resp exam 2

Card Set Information

resp exam 2
2013-10-10 00:23:14

resp sys
Show Answers:

  1. s/s of o2 toxicity
    dry cough, chest pain, numbness in extremities, nausea
  2. staging a tumor
    TNM Tumor- #of lymph nodes affected
  3. PEEP
    positive end expiratory pressure- to keep airways open
  4. triggers of asthma
    • smoking
    • allergens
    • infections
    • exercise
    • sinusitis
    • stress
    • gerd
    • heat
    • cold
  5. what is the primary clinical symptom of emphysema
  6. genetic screening is able to detect carriers of this disease...
    cystic fibrosis
  7. ________ o2 masks has 1 or more vents that close on inspiration and open during expiration and delivers 70-100% o2
  8. T/F the purpose of the cilia is to move mucus to back of larynx
  9. Abnormal distention of air spaces beyond the terminal bronchioles with destruction of the walls of the alveoli. Decreased alveolar surface area causes an increase in "dead space" and impaired o2 diffusion
  10. scope thru thoracic cavity is called what?
  11. Normal blood ph
  12. pneumonia can be caused by...
    • bacteria
    • virus
    • fungus
    • aspiration
    • artificial ventilation
    • hypostasis
    • chemical (such as mixing solutions and inhaling)
  13. the primary stage of tb is usually
  14. severe sustained asthma
    hypoxemia worsening
    continuous bronchus spasm
    resp rate increases
    respiratory alkalosis results
    status asthmaticus
  15. tobacco smoke causes __-__% of COPD cases
  16. what air remains in the lungs after forced respiration; increases with age
    residual volume
  17. inflammation of both layers of the pleurae- inflamed surfaces rub together with respiration, cause sharp pain, intensified with inspiration
  18. ____ is the most common cause of death from infection, especially in the elderly
  19. compression of the lung tissue
    increased permeability of capillaries
    pulmonary edema
    pulmonary contusion
  20. A ___ valve helps trach patients speak
    Passy-Muir speaking valve
  21. delivery of atmospheric air to gas exchange units
  22. ___is a chronic, irreversible dilation of the bronchi and bronchioles- chronic infection- usually secondary to an underlying condition
    bronchiectasis- sacs become fibrotic- cilia is impaired
  23. you will hear ___ when listening to a pt with acute reap distress syndrome...
  24. -severe form of acute lung injury
    -o2 doesnt relieve stress
    -decreased bld flow to lungs, platelets clump as an inflammatory response
    acute reap distress syndrome
  25. T/F the primary o2 admin method for a pt with COPD is a nasal cannula
    false- a pt with copd needs precise measurements with a venturi mask
  26. holding cough and cough forcefully
    deep breathing and coughing
  27. ___would be used for a pt acutely ill or hx or resp disorders, measures partial pressure (or concentration) of 02, co2, in arterial blood determines if gas exchange is adequate across alveolar membrane.
  28. the left lung has __ lobes
    2; upper and lower
  29. accumulation of thick, purulent fluid in pleural space
    emphysema: empyema
  30. s/s of cystic fibrosis
    • this tenacious sputum
    • freg resp infections
    • finger clubbing
    • malabsorption
    • fatty, foul smelling stolls
    • death from antibiotic-resistant infection
  31. obstruction of pulmonary artery or branch by blood clot, air, fat, amniotic fluid, or septic thrombus: most thrombus are blood clots from leg veins
    pulmonary emboli
  32. shallow rapid breathing causing increased permeability in capillary membranes where fluid can go into the interstitial spaces and alveoli
    flail chest
  33. reduction of the capillary bed increases pulm vascular resistance and pulmonary artery pressures 
    -hypoxemia result of these pathologic changes
    -increased pulmonary artery pressure may cause right sided heart failure (for pulmonaie)
  34. contagious bacterial infection that mainly involves the lungs, but may spread to other organs, may be active and become inactive. 5-10% of pts will become ill once theyre infected
    pulmonary tuberculosis
  35. increased co2 in blood
  36. T/F : Bradypnea is the most common sign for a possible pulmonary embolism
    false-tachypnea, sudden onset of dyspnea
  37. spontaneous pneumothorax is caused by
    weak area on the surface of lungs, could be a cancer pt or copd pt
  38. ___is for short term and should be moved from one side to the other to avoid damage to tissues or damage to vocal cords
  39. the most critical hours after dx of a flail chest are...
