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Pathophysiology for Nursing > Unit 2 Module 3: Respiratory > Flashcards

Unit 2 Module 3: Respiratory Flashcards

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1
Q

emphysema or chronic bronchitis:

Respiratory rate on the low side (12-14/min)

A

chronic bronchitis

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2
Q

Right lower lobe pneumonia is a type of [lobar/broncho] pneumonia

A

lobar

lobar: consolidation in a part of all of the lung of a lobe.
bronchopneumonia: patchy consolidation involving more than one lobe of the lung

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3
Q

emphysema or chronic bronchitis:

Patient has productive cough with a lot of thick tenacious sputum

A

chronic bronchitis

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4
Q

emphysema or chronic bronchitis: most VQ mismatch and therefore would have greater cyanosis?

A

Patient with primarily chronic bronchitis

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5
Q

emphysema or chronic bronchitis: can be caused by a genetic deficiency in alpha-1 antitrypsin

A

emphysema

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6
Q

infectious TB or not: positive ppd and positive sputum culture and has had a 10 lb weight loss, chronic cough and low grade fevers in the afternoon.

A

infectious

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7
Q

Four respiratory symptoms of pneumonia

A

cough, sputum production, dyspnea, tachypnea

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8
Q

What distinguishes asthma from COPD?

A

Asthma is a reversible lung disorder that is often triggered by an allergen.

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9
Q

Adequate perfusion but not ventilation

A

shunt

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10
Q

Define dyspneic

A

short of breath

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11
Q

Which is worse for a patient with asthma:

patient with wheezing, chest tightness, use of accessory muscles (intercostal retractions seen)

patient with a silent chest (no wheezing) and a pCO2 of 70 mmHg

A

silent chest and acidotic

When they are hyperventilating, they are more prone to respiratory alkalosis, but when they tire out and their respirations slow down, they retain pCO2 can become acidotic. At that point, they are not moving air at all and their chest becomes silent (no breath sounds).

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12
Q

emphysema or chronic bronchitis: thin, low weight individual

A

emphysema

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13
Q

Four agents that can cause pneumonia

A

microbe
smoke
aspiration
respiratory suctioning

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14
Q

Reduced oxygen in arterial blood

A

hypoxemia

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15
Q

emphysema or chronic bronchitis: assumes the tripod position to help breathing

A

emphysema

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16
Q

t/f: TB is only found in the lungs

A

TB is primarily a pulmonary infection, but can be found in lots of different areas in the body, such as the brain, prostate, intestine, etc.

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17
Q

What is in thick, white sputum

A

Inflammatory cells that have phagocytized the invader

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18
Q

emphysema or chronic bronchitis: Greater Ventilation/perfusion mismatch (VQ) resulting in more hypoxemia

A

chronic bronchitis

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19
Q

How do we know that cellular immunity has started working in someone with TB?

A

Positive PPD test

Cellular immunity helps to contain the bacilli in the lungs but it takes 2-10 weeks for this to occur. The production of antibodies against TB is what is seen with the positive PPD.

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20
Q

Decreased oxygen of cells in the tissues (could be related to problems with oxygenation, anemia, or necrosis)

A

hypoxia

21
Q

When a granuloma forms, what happens to the TB bacilli?

A

The bacilli become dormant

22
Q

Which symptoms are seen with patients with COPD with primarily emphysema symptoms?

A

prolonged expiration, barrel chested, pursed lip breathing

23
Q

emphysema or chronic bronchitis: Works hard to breathe with higher respiratory rate (24/min) and pursed lip breathing

A

emphysema

24
Q

infectious TB or not: AIDS patient with a negative ppd, positive AFB smear and asymptomatic

A

not – suspected MAC, not TB

25
Q

A patient received the BCG vaccination as a child. Which screening test is recommended for this patient to determine TB infection?

A

Quantiferon Gold

26
Q

A person has been exposed to someone with TB and gets infected. What is most likely going to happen?

A

latent TB infection

Only 5% develop active disease

27
Q

Which WBC respond to TB infection?

A

Phagocytes and macrophages engulf the bacilli and eventually wall it off by forming a granuloma. As the inside macrophages in granuloma die off, it develops a caseous (cheese like consistency) necrosis and it eventually forms a ghon complex, which can be seen on X-ray.

28
Q

A patient has a RLL infiltrate. What does that mean?

A

Right lower lobe pneumonia

29
Q

Gas exchange occurs in the alveoli. What are some diseases that affect gas exchange?

A

pulmonary embolism, pneumonia, viral bronchitis, pulmonary edema

30
Q

The ease that hemoglobin gives up oxygen and accepts carbon dioxide. (Ex: state of acidosis, hgb has decreased affinity for picking up oxygen).

A

oxyhemoglobin dissociation

31
Q

Four systemic symptoms of pneumonia

A

fever, chills, fatigue, loss of appetite

32
Q

The body works to contain a TB infection by forming a:

A

granuloma

33
Q

Adequate ventilation but poor perfusion

A

dead air space

34
Q

Order from best to worst:

  • active TB
  • multi-drug resistant TB
  • latent TB
  • extensively drug resistant TB
A

From least troubling to most concerning= latent TB, active TB, MDR-TB and then XDR-TB

Latent TB infection—positive ppd; no symptoms; may or may not have ghon complex. Active TB infection= responsive to normal therapy.

MDR-TB: multidrug resistant TB–Resistant to INH + Rifampin

XDR-TB: extensively drug resistant TB–Resistant to INH + Rifampin + fluroquinolones and at least one IV second line therapy

35
Q

emphysema or chronic bronchitis: loss of elastin

A

emphysema

36
Q

emphysema or chronic bronchitis: hypertrophy of mucus glands, goblet cells, and airway epithelium occurs

A

chronic bronchitis

37
Q

Where is nosocomial pneumonia acquired?

A

Hospital

Nosocomial refers to hospital acquired pneumonia and infections occur after 48 hours in the hospital and are usually bacterial and antibiotic resistant. VAP=ventilator associated pneumonia is an example.

38
Q

infectious TB? positive ppd with a CXR showing suspicious signs and patient asymptomatic

A

not – latent without symptoms

39
Q

emphysema or chronic bronchitis: Barrel chested

A

emphysema

40
Q

t/f: One week post TB exposure, ppd is > 15mm in induration

A

false

5mm is positive. Earliest positive result is 2 weeks.

41
Q

emphysema or chronic bronchitis: cyanosis common

A

chronic bronchitis

42
Q

What isolation should be placed on a patient with active TB?

A

airborne

TB is transmitted as a droplet, but patients are placed on airborne isolation, which is a more strict type of isolation because it can “hang out” in the air for a period of time and doesn’t just drop to the ground.

43
Q

How is pulmonary embolism related to perfusion and ventilation?

A

ventilation without perfusion

44
Q

What are the two hallmarks of an asthma attack?

A

inflammation and bronchoconstriction

45
Q

t/f: Uncontrolled asthma with frequent attacks can lead to long term bronchial remodeling and chronic obstructive pulmonary disease (COPD).

A

true, in a small population

46
Q

Increased levels of carbon dioxide in the blood

A

hypercapnia

47
Q

Pneumonia is most often caused by the microbe

A

S. pneumoniae

S.pneumoniae is the most common infectious agent. Pneumonia can be cause by bacteria, viruses and fungi.

48
Q

Why do patients with pneumonia have compromised gas exchange?

A

Inflammatory process leads to the accumulation of WBCs, causes capillary leak, edema and exudate in the alveoli.

Pathophysiology for Nursing (16 decks)

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