Respiratory

Question 1

Increased mucus secretion, chest wall contractions, pulsus paradoxus greater than 10 mm Hg, and bronchospasm are manifestations of?

Answer 1

Asthma

Question 2

Chronic productive cough; cyanosis; pulmonary hypertension are symptoms of ???

Answer 2

Bronchitis

Question 3

A barrel-shaped chest; dyspnea due to exertion; loss of elastic recoil in lungs are manifestations of ?

Answer 3

Emphysema

Question 4

What are the two major life-threatening complications associated with COPD?

Answer 4

1. Respiratory insufficiency
2. respiratory failure

Question 5

Examples of resp. insufficiency situations:

Answer 5

-pneumonia (infection causing lungs to fill with fluid or pus = inflamed)
-pneumothorax (collapsed lung= air built up between lung and chest wall)
-atelectasis: partial/full lung collapse by blocked air passage or lung pressure. Occurs when alveoli deflate
-pulmonary arterial hypertension (cor pulmonale): pulmonary arteries constrict and/or thicken making it more difficult for blood to flow through the lung.

Question 6

COPD non-medicinal therapeutic interventions:

Answer 6

-drink water to help liquefy secretions
-healthy diet and weight: eating will help energy levels used for respiration (a lot of calories lost during labored breathing)
-Reduce household irritants by using bagless vacuum and filtered heating/AC units
-pulmonary rehabilitation program
-exercise
-diaphragmatic breathing - strengthens diaphragm
-pursed-lip breathing: slows expiration and prevents collapse of airways; controls rate and depth or respirations
-respiratory muscle training: inhale against a set resistance for specific amnt of time daily = increased resistance = muscles better conditioned
-rest when dyspnea is occurring (especially in the am)

Question 7

What procedure reduces hyperinflation of the lungs and allows functional tissues to expand, resulting in improved elastic recoil of the lungs and improved chest wall diaphragmatic mechanics?

Answer 7

lung volume reduction surgery (does not increase lifespan but may aid in dyspnea reduction, improved lung function, and quality of life)

Question 8

end-stage emphysema is an indicator for which procedure?

Answer 8

lung transplant

Question 9

peribronchiolar fibrosis definition:

Answer 9

stiff bronchial tubes

Question 10

Pursed-lip breathing technique points to remember: (4)

Answer 10

1. The purpose is to slow breathing down and exhale the trapped air out of the lungs
2. In through the nose and slowly out through the mouth with pursed lips (like about to whistle)
3. Exhalation should always be twice as long as inhalation
4. Does not reduce feelings of anxiety or depression

Question 11

Which class of medications relax smooth muscles; decreases airway resistance and mucus drainage; and increases the vital capacity of the lungs?

Answer 11

Bronchodilators

Question 12

Which class of drugs triggers anti-inflammatory response; reduces gastric irritation; and allows the adrenal glands to recover from drug-induced atrophy?

Answer 12

Corticosteroid

Question 13

Which is a diagnosis priority:
A. Alteration in self-concept related to weight loss
B. Inadequate fluid volume related to dyspnea
C. Ineffective breathing pattern related to an ineffective cough
D. Activity intolerance related to dyspnea and fatigue

Answer 13

C. Airways are #1!

Question 14

nasal cannula care:

Answer 14

-remove and clean every 8 hours
-check for irritation and bleeding every 8 hours
-humidifier required in excess of 2 liters per min.

Question 15

Explanation to patient when about to perform nasal cannula oxygen admin:

Answer 15

-Explain rationale: improve breathing and supply biological oxygen needs
-Express that it will not hurt
-Can eat with it on
-Breath through nose with mouth closed
-Safety precautions

Question 16

Assessment for pt. receiving nasal cannula oxygen admin:

Answer 16

-vital signs
-oxygen saturation level
-level of consciousness
-respiratory rate, depth and rhythm
-auscultation of breath sounds
-presence of cough or excess secretions in airway
-changes in skin color
-mental status changes

Question 17

Steps to setting up a nasal cannula for oxygen admin with more than 2L per minute: (5)

Answer 17

1. Connect the flowmeter to wall access
2. Attach humidifier, if one is to be used, to flowmeter
3. Connect the nasal cannula to humidifier or flowmeter
4. adjust the flow rate as ordered
5. Check the oxygen is flowing out of the prongs

Question 18

Nasal cannula administration application (setting up on the patient) steps. (7)

Answer 18

1. Place prongs in the patient’s nostrils
2. If the prongs are curved, curve the points downs as they enter the nostrils. Adjust the tubing over and behind each ear with the adjuster comfortably under chin or around the patient’s head.
3. Correct placement of the prongs and fastener facilitates oxygen administration and pt. comfort.
4. Place gauze pads or commercial pads on the tubing at the ears to relieve pressure.
5. Once cannula is on, encourage patient to breathe through the nose with the mouth closed. (optimal delivery of oxygen)
6. Perform hand hygiene

Question 19

What should be included when documenting care after application of nasal cannula? (8)

Answer 19

1. Date/Time
2. Vitals and consciousness status
3. Respirations with any sounds heard
4. Expectorating secretion ability; presence of cough (productive/non or effective/ineffective)
5. Oxygen saturation % “on room air”
6. Physician notified
7. Oxygen application intervention equipment used with l/minute “per order”
8. Patient’s verbalization of understanding oxygen use “at this time”

Question 20

Which respiratory condition is characterized by chronic inflammation?

Answer 20

Asthma

Question 21

4 types of asthma:

Answer 21

-daily issue
-seasonal
-situational
-idiopathic/periodic

Question 22

How can intermittent airway obstruction occur with asthma?

Answer 22

bronchospasm; inflammation/bronchoconstriction

Question 23

Is asthmatic airway obstruction reversible?

Answer 23

Yes. ALSO a priority! 4 min. without o2 - brain death.