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Med-surge > Exam 2, Ch 27 (Week 3): Assessment of Respiratory System > Flashcards

Exam 2, Ch 27 (Week 3): Assessment of Respiratory System Flashcards

1
Q

The Mouth and Nose are part of the Upper Respiratory tract. What is their function in regard to air?

A

To Filter and warm Air

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1
Q

“Filtering and warming air” are features of what upper respiratory tract structures?

A

The Nose and Mouth

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2
Q

What upper respiratory structure carries air to and from the lungs? (Windpipe).

A

Trachea

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3
Q

The Trachea is connected to what two complimentary structures?

A

The Pharynx and the Larynx.

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4
Q

If the patient’s Trachea is damaged, what action becomes impossible to do?

A

Carry air to the lungs

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5
Q

Air filled cavities around the nasal cavities of the skull are what part of the upper respiratory tract?

A

The Paranasal Sinus

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6
Q

What is the primary function of the Paranasal Sinus?

A

To facilitate the respiratory immune response.

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7
Q

The Tonsils and Adenoids in the upper respiratory tract are a part of what system in the body? What do these structures do?

A

The immune system. They protect the body against diseases.

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8
Q

The Tonsils and the Adenoids are what type of tissue in the body?

A

Lymphatic Tissue

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9
Q

The Pharynx has several duties. These include the moving of what two things, and the production of what?

A

Moving air, Moving of food or drink, and the production of sound.

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10
Q

The Pharynx is responsible for moving air to what structure to produce a person’s voice?

A

The Larynx

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11
Q

The Larynx is also known as what? What does it produce?

A

The Larynx is the voice box. It produces sound.

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12
Q

A hollow tube that connects the back of the throat to the Trachea is known as the what?

A

Larynx.

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13
Q

True or False: The Nose and Mouth, The Pharynx, Tonsils and Adenoids, The Larynx, The Trachea, and The Paranasal Sinus are all structures that make up the Lower Respiratory Tract.

A

False.
The Nose and Mouth, Pharynx, Tonsils and Adenoids, Paranasal Sinus, Larynx, and Trachea all make up the Upper Respiratory Tract.

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14
Q

True or False: ALL Lower Airway structures, including the Right and Left main stem Bronchi, are found in the lungs.

A

False:
While all lower airway structures ARE found in the lungs, The Right and Left main stem Bronchi are not found in the lungs.

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15
Q

Aspiration is more likely to occur in the right lung, than in the left lung. Why is that?

A

The right mainstream bronchus is shorter, wider, and straighter than the left side.

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16
Q

The Trachea carries what to the Bronchi?
The bronchi carry what to the bronchioles? The bronchioles then carry what to where?

A

The Trachea carries AIR to the Bronchi.
The Bronchi carry AIR to the bronchioles.
The Bronchioles then carry the air to the ALVEOLI.

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17
Q

The physical structure that exists between the lungs is called what?

A

The Mediastinum.

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18
Q

What is the Mediastinum?

A

The physical structure that exists in between the lungs.

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19
Q

What is the Pleura?

A

Two Serous Membranes (One for each lung) that protect the lungs against friction.

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20
Q

A serous membrane that covers both the right and left lung is called a what? What does it do?

A

A Pleura.
It protects the lungs against friction.

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21
Q

These organs bring in fresh air and exchange oxygen and co2 throughout the body.

A

The Lungs

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22
Q

The small sacs in the lungs that are the primary site of O2 and CO2 exchange are called what?

A

The Alveoli

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23
Q

What are the Alveoli in the lungs?

A

Small sacs that are the primary site for O2 and CO2 exchange.

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24
Q

Surfactant, which is a viscous Lipoprotein, has what effect on the alveoli in the lungs?

A

Surfactant prevents alveoli collapse by lowering the surface tension.

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25
Q

Surfactant lowers the surface tension of the alveoli. What exactly does that mean for the alveoli?

A

It means that the tension needed to inflate the alveoli is reduced, which makes it harder for the Alveoli to collapse.

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26
Q

True or False: The Bronchi and Bronchioles, The Pleura, Alveoli, and the Mediastinum all make up the Lower Respiratory Tract

A

True.
The Lower Respiratory Tract is made up of the Bronchi, the Bronchioles, The Mediastinum, The Pleura, and the Alveoli.

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27
Q

O2 and CO2 exchange with the Alveoli occur with what vessels in the body?

A

The Capillaries. Specifically, The Pulmonary Capillaries.

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28
Q

The pressure of each gas in a mixture is known as what?

A

Partial Pressure

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29
Q

The Tidal Volume is the volume of what?

A

The volume of air exchanged with each breath.

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30
Q

What is the average Tidal Volume of a 150lb man?

A

500 mL

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31
Q

Oxygenation is the process of what?

A

Getting O2 from the air and giving it to the organs and tissues of the body.

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32
Q

O2 and Co2 move back and forth from the capillaries through the process of what?

A

Diffusion

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33
Q

What is Diffusion?

A

Movement from areas of High concentration to area’s of Lower concentration.

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34
Q

One Inspiration of the lungs, and then one Expiration of the lungs create the process known as what?

