Chronic Respiratory Disorders
Leading cause of cancer deaths worldwide?
Lung cancer.
💡 Rationale: Often diagnosed late with metastasis
What lab test helps rule out PE?
D-dimer.
💡 Rationale: Measures fibrin degradation from clots.
Primary treatment for PE?
Anticoagulation (Heparin, Warfarin).
💡 Rationale: Prevents further clot formation.
First nursing priority in any respiratory distress?
Assess airway and breathing.
💡 Rationale: Airway patency is always top priority.
Life-threatening complication of untreated pneumothorax?
Tension pneumothorax.
💡 Rationale: Trapped air compresses heart and lungs.
What is the most common symptom of a pulmonary embolism (PE)?
Dyspnea (shortness of breath).
💡 Rationale: PE blocks pulmonary blood flow, impairing oxygenation
Two major types of lung cancer?
Non-small cell and small cell.
💡 Rationale: NSCLC = 75%, SCLC = 25%, aggressive.
Best imaging for pleural effusion?
Chest X-ray.
💡 Rationale: Shows fluid accumulation and lung compression.
Drug that dissolves clots in PE emergency?
Alteplase (tPA).
💡 Rationale: Fibrinolytic that breaks down thrombus.
Position for maximal oxygenation in dyspnea?
A2: High Fowler’s.
💡 Rationale: Expands thoracic cavity and eases breathing.
Early sign of hypoxia?
Restlessness and anxiety.
💡 Rationale: Brain is first affected by low O₂.
Which test is most specific for detecting PE?
CT Pulmonary Angiography.
💡 Rationale: It visualizes the embolus directly.
Most common symptom of lung cancer?
Persistent cough.
💡 Rationale: Tumor irritation and obstruction cause chronic cough
ABG result expected in early respiratory distress?
Respiratory alkalosis.
💡 Rationale: Hyperventilation causes CO₂ loss.
Procedure to remove pleural fluid?
Thoracentesis.
💡 Rationale: Relieves pressure and allows lung expansion.
Teaching for anticoagulant therapy?
A3: Avoid injury, use soft toothbrush, report bleeding.
💡 Rationale: Prevents hemorrhagic complications
Which patient should be assessed first?
One with sudden onset dyspnea and chest pain.
💡 Rationale: Possible PE—life-threatening
Best position for a patient with PE?
High Fowler’s.
💡 Rationale: Promotes lung expansion and gas exchange.
What defines pleural effusion?
>25 mL fluid in pleural space.
💡 Rationale: Excess fluid compresses lung tissue.
ABG trend in ARDS?
Refractory hypoxemia, metabolic acidosis.
💡 Rationale: Impaired gas exchange and tissue hypoxia.
Device used for ongoing pleural drainage?
Chest tube.
💡 Rationale: Removes air or fluid from pleural space
Key nursing care for chest tube?
A4: Keep system below chest, monitor for bubbling or kinks.
💡 Rationale: Ensures proper drainage and function.
Major complication of CF?
Respiratory failure.
💡 Rationale: Chronic infection damages lungs over time.
Hallmark sign of tension pneumothorax?
Tracheal deviation to the opposite side.
💡 Rationale: Air trapped shifts mediastinal structures.
Two main types of pleural effusion?
Transudative and exudative.
💡 Rationale: Transudative from HF; exudative from infection or tumor.
Test confirming CF diagnosis?
Sweat chloride >60 mEq/L.
💡 Rationale: Diagnostic hallmark of CF.
Treatment goal for ARDS ventilation?
Use low tidal volumes with PEEP.
💡 Rationale: Prevents barotrauma and maintains oxygenation.
What should nurse do if chest tube disconnects?
A5: Place end in sterile water immediately.
💡 Rationale: Prevents air entry into pleural cavity.
Common side effect of fibrinolytics?
Bleeding.
💡 Rationale: Clot breakdown increases hemorrhage risk.
Type of pneumothorax that occurs without trauma?
Spontaneous pneumothorax.
💡 Rationale: Due to ruptured blebs, often in tall thin males or COPD
Genetic pattern of cystic fibrosis (CF)?
Autosomal recessive.
💡 Rationale: Two defective CFTR genes needed to express disease
What does a thoracentesis analyze?
Type and cause of pleural fluid.
