Respiratory Function Flashcards
temporary cessation of breathing
apnea
abnormal increase in clarity of transmitted voice sounds heard when auscultating the lungs
bronchophony
direct examination of the larynx, trachea, and bronchi using an endoscope
bronchoscopy
measure of the force required to expand or inflate the lungs
compliance
shortness of breath
dyspnea
abnormal change in tone of voice that is heard when auscultating the lungs
egophony
vibrations of speech felt as tremors of the chest wall during palpation
fremitus
decrease in arterial oxygen tension in the blood
hypoxemia
temporary absence of breathing during sleep secondary to transient upper airway obstruction
obstructive sleep apnea
shortness of breath when lying flat; relieved by sitting or standing
orthopnea
percentage of hemoglobin that is bound to oxygen
oxygen saturation
portion of the tracheobronchial tree that does not participate in gas exchange
physiologic dead space
exchange of gas molecules (oxygen and carbon dioxide) from areas of high concentration to areas of low concentration
pulmonary diffusion
blood flow through the pulmonary vasculature
pulmonary perfusion
deep, low-pitched snoring sound associated with partial airway obstruction, heard on chest auscultation
rhonchi
continuous, high-pitched, musical sound heard on inspiration, best heard over the neck; may be heard without use of a stethoscope, secondary to upper airway obstruction
Stridor
volume of air inspired and expired with each breath during normal breathing
tidal volume
whispered sounds heard loudly and clearly upon thoracic auscultation
whispered pectoriloquy
Upper airway structures consist of
the nose; paranasal sinuses; pharynx, tonsils, and adenoids; larynx; and trachea.
A prominent function of the sinuses is to serve as
a resonating chamber in speech.
Part of the larynx:
a valve flap of cartilage that covers the opening to the larynx during swallowing
Epiglottis
Part of the larynx:
the opening between the vocal cords in the larynx
Glottis
the middle of the thorax, between the pleural sacs that contain the two lungs
The mediastinum
the conducting airways contain about 150 mL of air in the tracheobronchial tree that does not participate in gas exchange
physiologic dead space
The whole process of gas exchange between the atmospheric air and the blood and between the blood and cells of the body is called
respiration
General appearance may give clues to
respiratory status
Peripheral circulation problems S/S
Clubbing of the fingers
Skin color (cyanosis)
Tool used in routine examination of the upper airway structures
Penlight
Common phenomena that may alter bronchial diameter, which affects airway resistance, include the following:
Contraction of bronchial smooth muscle—as in
asthma
Common phenomena that may alter bronchial diameter, which affects airway resistance, include the following:
Thickening of bronchial mucosa—as in
chronic bronchitis
Common phenomena that may alter bronchial diameter, which affects airway resistance, include the following:
Obstruction of the airway—by
mucus, a tumor, or a foreign body
Common phenomena that may alter bronchial diameter, which affects airway resistance, include the following:
Loss of lung elasticity—as in
emphysema
Condition characterized by connective tissue encircling the airways, thereby keeping them open during both inspiration and expiration
emphysema
the systolic blood pressure in the pulmonary artery is
20 to 30 mm Hg
the diastolic pressure is
5 to 15 mm Hg.
Adequate gas exchange depends on an
adequate ventilation–perfusion (V./Q.) ratio.
low level of cellular oxygen
hypoxia
The air we breathe is a gaseous mixture consisting mainly of
nitrogen (78%), oxygen (21%), argon (1%), and trace amounts of other gases
PACO2 =
Partial pressure of alveolar carbon dioxide
Normal levels—PaO2
> 70 mm Hg
Relatively safe levels of PaO2—
45–70 mm Hg
Dangerous levels—PaO2
<40 mm Hg
a normal value for PaO2
80 to 100 mm Hg
Normal SaO2 level
95% to 98%
A nurse assesses a client’s respiratory status. Which observation indicates that the client is having difficulty breathing?
Use of accessory muscles
A client has been newly diagnosed with emphysema. The nurse should explain to the client that by definition, ventilation:
is breathing air in and out of the lungs.
The nurse is in the radiology unit of the hospital. The nurse is caring for a client who is scheduled for a lung scan. The nurse knows that lung scans need the use of radioisotopes and a scanning machine. Before the perfusion scan, what must the client be assessed for?
Iodine allergy
The nurse is caring for a client who is to undergo a thoracentesis. In preparation for the procedure, the nurse places the client in which position?
Sitting on the edge of the bed
A client has recently been diagnosed with malignant lung cancer. The nurse is calculating the client’s smoking history in pack-years. The client reports smoking two packs of cigarettes a day for the past 11 years. The nurse correctly documents the client’s pack-years as
22
The nurse assessed a 28-year-old woman who was experiencing dyspnea severe enough to make her seek medical attention. The history revealed no prior cardiac problems and the presence of symptoms for 6 months’ duration. On assessment, the nurse noted the presence of both inspiratory and expiratory wheezing. Based on this data, which of the following diagnoses is likely?
