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125 Cards in this Set
- Front
- Back
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_____________ is the movement of air into and out of the lungs.
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Pulmonary ventilation (breathing)
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_______________ is the process by which oxygenated capillary blood passes through body tissues.
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Perfusion
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___________, the active phase, involves movement of muscles and the thorax to bring air into the lungs.
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Inspiration
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____________, the passive phase, is the movement of air out of the lungs.
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Expiration
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According to ____________the volume of a gas at a constant temperature varies inversely with the pressure. This means that less pressure in the lungs facilitates the movement of more air into the lungs. The pressure within the lungs (intrapulmonic pressure) decreases as the volume of the lungs increases.
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Boyle's law
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What happens during inspiration?
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the diaphragm contracts and descends, lengthening the thoracic cavity; the external intercostal muscles contract, lifting the ribs upward and outward; and the sternum is pushed forward, enlarging the chest from front to back.
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What happens during expiration?
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The diaphragm relaxes and moves up, the ribs move down, and the sternum drops back into position. This causes a decreased volume in the lungs and an increase in intrapulmonic pressure. As a result, air in the lungs moves from an area of greater pressure to one of lesser pressure and is expired
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The _____________ performs its functions through pulmonary ventilation, respiration, and perfusion.
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Respiratory system
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A normal functioning respiratory system depends on these three factors:
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1. The integrity of the airway system to transport air to and from the lungs
2. A properly functioning alveolar system in the lungs to oxygenate venous blood and to remove carbon dioxide from the blood 3. A properly functioning cardiovascular and hematologic system to carry nutrients and wastes to and from body cells |
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The ______________ is composed of the nose, pharynx, larynx, and epiglottis
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upper airway
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What is the main function of the upper air way?
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Its main function is to warm, filter, and humidify inspired air
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The ________, known as the tracheobronchial tree, includes the trachea, right and left mainstem bronchi, segmental bronchi, and terminal bronchioles
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lower airway
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What is the function of the lower air way?
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Its major functions are conduction of air, mucociliary clearance, and production of pulmonary surfactant
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The right lung has____ bronchopulmonary segments
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10
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The left lung has ____ bronchopulmonary segments
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8
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__________, a detergent-like phospholipid, reduces the surface tension between the moist membranes of the alveoli, preventing their collapse.
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Surfactant
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The average adult has more than ___________ alveoli.
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300 million
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The lungs and thoracic cavity are lined with a serous membrane called the ________.
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pleura
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The _________ pleura covers the lungs, and the parietal pleura lines the thoracic cavity
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visceral
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____________ refers to the movement of air into and out of the lungs.
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Pulmonary ventilation
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___________ involves gas exchange between the atmospheric air in the alveoli and blood in the capillaries.
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Respiration
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________ is the process by which oxygenated capillary blood passes through body tissues.
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Perfusion
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a loud, hollow, low-pitched sound, heard over normal lungs
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Resonance
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a loud, low, booming sound typically heard over emphysematous lungs
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Hyperresonance
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a sound detected over bone or heavy muscle
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Flatness
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a sound with medium pitch and intensity usually heard over the liver (fifth intercostal space at the right midclavicular line)
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Dullness
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a high-pitched, loud, drum-like sound produced over the stomach
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Tympany
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True or false?
Dullness over the lung field occurs when fluid or solid tissue replaces normal lung tissue in the pleural space. This finding requires further investigation. |
True
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Normal breath sounds include ________ (low-pitched, soft sounds heard over peripheral lung fields), ______(loud, high-pitched sounds heard primarily over the trachea and larynx); and ____________(medium-pitched blowing sounds heard over the major bronchi)
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vesicular; bronchial; bronchovesicular
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__________breath sounds, or abnormal lung sounds, are categorized as either discontinuous or continuous sounds
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Adventitious
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________, frequently heard on inspiration, are soft, high-pitched discontinuous (intermittent) popping sounds. They are produced by fluid in the airways or alveoli and delayed reopening of collapsed alveoli. They occur due to inflammation or congestion and are associated with pneumonia, congestive heart failure, bronchitis, and COPD.
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Crackles
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_____ __________are brief sounds, similar to the sound of hair rubbing together between the fingers.
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Fine crackles
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________ _________ are somewhat louder, moist, bubbling sounds
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Coarse crackles
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True or false?
