Sunday Quiz

What are possible causes of pleural effusion?

-Blockage of lymphatic drainage -Imbalance between intravascular and oncotic fluid pressure

Oxygen is carried into the blood in what two forms?

-Dissolved oxygen (PaO2) -Hemoglobin-bound oxygen. (SaO2)

What actions should the nurse take to prepare a patient for a pulmonary function test?

-Explain the procedure to the patient -Avoid scheduling the test immediately after a meal -Avoid administration of inhaled bronchodilator six hours before the procedure.

Blood samples for ABG analysis are collected from which arteries?

-Femoral artery -Radial artery

Where are the Mechanical receptors, such as juxtacapillary and irritant receptors located?

-Lungs, chest wall, and diaphragm.

What respiratory problems have a strong genetic link?

-cystic fibrosis -asthma (atopy) -COPD (aat deficiency)

After obtaining blood for an arterial blood gas measurement, the nurse should hold pressure on the puncture site for how many minutes to be sure that bleeding has stopped?

5 minutes

The most common symptom of pulmonary tuberculosis (TB) is?

A cough that progresses in frequency and produces mucoid or mucopurulent sputum

What are the classic symptoms of pulmonary embolus?

Acute onset of symptoms, tachypnea, shortness of breath, and chest pain.

When can airborne infection isolation for a patient with pulmonary tuberculosis (TB) be discontinued?

After three consecutive acid-fast bacillus (AFB) smears are negative Airborne infection isolation is indicated for the patient with pulmonary or laryngeal TB until the patient is noninfectious (defined as effective drug therapy, clinical improvement, and three negative AFB smears). Therapy must be deemed effective. Teaching the patient to properly use the HEPA mask isn't a criterion for terminating isolation. Chest x-rays are not criteria to terminate isolation.

What is the most common manifestation of a lung abscess?

Cough producing purulent sputum (often dark brown) that is foul smelling and foul tasting

Which defense mechanism is effective for removing secretions in the main airways?

Cough reflex

What is the cause of atelectasis?

Surfactant deficiency Surfactant is a lipoprotein that lowers the surface tension in the alveoli and reduces the amount of pressure needed to inflate the alveoli, making them less likely to collapse. Therefore the primary reason that atelectasis occurs is due to a surfactant deficiency.

Where are the central chemoreceptors located?

Medulla Oblongata Central chemoreceptors are located in the medulla oblongata and respond to changes in pH in the cerebrospinal fluid.

Because thoracentesis involves the introduction of a catheter into the pleural space, there is a risk of ?

Pneumothorax

Which interconnected structure allows the movement of air between the alveoli?

Pores of Kohn

_____________is performed to visualize pulmonary vasculature and locate obstruction or pathologic conditions (e.g., pulmonary embolus).

Pulmonary angiography

Thoracentesis may be used for treatment of?

Recurrent pleural effusion During and after a thoracentesis, monitor the patient's vital signs and pulse oximetry and observe the patient for any manifestations of respiratory distress, which may indicate a possible complication, such as pneumothorax or pulmonary edema.

What is the correct positioning for a thoracentesis?

Sitting upright with elbows on an over bed table and feet supported

____________ is the insertion of a large-bore needle through the chest wall into the pleural space to obtain specimens for diagnostic evaluation, remove pleural fluid, or instill medication into the pleural space.

Thoracentesis

A patient with a history of epilepsy is admitted to the hospital for treatment of fever and shortness of breath. The patient is diagnosed with pneumonia. On taking history, the nurse finds that the patient had a seizure four days ago with profuse vomiting. What type of pneumonia does the patient have? a.) Aspiration pneumonia b.) Opportunistic pneumonia c.) Hospital-associated pneumonia d.) Community-acquired pneumonia

a.) Aspiration pneumonia A patient who has seizures is at risk of developing aspiration pneumonia. The gastric contents enter the respiratory tract during the seizure and damage the lung tissue. Therefore this is the most probable reason for the patient's symptoms. The history of the patient does not suggest any exposure to pneumonia in the community. The patient has never been in the hospital; therefore, hospital-associated pneumonia is highly unlikely. The patient does not have a history of HIV, intake of immunosuppressive drugs, corticosteroids, or any disorders leading to immunosuppression. Therefore opportunistic pneumonia did not occur in this patient.

The nurse cares for a patient with a diagnosis of tuberculosis. Which assessment finding best indicates that the patient has been following the prescribed treatment plan? a.) Negative sputum cultures b.) Clear breath sounds bilaterally c.) Decrease in the number of coughing episodes d.) Conversion of the Mantoux test from positive to negative

a.) Negative sputum cultures A patient's sputum is expected to convert to negative within three months of the beginning of treatment. If it does not, the patient is either not taking the medication or has drug-resistant organisms. Bilaterally clear breath sounds and a decrease in coughing are good indications that the patient is following the prescribed plan, but they are not as confirmatory as negative sputum cultures. Once a person has been exposed to the tuberculosis-causing organism, the Mantoux test will always elicit a positive result.

A patient had an intradermal tuberculin skin test (Mantoux) administered 48 hours ago. The nurse assesses the injection site and identifies a 12-mm area of palpable induration. How should the nurse interpret this result? a.) Definitive evidence that the patient does not have tuberculosis b.) A significant indication that the patient has been exposed to tuberculosis c.) Delayed hypersensitivity with a high likelihood of infection with tuberculosis d.) A negative test that cannot be interpreted as ruling out the presence of tuberculosis

b.) A significant indication that the patient has been exposed to tuberculosis An area of 12 mm of induration at the injection site 48 hours after a Mantoux test is considered significant for a past or current tuberculin infection. An induration of less than 5 mm is considered a negative result. The other answer options are incorrect conclusions related to the findings.

A patient presents with a lung abscess. What treatment option would be the most appropriate? a.) Postural drainage b.) Antibiotic treatment c.) Chest physiotherapy d.) Reduction of fluid intake

b.) Antibiotic treatment Because there are mixed bacteria in a lung abscess, starting a broad spectrum antibiotic is the appropriate treatment option. Postural drainage and chest physiotherapy are not recommended because they may cause spillage of infection to other bronchi and spread the infection. Reducing fluid intake is not advisable; instead, adequate fluid intake is recommended.

The nurse is preparing the patient for a diagnostic procedure to remove a mucus plug. The nurse would prepare the patient for which test? a.) Thoracentesis b.) Bronchoscopy c.) Pulmonary angiography d.) Sputum culture and sensitivity

b.) Bronchoscopy Bronchoscopy is a procedure in which the bronchi are visualized through a fiberoptic tube. Bronchoscopy may be used for diagnostic purposes to obtain biopsy specimens and assess results of treatment, and also is used for treatment, such as removing mucus plugs or foreign bodies.

After admitting a patient from home to the medical unit with a diagnosis of pneumonia, the nurse will verify that which health care provider prescriptions have been completed before administering a dose of cefuroxime to the patient? a.) Pulmonary function evaluation b.) Sputum culture and sensitivity c.) Orthostatic blood pressures (BP) d.) Serum laboratory studies prescribed for the morning

b.) Sputum culture and sensitivity The nurse should ensure that the sputum for culture and sensitivity was sent to the laboratory before administering the cefuroxime, because this is community-acquired pneumonia. It is important that the organisms are identified correctly (by the culture) before the antibiotic takes effect. The test also will determine whether the proper antibiotic has been prescribed (sensitivity testing). Although antibiotic administration should not be unduly delayed while waiting for the patient to expectorate sputum, orthostatic BP, pulmonary function evaluation, and serum laboratory tests will not be affected by the administration of antibiotics.