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Respiratory NRN 102
Respiratory NRN 102 Test 3
| Question | Answer |
|---|---|
| The primary purpose of the respiratory system | Is gas exchange, which involves the transfer of oxygen and carbon dioxide between the atmosphere and the blood |
| Upper Respiratory Tract includes: | Nose, Pharynx, Adenoid, Tonsils, Epiglottis, Larynx, and Trachea |
| Low Respiratory Tract includes: | Bronchi, Bronchioles, Alveolar ducts, Alveoli |
| Tidal Volume (VT) | Volume of air exchanged with each breath |
| Ventilation | Involves inspiration (movement of air into the lungs) and expiration (movement of air out of the lungs) |
| Inspiration | Movement of air into the lungs |
| Expiration | Movement of air out of the lungs |
| ABGs are measured to determine | Oxygenation status and acid-base balance, ABG analysis includes measurement of the Pao2, PaCo2 acidity (pH) and bicarbonate (HCO3) in arterial blood |
| ABG analysis includes measurement of the | PaO2, PaCO2, acidity (pH), and bicarbonate (HCO3) in arterial blood |
| Arterial oxygen saturation can be monitored continuously using a | Pulse Oximetry probe on the finger, toe, ear, or bridge of the nose |
| The respiratory center in the brainstem is | Medulla responds to chemical and mechanical signals from the body |
| Medulla | Is the respiratory center in the brainstem responds to chemical and mechanical signals from the body |
| Chemorecptor | Is a receptor that responds to a change in the chemical composition (PaCO 2 and pH) of the fluid around it |
| Mechanical Receptors | Are stimulated by a variety of physiologic factors, such as irritants, muscle stretching, and alveolar wall distortion |
| Respiratory Defense Mechanisms include: | Filtration of air, The mucociliary clearance system, the cough reflex, reflex bronchoconstriction and alveolar macrophages |
| Respiratory Nursing Assessment | A cough should be evaluated by the quality of the cough and sputum. During physical examination the nose, mouth, phyarynx, neck, thorax, and lungs should be assessed and the respiratory rate, depth, and rhythm should be observed. |
| Respiratory Nursing Assessment Cont' | When listening to the lung sounds, there are 3 normal breath sounds: 1. Vesicular 2. Bronchovesicular 3. Bronchial |
| Adventitious Sounds | Are extra breath sounds that are abnormal and include Crackles, Rhonchi, Wheeze, and Pleural Friction Rub |
| Diagnostic Studies for Respiratory System | Chest X-Ray, Bronchoscopy, Thoracenties, Pulmonary Function Test (PFTs) |
| Chest X-Ray | Is the most commonly used test for assessment of the respiratory system as well as the progression of disease and response to treatment |
| Bronchoscopy | Is a procedure in which the bronchi are visualized through a fiberoptic tube and may be used for diagnostic purpose to obtain biopsy specimens and assess changes resulting for treatment |
| Thoracentesis | Is the insertion of a large bore needle through the chest wall into the pleural space to obtain specimens for diagnostic evaluation, remove pleural fluid, or instill medication into the pleural space |
| Pulmonary Function Test (PFTs) | Measure lung volumes and airflow. The results of PFTs are used to diagnose pulmonary disease, monitor disease progression, evaluate disability, and evaluate response to bronchodilators |
| Problems of the upper respiratory tract includes disorders of the | Nose, Pharynx, Adenoids, Tonsils, Epiglottis, Larynx, and Trachea |
| Pneumonia | Is an acute inflammation of the lung parenchyma |
| Pneumonia is caused by a | Microbial Organsim |
| Pneumonia is more likely to result when | Defense mechanisms become incompetent or are overwhelmed by the virulence or quantity of infectious agents |
| Pneumonia can be classified according to the | Causative organism, such as bacteria, viruses, Mycoplasma, fungi, parasites, and chemical |
| A clinically effective way to classify pneumonia is: | Community-Acquired Pneumonia Hospital-Acquired Pneumonia |
| Community-Acquired Pneumonia | Lower respiratory tract infection of the lung parenchyma with onset in the community or during the first 2 days of hospitalization |
| Hospital-Acquired Pneumonia | Pneumonia occurring 48 hours or longer after hospital admission and not incubating at the time of hospitalization |
| Aspiration Pneumonia | The sequelae occurring from abnormal entry of secretions or substance into the lower airway |
| Opportunistic Pneumonia | Presents in certain patients with altered immune responses who are highly susceptible to respiratory infections |
| 4 characteristic stages of pneumonia | Congestion, Red hepatization, Gray hepatization, Resolution |
| Nursing Management for Pneumonia | In the hospital, the nursing role involves identifying the patient at risk and taking measures to prevent the development of pneumonia The essential components of nursing care for patients with pneumonia include: Monitoring physical assessment parameters, |