Occasional fine crackles at the end of deep inspiration heard on auscultation of the infant's thorax are normal. |
True
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_________are continuous, musical sounds, produced as air passes through airways constricted by swelling, narrowing, secretions, or tumors.
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Wheezes
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____________wheezes originate in smaller airways and are high pitched and whistling,
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Sibilant
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______________ wheezes can be heard over larger airways and sound like a snore. They are often heard in patients with asthma, tumors, or a buildup of secretions.
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sonorous
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A _____________ is a continuous, dry grating sound. It is caused by inflammation of pleural surfaces and loss of lubricating pleural fluid. It resembles the sound made by rubbing two leather surfaces together.
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pleural friction rub
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Inert gas dilution, nitrogen washout, and body plethysmography measure__________
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lung volumes
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__________estimates the patient's ability to absorb alveolar gases and determine if a gas exchange problem exists.
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Diffusion capacity
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_____________ __________ _________help evaluate neuromuscular causes of respiratory dysfunction
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Maximal respiratory pressures
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____________ testing helps evaluate dyspnea during exertion.
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Exercise
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The amount of air displaced by maximal exhalation
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Vital Capacity (VC)
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The amount of air expelled from a point of maximal inspiration to a point of maximal inspiration
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Forced Expiratory Vital Capacity (FEVC)
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The amount of air inhaled from a point of maximal exhalation to a point of maximal expiration
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Forced Inspiratory Vial Capacity (FIVC)
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The forced expiratory volume that can be expressed in 1, 2, or 3 seconds in the first second of the FEVC maneuver
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Forced Expiratory Volume (FEV)
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The amount of air contained within the lungs at maximum inspiration
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Total Lung capacity (TLC)
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The amount of air left in the lungs at maximal expiration
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Residual Volume (RV)
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The maximum flow attained during the forced expiratory maneuver
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Peak Expiratory Flow Rate (PEFR)
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an instrument that measures lung volumes and airflow.
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Spirometer
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__________ measures the volume of air in liters exhaled or inhaled by a patient over time. It evaluates lung function and airway obstruction through respiratory mechanics.
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Spirometry
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True or false?
Peak expiratory flow rate (PEFR) refers to the point of highest flow during forced expiration. PEFR reflects changes in the size of pulmonary airways and is measured using a peak flow meter. It is routinely used for patients with moderate or severe asthma to measure the severity of the disease and degree of disease control. |
True
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___________is a noninvasive technique that measures the arterial oxyhemoglobin saturation (SaO2 or SpO2) of arterial blood
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Pulse oximetry
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True or false?
The nurse should know the patient's hemoglobin level before evaluating oxygen saturation because the test measures only the percentage of oxygen carried by the available hemoglobin. Thus, even a patient with a low hemoglobin could appear to have a normal SpO2 because most of that hemoglobin is saturated |
True
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Which of the following is the primary purpose of surfactant?
a. To propel sheets of mucus toward the upper airway b. To warm inspired air c. To produce watery mucus d. To reduce surface tension of the fluid lining the alveoli |
d.
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The small air sacs at the end of the terminal bronchioles that are the sites of gas exchange?
a. Alveoli b. Pleurae c. Labules d. Bronchioles |
a
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A patient who has difficulty breathing increased respiratory and pulse rates and pale skin with regions of cyanosis may be suffering form which of the following?
a. Hyperventilation b. Hypoxia c. Perfusion d. Atelectasis |
b.
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When inspecting a patients chest to assess respiratory status, the nurse should be aware of which of the following normal findings?
a. The contour of the intercostal spaces should be rounded. b. The skin at the thorax should be cool and moist. c. The anteroposterior diameter should be greater than the transverse diameter. d. The chest should be slightly convex with no sternal depression. |
d
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When percussing a normal lung which of the following sounds should be heard?
a. Tympany b. Resonance c. Dullness d. Hyperresonance |
b
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Which of the following normal breath sounds should be heard over the trachea?
a. Vesicular b. Bronchovesicular c. Bronchial d. Tympanic |
c
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A patient who develops air in the pleural space is experiencing which of the following conditions?
a. Pleural effusion b. Hemothorax c. Pneumothorax d. Pleurathorax |
c
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Which of the following cough suppressants is generally preferred despite its addictive quality?
