection
| - Whooping cough
129
What are the three stages of whooping cough?
- URI symptoms
- Coughing fits
- Chronic cough
130
What education should be provided to the caregivers of a child with whooping cough?
- Importance of vaccine
- Prevent spread of infection
- Cough may be present for up to 10 weeks
- Entire antibiotic must be finished before child returns to daycare/school
131
Who is most at risk for tuberculosis?
- AIDS/HIV
- Drug users
- Homelessness/crowded conditions
132
Blood-tinged or rust colored sputum is evidentiary of what disease?
Tuberculosis
133
What is considered the final diagnosis of tuberculosis?
Sputum culture
134
How long are medications prescribed for tuberculosis?
6 to 24 months
135
How long must the antibiotics for tuberculosis be taken before the patient is no longer considered contagious?
2 to 3 weeks
136
What is the most common problem associated with tuberculosis?
Patient compliance
137
How many sputum cultures must be negative before a patient diagnosed with tuberculosis can return to work?
3 negative sputum cultures
138
What is pleuritis?
Inflammation of visceral and parietal pleurae
139
Friction between the pleurae upon inspiration is indicative of what?
Pleuritis
140
What are the causes of pleuritis?
- Pneumonia
- Tuberculosis
- Tumor
- Trauma
141
What are the signs and symptoms of pleuritis?
- Sharp pain upon inspiration
- Shallow breathing
- Fever, elevated WBC
- Friction rub
142
What is pleural effusion?
Fluid between the lungs and the sac surrounding the lung
143
Fluid is not _______ with pleural effusion.
Reabsorbed
144
Pleural effusion may cause what?
Collapsed lung
145
What are the transudative causes of pleural effusion?
- Heart failure
| - Liver/kidney disease
146
What are the exudative causes of pleural effusion?
- Pneumonia
- Tuberculosis
- CA
147
What is the main diagnostic test for a pleural effusion?
Thoracentesis
148
What is a thoracentesis?
Culture and sensitivity of the fluid surrounding the lung
149
The nurse should anticipate a thoracentesis being done on the patient if the patient becomes what?
Short of breath
150
Once the pleural effusion is resolved, the nurse knows the patient will feel what?
Immediate relief of dyspnea
151
What is pulmonary fibrosis?
- Injury to alveoli
- Scarring
- Impaired gas exchange
152
Why is an ANA titer performed on a patient with pulmonary fibrosis?
To see if the disease is hereditary or autoimmune
153
What is atelectasis?
Collapse of the alveoli
154
What are the signs and symptoms of atelectasis?
- Fine crackles
- Diminished breath sounds
- Dyspnea
155
When does atelectasis most commonly occur?
Post-operation
156
What is the priority nursing intervention for atelectasis?
Prevention
157
Why do patients with COPD have impaired gas exchange?
- Because of air trapping
| - Loss of elasticity in alveoli
158
What is the expected ratio of the thoracic cage in a patient with COPD?
2:2 ratio
159
How is the chest cavity described in a patient with COPD?
Barrel chest
160
What are the signs and symptoms of COPD with chronic bronchitis?
- Wheezing, crackles
- Chronic cough
- Dyspnea
- Thick, tenacious sputum
- Mucous plugs
161
What are the signs and symptoms of COPD with emphysema?
- Diminished breath sounds
- Chronic cough
- Dyspnea
- Progressive activity intolerance
162
What medications are commonly used in a patient with COPD?
- Bronchodilators
- Corticosteroids
- Expectorants
163
What occurs if the patients O2 is too high?
Hypoxic drive
164
What causes asthmatic symptoms?
Inflammation of the lining of the airways
165
If the patient is having an asthma attack, the would want to hear what?
Wheezing
166
What is status asthmaticus?
Severe, sustained asthma attack
167
What occurs during status asthmaticus?
Respiratory alkalosis progresses to respiratory acidosis
168
Intermittent episodes of asthma are often treated with what medication?
- Albuterol
| - SABA
169
What is cystic fibrosis?
- Exocrine gland disorder
| - Thick, tenacious sputum
170
What is indicative of cystic fibrosis using the "Kiss Your Baby" test?
Infant will taste salty
171
What is a pulmonary embolism?
Blood clot in the lungs
172
What is used to prevent a pulmonary embolism?
-Anticoagulants (i.e. heparin)
173
What should the nurse monitor in a patient with a pulmonary embolism?
- Breathing
| - Bleeding
174
What is the most common symptom of pulmonary embolism?
Sudden onset dyspnea
175
Spontaneous pneumothorax usually occurs in individuals who are what?
- Tall
- Thin
- Smokers
176
What nursing care should be provided to a patient with a pneumothorax?
- Monitor respiratory staus
- Monitor chest drainage system
- Report changes promptly
177
What are the nursing diagnoses for chest trauma?
- Risk for infection
- Risk for gas exchange (breathing)
- Pain
178
Acute respiratory failure and acute respiratory distress is...
Respiratory acidosis
179
What is the number one cause of lung cancer?
- Smoking
| - Inhalation of radon gas
180
What is stage one of lung cancer?
In lung with no spread to lymph nodes
181
What is stage two of lung cancer?
In lung and nearby lymph nodes
182
What is stage three of lung cancer?
In lung, lymph nodes and mediastinum
183
What is stage four lung cancer?
In both lungs and pleurae or in distant areas
184
What should the nurse monitor in a post-op thoracic surgery patient?
- Vital signs
- Bleeding (decrease in blood pressure)
- ABGs
- Lung sounds
