Adult health chpt. 20

A nurse is instructing the client on the normal sensations that can occur when contrast medium is infused during pulmonary angiography. Which client statement demonstrates an understanding of the teaching? "I will feel a dull pain when the catheter is introduced." "I will feel light-headed when the contrast medium is introduced." "I will feel waves of nausea throughout the procedure." "I will feel warm and may have chest pain"

"I will feel warm and may have chest pain"

Inspection of a patient's skin color is part of the assessment of the integumentary system. Cyanosis, which is a late indicator of hypoxia, is present when the unoxygenated hemoglobin level is: 2 g/dL 3 g/dL 4 g/dL 5 g/dL

5 g/dL

atomspheric pressure at sea level

760 mm Hg

partial pressure of nitrogen in the atmosphere at sea level is

78.6% of 760, or 597 mm Hg

A nurse working in the radiology clinic is assisting with a client having an unusual arterial procedure. What assessment should the nurse notify the health care provider about? Raised temperature in the affected limb Excessive capillary refill Absent distal pulses Flushed feeling in the client

Absent distal pulses

Which is a true statement regarding air pressure variances? Air is drawn through the trachea and bronchi into the alveoli during inspiration. Air flows from a region of lower pressure to a region of higher pressure during inspiration. The diaphragm relaxes during inspiration. The thoracic cavity becomes smaller during inspiration.

Air is drawn through the trachea and bronchi into the alveoli during inspiration.

The nurse is interviewing a patient who says he has a dry, irritating cough that is not "bringing anything up." What medication should the nurse question the patient about taking? Angiotensin converting enzyme (ACE) inhibitors Aspirin Bronchodilators Cardiac glycosides

Angiotensin converting enzyme (ACE) inhibitors

The nurse is caring for a client diagnosed with pneumonia. The nurse assesses the client for tactile fremitus by completing which action? Asking the client to repeat "ninety-nine" as the nurse's hands move down the client's thorax Asking the client to say "one, two, three" while the nurse auscultates the lungs Instructing the client to take a deep breath and hold it while the diaphragm is percussed Placing the thumbs along the costal margin of the chest wall and instructing the client to inhale deeply

Asking the client to repeat "ninety-nine" as the nurse's hands move down the client's thorax

The nurse assessed a 28-year-old woman who was experiencing dyspnea severe enough to make her seek medical attention. The history revealed no prior cardiac problems and the presence of symptoms for 6 months' duration. On assessment, the nurse noted the presence of both inspiratory and expiratory wheezing. Based on this data, which of the following diagnoses is likely? Acute respiratory obstruction Adult respiratory distress syndrome Pneumothorax Asthma

Asthma

A nurse practitioner diagnosed a patient with an infection in the maxillary sinuses. Select the area that the nurse palpated to make that diagnosis. Above the eyebrows Between the eyes and behind the nose On the cheeks below the eyes Behind the ethmoid sinuses

Between the eyes and behind the nose

What finding by the nurse may indicate that the client has chronic hypoxia? Crackles Peripheral edema Clubbing of the fingers Cyanosis

Clubbing of the fingers

The nurse is assessing the lungs of a patient diagnosed with pulmonary edema. Which of the following would be expected upon auscultation? Crackles at lung bases Egophony Absent breath sounds Bronchial breath sounds

Crackles at lung bases

A son brings his father into the clinic, stating that his father's color has changed to bluish around the mouth. The father is confused, with a respiratory rate of 28 breaths per minute and scattered crackles throughout. The son states this condition just occurred within the last hour. Which of the following factors indicates that the client's condition has lasted for more than 1 hour? Respiratory rate Cyanosis Son's statement Crackles

Cyanosis

For air to enter the lungs (process of ventilation), the intrapulmonary pressure must be less than atmospheric pressure so air can be pulled inward. Select the movement of respiratory muscles that makes this happen during inspiration. Lungs are pulled up and pushed back against the thoracic cage. Diaphragm contracts and elongates the chest cavity. Intercostals muscles relax to allow for expansion. Anteroposterior rib diameter decreases.

Diaphragm contracts and elongates the chest cavity.

