Patho Exam 2 Flashcards
structures of the upper airway
nasopharynx and oropharynx
divides the upper and lower airways
The larynx
Structures in the lower airway
- The trachea and bronchi
The right and left main bronchi enter the lungs where?
Hila
The goblet cells secrete
mucus
What is the process called where carbon dioxide (CO2) is exchanged for oxygen?
Respiration
refers to actual blood flow and oxygen delivery
circulation
Which receptor monitors pH, PaCO2, and PaO2 of arterial blood?
Chemoreceptors
Which of the following would shift the oxyhemoglobin dissociation curve to the left?
Hypocapnia
Which are steps in the process of gas exchange?
- Ventilation
- Diffusion
- Perfusion
Which structures are considered part of the acinus?
- Respiratory bronchioles
- Alveolar ducts
- Alveoli
Which muscle has a major role in respiration?
- External Intercostal
- Diaphram
The respiratory center characteristics
- located in the brain stem.
- affecting the respiratory muscles’ ability to contract and relax
- transmitting impulses that bring about the physical act of breathing.
- influenced by emotions and pain.
inadequate alveolar ventilation in relation to metabolic demands
Hypoventilation
Which pathology most commonly results in pulmonary edema?
Increasing pressure in the left chambers of the heart
a diffuse, inflammatory obstruction of the small airways or bronchioles
Bronchiolitis
abnormal permanent enlargement of gas-exchange airways (acini) accompanied by destruction of alveolar walls without obvious fibrosis.
Emphysema
A patient has symmetrically dilated airways. Which type of bronchial dilation is this?
Cylindrical
when the bronchi become large and balloon like.
saccular
when constrictions and dilations destroy the bronchi.
Varicose
the persistent abnormal dilation of the bronchi
Bronchiectasis
indicates there was trauma to the chest resulting in the collapse of the lung
Secondary pneumothorax
Which diagnosis finding is characteristically present when the parietal pleura is infected?
Friction Rub
often associated with ectopic hormone production, especially antidiuretic hormone
Small Cell Carcinoma
Which condition can cause of hypercapnia?
- Disease of the medulla
- Large airway obstruction
- Thoracic cage abnormalities
- Depression of Respiratory Center
Expiratory stridor
a monophonic wheeze
Airway Obstruction is most likely to occur in which age group?
- in infants.
- This is due to their smaller airway and smaller diameter.
- more cartilage and collapse easily.
- A cough can be a sign of infection, foreign body, or obstruction.
Surfactant
- a lipid protein mix produced by type II cells.
- is found in the lining of the alveoli
- reduces surface tension
A 20 year old male presents to his primary health care provider, difficulty breathing when lying down. What term should the nurse use to document this condition?
orthopnea
Define Paroxysmal Nocturnal Dyspnea
- attacks of SOB & coughing that occur at night.
- Awakens the person from sleep, and may be quite frightening.
A patient with PND is most likely to have
left ventricular failure
A 20 year old male is in acute pain. ABG reveals decreased CO2. What is most likely the cause
hyperventilation
Cyanosis definition
- bluish discoloration of the skin & mucous membranes,
- caused by increasing amounts of desaturated or reduced hemglobin in the blood.
Reduced oxygenation of arterial blood
Hypoxemia
what is the most common cause of pulmonary edema?
- left sided heart failure
- increasing pressure of left chambers of the heart
Define Emphysema
- abnormal permanent enlargement of gas-exchange airways (acini) accompanied by destruction of alveolar walls without obvious fibrosis.
Clinical Manifestation of Pulmonary Edema
- dyspnea
- crackless
- dullness of percuss at lung bases
- pink frothy sputum
- hypercapnia
Define Open Pneumothorax
- air pressure in the pleural space equals barometric pressure
- b/c air that is drawn into the pleural space during inspiration is forced back out during expiration
Define Tension Pneumothorax?
- pleural rupture acts as a one way valve
- air ents on inspiration but preventing its escape by closing during expiration.
- air pressure exceeds barometric pressure
- life threatening
this is the collapse of lung tissue which tend to develop post op
Atelectasis
A 30 year old male is involved in a motor vehicle accident and sustains trauma to the lungs and chest wall. he experiences respiratory failure. which of the following lab values would the nurse expect
elevated PaCO2
A 60 year old female with emphysema is having difficulty expiring a given volume of air. when giving report, the nurse will relay that the patient is most likely experiencing ___ pulmonary disease
Obstructive Pulmonary Disease
Asthma related to Airway obstruction contributing to increased airflow resistance and hypoventilation in asthma is caused by
mucus secretion, bronchoconstriction, and airway edema
A 10 year old male is brought to the ER with prolonged bronchospasm and severe hypoxemia. the most likely diagnosis on the chart is
Status asthmaticus
a 53 year old male with a 20 year history of smoking is diagnosed with emphysema. when the nurse is asked what causes this, what is the nurse’s best response? changes in his lungs are caused by
Alpha-1-antitrypsin deficiency
A 53 year old male with a 20 year history of smoking is diagnosed with emphysema. Why the patient’s airways are obstructed?
Loss of elastic recoil
Pneumonia is caused by
viral or bacterial infections
A 30 year old male prison inmate contracted tuberculosis during an outbreak. while planning interactions, the nurse realizes the patient can transmit this disease through
airborne droplets
Who would be at highest risk for developing pulmonary embolism (PE)?
