Caring for Clients With Lower Respiratory Disorders

Question 1

Inflammation of the mucous membranes that line the major bronchi and their branches characterizes _______________.

Answer 1

Acute bronchitis

Question 2

_________________ is an abnormal collection of fluid between the visceral and parietal pleurae.

Answer 2

Pleural effusion

Question 3

________________ is an acute respiratory disease of relatively short duration.

Answer 3

Influenza

Question 4

______________ is the initial infection of a bacterial infectious disease primarily caused by M. tuberculosis.

Answer 4

Primary tuberculosis

Question 5

_______________ usually involves reactivation of the initial infection. The person already has had an immune response, and thus the lesions that form tend to remain in the lungs.

Answer 5

Secondary tuberculosis

Question 6

________________ is the collapse of alveoli. It may involve a small portion of the lung or an entire lobe. When alveoli collapse, they cannot perform their function of gas exchange.

Answer 6

Atelectasis

Question 7

____________ is an inherited multisystem disorder that affects infants, children, and young adults. It obstructs the lungs and pancreas, leading to major lung infections.

Answer 7

Cystic fibrosis

Question 8

_____________ is associated with factors such as upper respiratory infections, emotional upsets, and exercise.

Answer 8

Nonallergic asthma (intrinsic)

Question 9

____________ are a common injury and may result from a hard fall or a blow to the chest. The injuries are not usually considered serious unless accompanied by other injuries.

Answer 9

Rib fractures

Question 10

Gunshot and stab wounds are common types of _____________ to the lungs; they can potentially affect cardiopulmonary function and may be life threatening.

Answer 10

Penetrating wounds

Question 11

When symptoms of ______________ occur, they include chest pain, chest wall bulging, difficulty swallowing, dyspnea, and orthopnea. Symptoms are related to pressure on other chest structures.

Answer 11

Mediastinal tumors

Question 12

______________ refers to diseases caused by the inhalation of coal dust.

Answer 12

Black lung disease

Question 13

Most commonly gives rise to acute bronchitis.

Answer 13

Viral infection

Question 14

This lower respiratory disorder refers to an acute inflammation of the parietal and visceral pleurae.

Answer 14

Pleurisy

Question 15

These applications may provide some topical comfort for pleurisy.

Answer 15

Heat or cold

Question 16

Type of pneumonias referred to as typical pneumonias.

Answer 16

Bacterial pneumonia

Question 17

Found in clients with chronic obstructive pulmonary disease (COPD) and is characterized by chronic infection and irreversible dilatation of the bronchi and bronchioles.

Answer 17

Bronchiectasis

Question 18

Prolonged (or extended) inflammation of the bronchi, accompanied by a chronic cough and excessive production of mucus for at least 3 months per year for 2 consecutive years.

Answer 18

Chronic bronchitis

Question 19

This type of asthma occurs in response to allergens, such as pollen, dust, spores, and animal dander.

Answer 19

Allergic asthma (extrinsic)

Question 20

Components include chest physical therapy (including postural drainage, percussion, and vibration) two to four times daily, deep-breathing and coughing exercises, nebulized treatments, and medications.

Answer 20

Pulmonary toilet (cleansing)

Question 21

Silicosis and asbestosis are in a category of these lower respiratory disorders, which result in the lungs having a decreased volume and inability to expand completely.

Answer 21

Restrictive lung disease

Question 22

Occurs when two or more adjacent ribs fracture in multiple places and the fragments are free-floating. This affects the stability of the chest wall and results in impairment of chest wall movement.

Answer 22

Flail chest

Question 23

The name for the three conditions that predispose a person to clot formation: venostasis, disruption of the vessel lining, and hypercoagulability.

Answer 23

Virchow triad

Question 24

It remains the number one cause of cancer-related deaths among men and women in the United States.

Answer 24

Lung cancer

Question 25

Describe the signs and symptoms of acute bronchitis. How does it differ from tracheobronchitis?

Answer 25

The signs and symptoms of acute bronchitis initially include fever; chills; malaise; headache; and a dry, irritating, and nonproductive cough. Later, the cough produces mucopurulent sputum, which may be blood-streaked if the airway mucosa becomes irritated with severe tracheobronchitis and coughing. Clients experience paroxysmal attacks of coughing and may report wheezing. Moist, inspiratory crackles may be heard on chest auscultation. If the inflammatory process involves the trachea, it is referred to as tracheobronchitis. Typically, acute bronchitis begins as an upper respiratory infection; the inflammatory process then extends to the tracheobronchial tree, becoming tracheobronchitis.

Question 26

What are the causes of pneumonia in addition to microorganism infection?

Answer 26

Pneumonia is usually associated with an acute infection but also can result from radiation therapy, chemical ingestion or inhalation, or aspiration of foreign bodies or gastric contents. When pneumonia is combined with influenza, it ranks as the eighth leading cause of death in the United States (American Lung Association, 2015).

Question 27

What are the signs and symptoms of pneumonia? Describe nursing interventions for the management of pneumonia?

Answer 27

3. Symptoms vary for the different types of pneumonia:
   * The onset of bacterial pneumonia is sudden. The client experiences fever, chills, a productive cough, and discomfort in the chest wall muscles from coughing. There is also general malaise. The sputum may be rust colored. Breathing causes pain; thus, the client tries to breathe as shallowly as possible.
   * Viral pneumonia differs from bacterial pneumonia in that results of blood cultures are sterile, sputum may be more copious, chills are less common, and pulse and respiratory rates are characteristically slow. The course of viral pneumonia is usually less severe than that of bacterial pneumonia. Many clients with viral pneumonia are weak and ill for a longer period than those with successfully treated bacterial pneumonia.
   * Auscultation of the chest reveals wheezing, crackles, and decreased breath sounds. The nail beds, lips, and oral mucosa may be cyanotic. Sputum culture and sensitivity studies can help identify the infectious microorganism and effective treatment.
   Nursing interventions for the management of pneumonia include:
   * The nurse auscultates lung sounds and monitors the client for signs of respiratory difficulty.
   * The nurse monitors oxygenation status with a pulse oximeter, as well as arterial blood gases (ABGs).
   * The nurse assesses cough and sputum production.
   * The nurse places the client in the semi-Fowler position to aid breathing and increase the amount of air taken with each breath.
   * The nurse encourages increased fluid intake because it helps to loosen secretions and replace lost fluids through fever and increased respiratory rate.
   * The nurse monitors fluid intake and output, skin turgor, vital signs, and serum electrolytes, administering antipyretics as indicated and ordered.