Med Surg/Chapters 25 and 86-Respiratory System and Disorders

The oropharynx consists of _________ palantine tonsils and ___________lingual tonsils.

2 and 2

How many sinuses are there on each side of the nasal area?

4

An oxygen saturation value of less than ___%, using a pulse oximetry, indicates that tissues are not receiving enough oxygen.

90

What test is used to determine hypoxemia?

ABG

_______________ are more accurate for measurement of O2 concentration.

ABGs

The nurse makes an observation of a patient having difficulty breathing and notes the patient is using _____________ muscles to breath.

Accessory

What should a nurse look for on an x-ray to determine if the client has atelectasis

Air in pleural space

What is a pneumothorax?

Air in the pleural space

Place in the bronchi where the bronchioles first branch

Alveolar duct

Grape-like clusters in the bronchi where the bronchioles end

Alveolar sac

Oxygen and carbon dioxide exchange take place in the_____________.

Alveoli

unable to respond to antigens by producing antibodies; weak, lacking energy

Anergic

A student nurse is learning new terminology about the respiratory system. What is surfactant?

Answer: A chemical that lines the walls of the alveoli RATIONALE: The walls of the alveoli are composed of a single layer of cells and are lined with a chemical called surfactant, which helps to prevent the alveolar walls from collapsing between breaths. Mucous membranes line the nasal cavity.The pharynx is the tube-shaped passage for food and air. Four cavities called sinuses are found on each side of the nasal area.

A 60-year old client complains of snoring when sleeping. Which should the nurse suggest to the client as a remedy?

Answer: Avoid using sleeping pills RATIONALE: The client should avoid using sleeping pills to prevent snoring. Elevating the head of the bed and using a special pillow are some of the remedies for snoring. The nurse should tell the client to avoid heavy meals at night and to avoid sleeping in the supine position.

A nurse is preparing a client for bronchoscopy. Which is a possible complication of the procedure ?

Answer: Bleeding RATIONALE: Bleeding, swelling of the throat, and swallowing and breathing difficulties are the possible complications of bronchoscopy. Pneumothorax and hemothorax are postoperative complications of thoracotomy. Delirium is a symptom of hypoxia, but it is not seen as a complication of the bronchoscopy procedure.

A nurse is caring for a client with chronic sinusitis. Which of the following symptoms of chronic sinusitis should the nurse assess for?

Answer: Cough, facial pain, nasal stuffiness, and fatigue RATIONALE: The major symptoms of chronic sinusitis are cough due to postnasal drip, chronic headaches in the affected area, facial pain, nasal stuffiness, and fatigue

There are several protective respiratory reflexes in the human body. Which are protective respiratory reflexes?

Answer: Coughing, sneezing, yawning RATIONALE: Coughing and sneezing are protective reflexes needed to dislodge materials from the respiratory passages. Yawning is another respiratory reflex which equalizes pressure between the middle ear and the outside atmosphere, helping a person to maintain balance. Yawning is a response to a lack of oxygen or an accumulation of carbon dioxide. Tracheotomy is an artificial opening in the trachea. Expiration is the process of breathing out air. Tracheotomy and expiration are not protective respiratory reflexes.

A client has been diagnosed with acute rhinitis. Which information should the nurse provide to the client?

Answer: Drinking plenty of fluid help to reduce the fever RATIONALE: Drinking plenty of water helps to reduce the fever associated with acute rhinitis.The nurse should instruct the client to consult the healthcare provider if fever continues beyond 2 days, and not to wait 5 days. Acute rhinitis is transmitted through coughing or sneezing.Antibiotics are ineffective against the disease because it is a viral infection.

A nurse is caring for a client admitted to the pulmonary care unit. Which is an early symptom of hypoxia that the nurse should assess for?

Answer: Dyspnea RATIONALE: One of the early signs of hypoxia is dyspnea or shortness of breath on exertion. Hypotension, not hypertension, is a symptom of hypoxia. Hypotension, bradycardia, stupor, and coma are late symptoms of hypoxia.

A client's blood gas results indicate respiratory acidosis. Which are causes of respiratory acidosis?

Answer: Emphysema, Asthma, and Severe pneumonia RATIONALE: Respiratory acidosis can be caused by disorders such as emphysema, severe pneumonia,asthma, and pulmonary edema. Respiratory alkalosis is most commonly caused by hyperventilation(excessively rapid, deep breathing). Pleurisy is an inflammation of the pleura caused by infection,injury, or tumor.

A client with severe COPD has difficulty maintaining homeostasis during breathing. How is homeostasis maintained during respiration?

