Respiratory Anatomy
Explain the pharynx versus the larynx
The pharynx is the throat and the larynx is the voice box
What is the needle aspiration of pleural fluid or air from the pleural space for diagnostic purposes called?
Thoracentesis
Explain the following terms: Hemoptysis, Hypoxia, Hypoxemia
Hemoptysis - blood in sputum, Hypoxia- low O2 content in body tissues, Hypoxemia- low O2 content in the blood
Why do you administer bronchodilators prior to steroids?
The steroid lowers are swelling so that bronchodilator can make it into the lungs to open up the air passages.
The nurse is caring for a male client with a chest tube. If the chest drainage system is accidentally disconnected, what should the nurse plan to do?
A. Place the end of the chest tube in a container of sterile saline.
B. Apply an occlusive dressing and notify the physician.
C. Clamp the chest tube immediately.
D. Secure the chest tube with tape.
A. Place the end of the chest tube in a container of sterile saline.
Alveolar walls contain "type 2 pneumocyte" cells that secrete what? What does this secretion do?
Surfactant- lines alveoli and reduces alveolar surface tension
What is crepitus and how do you assess for it?
Air trapped under the skin (subcutaneous emphysema); feel skin with fingertips
What is orthopnea?
Shortness of breath that occurs when laying down and is relieved by standing up
The nurse instructs the client to avoid which over-the-counter products when taking theophyline (theo-Dur)?
A. acetaminophen (tylenol)
B. echinacea
C. diphenhydramine (benadryl)
D. St. John's wort
D. St. John's wort
Answer: D
A male elderly client is admitted to an acute care facility with influenza. The nurse monitors the client closely for complications. What is the most common complication of influenza?
A. Septicemia
B. Pneumonia
C. Meningitis
D. Pulmonary edema
B. Pneumonia
Where does gas exchange take place?
Groups of alveoli
What is the gold standard test for diagnosing pneumonia?
Chest x-ray
name 3 ways to tell a patient is struggling to breathe?
1. Cannot speak in full sentences.
2. Accessory muscle use
3. Retractions
4 Nasal flaring
5. Color changes
6. Body position
Which specific information will the nurse teach to the client with eosinophilic asthma newly prescribed benralizumab therapy?
A. Avoid breathing into the inhaler or getting wet.
B. The drug can only be given by a healthcare professional.
C. Do not chew, crush, or split the tablet
D. The drug must be taken at bedtime because of the extreme drowsiness it causes
C. Do not chew, crush, or split the tablet
Gina, a home health nurse is visiting a home care client with advanced lung cancer. Upon assessing the client, the nurse discovers wheezing, bradycardia, and a respiratory rate of 10 breaths/minute. These signs are associated with which condition?
A. Hypoxia
B. Delirium
C. Hyperventilation
D. Semiconsciousness
A. Hypoxia
Name 3 ways that smoking increases risk for heart disease
1 Raises blood pressure 2. Thickens blood 3. Causes blood clots 4. Plaque build up over time 5. Vessel damage over time
Name 3 conditions in which you might percuss "hyperresonance".
1. Emphysema.
2. Asthma
3. Pneumothorax (all indicating trapped air)
A patient is being discharged with a tracheostomy tube. What are the two biggest risk factors if they do not properly self-care for the airway?
1. Infection
2. Loss of skin integrity
A nursing home client who has completed a 2-week course of antibiotics for bacterial pneumonia asks if he can go to his grandsons high school graduation if he uses a wheelchair. What is the nurses best response?
A. "No, going out now before you have recovered your strength can cause a relapse of the pneumonia."
B. "No, the risk that you could spread the disease to other people is much too high."
C. "No, if you want to and feel that you could tolerate a couple hours of sitting."
D. "Yes, if you agree to wear a face mask to prevent spreading droplets."
C. "Yes, if you want to and feel that you could tolerate a couple hours of sitting."
A male client abruptly sits up in bed, reports having difficulty breathing and have an arterial oxygen saturation of 88%. Which mode of oxygen delivery would most likely reverse the manifestations?
A. Simple mask
B. Non-rebreather mask
C. Face tent
D. Nasal cannula
B. Non-rebreather mask
The nurse assessing an 88 year old client notices a severe kyphosis that curves the client's spine to the right and bends her forward. Which change in respiratory function does the nurse expect as a result of this age-related change?
A. Decreased gas exchange as a result of reduced airway elasticity
B. Decreased gas exchange as a result of ineffective movement
C. Reduced pulmonary perfusion as a result of decreased alveolar diffusion capacity
D. Reduced pulmonary perfusion as a result of decreased blood return to the right atrium
B. Decreased gas exchange as a result of ineffective movement
When assessing a client 2 hours after a thoracentesis, the nurse notes the skin around the puncture site is swollen and crackling is felt and heard when pressure is applied to the area. What is the nurse's best action.
A .Assess the clients SpO2 level at two separate sites
B. Obtain a prescription to culture the site
C. Document the finding as the only action.
D. Notify the respiratory health provider.
D. Notify the respiratory health provider.
While responding to questions in a health history, the clinet reports that he usually expectorates about 2 ounces of clear, colorless sputum daily, usually on getting up in the morning. What is the nurse's best action related to this finding?
A. Document the report as the only action
B. Arrange for the client to have tuberculosis testing
C. Collect a sputum test for laboratory analysis
D. Alert the primary health provider about this finding
A. Document the report as the only action
A female client with interstitial lung disease is prescribed prednisone (Deltasone) to control inflammation. During client teaching the nurse stresses the importance of taking prednisone exactly as prescribed and cautions against discontinuing the drug abruptly. A client who discontinues prednisone abruptly may experience:
A. Hyperglycemia and glycosuria
B. Acute adrenocotial insufficiency
C. GI bleeding.
D. Restlessness and seizures
B. Acute adrenocotial insufficiency
A male client with Guillain-Barré syndrome develops respiratory acidosis as a result of reduced alveolar ventilation. Which combination of arterial blood gas (ABG) values confirms respiratory acidosis?
A. PH 5.0; PaCO2 30 mm Hg
B. PH 7.40; PaCO2 35 mm Hg
C. PH 7.35; PaCO2 40 mm Hg
D. PH 7.25; PaCO2 50 mm Hg
D. PH 7.25; PaCO2 50 mm Hg