Module 2 Respiratory

Question 1

The nurse knows that the right lung has ______ lobes and the left lung has ______ lobes.

Answer 1

Right lung has three lobes and the left lung has two lobes.

Question 2

What is the purpose of the diaphragm?

Answer 2

The diaphragm is a dome-shaped muscular partition separating the thorax from the abdomen. It plays a major role in breathing it will move down contracting during inspiration and up relaxing during expiratory.

Question 3

The trachea is also known as the

Answer 3

The trachea is also known as a the windpipe. This structure is the central tube pictured in the image below. This structure will shift (deviate) to the right or left in a tension pneumothorax.

Question 4

What occurs at the alveoli?

Answer 4

The alveoli are the terminal air spaces of the respiratory tract and the actual site of gas exchange between the air and the blood. Any problem at the alveoli level will result in a patient not getting the oxygen they need and not being able to exhale the carbon dioxide.

Question 5

The nurse understands that the mucociliary blanket is very important in the respiratory system because it?

Answer 5

The mucociliary blanket is the mucus that is produced by the epithelial cells in the conducting airways. The airways of conduction are lined with mucus secreting glands, ciliated cells with hair-like projections, and serous glands that secrete a watery fluid containing antibacterial enzymes. The particles which do not need to be in the respiratory system are trapped in the blanket and the hair-like projections of the cilia move the particles up and the blanket is either coughed out, spit out, or swallowed. The cell changes that happen with things like smoking affect the cilia and therefore this process is impaired.

Question 6

What are the normal values for pH, HCO₃, and PCO₂ levels?

Answer 6

pH 7.35 -7.45

HCO₃ 22-26

PCO₂ 35 - 45

Question 7

What is the purpose of the cough reflex?

Answer 7

The cough reflex is the primary defense mechanism of the respiratory system. Conditions such as surgery and bedrest can weaken coughing which increases the patient’s risk for pneumonia.

Question 8

The nurse understands that Cheyne-Stokes respirations are?

Answer 8

Cheyne-Stokes respiration is a type of breathing disorder characterized by cyclical episodes of apnea and hyperventilation which can occur in certain conditions and in patient’s who are dying.

Question 9

The nurse understands that a diagnosis of the common cold is caused by infections that are typically _________ and therefore treatment would include what recommendations?

Answer 9

The nurse understands that the common cold is typically caused by a virus and therefore treatment includes rest, fluids, antipyretics (fever reducing medications), decongestants, and antihistamines.

Question 10

The nurse understands that sinusitis infections are typically viral. When a sinus infection is bacterial symptoms typically include:

Answer 10

Sinus pain and pressure that is one sided with a worsening of symptoms after five to seven days. The symptoms will typically persist greater than 10 days in bacterial sinus infections.

Question 11

The nurse understands that symptoms of pneumonia include fever, chills, headache, cough with sputum production, shortness of breath, fatigue, muscle aches, and joint pain. Which type of pneumonia would the nurse anticipate as the cause in an outbreak of pneumonia infections after several patient’s ate lunch at the local zoo near a fountain?

Answer 11

The nurse would anticipate the cause of these clients pneumonia to be Legionnaire’s disease since this bacteria is transmitted through the air from warm aerosolized water.

Question 12

The nurse would anticipate that a client who has difficulty swallowing (dysphagia) is at risk for this complication which can cause pneumonia.

Answer 12

The client would be at risk for aspiration which is when food/drinks/etc that should travel down the esophagus into the stomach travel down the trachea into the lungs instead. Aspiration of substances can result in aspiration pneumonia in clients.

Question 13

The nurse understands that TB (tuberculosis) is transmitted by droplet when a client with the infection coughs, sneezes, or shouts. This is why the disease will spread rapidly in crowded conditions. What symptoms would the nurse expect in a patient with TB?

Answer 13

• Fever
• Night sweats
• Persistent cough with bloody phlegm
• Shortness of breath

Question 14

The nurse understands that complications of the treatment of TB (tuberculosis) include:

Answer 14

Adherence to the treatment plan since the course of treatment involves multiple medications over a long period of time.