Answer: Interaction between the respiratory and renal systems RATIONALE: The respiratory and renal systems interact to maintain homeostasis. Carbon dioxide reacts with water to form carbonic acid. Hydrogen ion often combines to form acids, such as hydrochloric acid. The bicarbonate ion often combines to form basic compounds, which counteract acids.One such base compound is sodium carbonate.

A client's oropharynx is inflammed. What is the function of the oropharynx?

Answer: It carries food to the esophagus and air to the trachea RATIONALE: The oropharynx carries food to the esophagus and air to the trachea. The auditory tubes permit the air to enter or to leave the middle ear cavities. The nasopharynx is the passage way for air only. The tonsils destroy any foreign substance inhaled and ingested.

A client is having difficulty with diaphragmatic breathing because of discomfort from upper abdominal surgery. What describes the function of the diaphragm?

Answer: It separates the thoracic from the abdominal cavity RATIONALE: The diaphragm is a dome-shaped muscle that separates the thoracic and abdominal cavities. The nasal septum divides the internal nose into two sides or cavities. The auditory tube connects the nasopharynx with the middle ear.The blood vessels in the mucous membranes aid in warming and moistening the air before it reaches the lung.

A nurse is caring for a female client with asbestosis. Which cancerous condition is associated with asbestosis?

Answer: Mesothelioma RATIONALE: Mesothelioma is the cancerous condition related to asbestosis. Asbestosis is a dust related disease caused by breathing in asbestos.Cervical carcinoma, melanoma, and Kaposisarcoma are not associated with asbestosis.

A nurse is caring for a client with influenza. Which nursing care measure should be followed when caring for the client?

Answer: Monitor for the presence of purulent or rose-colored sputum RATIONALE: Monitoring the presence of purulent or rose-colored sputum helps to reduce the risk of secondary infection. The nurse should encourage the client to drink large quantities of fluids,including fruit juices and plenty of water. The nurse should discourage the client from drinking milk, because it tends to form a film in the throat.Mild analgesics in prescribed doses can be administered to relieve headache, fever, and muscle pain.

A nurse is caring for a client with bronchiectasis. Which of the following nursing care measures should be employed when caring for the client?

Answer: Monitor the client for the occurrence of hemoptysis, provide special mouth care to the client, and perform a postural drainage procedure RATIONALE: Bronchiectasis is a common cause of hemoptysis, so the nurse should monitor the client for the symptoms of hemoptysis. Special mouth care is needed to overcome the offensive taste and breath odor. Drainage can be accomplished by performing postural drainage. Humidification of the air helps to thin secretions so that the client can expectorate them easily. The nurse should encourage the client to cough and breathe deeply.

While describing the exchange of gases in the body, how will the nurse explain the formation of carbonic acid (H2CO3)?

Answer: Reaction of carbon dioxide with water RATIONALE: Carbon dioxide reacts with water to form carbonic acid (H2CO3). The hydrogen ion often combines to form acids, such as hydrochloric acid (HCl). The bicarbonate ion often combines to form basic compounds, which counteract acids.Carbon dioxide is constantly being produced by the body as a byproduct of metabolism.

A nurse is caring for a client after laryngectomy. Which of the following postoperative nursing care measures should be employed when caring for the client?

Answer: Remove secretions through the tracheostomy tube, administer oxygen using a mask or T-piece, and teach the client how to use the tracheoesophageal puncture for speech RATIONALE: The nurse should remove mucous secretions frequently by suction through the tracheostomy tube. The oxygen should be administered to the client using a mask or T-piece.The nurse should instruct the client about tracheoesophageal puncture, which is a speech alternative after a total laryngectomy. Food should be given to the client through a nasal or gastrostomy tube instead of reestablishing oral feeding. The client should avoid wearing a thin filmy scarf over the opening, because it could be sucked into the tracheostomy and obstruct breathing.

A nurse is caring for a client with tuberculosis (TB). Which of the following information should the nurse provide to the client?

Answer: TB spreads by inhalation of infected droplets, diabetic clients have an increased risk for TB infection, and TB spreads to other parts of the body through the blood RATIONALE: TB spreads through inhalation of infected droplets. Diabetic clients are at high risk of TB infection. The tubercle bacilli most frequently attack the lungs, but the blood can carry the organisms to other parts of the body,including the kidneys, spine, brain, and bones.Individuals with latent TB show a positive, not negative, skin test reaction. Pulmonary TB is characterized by low-grade fever, occurring mostly n the afternoon.

A nurse is reviewing a client the function of the pleura. What is the function of the pleura?