Asthma
The nurse auscultates lung sounds that are harsh and cracking, sounding like two pieces of leather being rubbed together. The nurse would be correct in documenting this finding as
pleural friction rub.
The term for the volume of air inhaled and exhaled with each breath is
tidal volume.
The nurse is caring for a client diagnosed with asthma. While performing the shift assessment, the nurse auscultates breath sounds including sibilant wheezes, which are continuous musical sounds. What characteristics describe sibilant wheezes?
They can be heard during inspiration and expiration.
A physician has ordered that a client with suspected lung cancer undergo magnetic resonance imaging (MRI). The nurse explains the benefits of this study to the client. What is the reason the client with suspected lung cancer would undergo magnetic resonance imaging (MRI)?
MRI can view soft tissues and can help stage cancers.
The nursing instructor is teaching students about the respiratory system. The instructor knows the teaching has been effective when a student makes which statement?
“Ventilation is the movement of air in and out of the respiratory tract.”
Perfusion refers to blood supply to the lungs, through which the lungs receive nutrients and oxygen. What are the two methods of perfusion?
The two methods of perfusion are the bronchial and pulmonary circulation.
The nurse is assessing the lungs of a patient diagnosed with pulmonary edema. Which of the following would be expected upon auscultation?
Crackles at lung bases
A client has just undergone bronchoscopy. Which nursing assessment is most important at this time?
Level of consciousness
While auscultating the lungs of a client with asthma, the nurse hears a continuous, high-pitched whistling sound on expiration. The nurse will document this sound as which of the following?
Wheezes
The nurse is caring for a client diagnosed with pneumonia. The nurse assesses the client for tactile fremitus by completing which action?
Asking the client to repeat “ninety-nine” as the nurse’s hands move down the client’s thorax
A nurse is discussing squamous epithelial cells lining each alveolus, which consist of different types of cells. Which type of alveolar cells produce surfactant?
Type II cells
Which term will the nurse use to document the inability of a client to breathe easily unless positioned upright?
Orthopnea
The nurse is caring for a client who is in respiratory distress. The physician orders arterial blood gases (ABGs) to determine various factors related to blood oxygenation. What site can ABGs be obtained from?
A puncture at the radial artery
A patient diagnosed with diabetic ketoacidosis would be expected to have which type of respiratory pattern?
Kussmaul respirations
A nurse enters a client’s room and observes a container with sputum. Upon questioning about the specimen, which information from the client would necessitate the nurse to obtain a new specimen?
“I coughed that up about 8 hours ago.”
What finding by the nurse may indicate that the client has chronic hypoxia?
Clubbing of the fingers
A nurse is concerned that a client may develop postoperative atelectasis. Which nursing diagnosis would be most appropriate if this complication occurs?
Impaired gas exchange
When assessing a client, which adaptation indicates the presence of respiratory distress?
Orthopnea
Which hollow tube transports air from the laryngeal pharynx to the bronchi?
trachea
The nurse is caring for a patient with a pulmonary disorder. What observation by the nurse is indicative of a very late symptom of hypoxia?
Cyanosis
an estimation of thoracic expansion and may disclose significant information about thoracic movement during breathing.
Respiratory excursion
describes vibrations of the chest wall that result from speech detected on palpation
Tactile fremitus
describes the ability to clearly and distinctly hear whispered sounds that should not normally be heard.
Whispered pectoriloquy
The volume of each breath is referred to as
the tidal volume
is measured by having the patient take in a maximal breath and exhale fully through a spirometer.
Vital capacity
evaluates the effort the patient is making during inspiration.
Inspiratory force
These studies aid in assessing the ability of the lungs to provide adequate oxygen and remove carbon dioxide, which reflects ventilation, and the ability of the kidneys to reabsorb or excrete bicarbonate ions to maintain normal body pH, which reflects metabolic states.
Arterial blood gas (ABG)
These studies reflect the balance between the amount of oxygen used by tissues and organs and the amount of oxygen returning to the right side of the heart in the blood.
Venous blood gas (VBG)
Imaging studies
Chest Xray, CT, Pulmonary Angiography, MRI
Radioisotope procedures (lung scans)
V/Q, Gallium scan, PET
Endoscopic procedures
Bronchoscopy, Thoracoscopy
Biopsies
Pleural, Lung, lymph node
Test that PRECEDES ALL OTHER STUDIES
CHEST X-RAY
Densities produced by fluid, tumors, foreign bodies, and other pathologic conditions can be detected by
X-ray
used for monitoring during special procedures: catheter insertion, bronchoscopy, thoracentesis, and chest tube placement.
Fluoroscopy
gives definition of small or questionable lesions and is useful for determining whether a lesion has calcification within it.
CT Scan
Test that can distinguish tumors from other structures
MRI
Used to investigate Thromboembolic diseases of the lungs.
Pulmonary angiography
Radioisotope injection usually to detect pulmonary emboli
Ventilation-perfusion lung scan (V/Q Scan)
Test that examines pulmonary fluid
Ultrasonography:
