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NUR 240 > NUR 240 E3 ch 17 resp assessment > Flashcards

NUR 240 E3 ch 17 resp assessment Flashcards

1
Q

4 functions of respiratory system

A

Oxygen transport
respiration
ventilation
gas exchange

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2
Q

the two tracts:

A

Upper respiratory tract: warms and humidifies air
lower respiratory tract: (lungs) gas exchange

both tracts are responsible for ventilation

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3
Q

paranasal sinuses

A

frontal, ethmoid, sphenoid, maxillary

function: serve as a resonating chamber in speech

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4
Q

Pharynx, tonsils and adenoids

A

Pharynx (throat) is divided into three regions: nasopharynx (posterior to nose, above soft palate), oropharynx (houses the palatine tonsils), laryngopharynx (extends from hyoid bone to cricoid cartilage
adenoids: pharyngeal tonsils, located on the roof of the nasopharynx
epiglottis forms the entrance to the larynx

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5
Q

Larynx (voice box) structures

A

connects the pharynx and trachea

Epiglottis: a valve flap of cartilage that covers the opening to the larynx during swallowing
Glottis: the opening between the vocal cords in the larynx
Thyroid cartilage: the largest of the cartilage structures; part of it forms the Adam’s apple
Cricoid cartilage: the only complete cartilaginous ring in the larynx (located below the thyroid cartilage)
Arytenoid cartilages: used in vocal cord movement with the thyroid cartilage
Vocal cords: ligaments controlled by muscular movements that produce sounds; located in the lumen of the larynx

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6
Q

Larynx function

A

produces sound, protects the lower airway from foreign substances and facilitates coughing
“watchdog of the lungs”

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7
Q

Lower respiratory tract structures

A

two lungs:
- right lung: 3 lobes
- left lung: 2 lobes

pleura (visceral-lungs, parietal-thoracic cavity): lubricates thorax and lungs

Mediastinum: middle of the thorax, between pleural sacs that contain the lungs

Bronchi and bronchioles

Alveoli- oxygen and CO2 exchange takes place here

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8
Q

Is it better to listen to the lungs anteriorly or posteriorly?

A

posteriorly

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9
Q

Oxygen transport

A

oxygen diffuses from the capillary through capillary wall to the interstitial fluid
CO2 moves from cell to the blood

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10
Q

respiration

A

process of gas exchange between air and the blood and between the blood and the cells

oxygen diffuses from alveoli to the blood
CO2 diffuses from blood to alveoli

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11
Q

ventilation

A

movement of diaphragm which increases or decreases the capacity of the chest

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12
Q

Ventilation: Air pressure variances

A

air flows from higher pressure to lower pressure.

inspiration- movement of diaphragm and intercostal muscles lowers pressure, draws air through the trachea and bronchi to the alveoli

expiration: diaphragm relaxes, lungs recoil, increases pressure, air flows from lungs to air

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13
Q

ventilation: airway resistance

A

with increased resistance, greater-than-normal respiratory effort is required to achieve normal levels of ventilation

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14
Q

ventilation: compliance

A

elasticity and expandability of the lungs and thoracic structures

factors that determine compliance: surface tension of alveoli, connective tissue and water content of lungs, and compliance of the thoracic cavity

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15
Q

pulmonary diffusion

A

process by which oxygen and carbon dioxide are exchanged from areas of high concentration to areas of low concentration

oxygen and CO2 diffuse across alveolar-capillary membrane

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16
Q

pulmonary perfusion

A

blood flow through the pulmonary vasculature

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17
Q

Inspiratory reserve volume (IRV)

A

The extra volume of air that can be inspired with maximal effort after reaching the end of a normal, quiet inspiration.

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18
Q

expiratory reserve volume ERV

A

the volume of air that can be forcefully exhaled after a normal resting expiration, leaving only the RV in the lungs.

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19
Q

residual volume RV

A

the volume of air left in the lungs at maximal expiration

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20
Q

tidal volume

A

Total amount of air inhaled and exhaled with one breath during normal breathing

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21
Q

vital capacity

A

maximum amount of air exhaled after maximum inspiration

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22
Q

inspiratory capacity

A

The maximum volume of air that can be inspired after reaching the end of a normal, quiet expiration

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23
Q

functional residual capacity

A

volume remaining in lungs after a normal, passive exhalation

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24
Q

total lung capacity

A

the volume of air in the lungs upon the maximum effort of inspiration

healthy= about 6 liters

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25
Q

ventilation-perfusion ratio

A

shows imbalance between ventilation and perfusion
imbalance causes shunting of blood –> Hypoxia

normal VQ ratio (1:1)
low VQ ratio: shunt
high VQ ratio (dead space)
silent unit- absence of ventilation and perfusion

put patient on supplemental O2

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26
Q

low VQ ratio indicates

A

when perfusion exceeds ventilation, a shunt exists, blood bypasses alveoli with gas exchange occurring

pneumonia, atelectasis, tumor, mucous plug

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27
Q

high VQ ratio

A

when ventilation exceeds perfusion, dead space results. alveoli do not have adequate blood supply for gas exchange to occur

pulmonary embolism, pulmonary infarction, cariogenic shock

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28
Q

Silent unit (VQ ratio)

A

limited or absent ventilation perfusion

pneumothorax, severe acute respiratory distress

29
Q

the amount of ___ in transit is one of the major determinants of the _____ balance of the body

