respiratory Flashcards
In relation to the structure of the larynx, the cricoid cartilage is
the only complete cartilaginous ring in the larynx.
Which respiratory volume is the maximum volume of air that can be inhaled after maximal expiration?
Inspiratory reserve volume
A client has a history of chronic obstructive pulmonary disease (COPD). Following a coughing episode, the client reports sudden and unrelieved shortness of breath. Which of the following is the most important for the nurse to assess?
Lung Sounds
A client arrives in the emergency department reporting shortness of breath. She has 3+ pitting edema below the knees, a respiratory rate of 36 breaths per minute, and heaving respirations. The nurse auscultates the client’s lungs to reveal coarse, moist, high-pitched, and non-continuous sounds that do not clear with coughing. The nurse will document these sounds as which type?
Crackles
A client with chronic obstructive pulmonary disease (COPD) expresses a desire to quit smoking. The first appropriate response from the nurse is:
“Have you tried to quit smoking before?”
A nursing instructor is discussing asthma and its complications with medical-surgical nursing students. Which of the following would the group identify as complications of asthma? Choose all that apply.
Status asthmaticus
Respiratory failure
Atelectasis
To help prevent infections in clients with COPD, the nurse should recommend vaccinations against two bacterial organisms. Which of the following are the two vaccinations?
Streptococcus pneumonia and Haemophilus influenzae
A nurse has just completed teaching with a patient who has been prescribed a meter-dosed inhaler for the first time. Which of the following statements would the nurse use to initiate further teaching and follow-up care?
“I do not need to rinse my mouth with this type of inhaler.”
A nursing student understands that emphysema is directly related to which of the following?
Respiratory acidosis from airway obstruction
Which of the following alveolar cells secrete surfactant?
Type II
Millions of alveoli form most of the pulmonary mass. The squamous epithelial cells lining each alveolus consist of different types of cells. Which type of alveolar cells produce surfactant?
Type II cells
A client with newly diagnosed emphysema is admitted to the medical-surgical unit for evaluation. Which does the nurse recognize as a deformity of the chest wall that occurs as a result of overinflation of the lungs in this client population?
Barrel Chest
The nurse is reviewing the blood gas results for a patient with pneumonia. What arterial blood gas measurement best reflects the adequacy of alveolar ventilation?
PaCO2, when the minute ventilation falls, alveolar ventilation in the lungs also decreases, and the PaCO2 increases.
The nurse is instructing the patient on the collection of a sputum specimen. What steps should be included in the instructions?
Initially, clear the nose and throat.
Take a few deep breaths before coughing.
Use diaphragmatic contractions to aid in the expulsion of sputum.
Upon assessment, the nurse suspects that a patient with COPD may have bronchospasm. What manifestations validate the nurse’s concern? Name three.
Compromised gas exchange
Decreased airflow
Wheezes
A child is having an asthma attack and the parent can’t remember which inhaler to use for quick relief. The nurse accesses the child’s medication information and tells the parent to use which inhalant?
Proventil
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:
Anterior surface of the right side of the chest, between the fourth and fifth rib.
A patient visited a health care clinic for treatment of upper respiratory tract congestion, fatigue, and sputum production that was rust-colored. Which of the following diagnoses is likely based on this history and inspection of the sputum?
An infection with pneumococcal pneumonia
The nurse, caring for a patient with emphysema, understands that airflow limitations are not reversible. The end result of deterioration is:
Respiratory acidosis.
A home health nurse sees a client with end-stage chronic obstructive pulmonary disease. An outcome identified for this client is preventing infection. Which finding indicates that this outcome has been met?
Decreased oxygen requirements
The nurse has instructed the client to use a peak flow meter. The nurse evaluates client learning as satisfactory when the client
Exhales hard and fast with a single blow
A nursing student is taking a pathophysiology examination. Which of the following factors would the student correctly identify as contributing to the underlying pathophysiology of chronic obstructive pulmonary disease (COPD)? Choose all that apply.
Inflamed airways that obstruct airflow
Mucus secretions that block airways
Overinflated alveoli that impair gas exchange
The nursing student recalls that the underlying pathophysiology of chronic obstructive pulmonary disease (COPD) includes the following components:
Inflamed airways obstruct airflow.
Mucus secretions block airways.
Overinflated alveoli impair gas exchange.
A client is being admitted to an acute healthcare facility with an exacerbation of chronic obstructive pulmonary disease (COPD). The client had been taking an antibiotic at home with poor relief of symptoms and has recently decided to stop smoking. The nurse is reviewing at-home medications with the client. The nurse is placing this information on the Medication Reconciliation Record. Which of the following is incomplete information?
salmeterol/fluticasone (Seretide) MDI daily at 0800
Which of the following is the key underlying feature of asthma?
