Pathophysiology Quiz #4

GAS EXCHANGE

Occurs: Within the bronchioles, alveolar ducts, and the alveoli. 1. Air enters the alveolus and O2 moves across the alveolar membrane to the RBC's 2. Simultaneously CO2 moves from the RBC into the alveolus to be excreted by exhalation ( AIRPORT) 3. O2 combines with the heme portion of hemoglobin to form Oxy-hemoglobin (UBER) . 4. O2 then leaves the lungs in the blood stream and take it to the peripheral tissues. 5. Once delivered CO2 then get on the RBC and is carried back to the lung to be excreted . Each hemoglobin can carry 4 O2 molecules ( 4-passenger car)

Which are the major restrictive lung diseases? Select all that apply. Emphysema Chronic bronchitis Bronchiectasis Pulmonary fibrosis Pneumothorax

Pulmonary fibrosis Pneumothorax

Of the following spirometry results, which are associated with obstructive pulmonary disorders? Select all that apply. Reduced forced vital capacity Reduced forced expiratory volume in 1 second Reduced total lung capacity Reduced ratio of forced expiratory volume in 1 second to forced vital capacity Increased total lung capacity

Reduced forced expiratory volume in 1 second Reduced ratio of forced expiratory volume in 1 second to forced vital capacity

Heart failure is classified into four different stages by the American College of Cardiology/American Heart Association. How is the condition of a client in stage B different from the condition of clients in other stages?

The client in B has a history of a previous myocardial infarction

After assessing a client's reports, a nurse finds that the client is suffering from wheezing, prolonged exhalations, and rhonchi. The client uses accessory muscles during breathing. As a treatment, the primary health-care provider prescribes bronchodilators and corticosteroids in the form of inhalers as treatment. What disorder can the nurse infer from the symptoms of the client and the treatment that has been provided to the client?

The client is suffering from asthma

A primary health-care provider finds a client complaining of chest pain, dyspnea, and an increased respiratory rate. On closer inspection, the chest expansion is found to be asymmetrical. On percussion, the primary health-care provider finds chest hyperresonance. What condition can the primary health-care provider interpret from this situation?

The client is suffering from pneumothorax or collapsed lungs.

A nurse hears a bruit while assessing the carotid artery of a client. What could be the reason behind the bruit?

Turbulent blood flow in the artery

A friction rub

is a grating, scratchy sound heard during inspiration and expiration with inflammation of the pleural surfaces.

ventilation-perfusion ratio (V-Q ratio)

is defined as the ratio of the amount of air reaching the alveoli to the amount of blood reaching the alveoli.• Occurs when ventilation & perfusion are equal or when there is ventilation & perfusion matching-Measured w/ a ventilation - perfusion scan .-Diagnostic test that rules out a Pulmonary Embolism (PE). -little ventilation = pulmonary arteries will constrict = easy for a blood clot to form-*chronic hypoxia leads to chronic pulmonary arterial vasoconstriction = which is pulmonary hypertension*

Perfusion

is the movement of blood through the pulmonary circulation, eventually providing oxygen to every part of the body. • And brings back carbon dioxide to be oxygenated • Poor perfusion - *can lead to cause of PE*

Ventilation

is the process of inspiration and expiration of air through the pulmonary airways.

Bronchi

o right is straight (can put you at risk for aspiration) o left branches

A nurse is advising a client about adult respiratory distress syndrome (ARDS). Which statement shows best that the nurse properly understands the disorder?

"An individual developing ARDS has multiple organ failure and becomes critically ill."

A nurse is teaching a group of student nurses about the administration of asthma medication. Which statement by a student nurse shows appropriate learning?

"An oral corticosteroid is added to the regimen of rescue medications when short-acting bronchodilators are not acting against asthma attacks."

A nurse is providing discharge instructions to a client who is being discharged after treatment for myocardial infarction. Which statement made by the client indicates effective learning?

"I have planned periods of rest in the morning and evening."

A registered nurse is teaching a nursing student about the effects of glucose on the arteries. Which statement made by the student nurse indicates effective learning?

"Increased serum glucose causes endothelium injury, which would lead to atherosclerosis."