    24-72hrs after dx
  40. those at high risk for atelectasis are
    postoperative pts
  41. cilliary function is damaged, alveoli damaged and macrophage function diminished in which disease?
  42. once youve treated for TB to be considered not a carrier you must have
    3 consecutive sputum cultures that read negative (takes 2-10 weeks to develop an immune response)
  43. females are at higher risk for which disorder
    arterial hypertension
  44. ___is used as a dx test or therapeutic, needle into the pleural space to aspirate fluid
  45. respiratory acidosis causes:
    hypoventillation- retain too much co2
  46. you should always wait for __ to return after a bronchoscopy before eating and check for reap distress
    gag reflex
  47. __ is a sterile swab and tongue blade, a swab at the back of throat
    throat culture, make sure pt is aware of gag reflex, no antiseptic mouth wash prior to swabbing.
  48. lung cancer that originates in the bronchi, metastasizes late, prognosis is better, associated with smoking
    squamous cell carcinoma
  49. pathophysiology of __ - inflammation of visceral and parietal pleura (parietal- pain receptors)- friction betwn pleurae (no pain receptors) on inspiration
  50. pathophysiology of ___  AFB implant on bronchioles or alveoli, tubercle formed, immune system keeps in check, may activate with impaired immunity
  51. normal lab values for PaCo2
    35-45 mm hg
  52. collection of fluid in pleural space usually secondary to another disease process- large effusions impair lung expansion, cause dyspnea
    pleural effusion- usually fluid is overproduced
  53. amnt of air that can be exhaled from maximum resp
    vital capacity
  54. before a pulmonary function test you should withhold ___ as they can affect the test results
  55. research shows a deficiency in vitamins _,_ and_ may contribute to lung cancer
  56. ____measure % of hemoglobin
    pulse oximetry
  57. max amnt of inhaled air at begining of a normal expiration distending lungs to the maximum
    inspiratory capacity
  58. sinusitis can spread and cause _____
  59. _____- continuous positive airway pressure, prevents airway from collapsing, positive pressure on inspiration and expiration
  60. what history would you need when assesing respiratory
    upper and lower reap symptoms, exposures/ smoking, current treatments, family history
  61. ___can be used to dx pulmonary disease and to assess medicine effectiveness
    pulmonary function test
  62. inflammation of the lymphoid tissue on each side of the oropharynx
  63. risk factors of COPD
    • tobacco smoke
    • passive smoking
    • occupational exposure 
    • ambient air pollution
    • genetic abnormalities such as Alpha-1:antitrypsin deficieny
  64. mouth care for a pt with intubation should be offered at least every _-_ hrs
  65. amnt of air in and out of lungs during normal breathing
    tidal volume
  66. ____ is caused by 
    airway obstruction
    diffuse airway injury
    pulmonary infections and obstruction of the bronchus or complications of long term pulmonary infections
    genetic disorders such as cystic fibrosis
    ideopathic causes
  67. the most common chronic disease of childhood, can occur at any age and allergy is the strongest predisposing factor of ___
  68. s/s of tb
    • cough
    • blood tinged sputum
    • night sweats
    • anorexia and weight loss
    • low- grade fever
    • dyspnea, chest pain (late)
  69. ____is when secretions settle in the base of the lungs causing pneumonia
  70. after surgery it is important to increase ____ to flush dye out
    fluid intake
  71. in COPD ___ become permanently distended and air becomes trapped in them
  72. s/s of sinusitis
    pain over affected sinus, fever, nasal discharge
  73. a __ indicates obstruction and heard with or without a stethoscope and sounds like a high pitched crowing sound
  74. s/s of atelectasis
    insidious, include cough, sputum production, low-grader fever. reap distress, anxiety, symptoms of hypoxia occur if large areas of the lungs are affected
  75. ___is a more accurate reading for hemoglobin
    ABG- arterial blood gas analysis
  76. atelectasis is often secondary to____
  77. ____ is the filling of the pulmonary capillaries w/blood
  78. a normal pulse ox reading is
  79. __lung cancer grows rapidly, anywhere and matastizes quickly- poor prognosis
    large cell carcinoma- NSCLC
  80. tramatic pneumothroax
    trauma such as a knife/ gunshot wound
  81. ___ can help reduce the risk of pulmonary emboli
  82. syndrome characterized by sudden, progressive pulmonary edema, increasing bilateral lung infiltrates on CXR, hypoxemia refractory to o2 therapy, decreased lung compliance