a. Cough syrup with codeine b. Benylin c. Balminil DM d. Benadryl |
a
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A patient who complains of difficulty breathing should be placed in which of the following positions?
a. Prone position b. Lateral Position c. Supine position d. Fowlers position |
d
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To drain the apical sections of the upper lobes of the lungs the nurse should place the patient in which of the following positions?
a. Left side with a pillow under the chest wall b. Side laying position, half on the abdomen and half on the side. c. High Fowlers position d. Trendeleburg position |
c
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Which of the following inhalers is used to liquefy or loosen thick secretions?
a. Bronchodilators b. Mucolytic agents c. Corticosteroids d. Metered dose inhalers |
b
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The brain is sensitive to hypoxia and will sustain irreversible brain damage after how many minutes?
a. 2 to 4 minutes b. 4 to 6 minutes c. 6 to 8 minutes d. 8 to 10 minutes |
b
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Mr. Park's has chronic obstructive pulmonary disease. His nurse has taught him pursed lip breathing, which helps him in which of the following ways?
a. Increased carbon dioxide which stimulates breathing b. Teaches him to prolong inspiration and shorten expiration. c. Helps liquefy his secretions d. Decreases the amount of air trapping and resistance. |
d
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A nurse suctioning a patient through a tracheostomy tube should be careful not to occlude the Y - port when inserting the suction catheter because it would cause which of the following to occur?
a. Trauma to the tracheal mucosa b. Prevention of suctioning c. Loss of sterile field d. Suctioning of carbon dioxide |
a
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When caring for a patient with a tracheotomy, the nurse should be aware of which of the following?
a. The wound around the tube and the inner cannula if one is present should be cleaned at least every 24hrs. b. The patient has not impairment of speaking function. c. A newly inserted tracheostomy tube requires no immediate attention. d. Suctioning of the tracheostomy tube must be done using sterile technique. |
d
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When percussing the lungs of a patient with emphysema the nurse would probably hear which of the following sounds?
a. Resonance b. Hyperresonance c. Tympany d. Dullness |
b
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Which of the following is a function of the upper airway?
a. Conduction of air b. Mucociliary clearance c. Production of pulmonary surfactant d. Purification of inspired air |
d.
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Which of the following are components of the upper air way? (select all that apply)
a. Nose b. Larynx c. Trachea d. Bronchi e. Epiglottis f. Bronchioles |
a, b, e
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Which of the following statements regarding the physiology of the lungs are accurate? ( select all that apply)
a. The right long has two lobes. b. Each lobe in the lung is further dived into lobules c. The right lung consists of 10 bronchopulmonary segments d. The lung is conposed of alveoli e. The lung is composed of alveoli f. Surfactant in the lungs increases the surface tension of the fluid lining the alveoli. |
b, c, e
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Which of the following statements accurately describe how respirations are controlled in the body? (select all that apply)
a. The medulla in the brain stem is the respiratory cent. b. The medulla is stimulated by a decrease in the concentration of carbon dioxide and hydrogen ions and by the decreased amount of oxygen in the arterial blood. c. Chemoreceptors in the aortic arch and carotid bodies can shut down the medulla. d. Stimulation of the medulla increasees the rate and depth of ventilation to blow off carbon dioxide and hydrogen and incrase oxygen levels. e. The medulla sends and impulse down the spinal cord to the respiratory muscles to stimulate a contraction leading to inhalation. f. The lungs contract in-response to pressure changes in the intrapleural space and lungs |
a, b, e
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Which of the following statements describe the developmental variations that occur in the respiratory process? ( select all that apply)
a. The normal infants chest is small although the airways are comparatively long and aspiration is a potential problem. b. The respiratory rate is slower in infants than at any other age c. Respiratory rate stabilizes in young adulthood. d. Surfactant is formed in utero at about 34 to 36 weeks. e. Respiratory activity is primarily abdominal in infants. f. Infants have a rounded chest wall in which the anteroposterior diameter is greater than the transverse diameter. |
c, d, e
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Which of the following normal conditions would a nurse expect to find when preforming a physical assessment of a patients respiratory system? (select all that apply)
a. The chest contour is slightly convex with no sternal depression. b. The anteroposterior diameter of the chest should be less than the transverse diameter. c. The contour of the intercostal spaces should be rounded and the movement of the chest should be symmetric. d. When palpating the trecha, the nurse should note a slightly higher skin temperature. e. When assessing tactile fremitus by placing a palm to the patients chest wall the vibrations from the patients repeated word should be equal bilaterally in different areas on the chest wall. f. Hyperresonance, a loud, hollow, low pitched sound should be heard over normal lungs when they are percussed. |
a, b, e
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Which of the following are normal lungs volumes and capacities? ( select all that apply)
