Respiratory - 11/15 Quiz Flashcards
Pressure of the air in the pleural space is the same as barometric pressure because the air drawn into the pleural space during inspiration is forced back out during expiration.
Communicating pneumothorax
Pressure of the air in the pleural space exceeds barometric pressure because air enters during inspiration but cannot exit during expiration.
Tension pneumothorax
Alternating periods of deep and shallow breathing; apnea lasting 15 to 60 seconds, followed by ventilations that increase in volume until a peak is reached, after which ventilation decreases again to apnea (e.g., CHF, sleep apnea)
Cheyne-Stokes (breathing pattern)
Increased ventilatory rate, small tidal volume
Restricted (breathing pattern)
Rhythmic and effortless with normal tidal volume
Eupnea (breathing pattern)
Irregular, quick inspirations with an expiratory pause
Gasping (breathing pattern)
Increased ventilatory rate, small tidal volume, increased effort, prolonged expiration, wheezing
Obstructed (breathing pattern)
Increased ventilatory rate, very large tidal volume, no expiratory pause
Kussmaul (breathing pattern) - DKA DM I & renal failure patients
waking up with dyspnea during the night and needing to sit upright or stand to breathe
Paroxysmal nocturnal dyspnea
Rib fractures that disrupt the mechanics of breathing can cause a portion of the chest wall to collapse ________ during inspiration, an acute condition known as _______ chest.
inward; flail
A person who has pneumothorax has _____ in the pleural space.
air
A person who has _______ has persistent abnormal dilations of the bronchi and a chronic cough that produces large amounts of purulent _______.
bronchiectasis; sputum
Pulmonary fibrosis is an excessive amount of ______ tissue in the lungs and causes ______ lung compliance.
fibrotic; decreased
In asthma, long-term airway damage that is irreversible is known as airway _________.
remodeling
During an acute asthma episode, inflammatory mediators cause inflammation, hypersecretion of ______, and bronchial smooth muscle ________.
mucus; constriction
An asthma episode that does not resolve with usual treatment is called ______ ________.
status asthmaticus
Genetic deficiency of ____ __________ causes early-onset emphysema because this enzyme normally inhibits the action of _________ _________ that can destroy lung tissue.
alpha-1 antitrypsin; proteolytic enzyme
Alveolar ventilation is inadequate in relationship to the metabolic demands; leads to respiratory acidosis
hypoventilation
Alveolar ventilation exceeds the metabolic demands; leads to respiratory alkalosis from hypocapnia.
hyperventilation
Head injuries causes…(hypo/hyper-ventilation)
hyperventilation
Airway obstruction causes… (hypo/hyper-ventilation)
hypoventilation
Respiratory muscle weakness causes… (hypo/hyper-ventilation)
hypoventilation
Reduced compliance of chest wall causes… (hypo/hyper-ventilation)
hypoventilation
Anxiety causes… (hypo/hyper-ventilation)
hyperventilation
A person who has ….. has persistent abnormal dilations of the bronchi and a chronic cough that produces large amounts of purulent …..
bronchiectasis; pus-like sputum
Most common cause of pulmonary edema
left-sided heart failure
Pink frothy sputum, dyspnea, hypoxemia, increased work of breathing, crackles/rales, dullness on percussion, hypoventilation with hypercapnia
Pulmonary edema
Cor pulmonale …-sided HF
Pulmonary edema …-sided HF
Right
Left
Conditions related to \_\_\_\_\_ : lung fluid increases, systemic inflammatory response occurrence, lungs dry out, lung volume decreased hypoxemia (always at end phase)
Acute Respiratory Distress Syndrome (ARDS)
RN receives report on pt w/ARDS who has been intubated for 6 days and had progressive hypoxemia that responds poorly to high levels of oxygen. This pt is in which phase of ARDS case management?
fibro-proliferative:
fibrotic and proliferative phase at same time
Airway obstruction is worse with expiration.
More force/time is required to expire given vol of air; emptying lungs is slowed.
unifying s/sx: wheeze & dyspnea.
Inc. WOB, vent-perf mismatch, dec. FEV1 (in 1 second).
Obstructive pulmonary disease
Types of obstructive pulmonary disease
asthma, chronic bronchitis, emphysema, COPD
Life threatening bronchospasms not reversed by usual measures
Status asthmaticus
Albuterol nebulizer
quick-relief agent
beta-adrenergic agonist
Oral prednisone
long-term control
steroid inflammatory
Ipratropium inhaler
quick-relief agent
anticholinergic
Salmeterol inhaler
long-term control
beta-adrenergic agonist
The pulmonary vasoconstriction leading to development of cor pulmonale in patient with COPD results from…
alveolar hypoxia and hypercapnia
pulmonary HTN -> vasoC
Abnormal permanent enlargement of gas-exchange airways accompanied by destruction of alveolar walls w/o obvious fibrosis.
Emphysema
Inherited deficiency of enzyme α1-antitrypsin;
Involves entire acinus, damage is more randomly distributed, involves LOWER lobes of lung.
Primary emphysema;
Panlobular/Panacinar
Main cause is cigarette smoke. Possible contributors: air pollution, occupational exposures, childhood resp. infxns.;
Septal destruction occurs in respiratory bronchioles & alveolar ducts, usu in UPPER lobes, alveolar sac remains intact, tends to occur in smokers w/chronic bronchitis.
Secondary emphysema;
Centrilobular/Centriacinar
Pneumonia acquired <48 hours of hospitalization.
Streptococcus pneumoniae
community-acquired
Pneumonia acquired >48 hours of hospitalization.
Staph, or commonly Gram-Neg e.coli, pseudo, kleb, enterob.
hospital acquired; nosocomial infection
