Test 1

Question 1

upper respiratory system

Answer 1

warms, filters, humidifies inspired air

Question 2

Upper respiratory system components

Answer 2

nose, pharynx, larynx

Question 3

Nose

Answer 3

lined with mucous membrane that warms and moistens the air

Question 4

Pharynx

Answer 4

passageways for moving air to the lungs and food to the esophagus

Question 5

Larynx

Answer 5

The glottis is the space between the folds of the vocal cords, attached to the front and back of the larynx.
Movements of the the mouth, lips, jaws, and tongue convert the sounds made by the rush of air through the glottis into speech sounds.

Question 6

Tonsils and adenoids

Answer 6

part of the lymphatic system

if they become inflamed and enlarged, they may interfere with breathing.

Question 7

Epiglottis

Answer 7

when swallowing begins, the epiglottis closes over the larynx, preventing aspiration of food and secretions into the lungs.

Question 8

Paranasal Sinuses

Answer 8

the paranasal sinuses (maxillary, frontal sphenoid and ethmoid) are air filled cavities lined the mucous membrane and situated among the facial bones around the nasal cavity.

Question 9

Lower respiratory system functions

Answer 9

conduction of air, micro-ciliary clearance, production of pulmonary surfactant (lowers surface tension, keeping alveoli from collapsing)

Question 10

Lower respiratory system components

Answer 10

Trachea
right and left mainstem bronchi
segmental bronchi
terminal brochioles

Question 11

Ventilation

Answer 11

the process of ventilation involves both acquiring oxygen (inspiration) and removing carbon dioxide (expiration) from the blood.

Question 12

ventilation

Answer 12

the transport of oxygen through the lungs is the ONLY mechanism for acquiring oxygen.

Question 13

ventilation cont…

Answer 13

oxygen is required for cellular metabolism, which means that for a cell to expand energy efficiently and perform its designated function, oxygen MUST be present. The release of carbon dioxide is equally as important because optimal cell functioning occurs within a narrow pH range.

Question 14

oxygen delivers to what?

Answer 14

the alveolar membrane for diffusion into the blood.

Question 15

what does that diaphragm do during inhalation?

Answer 15

moves down and intercostal muscles expand

Question 16

pleura consists of what?

Answer 16

two layers: visceral pleura (covers each lung) and parietal pleura (lines inner wall of chest cavity)

Question 17

mucous membrane contains what?

Answer 17

cilia that traps and propels small inhaled foreign particles toward the entrance of the respiratory tract.

Question 18

vesicular breath sounds

Answer 18

low to medium pitch with a soft whooshing quality; inspiration is two to three times the length of expiration.

Question 19

bronchovesicular breath sounds

Answer 19

moderate to high pitch with a hollow, muffled quality; equal time of inspiration and expiration.

Question 20

bronchovesicular breath sounds

Answer 20

moderate to high pitch with a hollow, muffled quality; equal time of inspiration and expiration.

Question 21

bronchial breath sounds

Answer 21

high pitch with a loud, harsh, tubular quality; inspiration half as long as expiration

Question 22

crackles

Answer 22

sounds when air moves through airway contains fluid

Question 23

wheezes

Answer 23

high pitch musical sound heard on expiration and sometimes on inspiration.

Question 24

rhonchi

Answer 24

low pitch sound that can be heard on inspiration or expiration caused by blockages the main airways by mucous or lesions etc, often compared to snoring

Question 25

pleural friction rub

Answer 25

caused by movement of inflamed pleural surfaces against each other (pneumonia, PE, etc) grating sounds

Question 26

stridor

Answer 26

death! high pitched caused by narrowed airway

Question 27

PFT's (pulmonary function test)

Answer 27

to determine integrity of mechanical function and gas exchange function of the lungs. nursing implication: done within 1-2 hr eating no smoking stop taking bronchodilator and corticosteroid

Question 28

bronchoscopy

Answer 28

inspect bronchi, to remove foreign objects or mucous plugs, to biopsy lesions.

Question 29

control of respiration

Answer 29

Respiratory center (pons and medulla, located in the brainstem

Question 30

what controls both involuntary and voluntary respiration?

Answer 30

central nervous system

Question 31

What factors affect the exchange of oxygen and carbon dioxide?

Answer 31

``` change in surface area available thickening of alveolar capillary membrane: edema, fluid partial pressure solubility chronic lung disease ```

Question 32

what are some normal lung sounds?

Answer 32

vesicular breath sounds bronchovesicular breath sounds bronchial breath sounds

Question 33

abnormal (adventitious) lung sounds

Answer 33

``` crackles wheezing rhonchi pleural friction rub stridor ```

Question 34

what causes a respiratory disorder?

Answer 34

``` trauma or disease: perfusion cardiac disease emboli bacteria fungi other disorders of the heart and pulmonary blood vessels ```

Question 35

what are the two major types of ventilatory disease?

Answer 35

restrictive (decreased lung volume) | obstructive (narrowed air passages)

Question 36

restrictive conditions

Answer 36

(scoliosis and kyphosis) | decrease lung capacity

Question 37

obstructive disorders

Answer 37

problems moving air in and out the lungs | asthma, emphysema, and chronic bronchitis and obstructive disorder

Question 38

causes of respiratory issures?

Answer 38

muscles of diaphragm and chest are paralyzed, apnea occurs | fractured ribs or injured

Question 39

factors that increase risk for respiratory infection

Answer 39

``` age older than 65 smoking chronic respiratory disorders residing in an extending care facility congenital or chronic cardiovascular disorder ```

Question 40

what are the guidelines for PPDS?