72 year old male who is recovering from hip replacement surgery in the hospital
Expected assessment findings for someone with a pulmonary embolism
- chest pain
- tachycardia
- tachypnea
- fever
- hemoptysis
a 50 year old male is diagnosed with pulmonary embolism (PE). what symptoms most likely occurred before treatment
chest pain and shortness of breath
A 60 year old male undergoes surgery for a bone fracture. what nursing measure would be most effective for preventing pulmonary embolism (PE) in this patient?
prevent deep vein thrombosis
A yougn patient is admitted to the pediatric unit with cystic fibrosis (CF) exacerbation. the nurse monitors the patient closely because the main cause of death in a child with CF is
respiratory failure
while reviewing lab results, the help confirm a diagnosis of cystic fibrosis in a 1-year old child which substance will be present in the child’s sweat
sodium chloride
While planning care for a child with asthma, which of the following is characteristic of asthma
Prolonged Expirations
a correct cause and effect sequence in the development of acute respiratory distress syndrome (ARDS)?
- alveolocapillary membrane injury causing a massive inflammatory response
characteristic of idiopathic pulmonary arterial hypertension (IPAH)
- fatigue
- dyspnea
- Jugular Vein Distention
Define Alveolar Dead Space
- a series of alveoli in the left lower lobe receive adequate ventilation but do not have adequate perfusion
asthma is thought to be caused by
interactions between genetic and environmental factors
a nurse recalls respiratory distress and hypoxemia in laryngotracheobronchitis are caused by
mucosal edema
When a patient has a massive pulmonary embolism (PE), what complications will the nurse monitor for
Shock & Death
to prevent sudden infant death syndrome, the nurse should instruct parents to
always lay infants down on their backs to sleep
A nurse remembers bronchiolitis mainly occurs in children under the age of ______
One
A nurse remembers a low ventilation-perfusion ratio results in
shunting
How is asthma classified
clinical severity
SIDS peaks between ____ and ____ months of age
3, 4
Airway hyper-responsiveness in asthma is related to
exposure to an allergen causing mast cell degranulation
mean pulmonary artery pressure reading will indicate to the nurse that pulmonary hypertension is occurring? Pulmonary artery pressure above _________ mmHg
Above 25
A newborn has respiratory distress syndrome, what is a predisposing factor
Premature Birth
A newborn has respiratory distress syndrome. A nurse recalls cardiovascular alterations seen in respiratory distress syndrome include
Opening of fetal shunt pathways
A newborn has respiratory distress syndrome. A nurse monitors the newborn for atelectasis because of
lack of surfactant
An infant was born 10 weeks premature and put on mechanical ventilation. two months later he presents with hypoxemia and hypercapnia, what is the diagnosis?
Bronchopulmonary dysplasia (BPD)
A group of mountain climbers experience confusion, tachycardia, edema, and decreased renal output after climbing Mount Rainier. A nurse recalls this condition is caused by
Decreased inspired oxygen
A geneticist is discussing cystic fibrosis (CF). which information should be included? CF is an ____ disease
autosomal recessive
a sinking in the supraclavicular and intercostal areas of the thorax was noted with inspiration. this observation is documented as
retractions
Asthma affects ____% of children between 5-17 years old
10%
An 80 year old female is in the hospital for a bone fracture. while there she develops a large, nonlethal pulmonary embolus. What is the result of the obstruction of pulmonary blood flow>
pulmonary hypertension
A 65 year old male recently had a cerebrovascular accident that resulted in dysphagia. he now has aspiration of gastric contents. the nurse assesses the patient for which complication
pneumonia
A patient is diagnosed with an antidiuretic hormone-producing lung tumor. What is the most likely diagnosis?
small cell carcinoma
A 60 year old male with a 40 year history of smoking presents with chest pain, cough, sputum production, and pneumonia. tests reveal widespread metastatic cancer, and the primary care provider plans radiation therapy. which of the following is the most likely type of cancer to be documented on the chart
Non Small Cell Carcinoma
A 60 year old female with a history of cirrhosis presents with dyspnea, impaired ventilation, and pleural pain. a diagnosis of pleural effusion is made, and a watery fluid is drained. when giving report, the nurse will refer to this fluid as
transudative
a 60 year old female with a 25 year history of smoking is diagnosed with emphysema. she has an increased anterior-posterior chest diameter. the nurse attributes this finding to
Air Trapping (Barrel Chest)
a 57 year old male presents with cough, sputum production, dyspnea, and decreased lung volume. he is diagnosed with pneumoconiosis, cause of illness?
inhalation of silica, asbestos, mica
A 50 year old diabetic male did not take his medication and is now in metabolic acidosis. eh is experiencing Kussmaul respirations. what type of breathing will the nurse observe upon assessment
a slightly increased ventilatory rate, large tidal volumes, and no expiratory pause
A 45 year old male undergoes lung transplantation. he now suffers from airway occlusion secondary to fibrosis. which diagnosis will the nurse see on the chart
bronchilitis obliterans
A 42 year old female presents with dyspnea, rapid, shallow breathing, inspiratory crackles, decreased lung compliance, and hypoxemia. tests reveal a fulminate form of respiratory failure characterized by acute lung inflammation and diffuse alveolocapillary injury.
Acute Respiratory Distress Syndrome (ARDS)
A 28 year old male reports to his primary care provider that he has had a cold for a week and is coughing up bloody secretions.
hemoptysis