| Nursing Management for Pneumonia Cont' | Facilitating laboratory and diagnostic test, providing treatment, and monitoring the patient's response to treatment |
| The essential components of nursing care for patients with pneumonia includes: | Monitoring physical assessment parametersFacilitating laboratory and diagnostic test, providing treatment, and monitoring the patient's response to treatment |
| Pleural Effusion | A collection of fluid in the pleural space. It is not a disease but rather a sign of a serious disease |
| Pleural Effusion is classified as: | Transudative or Exudative according to whether the protein content of the effusion is low or high, respectively |
| Transudate occurs | Primarily in noninflammatory conditions and is an accumulation of protein-poor, cell-poor fluid |
| Exudative effusion is | An accumulation of fluid and cells in an area of inflammation |
| Empyema | Pleural effusion the contains pus |
| The type of pleural effusion can be determined by | A sample of pleural fluid obtained via thoracentesis (a procedure done to remove fluid from the pleural space) |
| Thoracentesis | Determined type of pleural effusion (a procedure done to remove fluid from the pleural space) |
| Main goal of management of pleural effusion | Is to treat underlying cause |
| COPD | Is a preventable and treatable disease state characterized by airflow limitation that is not fully reversible. The airflow limitation is usually progressive and associated with an abnormal inflammatory response of the lungs to noxious particles or gases, |
| COPD CONT' | Primarily caused by cigarette smoking |
| COPD Causes | Cigarette smoking, Occupational chemicals, air pollution, infections are risk factors for developing COPD. Severe recurring respiratory tract infections in childhood have been associated with reduced lung function and increased respiratory SX in adulthood |
| Two types of obstructive airway diseases with COPD | Chronic Bronchitis Emphysema |
| Chronic Bronchitis | Presence of chronic productive cough for 3 months in each of 2 consecutive years in a patient in whom other causes of chronic cough have been excluded |
| Emphysema | Abnormal permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of their walls and without obvious fibrosis |
| Diagnosis of COPD | Any patient who has Sx of cough, sputum production, or dyspnea, and/or a history of exposure of risk factors for the disease. |
| Sx of COPD | Intermittent cough, which is the earliest Sx, usually occurs in the morning with the expectoration of small amounts of sticky mucus resulting from bouts of coughing |
| COPD can be classified as at: | Risk, Mild, Moderate, Severe and very severe |
| Complications of COPD include: | Cor Pulmonale, Respiratory Failure, Peptic Ulcer disease, Anxiety and depression |
| Cor Pulmonale | Hypertrophy of the right side of the heart, with or without heart failure, resulting from pulmonary hypertension and is a late manifestation of chronic pulmonary heart disease |
| Exacerbation of COPD | Signaled by change in the patient's usual dyspnea, cough, and/or sputum that is different than the usual daily patterns. These flares require changes in management |
| Risk for Respiratory Failure with COPD | Patients with severe COPD who have exacerbations are at risk for the development of respiratory failure |
| Peptic Ulcer Disease | Is increased in the person with COPD |
| Anxiety and Depression | Can complicate respiratory compromise and may precipitate dyspnea and hyperventilation |
| Diagnosis of COPD is confirmed by: | PFT |
| Goals of the diagnostic workup are to: | Confirm the diagnosis of COPD via spirometry, evaluate the severity of the disease and determine the impact of the disease on the patient's quality of life. |
| Primary goals of care for the COPD patient are to: | 1) Prevent disease progression 2) Relieve Sx and improve exercise tolerance 3) Prevent and treat complications 4) Promote patient participation in care 5) Prevent and treat exacerbation 6) Improve quality of life and reduce mortality |
| Single most effective and cost-effective intervention to reduce the risk of developing COPD and stop the progression of the disease is: | Cessation of cigarette smoking in all stages of COPD |
| O2 therapy is frequently used in the treatment of COPD and other problems associated with | Hypoxemia |
| Long-Term O2 Therapy | Improves survival, exercise capacity, cognitive performance, and sleep in hypoxemic patients |
| O2 delivery system are classified as: | Low-or high-flow system |
| Most methods of O2 adminstration are | Low-flow devices that deliver O2 in concentrations that vary with the person's respiratory pattern |