Answer 40

must be checked after 48-72 hours 15mm-general public without known factors 10mm-residents and employees of long term care facilities, IV drug abusers and recent immigrants (<5 years )

Question 41

D-dimer measures what?

Answer 41

to assess thrombin and plasmin activity as test provides assay of fibrin degradation diagnosis of pulmonary embolism and DIC light blue top

Question 42

CBC measures what?

Answer 42

adequacy of hemoglobin to carry oxygen and to determine if infection is present lavender top

Question 43

Thoracentesis

Answer 43

removes pleural fluid, instill medication or obtain fluid for diagnostic studies

Question 44

Thick, tenacious and "ropey"; difficult to cough up

Answer 44

chronic bronchitis. emphysema

Question 45

Scant, sticky, rusty colored

Answer 45

Pneumococcal pneumonia

Question 46

Frothy, pinkish or blood-tinged

Answer 46

Pulmonary edema

Question 47

Yellow, yellow-green or grayish yellow, with foul odor or taste

Answer 47

Pulmonary infection

Question 48

Respiratory Acidosis (throw acid on them...)

Answer 48

``` Hypoventilation-Hypoxia Cant breath low BP headache muscle weakness, hyperreflexia drowsiness, dizziness, disorientation ```

Question 49

Respiratory Alkalosis (doing the most)

Answer 49

``` Hyperventilation tachycardia low or normal bp hypokalemia numbness and tingling extremities seizures increased anxiety increased irritability muscle cramping ```

Question 50

what position should put your patient to promote proper breathing?

Answer 50

high folwer's

Question 51

Orthopnea means what?

Answer 51

when patient is having trouble breathing when supine

Question 52

orthopenic position?

Answer 52

sit upright, lean over the overbed table (which is padded with pillows) and elevate and round the shoulders to allow maximum expansion of the lungs

Question 53

what allergy prevents someone from getting the influenza vaccine?

Answer 53

eggs

Question 54

how long is an upper respiratory infection normally?

Answer 54

7 to 11 days but may take 14 days before all symptoms are gone

Question 55

upper respiratory infection and rhinitis treatment

Answer 55

``` antihistamines steroids mast cell stabilizers decongestants complementary and alternative therapies- echinacea; goldenseal; or combination of herbs, minerals, vitamins and amino acids ```

Question 56

Antihistamines-1st Generation

Answer 56

Diphenhydramine (Benadryl) | Relives sneezing, excessive secretions, itching, and nasal congestion

Question 57

Antihistamines- 2nd Generation

Answer 57

Loratadine (Claritin), Fexofenadine (Allegra), Cetirzine (Zyrtec), Desloratadine (Clarine), Levocetirizine (Xyzal) Relives sneezing, excessive secretions less likely to cross the blood brain, producing less drowsiness than 1st generation

Question 58

Intranasal Antihistamines

Answer 58

Azelastine (Astelin), Olopatadine intranasal (Patanase) Topical H1 receptor antagonists may release nasal congestion inhibits the release of histamine instruct not to use if patient has glaucoma or prostatic hypertrophy

Question 59

Corticosteroid Spray

Answer 59

Budesonide (rhinocort), fluticasone (flonase), Triamcinolone (nasacort), monetaone (nasonex) Inhibits inflammatory response Have low systemic absorption with normal doses *can result in nosebleed use daily

Question 60

Mast cell stabilzer

Answer 60

Cromolyn sodium spray (Nasalcrom) | stabilizers mast cells, preventing inflammatory reaction

Question 61

Decongestants

Answer 61

Oral: pseudoephedrine (sudafed) spray: phenylephrine (neo-synephrine), saline nasal spray or rinse promotes vasoconstriction by stimulating adrengic receptors on blood vessels

Question 62

Aspirin

Answer 62

should not be given to children younger than 18 years of age, association with reye's syndrome

Question 63

Sinusitis

Answer 63

inflammation of the mucosal lining of the sinuses

Question 64

`Acute sinusitis diagnostic criteria

Answer 64

physical examination ESR CRP WBC

Question 65

Sinusitis treatment

Answer 65

pain control promote sinus drainage control infection

Question 66

what are epistaxis?

Answer 66

Nosebleed

Question 67

Epistaxis treatment

Answer 67

sit forward and apply direct pressure by pinching the nose for 10-15 minutes cold compress may require cauterization, packing or small balloon to stop bleeding *avoid bending over and not blowing nose

Question 68

Endotracheal incubation

Answer 68

tube inserted into the trachea via the nose or mouth with the use of a laryngoscope

Question 69

Tracheostomy

Answer 69

surgical incision into the trachea for the propose of inserting a tube through which the patient can breathe.

Question 70

influenza

Answer 70

acute, highly infectious disease of the upper and lower respiratory tract. three types A,B,-seasonal each year. C- mild respiratory illness