    acute resp distress syndrome
  83. DX tests for pneumonia may include...
    • x-ray: showing pulmonary infultrates
    • ABGS- show hypoxemia
    • blood cultures- looking for the source
  84. t/f a pt with hyposemia will have an increase in the PaCo2 level
  85. most common fatal autosomal recessive disease among caucasion population.
    a mutation of a gene causes changes in chloride transport which leads to thick, viscous secretions in lungs, pancreas, liver, intestines and reproductive tract. pulmonary problems are the leading cause of morbidity and mortality
    normally dx in infants
    cystic fibrosis
  86. ___ cancer accounts for approx 1/2 of all head and neck cancers
    cancer of the larynx
  87. risk factors of ____
    -venous stasis
    -certain disease states: heart disease, trauma, postoperative/postpartum, DM, COPD.
    -other conditions: pregnancy, obesity, oral contraceptive use, consrictive clothing
    pulmonary emboli
  88. those at risk for pneumonia include
    ery young, elderly, smokers, those hospitalized, intubated, and those who are immunocompromised
  89. ____defused medicine in lungs
  90. tension pneumothorax
    buildup of pressure pushing on lungs- closed- causing mediastinal shift
  91. therapeutic positioning- respiratory distress
    • -fowlers
    • -semi-fowlers
    • 0good lung down
  92. x-ray of pulmonary vessels, radiopaque dye is used. check for allergies to dye. dye is injected up thru a femoral artery up into the heart
  93. in emphysema ___ secretion increases, alveoli become large and burst. there is a residual volume increase causing ____
    bronchioles, barrel chest
  94. s/s of acute respiratory distress syndrome
    • rigid onset of severe dyspnea
    • hypoxemia that does not respond to supplemental o2
  95. during crackles the fine sound is from
    alveoli popping open on inspiration
  96. pus-infection of the lungs
  97. referring to actual bloodflow within pulmonary circulation
  98. clinical manifestations of bronchiectais
    • chronic cough
    • purulent sputum in copious amnts
    • clubbing of fingers from chronic hypoxemia
  99. ___ can be described as course or fine, course is a moist bubbly sound
  100. the 4th leading cause of death and 12th leading cause of disability is
  101. decreased o2 in blood can lead to
  102. it is more likely that someone will aspirate into the ___ bronchus because its wider and shorter
  103. resp center includes (in brain)
    medulla and pons
  104. pt cant blow out on expiration, levels of co2 increase
  105. expiration is a ___process and causes ___ pressure
    passive, positive
  106. amnt of air remaining in lungs afer normal expiration
    functional residual capacity
  107. what is the primary symp of chronic bronchitis
    productive cough and sputum
  108. the exchange of gases betwn air in alveoli and bld in pulmonary caps
    external respiration
  109. s/s of ___ -hoarseness of more that 2 weeks-persistant cough-sore throat or pain, burning in throat-lump in neck- later symptoms: dysphagia, dyspnea, unilateral nasal obstruction, persistant hoarseness, persistent ulceration, foul breath
    generalized symp: weight loss, debilitation, lymphadenopathy, radiation of pain to ear
    cancer of the larynx
  110. collapse or airless condition of alveoli caused by hypoventilation, obstruction to airways or compression
  111. ___ mask gives a precise measurement of o2 to be delivered- doesnt allow for humidity
    venturi mask
  112. pulmonary emboli obstructed complications`
    • obstructed area has diminished or absent blood flow, altho area is ventilated, no gas exchange occurs
    • -inflammatory process causes regional bld vessels, bronchioles to constrict, further increasing pulmonary vascular resistance, pulmonary arterial pressure, right ventricular workload
    • -ventilation-perfusion imbalance, right ventricular failure, shock occur
