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19 Cards in this Set
- Front
- Back
What does surfactant do for alveoli?
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Surfactant is the substance that lowers the surface tension inside alveoli and prevents their walls from being drawn together. Adequate surfactant levels are key to preventing alveolar collapse and allowing alveolar expansion during breathing.
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What is the difference between ventilation and respiration?
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Ventilation and respiration have the following differences:
Ventilation is the movement of air into and out of the lungs through the act of breathing. Respiration is gas (carbon dioxide and oxygen) exchange. |
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Does poor peripheral perfusion increase risk for hypoxemia?
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No, poor peripheral perfusion increases the risk for tissue hypoxia.
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Which gas (oxygen or carbon dioxide) is more diffusible through capillary membranes?
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Carbon dioxide
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The level of which gas (oxygen or carbon dioxide) is the primary stimulant for breathing?
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Carbon dioxide
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What is the importance of diastole to perfusion of the heart?
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During diastole, the coronary arteries are the only arteries in the body that fill.
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When is a cough significant? What aspects of a cough should be assessed?
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cough generally becomes significant when it persists, is recurring, or is productive. A persistent or recurring cough is indicative of ongoing or recurring airway irritation. A cough that lasts more than 3 weeks and cannot be explained should be medically evaluated. The following aspects of a cough should be evaluated:
Type of cough (e.g., dry, productive, hacking, etc) Duration of cough Timing of cough Appearance of sputum (if any) Exacerbating factors Alleviating factors Types of treatments used to date and their effects Associated symptoms |
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Identify at least five signs that you may observe in a patient experiencing dyspnea.
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Answers may include any five of the following signs of dyspnea:
Nasal flaring Head bobbing Retractions Grunting Orthopnea Inability to speak complete sentences without stopping to breathe Stridor Wheezing |
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Identify normal PO2, SaO2, and PCO2 levels.
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Normal levels are as follows:
PO2, 80 to100 mm Hg SaO2, 95 to 100% PCO2, 35 to 45 mm Hg |
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What does a pulse oximetry reading tell you?
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Pulse oximetry is a noninvasive estimate of arterial blood oxygen saturation (SaO2 ). SaO2 reflects the percentage of hemoglobin molecules carrying oxygen. The normal value is 95 to 100%.
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Identify at least three nursing interventions to promote optimal respiratory function in a hospitalized patient with chronic lung disease.
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Answers may include any three of the following nursing interventions that promote optimal respiratory function:
Annual influenza vaccination Annual pneumonia vaccination Frequent position changes to keep all areas of lungs well ventilated Incentive spirometry 10 to 20 times per hour Positioning upright for meals |
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What to assess for breathing
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12-20/min, regular, quiet, inspiration ½ as long as expiration
AP diameter < transverse diameter subcostal angle @ 90 degrees (widens upon inspiration) no use of accessory muscles men use abdomen (diaphragm)/women use costal cage Respiratory rate, depth, rhythm, pattern Fremitus prominent over large bronchi, varies with voice pitch/intensity and chest wall thickness/structure |
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Respiratory distress Inspection Warnings
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Anxious expression
Nasal flaring Cyanosis around mouth (circumoral) Sternocleidomastoid muscle contraction Suprasternal notch/ intercostal, and substernal retraction Abnormal chest expansion (hyperexpansion) |
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Adventitious Breath Sounds
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Rales
Sibilant wheezes (wheezes) Sonorous wheezes (rhonchi) Course crackles Stridor Friction rubs Mediastinal crunch |
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Bronchitis Characteristic findings
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Dyspnea, productive cough (white, gray or yellow), use of accessory breathing muscles, cyanosis, finger clubbing, barrel chest, pedal edema, neck vein distention, wheezing, decreased breath sounds, increased expiratory time, tachypnea, elevated temperature
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Asthma Characteristic findings
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Pursed lip breathing, prolonged expiration, use of accessory muscles, trouble speaking more than a few words, increased AP diameter, cyanosis, confusion, lethargy, vocal fremitus, hyperresonance, decreased diaphragmatic excursion, hyperlinflated lungs, inspiratory/expiratory wheezing, diminished breath sounds, tachycardia, tachypenea, mild systolic hypertension
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Emphysema Characteristic findings
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Barrel chest, forward leaning position, pursed lip breathing, dyspnea, cough, expiratory wheeze, finger clubbing, use of accessory muscles, emaciation, restlessness and anxiety, decreased tactile fremitus, hyperresonance, decreased diaphragmatic excursion, wheezing, decreased breath and heart sounds, decreased voic sounds, prolonged expiration, increased temperature/heart rate/respiratory rate, decreased blood pressure,
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Airway obstruction Clinical findings
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Distressed look, panic, inability to speak, adventitious breath sounds over large airways (stridor, rhonchi, wheezing), decreased or absent breath sounds, use of accessory muscles, nasal flaring, cyanosis, hypoxemia, cardiac dysrhythmias
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Tension pneumothorax Clinical findings
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Sudden SOB with tachypnea, tachycardia, anxiety, asymetrical chest wall movement with mediastinal shift to affected side, diminished breath sounds on affected side, hyperresonance on the affected side, distended neck veins
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