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level: Level 1

Questions and Answers List

level questions: Level 1

QuestionAnswer
(breathing) the exchange of oxygen and carbon dioxide between the lungs and the environmentexternal respiration
the exchange of oxygen and carbon dioxide on a cellular levelinternal respiration
inserting a needlelike instrument into the pleural space and removing the fluidthoracentesis
difficulty breathingdyspnea
an abnormal condition in which a person must sit or stand to breathe deeply or comfortablyorthopnea
abnormal sounds superimposed on breath sounds, including sibilant wheezes, sonorous wheezes, crackles and pleural friction rubsadventitious sounds
musical, high pitched, squeaking to whistling sounds caused by the rapid movement of air through narrowed bronchiolessibilant wheezes
low-pitched, loud, coarse, snoring sounds, often heard on respirationsonorous wheezes
short, discrete, interrupted crackling or bubbling sounds that are heard most commonly through respirationcrackles
low-pitched, grating, or creaking lung sounds that occur when inflamed pleural surfaces rub together during respirationpleural friction rubs
oxygen deficiency in the cellular tissueshypoxia
this is performed by passing a bronchoscope into the trachea and bronchibronchoscopy
bleeding from the noseepistaxis
acute rhinitis is also called acute ______coryza
capable of producing diseasevirulent
pus accumulating in the pleural spaceempyema
the collapse of the alveoli, preventing the respiratory exchange of carbon dioxide and oxygenatelectasis
the condition in which the amount of air that enters the alveoli and takes part in gas exchange is not adequate for the body’s metabolic needshypoventilation
an abnormally rapid rate of breathingtachypnea
a collapsed lung due to a collection of air or other gas in the pleural space, causing the lung to collapsepneumothorax
caused by the passage of a foreign substance (blood clot, fat, air, tumor tissue, or amniotic fluid) into the pulmonary artery or its branches, with resulting obstruction of the blood supply to lung tissue and subsequent collapsepulmonary embolism (PE)
COPD can lead to this, an abnormal cardiac condition characterized by hypertrophic of the right ventricle of the heart as a result of hypertension of the pulmonary circulationcor pulmonale
greater than normal amounts of carbon dioxide in the lungshypercapnia
this type of asthma is caused by external factors, such as environmental allergens (pollen, dust, feathers, animal dander, foods)extrinsic
this type of asthma is from internal causes, not fully understood but often triggered by respiratory tract infectionintrinsic
this is responsible for the basic rhythm and depth of respirationsthe medulla oblongata and pons
adventitious breath sounds: brief, not continuous, interrupted bubbling sounds, common on inspiration, similar to hairs rolled between fingers near the earcrackling
adventitious breath sounds: high-pitched, sibilant crackling at the end of respirationfine crackles
adventitious breath sounds: medium pitched, sonorous, moisture sound, during mid inspirationmedium crackles
adventitious breath sounds: loud, bubbly sound, early in inspirationcoarse crackles
adventitious breath sounds: deep, running sound (may be continuous) loud, low, coarse sound, (like a snore) heard at any point of inspiration or expirationsonorous wheezes
adventitious breath sounds: high pitched, musical, whistle-like sound heard during inspiration or expiration, may be several notes or one, and may varysibilant wheezes
adventitious breath sounds: dry, crackling, grating, low-pitched sound with machine like quality during inspiration or expirations, loudest over anterior chestpleural friction rub
nursing interventions for bronchoscopyNPO until gag reflex returns (usually 2hrs), semi-fowler’s
what is thoracentesisaspirating fluid from the pleural space for examining the fluid for gravity wbc rbc and pathogens
nursing interventions for thoracentesisobtain written consent, relieve of anxiety, unaffected side head of bed elevated 30 degrees, monitor VS general appearance, fluid removal limited to 1300ml
Guidelines for Interpreting Arterial Blood Gas Values: each valuepH, PaCO2, PaO2, HCO3, SaO2