A registered nurse is teaching a nursing student the relationship between cardiac output (CO), blood pressure (BP), and peripheral vascular resistances (PVR). The student nurse is asked to recap the mathematical equation that relates the three factors. Which equation provided by the student nurse indicates the need for further teaching?

"PVR/CO=BP"

A registered nurse is teaching a group of nursing students about Homan's sign. Which statement made by the student nurse indicates effective learning?

"Place the client in the supine position with a straight knee and dorsiflex the client's foot."

A registered nurse is teaching a group of nursing students the preventive measures to be adopted for thromboemboli. Which response by a student nurse indicates effective learning?

"Thromboemboli is prevented through the use of anticoagulants."

A victim of a motor vehicle accident comes to a medical facility with a rib fracture that has punctured the pleural membrane. The open wound allows the pleural cavity to pull air into the opening of the wound, thus building a pleural space. What treatment can a nurse expect from the primary health-care provider?

A chest tube with suction to be applied on the affected area

Which of the following stimuli may cause an asthma attack? Select all that apply. Allergies Infections Exercise Pneumothorax Right-side heart failure

Allergies Infections Exercise

A left ventricular impulse is seen through the chest wall of a client. On palpation, a diastolic thrill is palpated along the left sternal border and a systolic thrill is palpable in the jugular notch. To which pathological condition could these symptoms be attributed?

Aortic valve deficiency

The nurse uses Homan's sign to assess a client for the presence of deep venous thromboembolism (DVT). Pain in what area is an indication of positive Homan's sign?

Calf

A client who has diabetes is diagnosed with high blood pressure. Which is the preferred medication for the client?

Captopril

Which statement best differentiates cardiac afterload from cardiac preload?

Cardiac afterload is the amount of resistance that the ventricle must overcome.

A client presents with chest pain. The pain has not reduced, even after administering three nitroglycerine tablets within 10 minutes. Which diagnostic test should the primary health-care provider recommend to confirm that the client has developed myocardial infarction?

Cardiac troponin test

Which area of the body should a nurse focus on when palpating the thoracic cage of a client when assessing for any pulmonary disease? Select all that apply.

Clavicles Ribs

How is stage C heart failure different from other stages of heart failure, according to the American College of Cardiology/American Heart Association classification?

Clients may have current or prior symptoms of heart failure

Which is a risk factor for hypertension?

Insufficient vitamin D in the diet

Which condition is also known as hypoventilation syndrome?

Obstructive sleep apnea (OSA)

A client is evaluated for a heart murmur in which the murmur is found to be loud. How should the heart murmur be rated?

6/6

Pulmonary aspiration

- ENTRY WAY for pneumonia to enter the bodyo If pt has trouble clearing lungs= at risk for pulmonary aspirationo Aspiration pneumonia = when bacteria is *SWALLOWED* • Lungs are also at risk for exposure to inhalants such as smoke, allergens & pollutants• Right Middle Lobe , a common area for aspiration pneumonia.

DIAGNOSTIC TESTS

-Culture and Sensitivity (sputum or swab of throat) -ABG (provide enough about gas exchange)-Pulse Oximetry -Chest x-ray (TB, pneumonia, pleural effusion) -CT scan (computed tomography) -MRI scan (magnetic resonance imaging) -V-Q scan (ventilation-perfusion Scan for PE)-Bronchoscopy (lung wash/biopsy, extract things lodged in the airway) -Thoracentesis (removing fluids that aren't supposed to be there in the pleural cavity )

(IMPENDING) RESPIRATORY FAILURE

-Serial arterial blood gases (ABGs) should be evaluated in all patients with respiratory problems. -Usually there is a gradual increase in arterial carbon dioxide and decrease in arterial oxygen when a patient is developing respiratory failure .-increased CO2 = hypoventilating-breathing slow = holding onto carbon dioxide -breathing fast = pushing out carbon dioxide -need intubation stuff at the bedside (< 8 = intubate) -Hypoxemic respiratory failure occurs when the pressure of oxygen in arterial blood (PaO2) is lower than 60 mm Hg w/ normal arterial carbon dioxide (PaCO2)•

Upper Respiratory Tract Function

1. conducts air to the lower tract . 2. Protects the lung from foreign matter 3. Warms , filters, and humidifies air it enters the lungs .