Which of the following clinical manifestations should a nurse monitor for during a pulmonary angiography, which indicates an allergic reaction to the contrast medium? Difficulty in breathing Hematoma Absent distal pulses Urge to cough

Difficulty in breathing

A nurse is preparing a client for bronchoscopy. Which instruction should the nurse give to the client? Do not walk after the procedure for 4 to 6 hours. Do not cough after the procedure until you are walking. Do not talk for 2 hours before the procedure. Do not eat or drink for 6 hours before the procedure.

Do not eat or drink for 6 hours before the procedure.

A client arrives at the physician's office stating dyspnea; a productive cough for thick, green sputum; respirations of 28 breaths/minute, and a temperature of 102.8° F. The nurse auscultates the lung fields, which reveal poor air exchange in the right middle lobe. The nurse suspects a right middle lobe pneumonia. To be consistent with this anticipated diagnosis, which sound, heard over the chest wall when percussing, is anticipated? Tympanic Resonant Hyperresonant Dull

Dull

Expiatory reserve volume .

ERV The maximum volume of air that can be exhaled forcibly after a normal exhalation 1100 mL Expiratory reserve volume is decreased with restrictive conditions, such as obesity, ascites, pregnancy

A patient with sinus congestion points to a location on the inside of his eye as the area of pain. The nurse documents that the patient is complaining of pain in which sinus? Frontal Ethmoid Maxillary Sphenoid

Ethmoid

Functional residual capacity

FRC The volume of air remaining in the lungs after a normal expiration: FRC = ERV + RV 2300 mL Functional residual capacity may be increased with COPD and decreased in ARDS and obesity.

Inspiratory capacity

IC The maximum volume of air inhaled after normal expiration: IC = TV + IRV 3500 mL A decrease in inspiratory capacity may indicate restrictive disease. It may also be decreased in obesity.

Inspiratory reserve volume

IRV The maximum volume of air that can be inhaled after a normal inhalation 3000 mL

A nurse is concerned that a client may develop postoperative atelectasis. Which nursing diagnosis would be most appropriate if this complication occurs? Ineffective airway clearance Impaired gas exchange Decreased cardiac output Impaired spontaneous ventilation

Impaired gas exchange

What would the instructor tell the students purulent fluid indicates? Cancer Infection Inflammation Heart failure

Infection

The nurse is in the radiology unit of the hospital. The nurse is caring for a client who is scheduled for a lung scan. The nurse knows that lung scans need the use of radioisotopes and a scanning machine. Before the perfusion scan, what must the client be assessed for? Bleeding Iodine allergy Dysrhythmias Inflammation

Iodine allergy

The nurse is working on a busy respiratory unit. In caring for a variety of clients, the nurse must be knowledgeable of diagnostic studies. With which diagnostic studies would the nurse screen the client for an allergy to iodine? Select all that apply. Lung scan Chest x-ray Fluoroscopy Pulmonary angiography Bronchoscopy Pulmonary functions test

Lung scan Fluoroscopy Pulmonary angiography

A physician has ordered that a client with suspected lung cancer undergo magnetic resonance imaging (MRI). The nurse explains the benefits of this study to the client. What is the reason the client with suspected lung cancer would undergo magnetic resonance imaging (MRI)? Tumor densities can be seen with radiolucent images. Narrow-beam x-ray can scan successive lung layers. Lung blood flow can be viewed after a radiopaque agent is injected. MRI can view soft tissues and can help stage cancers.

MRI can view soft tissues and can help stage cancers.

The nurse is reviewing the blood gas results for a patient with pneumonia. What arterial blood gas measurement best reflects the adequacy of alveolar ventilation? PaO2 PaCO2 pH SaO2

PaCO2

A patient describes his chest pain as knife-like on inspiration. Which of the following is the most likely diagnosis? Bacterial pneumonia Bronchogenic carcinoma A lung infection Pleurisy

Pleurisy

Residual volume

RV The volume of air remaining in the lungs after a maximum exhalation 1200 mL Residual volume may be increased with obstructive disease.

The nurse is admitting a client who just had a bronchoscopy. Which assessment should be the nurse's priority? Medication allergies Swallow reflex Presence of carotid pulse Ability to deep breathe

Swallow reflex

Total lung capacity

TLC The volume of air in the lungs after a maximum inspiration TLC = TV + IRV + ERV + RV 5800 mL Total lung capacity may be decreased with restrictive disease such as atelectasis and pneumonia and increased in COPD.