A

Ventilation.

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35
Q

What changes result in the movement of air in and out of the lungs?

A

Pressure changes.

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36
Q

What is Ventilation?

A

The process of inspiration and expiration of the lungs.

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37
Q

Which aspect of Ventilation requires the contraction of the diaphragm and intercostal muscles?

A

Expiration.

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38
Q

Compliance refers to the ability of the lungs to do what?

A

Expand

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39
Q

If a patient has decreased lung Compliance, what will this mean for the patient?

A

It will be harder for the patients’ lungs to inflate.

40
Q

A Pulmonary Edema, ARDS and Pneumonia make lung tissue less elastic and distensible. This results in the lungs being unable to effectively do what?

A

Expand, which decreases Compliance.

41
Q

Resistance, simply put, is defined as any what during airflow?

A

Blockage or obstacle.

42
Q

The MAIN factor that affects airway Resistance are changes to what?

A

Changes to the Diameter of the airways.

43
Q

Chemoreceptors are found in the Medulla, and they respond to what?

A

Chemoreceptors respond to changes in the PaCO2 and pH of the fluid around it.

44
Q

Chemoreceptors respond to the PaCO2 and pH of the fluid around it. Where are the Chemoreceptors found?

A

In the Medulla

45
Q

An Increase in H+ levels cause Alkalosis, which triggers the Chemoreceptors in the Medulla to start what respiratory effect?

A

Decrease the respiratory rate

46
Q

A Decrease in H+ levels cause Acidosis, which triggers the Chemoreceptors in the Medulla to start what respiratory effect?

A

Increase the respiratory rate

47
Q

Mechanical Receptors are responsible for the defense mechanism of what action?

A

Coughing

48
Q

What are the 3 major Mechanical Receptor types?

A

Stretch, Irritant, and juxta capillary

49
Q

Stretch, Irritant, and Juxta capillary are all types of what receptors? What do they help to create?

A

Mechanical receptors that initiate the cough reflex.

50
Q

What are the two types of respiratory receptor control?

A

Chemoreceptors and Mechanical receptors

51
Q

The Mucociliary Clearence system is a defense mechanism that is responsible for what?

A

The movement of mucus.

52
Q

How does the movement of Mucus by the Mucociliary Clearence system act as a defense mechanism for the Respiraroty System?

A

The mucus that is moved makes a blanket that traps particles and debris that are inhaled. Immunoglobin A in the mucus help to fight against bacteria and viruses caught in the debris.

53
Q

What defense mechanism in the Respiratory System clears the airway by using a high-pressure, high-velocity flow of air?

A

Cough Reflex

54
Q

What is the backup method (Plan B) for when the Mucociliary Clearence system is overwhelmed or ineffective?

A

Cough Reflex

55
Q

What is the Cough Reflex good for?

A

Removing secretions in the airways

56
Q

A person with Hyperactive airways, such as Asthma, may experience what Respiratory Defense Mechanism after the inhalation of triggers, such as cold air, perfume or other odors?

A

Bronchoconstriction

57
Q

Bronchoconstriction is when the Bronchi constrict as a response to what?

A

The inhalation of irritating substances

58
Q

The Alveoli are too deep into the lungs for the defense mechanisms of Mucociliary Clearence, The Cough Reflex, or Bronchoconstriction to be effective. Therefore, the primary defense mechanism at the alveolar level is what?

A

Macrophages

59
Q

The Macrophages in the Alveoli act as the only defense for the Alveoli by doing what Macrophages do best, which is what?

A

Macrophages Phagocytize foreign particles and debris, like bacteria.

60
Q

Particles in the Alveoli that cannot be Phagocytized, like coal dust or silica, are kept in the lungs indefinitely until an inflammatory response is triggered. For all other particles, they are removed via what body system?

A

The Lymphatic System

61
Q

What would the act of heavy smoking have on the alveolar macrophages?

A

Heavy smoking impairs the activity of macrophages, which increases the risk for lung disease.

62
Q

In Regard to age-related changes of the Respiratory System, Elderly have decreased cilia, mucous, cough reflex and gag reflex. These factors combined mean that elders have a decreased what?

A

Decreased protection against foreign invaders.

63
Q

In Regard to age-related changes of the Respiratory System, how would a decrease in cilia, mucous, cough and gag reflex manifest in a patients History and Physical examination (H&P)?

A

-Dry Mucous Membranes
-Respiratory Tract Infection (Rhinitis, Laryngitis, etc.)
-Slow/Impacted Swallowing
-Reduced sensations in the Pharynx

64
Q

In Regard to age-related changes of the Respiratory System, Elderly experience Increased Airway Resistance. What are the age-related changes to the structures of the lungs that would result in Airway resistance?

A

-Narrowing of the airway
-Increased thickness of alveoli
-Decreased elasticity

65
Q

How might Increase Airway Resistance manifest in an H&P finding?

A

Dyspnea

66
Q

In Regard to age-related changes of the Respiratory System, a decreased continuity of the diaphragm, or an increased stiffness of the diaphragm or thoracic cage make it harder for a patient to do what?