A 60-year-old client is seen at the clinic with skin inflammation. There is dusky discoloration around the ankle and in the lower leg of the client. What might be the cause of this condition?

Buildup of hemosiderin

A client with left lower extremity swelling and tenderness along a vein has to be assessed to rule out deep vein thrombosis (DVT). Which criteria would rule out DVT?

A negative D-dimer assay and Wells criteria score of less than 2

A nurse is reviewing the results of a diagnostic test of a client who is being moved out of the intensive care unit. A cardiac troponin T level assay was performed while the client was in the intensive care unit, which indicated high levels of troponin. Which condition was the client diagnosed with?

Acute myocardial infarction

A 65-year-old female client presents with complaints of crushing pain on the left side of the chest. After examining the client, it is found that the client has unstable angina. Which intervention to reduce the pain is appropriate for the client?

Administering nitroglycerin

ABNORMAL BREATH SOUNDS (ADVENTITIOUS SOUNDS)

Adventitious breath sounds are extra lung sounds superimposed over normal breath sounds present in various kinds of pulmonary dysfunction

Which of the following are obstructive lung diseases? Select all that apply. Pulmonary fibrosis Asthma Chronic obstructive pulmonary disease Pneumothorax Obstructive sleep apnea

Asthma Chronic obstructive pulmonary disease Obstructive sleep apnea

Which of the following statements are true related to chronic obstructive pulmonary disease? Select all that apply. Chronic hypercapnia Oxygen therapy maintained at low oxygen level Decreased red blood cell level Hypoxic drive Increased alveolar elasticity

Chronic hypercapnia Oxygen therapy maintained at low oxygen level Hypoxic drive

The nurse is assessing a 65-year-old patient with a history of smoking. The patient reports a frequent, productive cough of thick, pale yellow mucous. The nurse notes cyanosis is present in the patient. Which condition is consistent with these findings? Obstructive sleep apnea Asthma Chronic obstructive pulmonary disorder Bronchiectasis Pneumothorax

Chronic obstructive pulmonary disorder

Luke is a 50-year-old mine worker who comes into the acute care center complaining of shortness of breath. He has a chronic cough that produces gray sputum. Chest x-rays reveal round, dark opacities in the lungs. What disorder might Luke have? Select the disorder that is best exemplified by that scenario. adult respiratory distress syndrome coal worker's pneumoconiosis pneumothorax pulmonary edema pulmonary embolism pulmonary hypertension thoracic cage deformity

Coal Worker's Pneumoconiosis Coal worker's pneumoconiosis develops from exposure to coal dust. Inflammation results in the coal particles being deposited in the lungs. Clinical manifestations include cough, dyspnea on exertion, wheezing, gray sputum, dark opacities throughout the lung fields on chest x-ray or CT, and decreased FEV and total lung capacity values.The production of gray sputum is a hallmark of this disease.

A nurse is assessing a client diagnosed with secondary pulmonary hypertension. The increase in the pulmonary artery pressure has led to the client's elevated pulmonary venous pressure. Which condition does the nurse predict to occur in the client?

Collagen vascular disease

A nurse instructor is teaching a group of student nurses about obstructive sleep apnea (OSA). Which treatment, according to the nurse, should be most appropriate to keep the airways from closing?

Continuous positive airway pressure (CPAP)

A primary health-care provider finds that a client is suffering from symptoms such as jugular venous distension, ascites, hepatomegaly, and ankle or sacral edema. What condition does the health-care provider interpret from this situation?

