RESPIRATORY SYSTEM & PROBLEMS AFFECTING MULTIPLE SYSTEMS Flashcards
(99 cards)
1
Q
Which structures are in the upper airway?
A
Nasal cavities, sinuses, pharynx, tonsils, larynx
2
Q
Which structures are in the lower airway?
A
Conducting airways (trachea, bronchi, & bronchioles)
3
Q
How many lobes of the lung are there?
A
5
4
Q
What is the ability to move air in & out of lungs via pressure gradient?
A
Ventilation
5
Q
What is the gas exchange that supplies O2 to blood & body tissues & removes CO2?
A
Respiration
6
Q
What is the most common condition caused by pulmonary disease or injury? Define it.
A
Hypoxemia: deficient oxygenation of arterial blood
7
Q
What is the broad term meaning diminished availability of oxygen to body tissues?
A
Hypoxia
8
Q
The level of arterial oxygenation can be measured either directly by blood gas sampling to measure ___________ ___________ (PaO2) & ___________ ____________ (SaO2) or indirectly by ___________ ___________ (SpO2).
A
- Partial pressure
- Percentage saturation
- Pulse oximetry
9
Q
What is the normal value of PaO2?
A
80-100 mm Hg
10
Q
What is the normal value of SaO2 & SpO2?
A
95-100%
11
Q
What is the term for % of hemoglobin molecules in peripheral blood saturated w/ O2?
A
SpO2
12
Q
What is the measurement of O2 bound to heme protein of hemoglobin?
A
SaO2
13
Q
T/F: SpO2 levels are determined by arterial blood gas analysis.
A
F (SaO2)
14
Q
Elastic ___________ is decreased by intermolecular collagen crosslinks.
A
Recoil
15
Q
Chest wall ____________ decreases w/ aging bc of changes in joints of ribs & spine.
A
Compliance
16
Q
Diminished gas exchange is primarily due to increased physiologic ____________ ____________.
A
Dead space
17
Q
Where are cilia located to sweep away mucus & debris?
A
Primary bronchus
18
Q
When is maximal lung function (as measured by forced expiratory volume) attained?
A
Early 20s
19
Q
At what age is there especially an overall decrease in lung function?
A
55
20
Q
What is the acute lung injury where an inflammatory pulmonary response to offending organism & agent is present?
A
Pneumonia
21
Q
What are the 3 types of offending organism or agent associated w/ pneumonia?
A
- Bacterial, viral, fungal, mycoplasmal (viral & bacterial) infection
- Inhalation of toxic or caustic chems, smoke, dusts, gases
- Aspiration of food, fluids, or vomit
22
Q
What is the term for pneumonia at the level of the lobe? What about for more distally at bronchioles & alveoli?
A
- Lobe: lobar pneumonia
- Bronchioles & alveoli: bronchopneumonia
23
Q
What are the 4 major routes of infection of pneumonia?
A
- Airborne pathogens
- Circulation
- Sinus infection
- Aspiration
24
Q
About 30% of pneumonias are ____________ & are prevalent in older adult.
A
Bacterial
25
About 50% of pneumonias are _____________ & are not usually life-threatening.
Viral
26
About 20% of pneumonias are caused by ______________.
Mycoplasma
27
What type of pneumonia is when fluids or other material from oral cavity or GI tract is aspirated into lower respiratory tract?
Aspiration
28
In viral pneumonia, which virus is common in infants along w/ influenza?
RSV (respiratory syncytial)
29
What is the most prevalent bacterial pathogen in pneumonia?
Strep
30
Most cases of pneumonia are preceded by upper respiratory infection, it often follows ____________.
Influenza
31
Pneumonia has productive cough w/ ____________-colored sputum in bacterial & watery sputum in viral.
Rust
32
T/F: Older adults have fewer symptoms of pneumonia & may present w/ vague symptoms.
T
33
How many weeks of inflammation of trachea & bronchi occur in acute bronchitis?
1-3
34
What kind of infection typically causes acute bronchitis?
Viral
35
What is the common, preventable & treatable disease that has persistent respiratory symptoms & airflow limitation usually caused by exposure or noxious particles or gases?
Chronic obstructive pulmonary disease
36
In the US, what 2 main conditions is COPD referred to?
- Chronic bronchitis
- Emphysema
37
What are some common signs & symptoms of COPD?
- Constant cough
- Shortness of breath
- Can't breathe deep
- Excess sputum
- Wheezing
38
What is used to determine presence & extent of COPD?
Pulmonary function tests (PFTs)
39
What measures how much air lungs can hold & how well respiratory system can move air into & out of lungs?
Spirometry
40
Which medications are used for COPD?
- Bronchodilators
- Inhaled steroids
- Anti-inflammatory agents
41
What is the condition of productive cough lasting for at least 3 months a year for 2 consecutive years?
Chronic bronchitis
42
Irritants cause mucous hypersecretion & hypertrophy of mucus-producing glands in ____________ ____________.
Large bronchi
43
T/F: Obstruction in chronic bronchitis increases PaCO2.
T
44
What is the enlargement of air spaces beyond terminal bronchiole that's associated w/ loss of elasticity in distal airways, airway collapse, & gas trapping?
Emphysema
45
Out of these, which is the most common type of emphysema? - Paraseptal - Centriacinar - Irregular - Panacinar
Centriacinar
46
What is the major etiologic factor of emphysema?
Cigarette smoking
47
What is the reversible obstructive lung disease characterized by inflammation & increased reactivity of smooth muscle of airways to various stimuli, causing bronchoconstriction & airflow resistance?