A

carbon dioxide
acid-base

30
Q

Neurological control of ventilation

A

inspiratory and expiratory centers in the medulla and pons control the rate and depth of ventilation

31
Q

receptors for neurological control of ventilation

A

central and peripheral chemoreceptors
mechanoreceptors
proprioceptors
baroreceptors

32
Q

central chemoreceptors

A

respond to CSF changes
respond to an increase or decrease in the pH and message the lungs to change depth and rate to correct imbalance

33
Q

peripheral chemoreceptor

A

responds first to changes in PaO2 then to partial pressure of PaCO2, and pH

34
Q

mechanoreceptors

A

include stretch, irritant, and juxtacapillary receptors
respond to changes in resistance by altering breathing patterns

35
Q

Proprioceptors

A

respond to body movements causing an increase in ventilation

ROM exercises can stimulate breathing

36
Q

baroreceptors

A

respond to an increase of decrease in arterial blood pressure and cause reflex hypoventilation or hyperventilation

37
Q

major signs and symptoms of respiratory disease are

A

dyspnea, cough, sputum production, chest pain, wheezing, and hemoptysis

38
Q

general appearance that gives clue to respiratory status

A

clubbing of the fingers
skin color (cyanosis)- late indicator of hypoxia

39
Q

Barrel chest

A

occurs as a result of overinflation

hallmark signs of emphysema and COPD

40
Q

normal anteroposterior diameter ratio

A

1:2

41
Q

Funnel chest (Pectus Excavatum)

A

depression in the lower portion of the sternum

42
Q

Pigeon chest (pectus carinatum)

A

outward protrusion of the sternum

result of anterior displacement of the sternum
increases anteroposterior diameter

43
Q

Kyphoscoliosis

A

elevation of the scapula and a corresponding s-shaped spine

limits lung expansion

44
Q

normal breathing pattern

A

eupnea

45
Q

wheezing is common in patients with

A

asthma

46
Q

crackles

A

nonmusical, discontinuous
usually heard on inspiration

47
Q

wheezes

A

continuous musical
usually heard on expiration

48
Q

Rhonchi

A

a type of wheezing, are lower-pitched continuous sounds heard over the lungs in partial airway obstruction

49
Q

Bronchophony

A

vocal resonance that is more intense and clear than normal

50
Q

voice sounds

A

normal physiology- the sounds are faint and indistinct.
Pathology that increases lung density- pneumonia and pulmonary edema- alters this normal physiologic response and may result in bronchophony or egophony

51
Q

egophony

A

voice sounds are distorted due to consolidation

pt says E and you listen and it sounds like A

52
Q

Respiratory diagnostic tests

A

pulmonary function tests
arterial blood gases
venous blood gas studies
pulse oximetry
end-tidal carbon dioxide
cultures
sputum studies
imaging studies

53
Q

pleurisy

A

inflammation of the pleura
sharp like pain (knife into chest)

54
Q

___ are most helpful in protecting against respiratory infection

A

tonsils

55
Q

pleural effusion

A

a buildup of fluid between the layers of tissue that line the lungs and chest cavity

56
Q

A client presents to the ED reporting severe coughing episodes. The client states that “the episodes are more intense at night.” The nurse should suspect which of the following conditions based on the client’s primary report?

A

left sided heart failure

57
Q

cardinal sign of chronic hypoxia

A

clubbing of the finger nails

58
Q

Which of the following is an age-related change associated with the lung?

Increased thickness of the alveolar membranes
Increased elasticity of alveolar sacs
Decreased diameter of alveoli ducts
Decreased collagen of alveolar membranes

A

Increased thickness of the alveolar membranes

59
Q

A nurse is assessing a client’s respiratory system. Which alveolar cells secrete surfactant to reduce lung surface tension?

Type II
Type IV
Type I
Macrophages

A

type II

60
Q

A nurse is concerned that a client may develop postoperative atelectasis. Which nursing diagnosis would be most appropriate if this complication occurs?

Ineffective airway clearance
Impaired gas exchange
Decreased cardiac output
Impaired spontaneous ventilation

A

impaired gas exchange

61
Q

The nurse auscultates crackles in a patient with a respiratory disorder. With what disorder would crackles be commonly heard?

A

collapsed alveoli

62
Q

increased or high compliance

A

emphysema

63
Q

A client arrives at the physician’s office stating dyspnea; a productive cough for thick, green sputum; respirations of 28 breaths/minute, and a temperature of 102.8° F. The nurse auscultates the lung fields, which reveal poor air exchange in the right middle lobe. The nurse suspects a right middle lobe pneumonia. To be consistent with this anticipated diagnosis, which sound, heard over the chest wall when percussing, is anticipated?

A

dull

64
Q

The nurse auscultated a patient’s middle lobe of the lungs for abnormal breath sounds. To do this, the nurse placed the stethoscope on the:

A

Anterior surface of the right side of the chest, between the fourth and fifth rib.

65
Q

respiration

A

gas exchange between atmospheric air and the blood and between the blood and cells of the body

66
Q

ventilation

A

movement of air in and out of the lungs

67
Q

pulmonary diffusion

A

exchange of gas molecules (oxygen and carbon dioxide) from areas of HIGH concentration to areas of LOW concentration

68
Q

pulmonary perfusion

A

blood flow through the pulmonary vasculature

NUR 240 (18 decks)

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