Cor pulmonale

What is the diagnostic outcome of coal miner's pneumoconiosis? Select all that apply

Decreased FEV count during PFT. Hypoxemia is found in an arterial blood gas (ABG) test

Select the statements that apply to Obstructive sleep apnea Also called hyperventilation syndrome Involves recurrent episodes of sleep apnea 5 to 7 minutes in duration Symptoms include loud snoring and unrestful sleep Diagnosis requires a sleep study Obesity is a risk factor

Diagnosis requires a sleep study Obesity is a risk factor Symptoms include loud snoring and unrestful sleep Obstructive sleep apnea, also called hypoventilation syndrome, results in the upper airway closing intermittently during sleep. It involves recurrent episodes of sleep apnea of 2 to 3 minutes in duration. Symptoms include loud snoring, choking during sleep, unrestful sleep, and sleepiness during the day. Obesity is a risk factor. Polysomonography, or a sleep study, is used for diagnosis.

Which diseases fall under restrictive pulmonary diseases? Select all that apply.

Diseases that prevent complete ventilation. Diseased that reduce the total lung capacity. Diseases that act as an impediment to alveoli.

Which procedures are specifically utilized for the treatment of pleural effusion? Select all that apply

Drainage Chest tube attached to suction

Which of the following conditions affects the elasticity of the alveoli, resulting in air trapping? Select all that apply. Asthma Emphysema Bronchitis Hyperreactive airways Sleep apnea

Emphysema

What is a clot that has traveled to the pulmonary arterial circulation and caused obstruction of the arterial blood flow through the lungs known as?

Pulmonary embolism

Which of the following is one of the primary treatments of pulmonary hypertension? Re-inflating the lungs Focusing on the vasodilation of the pulmonary arterial vessels Using mechanical ventilation to facilitate oxygenation of tissues Using a chest tube for suctioning Focusing on thoracotomy

Focusing on the vasodilation of the pulmonary arterial vessels

A nurse has been assessing a client who has been working as a butcher for an extensive period. The client had a prolonged and intense exposure to inhaled organic dust in the form of animal protein. What disorder, according to the nurse, can affect the client the most?

Hypersensitivity pneumonitis

A nurse is preparing a client for a central venous catheter insertion. Which condition during the operating procedure should the nurse be most alert of?

Iatrogenic pneumonothorax

After assessing the recent chest x-rays of a client, a nurse finds nodules and honeycomb lung patterns. On assessing the client's previous chest x-ray report, the nurse finds diffused "ground glass" markings in the lower lung fields. What condition can the nurse infer from these observations?

Idiopathic pulmonary fibrosis

Lower Respiratory Function

In gas exchange by O2 blood and excreting CO2

Respiratory Infection

In primary care, URI is the most common reason for the patient to seek care. Caused by • Inhaled viruses • Bacteria Most frequently acquired respiratory infection is the common cold (but can also be anywhere from common cold to TB *Main symptom is cough* - Transmitted by casual contact

Which of the following may you expect in a patient with chronic restrictive lung disease? Select all that apply. Increased erythropoietin Increased forced vital capacity Decreased total lung capacity Normal FEV1/FVC ratio Decreased red blood cell level

Increased erythropoietin Decreased total lung capacity

How should a nurse document a client's heart murmur that begins just before S2 and ends at S2?

Late systolic

A primary health-care provider is assessing a client who is a minor and has been constantly exposed to silica. What immediate test does a nurse expect the primary health-care provider to carry on the client for detecting tuberculosis (TB)?

Mantoux test

A nurse is assessing a client who has been working in the paint factory for an extensive period. The client has been constantly exposed to mineral crystals in the form of asbestos. The client has been a chain smoker as well. What prevalent disease, according to the nurse, is the client prone to?

Mesothelioma

A client presents with complaints of difficulty breathing and looks pale. The client experiences excessive perspiration and his or her electrocardiogram shows an irregular rhythm. Which other finding will indicate that the client may have developed myocardial infarction?

Nitroglycerin did not relieve the pain, even after taking three doses.

ARTERIAL BLOOD GASES

Normal ABG levels -Blood pH 7.35 to 7.45 -Pco2 35 to 45 mm Hg (carbon dioxide) -Po2 90 to 100 mm Hg (med surg book = 80-100)-HCO3- 22 to 26 mg/dL (bicarb) -Sao2 95% to 100%

A nurse is assessing a client with a short but thick neck circumference. Which form of cardiopulmonary disorder can the nurse suspect in the client?