The nurse receives an order to obtain a sputum sample from a client with hemoptysis. When advising the client of the physician's order, the client states not being able to produce sputum. Which suggestion, offered by the nurse, is helpful in producing the sputum sample? Tickle the back of the throat to produce the gag reflex. Drink 8 oz of water to thin the secretions for expectoration. Use the secretions present in the oral cavity. Take deep breaths and cough forcefully.

Take deep breaths and cough forcefully.

The client is returning from the operating room following a bronchoscopy. Which action, performed by the nursing assistant, would the nurse stop if began prior to nursing assessment? The nursing assistant is assisting the client to a semi-Fowler's position. The nursing assistant is assisting the client to the side of the bed to use a urinal. The nursing assistant is pouring a glass of water to wet the client's mouth. The nursing assistant is asking a question requiring a verbal response.

The nursing assistant is pouring a glass of water to wet the client's mouth.

A client experiences a head injury in a motor vehicle accident. The client's level of consciousness is declining, and respirations have become slow and shallow. When monitoring a client's respiratory status, which area of the brain would the nurse realize is responsible for the rate and depth? The pons The frontal lobe Central sulcus Wernicke's area

The pons

You are studying for a physiology test about the respiratory system. What should you know about central chemoreceptors in the medulla? They respond to changes in CO2 levels and hydrogen ion concentrations (pH) in the cerebrospinal fluid. They respond to changes in the O2 levels in the brain. They respond to changes in CO2 levels in the brain. They respond to changes in O2 levels and bicarbonate levels in the atmosphere.

They respond to changes in CO2 levels and hydrogen ion concentrations (pH) in the cerebrospinal fluid.

Upper Respiratory Tract anatomy

Upper airway structures consist of the nose; paranasal sinuses; pharynx, tonsils, and adenoids; larynx; and trachea.

Vital capacity

VC The maximum volume of air exhaled from the point of maximum inspiration: VC = TV + IRV + ERV 4600 mL A decrease in vital capacity may be found in neuromuscular disease, generalized fatigue, atelectasis, pulmonary edema, COPD, and obesity.

Tidal volume

VT or TV The volume of air inhaled and exhaled with each breath Normal Range: 500 mL or 5-10 mL/kg The tidal volume may not vary, even with severe disease.

What is the difference between respiration and ventilation? Ventilation is the process of gas exchange. Ventilation is the movement of air in and out of the respiratory tract. Ventilation is the process of getting oxygen to the cells. Ventilation is the exchange of gases in the lung.

Ventilation is the movement of air in and out of the respiratory tract.

A nurse is preparing a client with a pleural effusion for a thoracentesis. The nurse should: assist the client to a sitting position on the edge of the bed, leaning over the bedside table. raise the arm on the side of the client's body on which the physician will perform the thoracentesis. place the client supine in the bed, which is flat. raise the head of the bed to a high Fowler's position.

assist the client to a sitting position on the edge of the bed, leaning over the bedside table.

A client is being seen in the pediatric clinic for a middle ear infection. The client's mother reports that when the client develops an upper respiratory infection, an ear infection seems quick to follow. What contributes to this event? eustachian tubes genetics oropharynx epiglottis

eustachian tubes

A black client with asthma seeks emergency care for acute respiratory distress. Because of this client's dark skin, the nurse should assess for cyanosis by inspecting the: lips. mucous membranes. nail beds. earlobes.

mucous membranes.

The air we breathe is a gaseous mixture consisting mainly of

nitrogen (78.6%) and oxygen (20.8%)

baroreceptors, also located in the aortic and carotid bodies

respond to an increase or decrease in arterial blood pressure and cause reflex hypoventilation or hyperventilation.

Proprioceptors in the muscles and chest wall

respond to body movements, causing an increase in ventilation. Thus, range-of-motion exercises in an immobile patient stimulate breathing.

Mechanoreceptors in the lung include

stretch, irritant, and juxtacapillary receptors, and respond to changes in resistance by altering breathing patterns to support optimal lung function.

partial pressure of oxygen in the atmosphere at sea level is

that of oxygen is 20.8% of 760, or 158 mm Hg

upper and lower respiratory tract

upper respiratory tract, known as the upper airway, warms and filters inspired air so that the lower respiratory tract (the lungs) can accomplish gas exchange or diffusion