resp exam 2

s/s of o2 toxicity

staging a tumor

PEEP

triggers of asthma

what is the primary clinical symptom of emphysema

genetic screening is able to detect carriers of this disease...

________ o2 masks has 1 or more vents that close on inspiration and open during expiration and delivers 70-100% o2

T/F the purpose of the cilia is to move mucus to back of larynx

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

scope thru thoracic cavity is called what?

Normal blood ph

pneumonia can be caused by...

the primary stage of tb is usually

severe sustained asthma
hypoxemia worsening
continuous bronchus spasm
resp rate increases
respiratory alkalosis results

tobacco smoke causes __-__% of COPD cases

what air remains in the lungs after forced respiration; increases with age

inflammation of both layers of the pleurae- inflamed surfaces rub together with respiration, cause sharp pain, intensified with inspiration

____ is the most common cause of death from infection, especially in the elderly

compression of the lung tissue
increased permeability of capillaries
pulmonary edema

A ___ valve helps trach patients speak

delivery of atmospheric air to gas exchange units

___is a chronic, irreversible dilation of the bronchi and bronchioles- chronic infection- usually secondary to an underlying condition

you will hear ___ when listening to a pt with acute reap distress syndrome...

-severe form of acute lung injury
-o2 doesnt relieve stress
-decreased bld flow to lungs, platelets clump as an inflammatory response

T/F the primary o2 admin method for a pt with COPD is a nasal cannula

holding cough and cough forcefully

___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.

the left lung has __ lobes

accumulation of thick, purulent fluid in pleural space

s/s of cystic fibrosis

obstruction of pulmonary artery or branch by blood clot, air, fat, amniotic fluid, or septic thrombus: most thrombus are blood clots from leg veins

shallow rapid breathing causing increased permeability in capillary membranes where fluid can go into the interstitial spaces and alveoli

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)

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

increased co2 in blood

T/F : Bradypnea is the most common sign for a possible pulmonary embolism

spontaneous pneumothorax is caused by

___is for short term and should be moved from one side to the other to avoid damage to tissues or damage to vocal cords

the most critical hours after dx of a flail chest are...

those at high risk for atelectasis are

cilliary function is damaged, alveoli damaged and macrophage function diminished in which disease?

once youve treated for TB to be considered not a carrier you must have

females are at higher risk for which disorder

___is used as a dx test or therapeutic, needle into the pleural space to aspirate fluid

respiratory acidosis causes:

you should always wait for __ to return after a bronchoscopy before eating and check for reap distress

__ is a sterile swab and tongue blade, a swab at the back of throat

lung cancer that originates in the bronchi, metastasizes late, prognosis is better, associated with smoking

pathophysiology of __ - inflammation of visceral and parietal pleura (parietal- pain receptors)- friction betwn pleurae (no pain receptors) on inspiration

pathophysiology of ___  AFB implant on bronchioles or alveoli, tubercle formed, immune system keeps in check, may activate with impaired immunity

normal lab values for PaCo2

collection of fluid in pleural space usually secondary to another disease process- large effusions impair lung expansion, cause dyspnea

amnt of air that can be exhaled from maximum resp

before a pulmonary function test you should withhold ___ as they can affect the test results

research shows a deficiency in vitamins _,_ and_ may contribute to lung cancer

____measure % of hemoglobin

max amnt of inhaled air at begining of a normal expiration distending lungs to the maximum

sinusitis can spread and cause _____

_____- continuous positive airway pressure, prevents airway from collapsing, positive pressure on inspiration and expiration

what history would you need when assesing respiratory

___can be used to dx pulmonary disease and to assess medicine effectiveness

inflammation of the lymphoid tissue on each side of the oropharynx

risk factors of COPD

mouth care for a pt with intubation should be offered at least every _-_ hrs

amnt of air in and out of lungs during normal breathing

____ 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

the most common chronic disease of childhood, can occur at any age and allergy is the strongest predisposing factor of ___

s/s of tb

____is when secretions settle in the base of the lungs causing pneumonia

after surgery it is important to increase ____ to flush dye out

in COPD ___ become permanently distended and air becomes trapped in them

s/s of sinusitis

a __ indicates obstruction and heard with or without a stethoscope and sounds like a high pitched crowing sound

s/s of atelectasis

___is a more accurate reading for hemoglobin

atelectasis is often secondary to____

____ is the filling of the pulmonary capillaries w/blood

a normal pulse ox reading is

__lung cancer grows rapidly, anywhere and matastizes quickly- poor prognosis

tramatic pneumothroax

___ can help reduce the risk of pulmonary emboli

syndrome characterized by sudden, progressive pulmonary edema, increasing bilateral lung infiltrates on CXR, hypoxemia refractory to o2 therapy, decreased lung compliance