Pickwickian syndrome

Brian presents to the emergency room following an impact accident from skateboarding that resulted in a fractured rib. He complains of severe chest pain and an inability to catch his breath. Chest movement during inspiration and expiration is asymmetric.What disorder do you suspect? Select the disorder that is best exemplified by that scenario. adult respiratory distress syndrome coal worker's pneumoconiosis pneumothorax pulmonary edema pulmonary embolism pulmonary hypertension thoracic cage deformity

Pneumothorax A pneumothorax is also known as a collapsed lung. Several types of pneumothorax exist, and in Brian's case, the pneumothorax is due to blunt trauma to the thoracic area. Small, uncomplicated pneumothoraxes will heal on their own.

Which of the following statements are incorrectly matched? Select all that apply. Pneumothorax - collection of fluid within chest wall Pleuritis - inflammation of pleural membrane Pleural effusion - trapping of air in lungs Cor pulmonate - left-side heart failure Pneumothorax - collapsed lung

Pneumothorax - collection of fluid within chest wall Pleural effusion - trapping of air in lungs Cor pulmonate - left-side heart failure

A nurse suspects a client may have obstructive sleep apnea (OSA). What should the nurse utilize as a diagnostic tool to diagnose OSA?

Polysomnography

A nurse is assessing a 28-year-old client who is a smoker and has inherited Marfan syndrome as a genetic disorder. The previous medical reports of the client do not suggest any evidence of an underlying lung disease. Which condition is possible in the client according to the nurse's prediction?

Primary spontaneous pneumothorax

Which lung condition is common in clients with a genetic disorder such as Marfan syndrome as well as frequent smokers?

Primary spontaneous pneumothorax

Frank, age 62 years, has the primary complaint of sudden-onset dyspnea and a racing heart. He has a history of atherosclerosis and hyperlipidemia. Frank led a sedentary lifestyle and reports almost no regular physical activity. A V-Q scan reveals decreased, localized perfusion.What disorder does Frank have? Select the disorder that is best exemplified by that scenario. adult respiratory distress syndrome coal worker's pneumoconiosis pneumothorax pulmonary edema pulmonary embolism pulmonary hypertension thoracic cage deformity

Pulmonary Embolism In pulmonary embolism, a clot travels to pulmonary circulation, causing obstruction to circulation within the lungs. In this case, Frank has several risk factors for blood clot formation including atherosclerosis, hyperlipidemia, and inactive lifestyle.Clinical manifestations of pulmonary embolism include dyspnea, chest pain, increased respiratory rate and heart rate. A V-Q scan will show decreased perfusion in the area of the embolus.

Gavin has suffered from congestive heart failure for the past 2 years. He complains of dyspnea, especially when trying to sleep at night. Auscultation reveals crackles in the lungs. Follow up echocardiogram shows enlargement of the left ventricle.What disorder may Gavin have? Select the disorder that is best exemplified by that scenario. adult respiratory distress syndrome coal worker's pneumoconiosis pneumothorax pulmonary edema pulmonary embolism pulmonary hypertension thoracic cage deformity

Pulmonary edema Left ventricular heart failure often causes pulmonary edema, which is an accumulation of fluid around the alveoli. As the left ventricle is unable to pump blood effectively, the blood backs up in the pulmonary system. Clinical manifestations include cough, dyspnea, stridor, pink sputum, and course crackles on auscultation.

Which of the following is true regarding bronchiectasis? Select all that apply. A common condition of inflamed bronchioles Severe bronchoconstriction Results from chronic infections Relatively rare condition Bronchodilation

Results from chronic infections Relatively rare condition Bronchodilation

Select the statements that apply to Bronchiectasis Results from untreated infections Common disorder Signs and symptoms include clubbing of the fingers and cyanosis Components of the bronchiole wall are replaced with fibrous tissue Bronchiole dilatation is present Hemoptysis is caused by inflamed airway mucosa

Results from untreated infections Components of the bronchiole wall are replaced with fibrous tissue Bronchiole dilatation is present Hemoptysis is caused by inflamed airway mucosa This uncommon disease results from untreated infections that damage the bronchioles. Fibrotic changes due to inflammation results in bronchiole dilatation. Hemoptysis is often present.