Asthma
48
Asthma is a chronic condition w/ ____________ exacerbations.
Acute
49
What are the 2 main types of asthma?
- Extrinsic (allergic)
- Intrinsic (nonallergic)
50
Mechanisms of airway obstruction by immune system in asthma include IgE & which 2 types of cells?
- T-helper
- Mast
51
70% of people w/ sleep apnea are ___________.
Obese
52
What is the most common type of sleep apnea?
Obstructive
53
Which type of sleep apnea has significant daytime symptoms?
Obstructive
54
What refers to co-occurrence of obstructive sleep apnea & COPD?
Overlap syndrome
55
What are the 3 types of sleep apnea?
- Obstructive
- Central
- Mixed
56
T/F: Fever, bradycardia, & hypermetabolic state seen in acute inflammation.
F (tachycardia)
57
Which elevated levels are seen in acute inflammation?
- Serum protein
- WBCs
58
What is the normal value of WBCs?
5k-10k / mm3
59
What type of inflammation are these symptoms seen in? - Low-grade fever - Malaise - Weight loss - Anemia - Fatigue - Leukocytosis - Lymphocytosis
Chronic
60
Chronic inflammation has increased ____________ ____________ rate which decreases when disease improves.
Erythrocyte sedimentation
61
Which kind of immunodeficiency do patients encounter more often?
Acquired
62
Which disease are these symptoms a sign of? - Weight loss, muscular weakness, anorexia, anemia - Bone erosion or liver, GI, pulmonary, vascular obstruction - Increased intracranial pressure in brain - Hemorrhage - Cachexia
Neoplasm
63
What are all of these classified as? - Medication errors - Adverse drug reactions - Allergic drug reactions - Overdoses
Adverse drug events
64
T/F: Most ADEs are medication reactions or side effects.
T
65
Dose-related ADEs are _____________ drug injuries while non dose-related are unpredictable or _____________.
- Predictable
- Idiosyncratic
66
Which type of ADEs are associated w/? - Drug toxicity from overdose - Variations in pharmacological preparation - Pre-existing liver disease - Comorbidities - Drug interactions
Dose-related
67
Which type of ADEs are associated w/? - Hypersensitivity - Acute anaphylaxis
Non dose-related
68
Potential ADEs are referred to as ______________ _____________ & are medication errors that do not cause harm to client or caught by staff prior.
Near misses
69
T/F: Drug-drug interaction occurs when medications interact favorably or unfavorably.
F (unfavorably)
70
T/F: Side effects & overdosage toxicity are both predictable just depending on the range.
T
71
Over 11.4 million people misuse which type of drug?
Opioids
72
T/F: Older adults are 2x as likely to go to ED because of ADEs.
T
73
What are the 3 common signs of drug toxicity?
- Rashes
- Fever
- Jaundice
74
Which risk factor of drug toxicity has the most prevalent effect?
Age
75
Low ___________ stores increase proportion of drug that is free & active.
Albumin
76
Approx 30% of patients 65 yrs & older are prescribed 5 or more drugs & ___ in 5 drugs may be inappropriate, increasing to 1/3 among those in aged care facilities.
1
77
What is the progressive, autoimmune disease that affects synovial tissue & joints?
RA
78
What is the threatening organ dysfunction caused by deregulated host response to infection w/ systemic inflammation?
Sepsis
79
What is when sepsis is associated w/ organ dysfunction distant from site of infection?
Severe sepsis
80
T/F: Septic shock is accompanied by hypertension despite adequate fluid infusion.
F (hypotension)
81
What is bacteremia?
Bacteria in blood
82
In pathogen-associated molecular patterns of sepsis, pattern-recognition proteins that recognize infectious organisms can be found in cell membranes or ___________.
Cytosol
83
Which type of molecules are associated w/ damage-associated molecular patterns?
Non-infectious
84
Which levels are elevated in sepsis? How about in septic shock?
- Sepsis: lactate
- Septic shock: BUN, creatinine, WBCs
85
What is the most common cause of death in the ICU?
Multiple organ dysfunction syndrome
86
What is the normal range of pH?
7.35-7.45
87
When is cell function impaired seriously in regards to pH?
< 7.2 or > 7.55
88
Which acid does the lung excrete within minutes to hours?
Carbonic acid H2CO3
89
Which base does kidneys reclaim within 3-5 days?
Bicarbonate HCO3-
90
Which test measures amount of dissolved O2 & CO2 in arterial blood & indicates acid-base status by measurement of arterial blood pH?
Arterial blood gas test
91
As H+ increases (acidosis), pH ____________.
Decreases
92
As CO2 increases, pH ____________.
Decreases
93
What are the 4 classes of acid-base imbalance?
- Respiratory acidosis
- Respiratory alkalosis
- Metabolic acidosis
- Metabolic alkalosis
94
Respiratory acidosis is nearly always due to ___________ & subsequent retention of CO2.
Hypoventilation
95
What is most commonly seen in? - COPD - Asthma - Depressed CNS - Impaired diaphragm
Respiratory acidosis
96
What occurs as a result of loss of acid (hypocapnia) w/o compensation due to increased ventilation?
Respiratory alkalosis
97
Renal failure often leads to metabolic ___________ since kidney not able to excrete ammonium & phosphoric acid.
Acidosis
98
What occurs when abnormal loss of acid or excess accumulation of bicarbonate occurs through volume loss, vomiting, postop loss, & use of diuretics?
Metabolic alkalosis
99
T/F: Older adults are prone to respiratory acidosis & alkalosis.
T
