Respiratory Conditions

Question 1

Central Chemoreceptors

Answer 1

sense changes in pH (increased CO2) of CSF

Question 2

Peripheral Chemoreceptors

Answer 2

Sense changes in paCO2 but primarily sensitive to PaO2

Question 3

PaO2 and normal range

Answer 3

Partial pressure of oxygen. The diffused oxygen in the arteries and arterioles. Very sensitive indicator of gas exchange impairment. Indicator of oxygen availability in blood.
Want it between 60-100

Question 4

Perfusion

Answer 4

Exchange of gasses in the lungs

Question 5

Ventilation

Answer 5

Air entering the lungs and respiratory tract

Question 6

Most important cause of pulmonary artery constriction is…

Answer 6

Low oxygen (pulmonary hypotension)

Question 7

Respiratory Defense Mechanisms

Answer 7

• Filtration of air
• Mucociliary escalator
• IgA antibodies
• Cough reflex
• Reflex bronchoconstriction
• Alveolar macrophages

Question 8

Diagnostic Studies for Respiratory Disorders (PVAX)

Answer 8

P - pulmonary function tests
V - ventilation/perfusion scan
A - arterial blood gas
X - chest X-ray

Question 9

Arterial Blood Gas (ABG)

Answer 9

• Assess for hypoxemia, hypercapnia, respiratory acidosis

Question 10

Ventilation/perfusion (V/Q) scan

Answer 10

• for diagnosis of PE (pulmonary embolism)

Question 11

Chest X-ray

Answer 11

Enlarged airways & check for pneumonia

Question 12

Pulmonary Function Tests

Answer 12

• Spirometry
• Forced spirometry
• Peak flow meter
• Lung volume test

Question 13

FVC

Answer 13

Forced vital capacity. Measuring the vital capacity that an individual can expire in one breath

Question 14

FEV1

Answer 14

Forced expiratory volume in 1 second

Question 15

SaO2

Answer 15

Oxygen saturation. Percentage of available binding sites on hemoglobin that are bound with oxygen in arterial blood.
normal values 95-100%

Question 16

Hypoxia

Answer 16

Reduced level of tissue oxygenation. Can be due to defective delivery of oxygen or defective utilization of oxygen by the tissue.

Question 17

Hypoxemia

Answer 17

Decrease in the partial pressure of oxygen in the blood.

Question 18

Hypercapnia

Answer 18

Elevated CO2 in the blood

Question 19

Oxygen-hemoglobin dissociation curve

Answer 19

• relationship between SaO2 and PaO2

- tells us our oxygen saturation and how a condition impacts our bodies way of releasing oxygen

Question 20

What is Atelectasis and when is it common

Answer 20

Collapse of alveoli or lung tissue common after surgery

Question 21

Those at risk for atelectasis

Answer 21

• Older adults
• Obese
• Bedridden
• Smoking hx

Question 22

How do nurses prevent atelectasis (main goal)

Answer 22

• Frequent position changes
• early ambulation
• DB&C
• Incentive spirometry
• Pain meds, with caution (can lead to respiratory depression)

Question 23

Treatment of underlying causes of Atelectasis

Answer 23

• O2 administration
• Postural drainage
• physiotherapy
• Tracheal suctioning

Question 24

What is pneumonia

Answer 24

• acute infection of lung “paranchyma” caused by a microbial agent
• associated with a marked increase in interstitial fluid & alveolar fluid
• leading cause of death and hospitalization in older people and people with chronic disease

Question 25

Predisposing Factors for Pneumonia (6)

Answer 25

1. Older adults 2. Smoking 3. Bedrest 4. Intubation 5. People with HIV (immunocompromised) 6. Upper respiratory tract infection

Question 26

Types of Pneumonia (7)

Answer 26

1. Lobar 2. Lobular of Bronchopneumonia 3. Community acquired 4. Hospital acquired 5. Fungal 6. Aspiration 7. Opportunistic

Question 27

Lobar Pneumonia

Answer 27

Consolidation of one lobe and of one lung

Question 28

Lobular of Bronchopneumonia

Answer 28

Patchy consolidation throughout the lung

Question 29

Community-Acquired Pneumonia

Answer 29

- Streptococcus pneumonia, mycoplasma, mycobacterium tuberculosis, legionella, chlamydia, viral

Question 30

Hospital-Acquired Pneumonia

Answer 30

- Pseudomonas, Enterobacter, S. aureus, MRSA, S. pneumonia

Question 31

Clinical Manifestations of Pneumonia

Answer 31

Green/yellow sputum, fever, shaking, chills, hemoptysis, pleuritic chest pain, headache Older adults: confusion, lower body temp

Question 32

Diagnostic tests

Answer 32

chest x-ray | Sputum C&S provides diagnosis of specific bacteria or virus causing pneumonia

Question 33

Subjective Data Pneumonia

Answer 33

health history Symptoms Fever/weakness/fever/chills

Question 34

Objective Data Pneumonia

Answer 34

``` General Respiratory status Cardiovascular and neurological Blood work VS ```

Question 35

Nursing Diagnosis Pneumonia (5)

Answer 35

1. Ineffective breathing pattern 2. Ineffective airway clearance 3. Acute pain 4. Imbalance nutrition: less than body requirement 5. Impaired gas exchange

Question 36

Care for Pneumonia (FVANS)

Answer 36

``` F - fluid & electrolyte management V - vaccines A - antibiotic therapy N - Nutrition support S - Supportive measures (oxygen, analgesics, antipyretics, bronchodilators, postural drainage, chest physiotherapy, suctioning) ```

Question 37

What is Tuberculosis

Answer 37

- bacterial infection that usually involves the lungs - caused by mycobacterium tuberculosis - kills more people worldwide than any other infectious disease

Question 38

How is TB spread?

Answer 38

- Spread via airborne droplets - Not highly infectious - Spread via lymphatic system and grows in favourable environments: Kidneys, adrenals, bones, brain, lungs

Question 39

TB in its latent phase

Answer 39

- Majority of people have mount effective immune response to encapsulate TB organisms, preventing primary infection from progressing disease - reactivation of TB can occur if host's defense mechanisms become impaired

Question 40

Clinical Manifestations of TB (Systemic)

Answer 40

- fatigue, malaise, anorexia, weight loss, low-grade fevers, night sweats, chest pain (dull or tight), hemoptysis

Question 41

Acute manifestations of TB

Answer 41

- high fever, chills, generalized flulike symptoms, pleuritic pain, productive cough

Question 42

Diagnostic Studies for TB

Answer 42

TB skin test - positive reaction 2-12 weeks after initial infection Chest X-ray Bacteriological studies - sputum test for acid-fast bacilli (3 consecutive samples)

Question 43

Collaborative Care for TB

Answer 43

- antimicrobial drugs are mainstay of treatment. aggressive. combination of 4 drugs. - follow up bacteriological studies & chest x-ray. (sputum samples weekly then monthly) - long-term follow up to ensure adherence to treatment regimen. - follow up for 12 months after completion of therapy

Question 44

Nursing management of TB

Answer 44

- place in respiratory isolation in negative-pressure room - N-95 mask - four drug therapy - teach patient to cover mouth and nose when producing sputum - careful hand washing - identification of contacts to determine possibility of infection

Question 45

Four Drugs for TB (PRISE)

Answer 45

1. Pyrazinamide 2. Rifampin 3. Isoniazid 4. Streptomycin & Ethambutol