A nurse is assessing a child with chronic asthma. Which microorganisms, according to the nurse, are responsible for causing asthma in the child? Select all that apply.

Rhinovirus Respiratory syncytial virus

Which of the following are forms of restrictive lung disease due to exposure to environmental factors? Select all that apply. Bronchiectasis Silicosis Pleural effusion Asbestosis Pneumoconiosis

Silicosis Asbestosis Pneumoconiosis

Select the statements that apply to Chronic obstructive pulmonary disease Comprised of airway hyperreactivity, emphysema, and chronic pneumonia Smoking is a major cause Associated with intravenous drug use In emphysema, there is inflammation, edema and excess mucus in the airways Alpha 1-antitrypsin deficiency (AAT) Signs and symptoms include clubbing of the fingers, cyanosis, and pursed-lip breathing Decreased anterior-posterior chest diameter is a clinical sign Pulmonary function tests are key to diagnosis

Smoking is a major cause Associated with intravenous drug use Alpha 1-antitrypsin deficiency (AAT) Signs and symptoms include clubbing of the fingers, cyanosis, and pursed-lip breathing Pulmonary function tests are key to diagnosis Three components comprise COPD: airway hyperreactivity, emphysema, and chronic bronchitis. In emphysema, there is excess air in the alveoli. In chronic bronchitis, there is inflammation, edema and excess mucus in the airways. Patients may present with clubbing of the fingers, cyanosis, barrel-chested appearance, increased anterior-posterior chest diameter, and pursed-lip breathing. Smoking is a significant risk factor in the development of this condition.It is also associated with IV drug use. Deficiency in the enzyme alpha 1-antitrypsin is the only identified (at this time) genetic risk factor for developing COPD. Pulmonary function tests are key to diagnosis of COPD.

Hypercapnia

Stimulate the process of breathing . High levels of CO2

Select the statements that apply to Asthma Categories of asthma include stage 1, stage 2, and stage 3 Medications consist of maintenance medications and rescue medications Symptoms can be alleviated by exercise Allergy is the most common etiology Symptoms include dyspnea, wheezing and chest tightness

Symptoms include dyspnea, wheezing and chest tightness Medications consist of maintenance medications and rescue medications Allergy is the most common etiology Asthma is a hyperactive airway disease, most often caused by allergy. Signs and symptoms include dyspnea, wheezing, and coughing, especially at night or with exercise. Categories of asthma include mild intermittent, mild persistent, moderate persistent, moderate persistent, and severe persistent. Treatment involves a combination of maintenance and rescue medications for acute episodes.

A client 50 years of age is diagnosed with Class III (moderate) heart failure. How is Class III heart failure different from other classes of heart failure in the client, according to the New York Association of Classification of Heart Failure?

The client with Class III (moderate) heart failure will have symptoms such as fatigue, palpitations, or dyspnea while doing less than normal physical activities.

ATELECTASIS

The collapse of a small number of alveoli, resulting in reduced gas exchange. -Can occur b/c of a compressive force on the alveoli as in that created by a mass. -Can be caused by an obstruction of the bronchioles that inhibits the full inflation of alveoli. -Predisposes individuals to pneumonia * Most often occurs in post.op pt's.*

How does the heart function when a client is diagnosed with heart failure?

The contractility and stroke volume decreases.

At which intercostal space is auscultation of the pulmonic valve best heard?

The second intercostal space in the left sternal border

Courtney, age 17, needs a routine physical exam to enable her to participate in high school sports. The clinician notes that Courtney has one hip and shoulder higher than the other, along with significant curvature of the spine. Courtney says that this is how she has "always been." When she runs, she sometimes experiences a feeling of "breathlessness."What condition do Courtney's signs and symptoms indicate? Select the disorder that is best exemplified by that scenario. adult respiratory distress syndrome coal worker's pneumoconiosis pneumothorax pulmonary edema pulmonary embolism pulmonary hypertension thoracic cage deformity

Thoracic cage deformity Thoracic cage deformities such as kyphoscoliosis (as in Courtney's case) can cause restrictive lung disease. Deformity can diminish ventilation of the lungs leading to trouble breathing and a feeling of breathlessness on exertion.