Guidelines for Interpreting Arterial Blood Gas Values: pH normal value7.35-7.45
Guidelines for Interpreting Arterial Blood Gas Values: PaCO2 normal value35-45 mm Hg
Guidelines for Interpreting Arterial Blood Gas Values: PaO2 normal value80-100 mm Hg
Guidelines for Interpreting Arterial Blood Gas Values: HCO3 normal value21-28 mEq/L
Guidelines for Interpreting Arterial Blood Gas Values: SaO2 normal value95%
pH = acidity pH = alkalinitypH < 7.35 = acidity pH > 7.45 = alkalinity
how can inaccurate pulse ox resulton cold area, nail polish, artificial nails, or irregular heartbeat
epistaxis (bleeding from the nose) assessment includes whatduration/severity of bleeding, both nostrils or one, anterior or posterior portion of nasal passageway, assess for hypotension, any signs of shock
hay fever clinical manifestations (allergenic condition)ocular: edema, photophobia, tearing, blurred vision, pruritus rhinitis: secretions or inability to breathe thru nose otitis: ear fullness, ear popping, decreased hearing
sleep apnea risk factorsmales, older age, obesity, nasal conditions, receding chin, pharyngeal obstruction abnormalities
laryngitis may cause respiratory distress inchildren younger than 5 years because small larynx subject to spasm
legionnaires disease pathophysiology (influenza other form)organism thrives in water reservoirs (such as AC) transmitted thru airborne routes
legionnaires disease diagnostic testsurine, blood, sputum, pulmonary tissue or fluid cultures
SARS (severe acute respiratory syndrome) pathophysiologyinfection caused by coronavirus, spread by close contact between people, most likely droplets in the air/contaminated objects
3 types on anthrax: 1. most common type, after bacteria enters skin, rarely fatal if treated with antibiotics 2. least common type, occurs after ingestion of contaminated organism, unless treated early can die from sepsis 3. seen in global germ warfare, most deadly type, infects the lungs then other organs1. cutaneous anthrax 2. gastrointestinal anthrax 3. inhalational anthrax
anthrax medical managementit is important to differentiate with TB, myobacteria
pneumonia pathophysiologyinflammatory process of bronchioles and alveolar spaces, most common during winter/early spring, most common in infants and older adults
pneumonia nursing interventionsfluid intake of at least 3L/d, “good lung down” high fowler’s
atelectasis (collapse of alveoli) pathophysiologycommon postoperative complication resulting from shallow breathing
pneumothorax (collapsed lung due to collection of air or other gas in pleural space) pathophysiologycan be caused from ruptured bleb on lung surface or coughing episode, penetrating chest injury that punctures the pleural lining, fractured ribs or injury to the pleura from catheter, or NO CAUSE AT ALL
pneumothorax clinical manifestationsdecreased breath sounds on affected side and sudden, sharp pleuretic chest pain with dyspnea
cancer of the lung clinical manifestationslung cancer insidious because it is asymptomatic in the early stages
edema pathophysiologyunderlying cardiac disease, failure of left ventricle causes pooling of fluid, patients begin to drown in their own secretions, may lead to death unless treated rapidly
pulmonary embolism clinical manifestationsnot all patients have all the classic symptoms: sudden, sharp, constant, nonradiating, pleuretic chest pain
PE nursing inteventionsTED stocking, patient teaching on TED stocking, anticoagulant therapy
PE diagnostic testsPFT’s & ABG’s
emphysema pathophysiologyusually in 40’s increasing by 50-60, enlargement of alveoli accompanied by destruction of their wall (overlap between bronchitis)
emphysema pathophysiology cigarette smokingworsened by cigarette smoking, 30-35 years, 90% of COPD cases are caused by cigarette smoking
emphysema clinical manifestationsbarrel-chested appearance
emphysema nursing interventionsadminister low flow oxygen
asthma pathophysiologyGERD can trigger attack, recurrent reversible obstruction of airflow, increased capillary permeability, acute inflammatory response by mast calls in the lungs
asthma medical managementleukotriene modifiers
nursing diagnosisanxiousness, inability to clear airway, inability to tolerate activity, insufficient oxygenation, insufficient nutrition