Ch 11

Question 1

Dyspnea

Answer 1

shortness of breath

Question 2

Hypoxia

Answer 2

abnormal reduction of oxygen delivery to body tissue

Question 3

Hypoxemia

Answer 3

abnormal reduction of oxygen content in the arterial blood

Question 4

Subcutaneous Emphysema (Crepitus)

Answer 4

when air gets into tissues under the skin

bubbles underneath the skin

Question 5

Tripod Positioning

Answer 5

one sits or stands leaning forwards and supporting the upper body with hands on knees or on another surface

orthopneic position

Question 6

Orthopnea

Answer 6

difficulty breathing in any position other than an upright one

Question 7

Cyanosis

Answer 7

bluish-gray discoloration of skin and mucous membranes` caused by an excess of deoxygenated hemoglobin in blood

Question 8

Three-pillow Orthopnea

Answer 8

person needs to prop up with 3 pillows to relieve dyspnea

Question 9

Bronchial Breath Sounds

Answer 9

expected sounds heard over TRACHEA and area immediately above the manubrium of sternum (top of sternum)

Question 10

Bronchovesicular Breath Sounds

Answer 10

expected sounds heard over central area of anterior thorax around the STERNAL BORDER

Question 11

Vesicular Breath Sounds

Answer 11

should be heard throughout anterior thorax, including the apex of the lungs above the clavicles

Question 12

Tachypnea

Answer 12

> 20 breaths/min; rapid breathing

Question 13

Bradypnea

Answer 13

< 12 breaths/min; abnormally slow breathing

Question 14

Cheynes-Stokes Respirations

Answer 14

rare, abnormal breathing pattern that can occur while awake but usually occurs during sleep

NEAR DEATH BREATHING PATTERN

Question 15

Kussmaul Respirations

Answer 15

fast, deep breaths that occur in response to metabolic acidosis

Question 16

Stridor

Answer 16

harsh, high-pitched sound associated with breathing that is often caused by laryngeal or tracheal obstruction

Question 17

Crackles

Answer 17

discontinuous bubbling sounds

FLUID IN SMALL AIRWAYS

can be fine or course

Question 18

Wheezes

Answer 18

whistle or rattling sound as result of obstruction in air passageway

NARROWING OF AIRWAYS OR OBSTRUCTION

Question 19

Rhonchi

Answer 19

wheezing heard after coughing in BRONCHI

Question 20

Atelectasis

Answer 20

collapse of alveoli

Question 21

Pneumothorax

Answer 21

air in the pleural spaces

signs vary depending on amount of lung collapse

with minor collapse: slightly short of breath, anxious, and have chest pain

with large amount of lung collapse: may be in severe respiratory distress, including dyspnea, tachypnea, and cyanosis

Question 22

Hemothorax

Answer 22

blood in the pleural spaces

Question 23

Pleural Effusion

Answer 23

accumulation of serous fluid in the pleural space between the visceral and parietal pleurae

Question 24

Hemoptysis

Answer 24

coughing up blood or referring to bloody sputum

Question 25

Pleural Space

Answer 25

cavity that exists between lungs and underneath the chest wall

Question 26

Difficulty breathing when you sleep could be...

Answer 26

sleep apnea or proximal nocturnal dyspnea

Question 27

Shortness of breath can cause... What can help this?

Answer 27

anxiety; pursed lip breathing helps

Question 28

What are the accessory muscles that help with breathing?

Answer 28

diaphragm and intercostal muscles

Question 29

When is it common for atelectasis to occur?

Answer 29

after surgery (coming out of surgery/immobility)

Question 30

How do you document smoking?

Answer 30

pack years = years smoked x packs per day

Question 31

What are some examples of respiratory diseases that you can develop while travelling?

Answer 31

Histoplasmosis in Southeast and Midwest Severe Acute Respiratory Syndrome (SARS) COVID-19

Question 32

What are some commonly reported problems related to the lungs?

Answer 32

cough shortness of breath chest pain with breathing (could be pleuritis)

Question 33

What will sputum look like for a viral infection?

Answer 33

white/clear

Question 34

What will sputum look like for a bacterial infection?

Answer 34

green/yellow

Question 35

What should you inspect a pt for when examining respiratory system?

Answer 35

general appearance posture breathing effort rate and quality breathing pattern chest expansion nails, skin, and lips for color

Question 36

Dyspnea could cause...

Answer 36

finger clubbing could have cyanosis may look tired may be in tripod position may be using accessory muscles to breathe

Question 37

Anteroposterior to Lateral Diameter (A/P Diameter)

Answer 37

1:2 ratio front and back are twice as wide as lateral chest

Question 38

Hyperpnea

Answer 38

deep breaths

Question 39

Hypopnea

Answer 39

shallow breaths

Question 40

Pleural Friction Rub

Answer 40

two inflammed pleural surfaces rub against each other

Question 41

Acute Shortness of Breath (immediate assessments)

Answer 41

RR >30 O2 Sat <92% dyspnea cyanosis confusion retractions (sinking in of chest cavity) use of accessory muscles

Question 42

Where should you start auscultating the lungs when a pt presents with acute shortness of breath?

Answer 42

start with bases (bottom of lungs) posterior first

Question 43

Normal presentation of Respiratory System

Answer 43

RR 12-20/min regular pattern good effort at rest no complaints of shortness of breath pink color adequate capillary refill (<2 sec) lung sounds clear no use of accessory muscles no dyspnea on exertion

Question 44

Symptoms of Hypoxia (RAT BED FINES)

Answer 44

early R - restlessness A - Anxiety T - tachycardia/tachypnea late B - bradycardia E - extreme restlessness D - dyspnea (severe) pediatrics F - feeding difficulty I - inspiratory stridor N - nares flare E - expiratory grunting S - sternal retractions

Question 45

Acute Bronchitis

Answer 45

inflammation of mucous membranes of bronchial tree caused by viruses or bacteria

Question 46

Pneumonia

Answer 46

inflammation of terminal bronchioles and alveoli may be caused by bacteria, fungi, viruses, mycoplasma, or aspiration of gastric secretions

Question 47

Asthma

Answer 47

hyperreactive airway disease characterized by bronchoconstriction, airway obstruction, inflammation prolonged expiration, expiratory and occasionally inspiratory wheeze, and diminished breath sounds are common findings with auscultation

Question 48

Emphysema

Answer 48

destruction of alveolar walls that causes permanent abnormal enlargement of air spaces

Question 49

Chronic Bronchitis

Answer 49

hypersecretion of mucus by goblet cells of trachea and bronchi resulting in productive cough for 3 months in each of 2 successive years caused by irritants such as cigarette smoke and air pollution or by infection

Question 50

Lung Cancer

Answer 50

uncontrolled growth of anaplastic cells in lung agents such as tobacco smoke, asbestos, ionizing radiation, and other noxious inhalants can be causative agents