Gas Exchange II: COPD And Pneumonia Flashcards
Considering the pathophysiology of pneumonia, how does the inflammatory response lead to decreased gas exchange?
When pneumonia develops, the body triggers an inflammatory response in the lungs to fight off the infection. This process increases blood flow and makes blood vessels more permeable, allowing immune cells like neutrophils to reach and destroy the pathogens. However, this response also leads to swelling in the airways and fluid leakage into the alveoli, the tiny air sacs where gas exchange occurs. As these spaces fill with fluid, oxygen transport becomes impaired, reducing the amount of oxygen that reaches the bloodstream. This results in symptoms of hypoxia, such as rapid breathing (tachypnea), difficulty breathing (dyspnea), and an increased heart rate (tachycardia)
Which of the following are risk factors for pneumonia?
Upper respiratory infection
Surgery
Nasogastric tube feedings
Smoking
Which tests are commonly ordered for pneumonia?
Chest X-ray
Arterial Blood Gasses
CBC (complete blood count) with differential
Sputum Culture
The healthcare provider has prescribed penicillin for a client admitted to the hospital for treatment of pneumonia. Prior to administering the first dose of penicillin, the nurse should ask the client which of the following?
“Have you had a previous allergy to penicillin?”
Atelectasis
Collapsed Alveoli
Pneumonia
Bronchial breath sounds, course or fine crackles
Chronic Obstructive Pulmonary Disease
Barrel Chest and wheezing
Asthma exacerbation
Prolonged Expiration and wheezing
Explain the pathophysiology of Chronic Obstructive Pulmonary Disease (COPD)
Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung disease characterized by chronic inflammation, airway obstruction, and alveolar damage. The primary cause is prolonged exposure to irritants like cigarette smoke, which triggers an inflammatory response involving neutrophils, macrophages, and lymphocytes. This leads to excess mucus production, airway swelling, and destruction of lung tissue. Over time, the loss of elastic recoil and narrowing of the small airways cause air trapping, making it difficult to exhale fully. As a result, the lungs become hyperinflated, leading to a barrel-shaped chest and increased effort to breathe.
As COPD progresses, gas exchange becomes impaired, resulting in low oxygen (hypoxemia) and high carbon dioxide (hypercapnia) levels, particularly during exertion. The destruction of alveoli forms non-functional air spaces (bullae and blebs), further reducing oxygen absorption. Severe cases may lead to pulmonary hypertension and right-sided heart failure (cor pulmonale). Patients experience progressive shortness of breath (dyspnea), reduced exercise tolerance, and respiratory muscle fatigue, worsening their overall quality of life.
Which assessment finding in a client with COPD indicates to the nurse that the client’s respiratory problem is chronic?
Clubbing in fingers
The nurse has given instructions on pursed-lip breathing to a client with COPD. Which statement by the client would indicate effective teaching?
“I should tighten my abdominal muscles with exhalation.”
True or False. A nurse should administer a bronchodilator to a patient before performing postural drainage and chest physiotherapy because it will open the airways and allow for easier removal of secretions.
True
The nurse is teaching a patient with COPD about early recognition of COPD exacerbations. Which statement by the nurse is the most correct?
“Signs of a COPD exacerbation include feeling short of breath, increased mucous production, and you may notice your mucous has changed colors.”
Which of the following are true about medication management for Chronic Obstructive Pulmonary Disease (COPD)?
Roflumilast (Daliresp) helps decrease exacerbations
Bronchodilators are the first line of treatment
Medication therapy depends on severity of symptoms
Which statement made by the client indicates that further teaching is needed regarding physical activity and COPD?
“I should not do any physical activity because it is bad for me.”