Inflammation
Asthma is cause by which type of response?
IgE-mediated
Which diagnostic test is most accurate in assessing acute airway obstruction?
Pulmonary function studies
In which grade of COPD is the forced expiratory volume in 1 second (FEV1) greater than 80% predicted?
I
A physician orders triamcinolone (Azmacort) and salmeterol (Serevent) for a client with a history of asthma. What action should the nurse take when administering these drugs?
Administer the salmeterol and then administer the triamcinolone.
A nurse is caring for a client admitted with an exacerbation of asthma. The nurse knows the client’s condition is worsening when he:
uses the sternocleidomastoid muscles.
A nurse has established a nursing diagnosis of ineffective airway clearance. The datum that best supports this diagnosis is that the client
Has wheezes in the right lung lobes
A client experiencing an asthmatic attack is prescribed methylprednisolone (Solu–Medrol) intravenously. The nurse:
Assesses fasting blood glucose levels
A client is at risk for emphysema. When reviewing information about the condition with the client, which would the nurse emphasize as the most important environmental risk factor for emphysema?
Cigarette smoking
Which measure may increase complications for a client with COPD? (Administering too much oxygen can result in the retention of carbon dioxide.)
Increased oxygen supply
Which of the following is a symptom diagnostic of emphysema?
Dyspnea
The classification of Stage IV of COPD is defined as
very severe COPD.
A home health nurse visits a client with chronic obstructive pulmonary disease who requires oxygen. Which statement by the client indicates the need for additional teaching about home oxygen use?
“I make sure my oxygen mask is on tightly so it won’t fall off while I nap.”
A client with chronic obstructive pulmonary disease (COPD) is recovering from a myocardial infarction. Because the client is extremely weak and can’t produce an effective cough, the nurse should monitor closely for:
atelectisis
A young adult with cystic fibrosis is admitted to the hospital for aggressive treatment. The nurse first:
Collects sputum for culture and sensitivity
A client with asthma has developed obstruction of the airway. Which of the following does the nurse understand as having potentially contributed to this problem? Choose all that apply.
Thick mucus
Swelling of bronchial membranes
Airway remodeling
A client is being admitted to the medical–surgical unit for the treatment of an exacerbation of acute asthma. Which medication is contraindicated in the treatment of asthma exacerbations?
Cromolyn sodium
The nurse is reviewing pressurized metered-dose inhaler (pMDI) instructions with a client. Which statement by the client indicates the need for further instruction?
“I can’t use a spacer or holding chamber with the MDI.”
The nurse is assigned to care for a patient with COPD with hypoxemia and hypercapnia. When planning care for this patient, what does the nurse understand is the main goal of treatment?
Providing sufficient oxygen to improve oxygenation
A patient with asthma is prescribed a short acting beta-adrenergic (SABA) for quick relief. Which of the following is the most likely drug to be prescribed?
Proventil
A nurse notes that the FEV1/FVC ratio is less than 70% and the FEV1 is 65% for a patient with COPD. What stage should the nurse document the patient is in?
II
A nurse is caring for a client with status asthmaticus. Which medication should the nurse prepare to administer?
An inhaled beta2-adrenergic agonist
A client has been classified as status asthmaticus. The nurse understands that this client will likely initially exhibit symptoms of:
Respiratory Alkalosis
A client has intermittent asthma attacks. Which of the following therapies does the nurse teach the client to use at home when experiencing an asthma attack?
Inhaled albuterol (Ventolin)
In chronic obstructive pulmonary disease (COPD), decreased carbon dioxide elimination results in increased carbon dioxide tension in arterial blood, leading to which of the following acid–base imbalances?
Respiratory acidosis
Which of the following is a leading cause of chronic obstructive pulmonary disease (COPD) exacerbation?
Bronchitis
At 11 p.m., a client is admitted to the emergency department. He has a respiratory rate of 44 breaths/minute. He’s anxious, and wheezes are audible. The client is immediately given oxygen by face mask and methylprednisolone (Depo-medrol) I.V. At 11:30 p.m., the client’s arterial blood oxygen saturation is 86%, and he’s still wheezing. The nurse should plan to administer:
albuterol (Proventil).
A client with bronchiectasis is admitted to the nursing unit. The primary focus of nursing care for this client includes:
Implementing measures to clear pulmonary secretions.