a. Tidal volume of 200 ml b. Inspiratory reserve volume of 2500 mL c. Functional residual volume of 2400mL d. Total lung capacity of 6000mL e. Expiratory reserve volume of 1200mL f. Residual volume of 2400mL |
c, d, e
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Which of the following statements accurately describe the use of common diagnostic methods to assess respiratory functioning? (select all that apply)
a. Spirometry studies measure lung capacity volumes and flow rates while the patient inhales deeply and exhales forcefully into a spirometer. b. PERF is measured using a peak flowmeter with the patient standing or sitting and exhaling forcibly into the meter c. PERFs can be performed at home to monitor air flow in conditions such as asthma. d. Pulse oximetry is an invasive technique useful for monitoring patients receiving oxygen therapy those at risk for hypoxia, and postoperative patients e. Pulse oximetry can be used as a replacement for arterial blood gas analysis. f. Thoracentesis is a noninvasive procedure that is usually carried out when the patient is standing erect and supported by nursing staff. |
a, b, c
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Which of the following action should a nurse perform when inserting an oropharyngeal airway? (select all that apply)
a. Use an airway that is the correcct size (size 6 or 7 is appropriate for the average adult) b. Wash hands and don gloves. Wear a mask and goggles if the patients is coughing. c. position patient on his or her back with the head turned to one side resting on the cheekbone. d. Insert the airway with the curved tip pointing down toward the base of the mouth. e. Slide the airway across the tongue to the back of the mouth and rotate it 180 degrees as it passes the uvula. f. Remove airway fro a brief period every 4 hours. |
d, e, f
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Which of the following actions would a nurse perform when correctly providing postural drainage? (select all that apply)
a. Place the patient in a high Fowlers position to drain the apical sections of the upper lubes of the lungs. b. Place the patient in the Trendelenburg position to drain the right lobe of the lung. c. Carry out postural drainage two to four times a day for 20 to 30 mins. d. Perform postural drainage 15 mins after meals to aid digestion. e. Place the patient in a lying position half on the abdomen and half on the side right and left to drain the posterior sections of the upper lobes of the lungs. f. Place the patient in a lying on the right side with a pillow under the chest wall to drain the right lobe of the lung. |
a, c, e
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Which of the following statements describes the proper use of inhaled medications? (select all that apply)
a. Bronchodilators are used to liquefy or loosen thick seccretions or reduce inflammation in airways. b. Nebulizers are used to deliver a controlled dose of medication with each compression of the canister. c. When using a MDI the patient must activate the device before and after inhaling. d. DPIs are actuated by the patients inspiration so there is no need to coordinate the delivery of puffs with inhalation. e. A microchip based inhaler determines when the patient is breathing at an ideal rate to deliver a metered dose of asthma medication. f. Inhalers can be used safely without serious side effects whenever they are needed by the patient. |
a, d, e
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Which of the following nutritional guidelines are recommended for a patient with COPD? (select all that apply) (Last one I swear)
a. The patient should follow a high protein and low calorie diet. b. The diet should consist of 40 to 55 % carbohydrates. c. The diet should be rich in antioxidants and vitamin A, C, and B. d. The diet should contain 45% to 50% fat to counter malnutrition. e. The diet should contain 12% to 20% protein. f. Obese patients should not be encouraged to try to lose weight to prevent malnutrition from occurring as a the disease progresses. |
b, c, e
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Movement of muscles and thorax to bring air into the lungs
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Inspiration
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Movement of oxygen and carbon dioxide between the air and the blood
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Diffusion
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Incomplete lung expansion or lung collapse
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Atelectasis
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An inadequate amount of oxygen in the cells
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Hypoxia
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Movement of air in and out of the lungs
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Ventilation
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Any impediment or obstruction that air meets as it moves through the airway
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Airway resistance
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Stretchability of the lungs or the ease with which the lungs can be inflated
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Lung compliance
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Process in which the oxygenated capillary blood passes through tissue
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Perfusion
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A decreased rate of air movement into the lungs
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Hypoventilation
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An increased rate and depth of ventilation above the body's normal metabolic requirements
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Hyperventilation
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Connects to oxygen tubing, a humidifier, and flowmeter, and delivers 35% to 60% oxygen; should cover nose and mouth; has vents in sides to allow room air to leak in at many places diluting the source oxygen.