A

Harder to breath

67
Q

An increase in diaphragm stiffness can make it harder for a patient to breath. What would be the physiological response of the respiratory system to counteract stiffness of a diaphragm or thoracic cage?

A

An increased use of the accessory muscles, such as the intercostals.

68
Q

An increased use of the intercoastal accessory muscles to counteract stiffness of the diaphragm, or decreased continuity, would result in what H&P finding?

A

-A Barrel-Chested patient
-A flattened Lumbar Curve

69
Q

When obtaining History and Subjective data, what may be some good questions to ask a patient to assess for Respiratory risks?

A

-Do seasonal changes influence these problems?
-What allergies do you have?
-Do you smoke, or experience pollen or mold exposure?
-Do you or your family have a history of Asthma?

70
Q

When assessing for Dyspnea (Shortness of breath) what might be a factor to assess for?

A

-Heart problems, such as heart failure
-Airway narrowing from increased alveoli thickness
-Airway blockage, such as a Pulmonary Embolism
-Obesity
-Myocardial Ischemia
-

71
Q

Cigarette smoking is a major risk factor for developing what pulmonary disorder?

A

COPD

72
Q

COPD is thought to have a genetic link. What other Respiratory issue is strongly linked to genetics?

A

Cystic Fibrosis

73
Q

Hemoptysis is what?

A

The spitting or coughing up of blood

74
Q

When assessing Sputum, what does it mean if Sputum is clear, or slightly whitish?

A

It means its normal

75
Q

When assessing Sputum, what does it mean if it is grey with occasional specks of brown?

A

The patient is a smoker.

76
Q

If a patient is a smoker, what would their sputum most likely look like?

A

Grey, with occasional brown specks.

77
Q

A patient’s sputum in the morning is whitish, and slightly yellow as well. What would this possibly indicate?

A

A COPD infection

78
Q

A patient experiencing shortness of breath and the presence of White/Yellowish sputum would indicate what?

A

A Possible COPD infection

79
Q

A patient’s Sputum is thick, with a pink tinge to it. What does this suggest?

A

The patient is dehydrated, or they have a sinus infection; Post-Nasal drip.

80
Q

A patient’s Sputum is thin and frothy, with a pink tinge to it. What does this suggest?

A

Dehydration or a sinus infection; Post-nasal drip.

81
Q

A patient requests a tissue to cough into. Upon inspection, you see that the patient’s sputum has flecks of red. You realize that the patient is coughing up blood. What is this called?

A

Hemoptysis.

82
Q

The most important thing to confirm upon patient inspection is what?

A

Patient’s Airway, Breathing and Circulation

83
Q

When inspecting the patients Respiratory Function, you notice that the patient is experiencing Clubbing. What is clubbing?

A

Long standing Hypoxemia that causes the fingertips to increase in bulk and sponginess.

84
Q

You are assessing for Respiratory Issues in a dark-skinned patient. You inspect the palms of the hand for discoloration and notice nothing unusual, but you do notice a grey-white discoloration in the conjunctivae and around the mouth. This is a sign of what Respiratory Issue? What would this look like in a light-skinned patient?

A

Cyanosis, caused by hypoxemia or decreased cardiac output.
In a light-skinned patient, Cyanosis would appear as a blue discoloration in the lips, mucous membrane and palms of the hands.

85
Q

For the Lower Respiratory Tract Inspection, you would use what 4 methods, and in what order?

A

-Inspection
-Palpation
-Percussion
-Auscultation

86
Q

A Tactile Fremitus exam, involves what inspection technique?

A

Palpation in a sequence as you assess for vibration differences. Have the patient say “99” at each specific spot.

87
Q

With regard to an inspection, when a lung becomes filled with fluid or denser, there is an increase in what?

A

Fremitus: Vibrations

88
Q

What diseases could result in an increase in Tactile Fremitus?

A

-Pneumonia
-Tumors
-Thickened Bronchial Secretions
-Pleural Effusion (The lung is compressed upwards)

89
Q

In a chest expansion test, the nurse is looking for what type of expansion?

A

Bilateral expansion

90
Q

During Auscultation of the lungs, the patient undergoes a full inspiratory phase and expiratory phase. During which, you hear crackles and popping. What area of the lungs are you auscultating?

A

Bronchial

91
Q

In a Bronchovesicular Auscultation, the patient has a Full inspiratory phase with a shortened and softer expiratory phase. What adventitious sounds might you hear in the Bronchovesicular area?

A

Wheezes and whistling

92
Q

In a vesicular Auscultation, there is a Quiet, wispy inspiratory phase followed by a short, almost silent expiratory phase. What are some of the adventitious sounds you may hear in a vesicular ausculation?

A

Stridor or Course/Snoring

93
Q

Excess gas that accumulates in the GI tract and causes abdominal distention is called what?

A

Tympany

94
Q

Tympany is excess gas that accumulates where?

A

In the GI tract, causing abdominal distention

95
Q

What are normal pH levels?

A

7.35-7.45

96
Q

What are the normal partial pressure of CO2 levels (PCO2)?

A

35-45mmHg

97
Q

What are the normal Serum Albumin levels?

A

3.5-6

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