  113. cloudy-gunky fluid containing WBC in fluid associated with pneumonia, TB or CA
  114. pathophysiology of ___ ____ injury to alveoli 
    -scarring, fibrosis
    -impaired gas exchange
    pulmonary fibrosis
  115. ___ test shows if any bacteria will grow and which antibiotic will destroy the bacteria
  116. ____+____ work together to maintain homestasis
    lungs and kidneys
  117. lung cancer that occurs more frequently in women tha men, peripheral fields, slow growing, usually not DX until its metastasized elsewhere. linked with smoking, prognosis=better
    adenocarcinoma (NSCLC)
  118. the right lung has ___ lobes
    3- upper, middle, and lower
  119. pathophysiology- air in the interpleural space (air btwn the visceral pleura)
  120. SCLC usually from smoking has a poor prognosis and the survival time is usually
    9-10 months
  121. normal breath sounds
    • -vesivular
    • -brochovesicular
    • -bronchial
  122. causative factors for pulmonary disease
    • cig smoking
    • air pollution
    • can be hereditary
    • virus that hits lungs
    • toxic inhalhent
    • immune dysfunction- RA, lupus
  123. respiratory alkalosis causes:
    hyperventillation- blowing off too much quickly
  124. epistaxis may be a serious problem if ____
    there is significant bld lose or an airway compromise
  125. inspiration is ___ of the respiratory cycle
  126. ___ is a bi-lobed positive airway for people who are alert and can breath on their own for periods of time without excessive secretions
    Bi-pap- always check for skin breakdown and anxiety
  127. ___ shows soft tissue damage, no metal can be on pt
  128. ___ accounts for more than 10% of all hospital admissions
  129. max amnt of exhaled air in excess of norm tidal vol
    expiratory reserve vol.
  130. DX testing for pneumonia
    • chest xray
    • sputm test
  131. ___ test shows fibrin products and will show bld clots
  132. watery fluid fill capillaries, associated w/heart failure, liver or kidney disease
  133. inflammation of the mucous membrane lining larynx
  134. a simple o2 mask gives __-__% of o2
  135. factors that affect lung vol.
    • sex
    • height
    • smoking/non
    • athletes/non
    • living in higher or lower altitudes
  136. asymetrical chest movt, crackles, diminshed breath sounds, rise in vitals or lowered bp may be a sign of
  137. ____ sound is pleura rubbing together, sounds like leather rubbing together
    friction rub
  138. lung cacner that usually grows rapidly, orginates in major bronchi, metastasizes quickly to bone, liver, and brain
    small cell lung cancer (SCLC)- oat cell 13%
  139. shunting of bld occurs if there is an imbalance of V/Q and results in ___
  140. the movemnt of air in and out of lungs is
  141. therapeutic measures for breathing-breathing in nose and out through mouth
    pursed-lip breathing
  142. cystic fibrosis is a dysfunction of __ glands
  143. the main cause of TB
    mycobacterium TB- spread by droplets
  144. inflammation of the sinus mucosa, may be bacterial or allergic
  145. etiology of secondary pulmonary arterial hypertension
    CAD, valve disease
  146. movnt of air to and from alveoli
  147. gas exchange takes place in the
  148. decreased air mount- decreased lung sounds
    diminshed breath sounds
  149. ceptal cells (type 2) in alveoli secrete
  150. ___ bond is formed in lungs
  151. o2 is carried by ___portion of RBC
  152. air must reach the ___ to be availible for gas exchange
  153. pathophysiology of _____
    -acute lung infection
    -inflammation and alveolar damage
    -alveoli filled with exudate
    -reduced surface area for gas exchange
  154. normal inspiratory pressure is approx___ cm
  155. _____procedures asses lung function and gas exchange
    radioisotope procedures
  156. those at risk for influenza are _____
    elderly and children
  157. scar tissue and narrowing occurs in the airways.
    substances activated by chronic inflammation damage the parenchyma.