| Dry O2 | Irritating effect on mucous membranes and dries secretions. Therefore it is important that O2 be humidified when administered, either by humidification or nebulization |
| Asthma | Chronic inflammatory lung disease that results in recurrent episodes of airflow obstruction, but it is usually reversible. The chronic inflammation causes an increase in airway hyperresponsiveness that leads to recurrent episodes of wheezing, |
| Asthma Cont' | Breathlessness, chest tightness, and cough, paticularly at night or in the early morning |
| Triggers of Asthma | Allergic, Physical exertion, Air pollutants, Occupational, Respiratory infections, Sensitivity to specific drugs, GERD, Crying, laughing, anger, fear |
| Allergic Asthma | Related to allergies such as tree or weed pollen, dust mites, molds, animals, feathers, and cockroaches |
| Exercise Induced Asthma | Asthma that is induced or exacerbated during physical exertion. Typically, this type of asthma occurs after vigorous exercise, not during it |
| Air Pollutants Asthma | Cigarette or wood smoke, vehicle exhaust, elevated ozone levels, sulfur dioxide, and nitrogen dioxide |
| Occupational Asthma | Occurs after exposure to agents of the workplace. These agents are diverse such as wood and vegetable dusts (flour), pharmaceutical agents, laundry detergents, animal and insect dust, secretions and serums (e.g., chicken, crab) metal salts, chemicals, |
| Respiratory Infections Asthma | (i.e., viral and not bacterial) or allergy to microorganisms is the major precipitating factor of an acute asthma attack |
| Sensitivity to specific drugs Asthma | Occur in some asthmatic persons, especially those with nasal polyps and sinusitis, resulting in an asthma episode |
| Characteristic Clinical Manifestations of Asthma | Wheezing, Cough, Dyspnea, and Chest tightness after exposure to a precipitating factor or trigger. Expiration may be prolonged |
| Asthma can be classified as | Mild intermittent, Mild persistent, moderate persistent, or Severe persistent |
| Severe acute asthma can result in complications such as: | Rib fractures, Pneumothorax, Pneumomediastinum, Atelectasis, Pneumonia, and status Asthmaticus |
| Status Asthmaticus | A severe life threatening asthma attack that is refractory to usual treatment and places the patient at risk for developing respiratory failure |
| Cornerstone of asthma management | Patient education and should be carried out by health care providers providing asthma care |
| Desirable therapeutic outcomes include: | 1)Control or elimination of chronic Sx such as cough, dyspnea, and nocturnal awakenings 2) Attainment of normal or nearly normal lung function 3) restoration or maintenance of normal levels of activity |
| Desirable therapeutic outcomes include Cont': | 4) reduction in the number or elimination of recurrent exacerbations 5) Reduction in the number or elimination of ER department visits and acute care hospitalizations 6) Elimination or reduction of side effects of medications |
| Medications are divided into two general classifications: | 1) Long-Term-Control Medications 2) Quick-Relief Medications |
| Long-Term-Control Medications | To achieve and maintain control of persistent asthma |
| Quick-Relief-Medications | To treat Sx and exacerbations |
| Corticosteroids | Suppress the inflammatory response, are the most potent and effective antiinflammatory medication currently available to treat asthma |
| Mast cell stabilizers | Nonsteroidal antinflammatory drugs that inhibit the IgE mediated release of inflammatory mediators from mast cells and suppress other inflammatory cells (e.g., eosinophils) |
| Leukotriene Modifiers | Can successfully be used as add-on therapy to reduce (not substitute for) the doses of inhaled corticosteroids |
| Short-Acting Inhaled | B2-Adrenergic agonist are the most effective drugs for relieving acute bronchospasm. They are also used for acute exacerbations of asthma |
| Methylxanthine (theophylline) | Preparations are less effective long-term control bronchodilators as compared to B2-adrenergic agonistis |
| Anticholinergic Agents | (e.g., ipratropium [Atrovent], tiotropium [Spiriva]) block the bronchoconstricting influence of parasympathetic nervous system |
| Major factors for determining success in asthma management is the | Correct administration of drug |
| Inhalation Devices include: | Metered-Dose inhalers, Dry powder inhaler, and Nebulizers |
| Goal in Asthma Care is to: | Maximize the ability of the patient to safely manage acute asthma episodes via an asthma action plan developed in conjunction with the health care provider. |
| Important nursing goal during an acute attack is to: | Decrease the patient's sense of panic |
| Written asthma action plans should be developed with the: | Patient and family especially for those with moderate or severe persistent asthma or history of severe exacerbations |
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