Question 15

The nurse understands that epiglottitis is inflammation of the epiglottis (flap of cartilage that covers the airway during swallowing). The nurse would anticipate the following symptoms in a client with epiglottitis:

Answer 15

• Fever
• Sore throat
• Drooling
• Stridor
• Shortness of breath
• Tripod condition (air hunger)

Question 16

The nurse understand that the priority treatment in a client with epiglottis is:

Answer 16

• Keep the child calm
• Have trach kit at bedside
• Minimize crying
• Monitor the airway

Question 17

Croup is an upper airway infection that is caused by viral infections. The nurse understands that croup will produce what symptoms in a child?

Answer 17

• Barking cough
• Stridor
• Cold symptoms

Question 18

The nurse understands that croup is treated by

Answer 18

• Cool humidified air
• Antipyretics for fever
• Possibly steroid medication if symptoms warrant the need

Question 19

State the signs of impending respiratory failure in children.

Answer 19

• Accessory muscle usage with retractions
• Nasal flaring
• Grunting with expiration
• Rapid breathing

Question 20

The nurse understands that what is considered the normal respiratory rate for an adult may very based on the resource used to look up the information. Typically the normal rate in an adult would be considered:

Answer 20

Normal rate for an adult resting would be 12 to 24 breaths a minute

Question 21

The nurse understands that a pleural effusion is

Answer 21

A pleural effusion is an abnormal collection of fluid in the pleural cavity.

Question 22

The nurse understands that in a pneumothorax the patient will exhibit these symptoms because the entire lung has collapsed due to air in the pleural space.

Answer 22

• Chest pain
• Increased respirations
• Shortness of breath (dyspnea)
• Asymmetry of the chest
• Tension pneumothorax - deviation of the trachea

Question 23

The treatment of a tension pneumothorax involves the insertion of a large bore needle or chest tube what action should the nurse immediately take if the patient pulls out a chest tube and a sucking chest wound is noted?

Answer 23

The nurse should immediately apply an occlusive dressing such as Vaseline gauze.

Question 24

Explain what is occurring in a patient diagnosed with atelectasis

Answer 24

Atelectasis is an incomplete expansion of a lung or portion of the lung. This condition is also noted as a complete or partial collapse of the entire lung or lobe of the lung. It occurs when the alveoli within the lung become deflated or possibly filled with alveolar fluid.

Question 25

The nurse understands that a preterm infant is at risk for atelectasis due to the immature lungs lacking this substance ___________. In the adult client atelectasis may occur as a complication from surgery, due to pneumonia, or from prolonged bedrest. What education would the nurse provide to the client to aid in the prevention of atelectasis.

Answer 25

• The immature lungs in a preterm infant are lacking surfactant that should be produced by alveoli type II cells in a fully developed infant.
• The nurse would want to educate the adult client to turn, cough, and deep breath to promote air movement and full lung expansion to reduce the risk of atelectasis

Question 26

The nurse understands that asthma is a chronic disorder of the airways which is characterized by bronchial hyperresponsiveness, airway inflammation, and airway remodeling. When exposed to a trigger such as allergens, exercise, or infection the client will have the following symptoms:

Answer 26

• Cough
• Chest tightness
• Wheezing
• Increase in respiratory rate

Question 27

The nurse understands that the correct treatment for an asthma attack is:

Answer 27

The correct treatment is to provide quick acting relief medications beta 2 adrenergic agonists (albuterol), avoid triggers, potentially administer steroid medications or racemic epi in severe attacks.

Question 28

What is the chronic lung disease resulting in obstruction of the airflow and symptoms of chronic cough, sputum, dyspnea, clubbing of the fingers, and barrel chest? The most common cause of this disease is smoking

Answer 28

COPD (Chronic obstructive pulmonary disease)

Question 29

The nurse understands that a pulmonary embolism is a clot in the lungs from coagulated blood, fat, or amniotic fluid. Risk factors include recent surgery, fracture, child birth, and DVT. What symptoms would the nurse anticipate in a client with a PE?

Answer 29

• Chest pain
• Shortness of breath
• Increased respirations
• Feeling of impending doom
• Cough
• Decreased oxygen saturation

Question 30

ARDS can have many causes that all produce similar changes in the lungs including diffused epithelial cell injury with increased permeability of the alveolar-capillary membrane which produces symptoms of respiratory distress with often poor prognosis due to respiratory failure. True or false?

Answer 30

True