    inflammatory response causes change in pulmonary vasculature
  158. s/s of ____ _____
    • dyspnea
    • pain
    • cough
    • tachypnea
    • diminshed lung sounds
  159. inflammation of the nasal mucous membranes (common-cold- release of histamine)
  160. ____ ____ is caused by 3 or more rib fractures, in 2 or more places- part of the chest collapses, from severe trauma
    flail chest
  161. s/s of tonsilititis
    sore throat, fever, chills, malaise. pain on swallowing,malgasia
  162. high concentrations of o2 can become toxic. after __-___ hrs of being on high o2 youre at risk for o2 toxicity
  163. acute pharyngitis can lead to
    staph or kidney damage
  164. decreased co2 in blood
  165. the at risk group for TB are
    the elderly, infants, immunosupressed pts (aids, chemo) those with anti rejection drugs from an organ transplant, those with crowded living spaces and those with poor nutrition
  166. causes of atelectasis
    bronchial obstruction by secretions due to impaired cough mechanism or conditions that restrict normal lung expansion on inspiration
  167. ____ is a chronic inflammatory disease of the airways that causes hyper responsiveness, mucosal edema, and mucous production-inflammation leads to cough, chest tightness, wheezing and dyspnea
  168. intraplural pressure
    in plueral space
  169. sum of all lung vols- total amnt of air the lungs can hold
    total lung capacity
  170. inspiratory or expiratory sound caused by narrowed airways is _____
  171. death usually occurs ____ after DX of primary arterial HTN
    2-5 years
  172. expiration accounts for ___% of reap cycle
  173. smokers are ___% more likely to develop lung cancer
  174. the cause of primary pulmonary arterial hypertension is
    unknown-primary shows a genetic link
  175. Q's to ask about reap disease
    • where is it
    • how does it feel
    • aggravating or alleviating factors
    • timing
    • severity
    • pt pain
    • patients perception
  176. emphysema comes from the greek term meaning
    over inflated
  177. inflammation of the pharynx- bacterial or viral
    pharyngitis (sore throat)
  178. ____ is usually secondary to pneumonia, TB, CA, PE (cancer, pulmonary embolism)
  179. Respiratory muscles ___during respiration causing ___ pressure
    contract, causing neg pressure
  180. abnormal breath sounds
    crackles, wheezes, friction rubs
  181. t/f? an early sign of cancer of the larynx is the glottic area is enlarged cervical nodes
    false- effects voice sounds
  182. risk factors for aspiration
    • brain injury
    • cognitive status
    • seizures
    • consciousness
    • drug and alcohol intoxification
    • excessive sedation
    • high residual vol
    • stroke
    • cardiac arrest
  183. s/s: harsh, hoarse cough, thick sputum- worse in morning, wheezes and crackles for more than 10 days
  184. tension pneumothroas s/s
    • tracheal deviation- will move trach to the side-emergency
    • bradycardia
    • cyanosis
    • shock and death if untreated
  185. entrinsic asthma
    not caused by allergies, usually environmental, related to recurrent respiratory infections
  186. what is gas exchange btwn the lungs and blood, btwen the bld and tissues?
  187. the bacteria that normally causes pneumonia is______
  188. normal lab values for PaCo2
    80-100mm Hg
  189. pneumonia s/s
    • chest pain
    • fever, chills
    • cough, dyspnea
    • yellow, rusty or blood tinged sputum
    • crackles, wheezes
    • malaise (tired)
  190. _____ test shows RBS, hemoglobin, o2 carrying capacity- WBC for infection
  191. ___ rate effects maximal expiratory flow and is freq done by pts using a home spirometer
    peak flow
  192. before a ____ test you should drink plenty of h2o so you can liquify secretions
    sputum tests, secretions that are liquified are easier to cough up.
