Unit 8 Pulmonary Cumulative Quiz Flashcards
(29 cards)
J-receptors (juxtapulmonary capillary receptors) are located near the capillaries in the alveolar septa. They are sensitive to increased __________ capillary pressure, which stimulates them to initiate rapid, shallow breathing, hypotension, and bradycardia
Pulmonary capillary pressure
Hypoxemia caused by inadequate ventilation of well-perfused areas of the lung is a form of mismatching called_____
Shunting
A patient has an acute infection of B-lymphocytes related to the epstein barr virus, which has resulted in lymph node enlargement, splenomegaly, hepatomegaly, and malaise (feel cruddy and super tired). Which condition should the nurse suspect?
mono
What is the most effective way to prevent pulmonary embolism (PE) in post-surgical patients?
Prevent deep vein thrombosis formation
PE is most commonly results from embolization of a clot from deep vein thrombosis (DVT) involving the lower leg; thus, preventing these will help prevent PE
Fluid intake will help but is not as important as preventing DVT
What problem should the nurse suspect for a client with hypotension, hypoxemia, and tracheal deviation to the left, with labs that reveal the air pressure in the pleural cavity is greater than barometric atmospheric pressure?
Tension pneumothorax
Tracheal deviation suggests tension pneumothorax, not pleural effusion. With open pneumothorax, a sucking sound would be heard without tracheal deviation.
Describe the risks and pathophysiology associated with aspiration pneumonia
Pneumonia is when there is an infection in the lung that leads to inflammation. In aspiration pneumonia, a food substance enters the airways. This triggers an inflammatory response since the body treats it as any other foreign substance and that can lead to severe infection. An NG tube can illicit the same inflammatory response if contents accidentally go into the lungs.
What is the pathophysiology behind Multiple Myeloma
Plasma cell cancer. Slow spread of malignant cells. Tumor IN bone marrow destroys bone. Less osteocytes to rebuild bone and produce RBCs. 50% of dx cases found with kdney problems. MM can cause nervous system damage when WBCs enter CNS, CSF, or meninge. We believe MM causes mutations and lifestyle choices determinants increase chances of getting MM.
To rid the body of excess carbon dioxide, the rate and depth of respiration are ___________.
increased
Overactivity of the RAAS results in primary hypertension by causing both retention of salt and water and _______
Increased vascular resistance
Describe the difference between preload and afterload, and explain the condition that are most likely to increase the afterload of the heart
Preload is volume and pressure in ventricle after filling with blood (diastole). Determined by how much blood is left at the end of contraction (ESV) and venous blood return during diastole. After load is the force of resistance that the heart has to overcome to pump blood. Preload is after diastole, after load is before systole.
Afterload is commonly caused by HTN and HF
A 50-year-old male is diagnosed with pulmonary embolism (PE). Which of the following symptoms most likely occurred before treatment was initiated?
Chest pain and shortness of breath
A person with PE ususalyy presents with sudden onset of pleuritic chest pain, dyspnea, tachypnea, tachycardia, and unexplained anxiety. Individuals with PE do not experience a cough or wheezing. Kussmaul respirations are associated with acidosis
Diffusion of respiratory gases takes place across the ______ _______.
Diffusion of respiratory gases takes place across the alveolocapillary membrane. The visceral and parietal pleurae are the linings of the lung; gas exchange does not occur here. THe respiratory center is where impulses to the respiratory muscles are generated.
What action would the nurse avoid when assessing a pediatric patient who present with high fever, inspiratory stridor, severe respiratory distress, drooling, and dysphagia?
Examining throat for redness
The child’s presentation is suspect for epiglottis. Any irritation of the throat in a client with epiglottis can lead to further laryngospasm and a total occlusion of the airway.
Examination of the throat should not be attempted as it may trigger laryngospasm and cause respiratory collapse. It is appropriate to attempt to keep the child calm, listen, and count the child’s RR and HR
List the stages of atherosclerosis
Stage 1- Damage to the endothelium of a. Think smoking, HTN, toxins, viruses, and immune rxns.
Stage 2- Foam cells create a fatty streak when macrophages invade intima and engulf oxidized LDLs (foam cells).
STage 3- Fibrous plaque is formed as macrophages release growth factors which cause collagen to cover fatty streak.
Stage 4 Complicated plaques where they rupture. Leads to platelet adhesion, clotting cascade, and rapid thtombus formation.
These types of respirations are characterized by alternating periods of deep and shallow breathing, with periods of apnea lasting from 15 to 60 seconds.
Cheyne-Stokes respirations
The _______ ______ are sensitive to very small changes in the pH of CSF and can maintain a normal PaCO2
Central Chemoreceptors
Central Chemoreceptors
A 10-year-old is brought to the ER with prolonged bronchospasm and severe hypoxemia that has not responded to his treatments. The symptomology supports which diagnosis?
- exercise-induced asthma
- COPD
- Status asthmaticus
- Bronchiectasis
Status asthmaticus
When bronchospasm is not reversed by the ususal measure, the individual is considered to have severe bronchospasm or status asthmaticus since exercise-induced asthma resolves itself.
COPD is manifested by air trapping and hypercapnia, not by bronchospasm
Bronchiectasis is manifested by bronchiolar changes, not by bronchospasm
The standard method of diagnosis for Cystic Fibrosis is the sweat test, which reveals sweat ______ concentration in excess of 60 milliequivalents per liter
Sweat Chloride concentration
Explain how atelectasis can result in V/Q mismatch or shunt
V is amount of air into alveoli aka VENTILATION, Q is amount of blood that makes it to the capillaries surrounding the alveoli aka PERFUSION. If there is not enough air, then blood cannot be properly oxygenated. V/Q mismatch is an imbalance between ventilation and perfusion. A shunt is a type of V/Q mismatch that is quite bad. When a lung collapses then the amount of oxygenated blood will drop because the alveoli have been damaged, ventilation has decreased, meanwhile, perfusion has not changed. A shunt is the result of hypoxia caused by inadequate ventilation.
Surfactant facilitates alveolar distention and ventilation by:
Decreasing surface tension in alveoli
A patient involved in a motor vehicle accident experiences a severe head injury and dies as a result of the loss of respiration. The nurse suspects the area of the brain most likely damaged is the:
Brain stem
The respiratory center in the brainstem controls respiration by transmitting impulses to the respiratory muscles, causing them to contract and relax. Respirations are not controlled by the cerebral cortex, the thalamus, or the basal ganglia
Type II alveolar cells produce _____
Surfactant
Describe what each segment of the ECG/EKG represents
P- wave is (R) atrial depolarization when the action begins after SA node starts it
- PR interval is the time between atrial activation to ventricle activation. Wildfire spreading from A to V.
- QRS interval captures the period of ventricular depolarization. Amp varies among ppl.
- T-wave is ventricular repolarization, when part is over.
- ST wave encompasses the depolarization and repolarization of the ventricles.
Most oxygen is transported bound to
Hgb