💡 Rationale: Determines transudate vs exudate.
Pediatric croup treatment?
Humidified O₂, steroids, racemic epinephrine.
💡 Rationale: Reduces airway inflammation and obstruction
Diet teaching for CF patient?
A6: High-protein, high-calorie meals with enzyme supplements.
💡 Rationale: Offsets malabsorption and energy needs
What lab indicates hypoxemia?
PaO₂ < 80 mmHg.
💡 Rationale: Below normal arterial oxygen.
Priority intervention for ARDS?
Maintain oxygenation, prepare for ventilation.
💡 Rationale: Hypoxemia is severe and refractory to O₂.
Diagnostic test that confirms CF?
Sweat chloride test.
💡 Rationale: Elevated chloride >60 mEq/L indicates defective chloride transport.
Gold standard for lung cancer confirmation?
Tissue biopsy via bronchoscopy.
💡 Rationale: Confirms malignancy type.
First-line management for spontaneous pneumothorax?
Oxygen and chest tube insertion.
💡 Rationale: Removes trapped air and re-expands lung
Psychosocial intervention for lung cancer?
A7: Provide emotional support and involve family in care.
💡 Rationale: Diagnosis and prognosis cause distress
What finding after thoracentesis must be reported immediately?
Sudden shortness of breath.
💡 Rationale: Could indicate pneumothora
Chest X-ray difference between ARDS and heart failure?
ARDS shows bilateral infiltrates with normal heart size.
💡 Rationale: Non-cardiogenic pulmonary edema.
Main cause of recurrent infections in CF?
Thick, sticky mucus in airways.
💡 Rationale: Obstructs airways and traps bacteria
Which lab must be monitored for heparin therapy?
aPTT.
💡 Rationale: Measures coagulation for safe anticoagulation dosing
What should nurse monitor after thoracentesis?
Signs of pneumothorax (SOB, diminished breath sounds).
💡 Rationale: Accidental puncture can collapse lung
Infection prevention teaching for CF child?
Hand hygiene, avoid sick contacts, airway clearance daily.
💡 Rationale: Reduces pulmonary infections
Priority nursing action for ARDS patient with low O₂ despite ventilation?
Notify provider—adjust ventilator or consider proning.
💡 Rationale: May need higher PEEP or repositioning.
Continuous bubbling in water seal chamber indicates?
Air leak in chest tube system.
💡 Rationale: Continuous bubbling = system not sealed
Nutritional management for CF?
High-calorie diet, pancreatic enzymes, fat-soluble vitamins (ADEK).
💡 Rationale: Fat malabsorption leads to steatorrhea and malnutrition.
Which ABG parameter shows oxygenation?
PaO₂.
💡 Rationale: Indicates effectiveness of O₂ exchange.
Why are pancreatic enzymes given in CF?
A9: To aid digestion and nutrient absorption.
💡 Rationale: Thick secretions block pancreatic ducts.
Post-thoracentesis priority assessment?
Monitor for pneumothorax or respiratory distress.
💡 Rationale: Procedure can puncture lung tissue.
What patient needs immediate isolation?
Child with RSV/bronchiolitis.
💡 Rationale: Highly contagious via droplets/contact.
Pediatric illness with barking cough and inspiratory stridor?
Croup.
💡 Rationale: Viral swelling of upper airway
Definitive treatment for advanced CF?
Lung transplantation.
💡 Rationale: Replaces damaged lungs to prolong survival.
In a tension pneumothorax, what does a pulse oximeter show?
Rapid drop in SpO₂ despite O₂ therapy.
💡 Rationale: Collapsed lung prevents effective oxygenation.
When is an embolectomy indicated?
Massive PE unresponsive to anticoagulants.
💡 Rationale: Surgically removes clot to restore perfusion.
Most important nursing focus for ARDS?
Continuous monitoring of O₂, ABGs, and ventilator settings.
💡 Rationale: Rapid changes require prompt adjustment.
Two key nursing priorities across all respiratory disorders?
Maintain airway and ensure adequate oxygenation.
💡 Rationale: Fundamental to prevent hypoxia and death.
Drooling + tripod position + high fever = ?
Epiglottitis. Do not inspect throat, maintain airway.
💡 Rationale: Exam can trigger full obstruction.