  193. A pt w/ __is usually acutley ill, fluid, fibrin development, loculation impair lung expansion. resolution is a prolonged process
  194. changes in arteries in the heart and in the lung become narrowed and hardened and cannot expand like b4 building pressure- this happens in which disease
    pulmonary arterial HTN
  195. a DX test for sinusitis would be___
    xray- showing a cloudy result, but may require a CT scan
  196. aspiration prevention:
    • elevate HOB
    • turn pt to side when vomiting 
    • prevention of stimulation of gag reflex with suctioning or other procedures
    • assessment, proper admin of tube feeding
    • rehabilitation therapy for swallowing
  197. wheezes are considered an adventious breath sound? T/F
  198. s/s of lung cancer
    • none until late
    • productive cough
    • recurrent infection
    • dyspnea
    • hemoptysis
    • anorexia and weight loss
    • pain
    • wheezing/stridor
  199. ____test shows blood o2 sat
    pulse oximetry (SaO2)
  200. ___ will eventually make alveoli non functional with scarring, losing ability to expand and contract
    pulmonary fibrosis
  201. with an angioplasty the pt should be NPO for ___hrs and lying flat on their back for ___-___ hrs after with a sand bag over site
    8 hrs, 3-8hrs
  202. ____ _____ test asses resp function and determine extent of the dysfunction
    pulmonary function tests
  203. prevention for aspiration
    • keep HOB elevated during and after tube feedings
    • check gastric residual when admin tube feedings
    • use of thickened liquids
    • dont use straws
  204. epistaxis
    hemorrhage from the nose, nosebleed. most common site- anterior septum
  205. antitripsin deficiency- hereditary- associated with which disease
  206. a pt with COPD should receive no more than __L of o2
    2 more could knock out breathing
  207. ausculating breathing- check for
    • normal breath sounds
    • adventious sounds
    • compare bilaterally
  208. s/s of ___ -sharp pain on inspiration (knife-like) shallow breating
    fever, elevated WBC
    friction rub
  209. mechanical ventiallation uses __pressure to push o2 thru the tube
  210. grading a tumor
    by size and tissue involvement
  211. max amnt of inhaled air on excess of normal tidal vol
    inspiratory reserve vol.
  212. etiology of pulmonary fibrosis
    • hereditary
    • virus
    • env/ occupational exposure
    • immune dysfunction
    • idiopathic
  213. elevated pressure in pulmonary arteries and rght ventricualr failure-pathophysiology of ___
    pulmonary arterial hypertension
  214. s/s of arterial HTN
    JVD, peripheral edema
  215. using a nebulizer helps decrease
    side effects, delivering directly to lungs instead of whole body
  216. exchange of o2 and co2
  217. decreased o2 in inspired air can lead to
  218. influenza spreads by ___and lasts for approx ___ days
    droplets, 10 days
  219. s/s of infection in elderly
    • new-onset
    • confusion
    • lethargy
    • fever
    • dyspnea
  220. for a flail chest you should monitor ___they may need a ___ or a ___
    ABG's, chest tube or ventilator
  221. DX test for pleurisy
    • chest x-ray
    • sputum culture
    • CBC
  222. ___o2 mask has vents on sides to allow room air to mix in with o2 gives up to 50% of o2
    partial rebreather
  223. airflow limitation is progressive and is associated with abnormal inflammatory response of the lungs to noxious agents. inflammatory response occurs throughtout the airways, lung parenchyma and pulm vasculature
  224. scope into mouth or nose to remove objects-rigid or flexible to view
  225. A____  measures vols of air exhaled and is used to assess lung capacitys
  226. intrathoracic pressure
    in thoracic cavity
  227. pathophysiology of acute respiratory distress
    • alveolocapillary membrane damage
    • pulmonary edema
    • alveolar collapse
    • lungs stiff and noncompliant
    • lungs may hemorrhage
    • can lead to atelectasis
    • pt will become hypoxic
  228. exchange of gases btwn bld in body cells is____
    internal respiration
  229. what will the EKG show for arterial HTN
    Rght hypertrophy-enlarged heart, could be caused by COPD
  230. T/F: for pts with chronic bronchitis, the nurse expects to see the major clinical sym's of tachypnea and tachycardia
    false- sputum and productive cough
  231. ANA titer shows
    immune response
  232. when inspecting you should check for
    • symmetry
    • dyspnea
    • use of accessory muscles
    • color-cyanosis
    • resp rate and rythm
    • chest shape
  233. atmospheric pressure has the ___ pressure
  234. during crackle the coarse sound is from
    fluid in airways
  235. extrensic asthma
    allergies usually cause this- kids normally outgrow this
  236. intropulmonary pressure
    pressure in airways
  237. force of less than ___ cm usually requires a ventilator
  238. there are approx ___ alveoli in the adult lung
    300 million
  239. exhale deely, deep breath in and use abdominal muscles to cough
    huff coughing