DX tests for pneumonia may include...

t/f a pt with hyposemia will have an increase in the PaCo2 level

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

___ cancer accounts for approx 1/2 of all head and neck cancers

risk factors of ____
-venous stasis
-hypercoagulability
-certain disease states: heart disease, trauma, postoperative/postpartum, DM, COPD.
-other conditions: pregnancy, obesity, oral contraceptive use, consrictive clothing

those at risk for pneumonia include

____defused medicine in lungs

tension pneumothorax

therapeutic positioning- respiratory distress

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

in emphysema ___ secretion increases, alveoli become large and burst. there is a residual volume increase causing ____

s/s of acute respiratory distress syndrome

during crackles the fine sound is from

pus-infection of the lungs

referring to actual bloodflow within pulmonary circulation

clinical manifestations of bronchiectais

___ can be described as course or fine, course is a moist bubbly sound

the 4th leading cause of death and 12th leading cause of disability is

decreased o2 in blood can lead to

it is more likely that someone will aspirate into the ___ bronchus because its wider and shorter

resp center includes (in brain)

pt cant blow out on expiration, levels of co2 increase

expiration is a ___process and causes ___ pressure

amnt of air remaining in lungs afer normal expiration

what is the primary symp of chronic bronchitis

the exchange of gases betwn air in alveoli and bld in pulmonary caps

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

collapse or airless condition of alveoli caused by hypoventilation, obstruction to airways or compression

___ mask gives a precise measurement of o2 to be delivered- doesnt allow for humidity

pulmonary emboli obstructed complications`

cloudy-gunky fluid containing WBC in fluid associated with pneumonia, TB or CA

pathophysiology of ___ ____ injury to alveoli 
-scarring, fibrosis
-impaired gas exchange

___ test shows if any bacteria will grow and which antibiotic will destroy the bacteria

____+____ work together to maintain homestasis

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

the right lung has ___ lobes

pathophysiology- air in the interpleural space (air btwn the visceral pleura)

SCLC usually from smoking has a poor prognosis and the survival time is usually

normal breath sounds

causative factors for pulmonary disease

respiratory alkalosis causes:

epistaxis may be a serious problem if ____

inspiration is ___ of the respiratory cycle

___ is a bi-lobed positive airway for people who are alert and can breath on their own for periods of time without excessive secretions

___ shows soft tissue damage, no metal can be on pt

___ accounts for more than 10% of all hospital admissions

max amnt of exhaled air in excess of norm tidal vol

DX testing for pneumonia

___ test shows fibrin products and will show bld clots

watery fluid fill capillaries, associated w/heart failure, liver or kidney disease

inflammation of the mucous membrane lining larynx

a simple o2 mask gives __-__% of o2

factors that affect lung vol.

asymetrical chest movt, crackles, diminshed breath sounds, rise in vitals or lowered bp may be a sign of

____ sound is pleura rubbing together, sounds like leather rubbing together

lung cacner that usually grows rapidly, orginates in major bronchi, metastasizes quickly to bone, liver, and brain

shunting of bld occurs if there is an imbalance of V/Q and results in ___

the movemnt of air in and out of lungs is

therapeutic measures for breathing-breathing in nose and out through mouth

cystic fibrosis is a dysfunction of __ glands

the main cause of TB

inflammation of the sinus mucosa, may be bacterial or allergic

etiology of secondary pulmonary arterial hypertension

movnt of air to and from alveoli

gas exchange takes place in the

decreased air mount- decreased lung sounds

ceptal cells (type 2) in alveoli secrete

___ bond is formed in lungs

o2 is carried by ___portion of RBC

air must reach the ___ to be availible for gas exchange

pathophysiology of _____
-acute lung infection
-inflammation and alveolar damage
-alveoli filled with exudate
-reduced surface area for gas exchange

normal inspiratory pressure is approx___ cm

_____procedures asses lung function and gas exchange

those at risk for influenza are _____

scar tissue and narrowing occurs in the airways.
substances activated by chronic inflammation damage the parenchyma.
inflammatory response causes change in pulmonary vasculature

s/s of ____ _____

inflammation of the nasal mucous membranes (common-cold- release of histamine)