While assessing the reports of a client, a nurse finds that there has been an abnormal collection of fluid within the pleural cavity. What remedy can the nurse infer about the condition based on the symptoms?

Thoractomy as well as a chest tube attached for suctioning

What is the purpose of a Greenfield filter?

To prevent a blood clot from traveling

Diaphragm & Phrenic Nerve (C4- cervical spinal cord #4)

When a spinal cord injury occurs at or above C4, motor and sensory conduction to the diaphragm is interrupted and respirations cease. *The patient will require respiratory support to maintain life*. -It is critical to carefully assess all patients with spinal cord injuries for signs of respiratory distress. -Runs along neck & in b/t lung & heart & reaches down into diaphragm (phrenic nerve)

Wheezes

are high-pitched, whistling sounds related to the constricted diameter of the airways and may be inspiratory or expiratory in nature.

Rhonchi

are low-pitched, snore-like sounds present over inflamed bronchial airways.

Bronchiole dilation resulting from chronic infections is present in ____________. bronchiectasis chronic obstructive pulmonary disease obstructive sleep apnea asthma emphysema

bronchiectasis

Which of the following are associated with chronic obstructive pulmonary disease? Select all that apply. pleural effusion hyperreactive airways chronic bronchitis bronchiectasis emphysema

hyperreactive airways chronic bronchitis emphysema

The upper airways closing during sleep is known as ____________. bronchiectasis chronic obstructive pulmonary disease obstructive sleep apnea pneumothorax pleural effusion

obstructive sleep apnea

Michaela has chronic obstructive pulmonary disease. She is experiences syncope and trouble breathing with activity. Her healthcare provider orders a transthoracic echocardiogram, which shows right ventricular hypertrophy. Cardiac catheterization reveals high pulmonary artery pressure.What disorder might Michaela have? Select the disorder that is best exemplified by that scenario. adult respiratory distress syndrome coal worker's pneumoconiosis pneumothorax pulmonary edema pulmonary embolism pulmonary hypertension thoracic cage deformity

pulmonary hypertension Pulmonary hypertension is high pressure within the pulmonary arteries. Secondary pulmonary hypertension, as show in Michaela's case, may result from COPD, as hypoxia induces pulmonary vasoconstriction. Pulmonary hypertension can cause the right ventricle to hypertrophy and fail, as the heart works against the higher pressure in the pulmonary system.

Crackles

sometimes called rales, are non-continuous sounds that occur when deflated alveoli open and close against fluid. They are commonly present in heart failure or pneumonia.

Hypoxia

stimulates erythropoiesis (to try & stimulate RBC secretion) • Any condition that causes hypoxia, such as cardiac disease, lung disease, or change in atmospheric pressure, will stimulate erythropoietin. • Chronic hypoxia stimulates erythropoietin secretion by the kidney. • Erythropoietin stimulates the bone marrow to synthesize red blood cells (RBCs). • Will see a lower oxygen stat - lower oxygen level in the blood stream • Kidneys will try to stimulate erythropoietin

Mucociliary Apparatus

• In the bronchioles, there is a specialized cellular mechanism where cells secrete mucus. • Inhaled particles such as dust, pollen, and pathogens are trapped by the mucus in the upper respiratory tract • Upward motion of the cilia moves the mucus from the bronchioles up to the throat where it is swallowed . • Smoking (cigarette smoke) paralyzes the Mucociliary apparatus • Failure to remove excess particles from the respiratory system the risk of infection

Lung anatomy:

• Left - 2 lobes • Right - 3 lobes

oxyhemoglobin

• The* percentage of hemoglobin saturated by oxygen can be measured using a pulse oximeter*, a monitor usually placed on the finger. (SPO2) o SPO2 normal levels = 95 -100 If the pressure of oxygen in the arterial blood (Po2) stays within the 90 to 100 mm Hg range, hemoglobin remains maximally saturated with oxygen and tissues remain oxygenated. When Po2 falls below 60 mm Hg, hemoglobin drops all O2 molecules off quickly