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Simple oxygen mask
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Produces the highest concentratoin of oxygen with a mask; contains two one way valves that prevent concervation of exhaled air, which escapes through side vents.
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Nonrebreather Mask
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A tube is inserted into the throat through one nostril and must be changed to the other nostril every 9hrs. Gastric distention often occurs
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Nasal catheter
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This mask delivers the most precise concentration of oxygen and has a large concentration of oxygen and has a large tube with an oxygen inlet. As the tube narrows pressure drops causing air to be sucked in through the side ports.
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Venturi mask
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Probably the most commonly used respiratory aid, this consists of a disposable plastic device with two protruding prongs for insertion into the nostrils; it is connected to an oxygen source with a humidifier and a flowmeter.
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Nasal cannula
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A small catheter is inserted into the trachea under local anesthesia.
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Transtracheal oxygen delivery
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This mask is equipped with a reservoir bag for the collection of the first part of the patients exhaled air. The air is mixed with 100% oxygen of the next inhalation.
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Partial rebreather maks
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The amount of air inspired and expired in a normal respiration. Normal is 500mL
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Tidal volume
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The largest amount of air that can be inhaled following a normal quiet inhaled following a normal quiet exhalation. Normal is 3600
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Vital capacity
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The amount of air that can be exhaled beyond tidal volume. Normal is 3100mL.
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Inspiration reserve volume
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The sum of the TV+IRV + ERV+ RV. Normal 6000mL:
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Total lung capacity
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The amount of air remaining in the lungs after a maximal expiration. Normal is 1200mL
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Residual volume
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_____________refers to the point of highest flow during forced expiration
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Peak expiratory flow rate (PEFR)
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____________is a noninvasive technique that measures the arterial oxyhemoglobin saturation (SaO2 or SpO2) of arterial blood.
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Pulse oximetry
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______________is the procedure of puncturing the chest wall and aspirating pleural fluid.
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Thoracentesis
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What are the normal values for an Arterial Blood Gas and pH Analysis?
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Normal results are: pH (7.35–7.45), PCO2 (35–45 mm Hg), PO2 (80–100 mm Hg), HCO3 (22–26 mEq/L), and base excess or deficit (-2 to +2 mmol/L).
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A ____________ is done to measure integrity of pulmonary blood vessels and evaluate blood flow abnormalities (eg, pulmonary emboli)
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perfusion scan (Q scan)
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A _____________ is done to detect ventilation abnormalities (especially in patients with emphysema)
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ventilation scan (V scan)
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The amount of air displaced by maximal exhalation
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Vital Capacity (VC)
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The amount of air expelled from a point of maximal inspiration to a point of maximal inspiration
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Forced Expiratory Vital Capacity (FEVC):
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The amount of air inhaled from a point of maximal exhalation to a point of maximal expiration
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Forced Inspiratory Vial Capacity (FIVC):
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The forced expiratory volume that can be expressed in 1, 2, or 3 seconds in the first second of the FEVC maneuver
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Forced Expiratory Volume (FEV)
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The amount of air contained within the lungs at maximum inspiration
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Total Lung capacity (TLC)
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The amount of air left in the lungs at maximal expiration
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Residual Volume (RV)
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The maximum flow attained during the forced expiratory maneuver
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Peak Expiratory Flow Rate (PEFR)
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During thoracentesis what is the maximum amount of fluid that can be removed?
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1,000 mL
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Patients with pulmonary disease who are acutely ill, turning to the __________ position on a regular basis promotes oxygenation
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prone
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True or false
In patients with right-sided heart failure, fluid intake should not exceed 1.5 quarts (1.4 L) daily. |
true
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Normal pH
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7.35 - 7.4
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What is the normal values for PaO2
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80 -100mm Hg
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What is the normal values for PaCO2?
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35 -45 mm Hg
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What is the normal values for HCO3?
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22 - 26mEq/L
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What is the normal value for SaO2?
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92 - 98%
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