____ ____ is caused by 3 or more rib fractures, in 2 or more places- part of the chest collapses, from severe trauma

s/s of tonsilititis

high concentrations of o2 can become toxic. after __-___ hrs of being on high o2 youre at risk for o2 toxicity

acute pharyngitis can lead to

decreased co2 in blood

the at risk group for TB are

causes of atelectasis

____ 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

intraplural pressure

sum of all lung vols- total amnt of air the lungs can hold

inspiratory or expiratory sound caused by narrowed airways is _____

death usually occurs ____ after DX of primary arterial HTN

expiration accounts for ___% of reap cycle

smokers are ___% more likely to develop lung cancer

the cause of primary pulmonary arterial hypertension is

Q's to ask about reap disease

emphysema comes from the greek term meaning

inflammation of the pharynx- bacterial or viral

____ is usually secondary to pneumonia, TB, CA, PE (cancer, pulmonary embolism)

Respiratory muscles ___during respiration causing ___ pressure

abnormal breath sounds

t/f? an early sign of cancer of the larynx is the glottic area is enlarged cervical nodes

risk factors for aspiration

s/s: harsh, hoarse cough, thick sputum- worse in morning, wheezes and crackles for more than 10 days

tension pneumothroas s/s

entrinsic asthma

what is gas exchange btwn the lungs and blood, btwen the bld and tissues?

the bacteria that normally causes pneumonia is______

normal lab values for PaCo2

pneumonia s/s

_____ test shows RBS, hemoglobin, o2 carrying capacity- WBC for infection

___ rate effects maximal expiratory flow and is freq done by pts using a home spirometer

before a ____ test you should drink plenty of h2o so you can liquify secretions

A pt w/ __is usually acutley ill, fluid, fibrin development, loculation impair lung expansion. resolution is a prolonged process

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

a DX test for sinusitis would be___

aspiration prevention:

wheezes are considered an adventious breath sound? T/F

s/s of lung cancer

____test shows blood o2 sat

___ will eventually make alveoli non functional with scarring, losing ability to expand and contract

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

____ _____ test asses resp function and determine extent of the dysfunction

prevention for aspiration

epistaxis

antitripsin deficiency- hereditary- associated with which disease

a pt with COPD should receive no more than __L of o2

ausculating breathing- check for

s/s of ___ -sharp pain on inspiration (knife-like) shallow breating
fever, elevated WBC
friction rub

mechanical ventiallation uses __pressure to push o2 thru the tube

grading a tumor

max amnt of inhaled air on excess of normal tidal vol

etiology of pulmonary fibrosis

elevated pressure in pulmonary arteries and rght ventricualr failure-pathophysiology of ___

s/s of arterial HTN

using a nebulizer helps decrease

exchange of o2 and co2

decreased o2 in inspired air can lead to

influenza spreads by ___and lasts for approx ___ days

s/s of infection in elderly

for a flail chest you should monitor ___they may need a ___ or a ___

DX test for pleurisy

___o2 mask has vents on sides to allow room air to mix in with o2 gives up to 50% of o2

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

scope into mouth or nose to remove objects-rigid or flexible to view

A____  measures vols of air exhaled and is used to assess lung capacitys

intrathoracic pressure

pathophysiology of acute respiratory distress

exchange of gases btwn bld in body cells is____

what will the EKG show for arterial HTN

T/F: for pts with chronic bronchitis, the nurse expects to see the major clinical sym's of tachypnea and tachycardia

ANA titer shows

when inspecting you should check for

atmospheric pressure has the ___ pressure

during crackle the coarse sound is from

extrensic asthma

intropulmonary pressure

force of less than ___ cm usually requires a ventilator

there are approx ___ alveoli in the adult lung

exhale deely, deep breath in and use abdominal muscles to cough