Answer: To allow the lungs to move without causing any pain or friction against the chest walls RATIONALE: The lower respiratory tract contains a smooth double-layered sac of serous membrane called pleura. One layer covers the lungs (the visceral pleura), and the outer layer (the parietal pleura) lines the chest cavity. Their surfaces are inconstant contact and are moist because they secrete serous lubricating fluid. The pleura allow the lungs to move without causing pain or friction against the chest wall. The diaphragm contracts and flattens to increase the chest space and create a vacuum. The oropharynx carries food to the esophagus and air to the trachea. The epiglottis guards the entrance to the larynx.

The client is a miner and many of the hairs of the nostril have been destroyed over the years in this occupation. What is the function of the hairs in the nostril?

Answer: To filter the air and remove foreign particles to prevent them from entering the lungs RATIONALE: Hairs at the entrance of the nostrils and cilia (tiny hair-like projections) on the membranes serve as filters to remove foreign particles that otherwise might be carried to the lungs. The blood vessels in the mucous membrane said in warming and moistening the air before it enters the lungs. The sticky mucus traps dust particles, dirt, and microorganisms from the air.The nasal septum divides the internal nose into two cavities.

Why should a nurse encourage clients to perform deep-breathing exercises?

Answer: To improve oxygen delivery to the lungs and tissues RATIONALE: The nurse should encourage frequent coughing and deep-breathing exercise to improve oxygen delivery to the lungs and tissues. A low blood level of carbon dioxide is the major stimulus for breathing in healthy adults. The voice becomes louder and stronger when a person rapidly forces out a lot of air. The surfactant in the lungs acts to break up the surface tension in the pulmonary(lung) fluids

The rescue squad brings a client into the Emergency Department who has a blocked airway after choking on a piece of steak. The client is unresponsive and resuscitation efforts are continued with a bag-valve-mask. What action by the nurse is a priority? a. Gather equipment for an emergency tracheotomy. b. Intubate the client. c. Start an intravenous infusion. d. Perform a blind finger sweep.

Answer: a Cognitive Level: Analyze Explanation: In the event of a blocked airway, a tracheotomy may be needed. This is an artificial opening, either temporary or permanent, into the trachea. Without additional training, it is outside the scope of practice for the nurse to intubate the client. In addition, it would not be an appropriate action considering that the airway is obstructed. Performing a blind sweep may cause further dislodgement of the foreign body. Starting an IV is not a priority action and will not improve the outcome if the airway is obstructed.

The nurse is caring for a client with left lower lobe pneumonia. What nursing action would assist in improving oxygen delivery to the lungs and tissues? a. Encourage frequent coughing and deep breathing. b. Position the client with the head of the bed slightly elevated. c. Provide deep endotracheal suctioning. d. Use a bag-valve-mask to ventilate the client.

Answer: a Cognitive Level: Apply Explanation: Many factors can cause a decrease in gas exchange, including immobility, thoracic/pulmonary surgery, or pneumonia. Encouraging frequent coughing and deep breathing should assist in improving oxygen delivery to the lungs and tissues. Supplemental oxygen may also be ordered to improve arterial oxygen levels (O2 saturation).

The nurse is caring for a client in the clinic who is diagnosed with the common cold. What education should the nurse reinforce to help alleviate symptoms? a. Take antibiotics as prescribed. b. Drink plenty of fluids. c. Increase activity level. d. Avoid contact with others for 2 weeks.

Answer: b Cognitive Level: Apply Explanation: Drinking plenty of fluids will assist in thinning the secretions to allow them to be expectorated more easily, and maintains hydration. Antibiotics are not indicated for viruses, only bacteria, and would be ineffective in treating cold symptoms. The activity level should be decreased and the client should get plenty of rest. It is not necessary for the client to avoid the public for 2 weeks.

The nurse is ambulating a client with chest tubes to the bathroom when the tube becomes disconnected and falls on the floor. What is the priority action by the nurse? a. Reconnect the tubing. b. Double clamp tube close to the chest wall. c. Allow the client to ambulate to the bathroom. d. Place the client in the supine position.

Answer: b Cognitive Level: Apply Explanation: If the tubes become disconnected, double-clamp all tubes close to the chest wall and summon assistance immediately. This is an emergency situation requiring prompt intervention. If air enters the chest cavity, the person's lungs will collapse. Therefore, the client should not continue to ambulate to the bathroom. The client should be placed in Fowlers position, not supine. Reconnecting the tubing that has fallen on the floor may introduce pathogens into the lungs when reconnected and should not be done.

A client has a defective cranial nerve I. What data would the nurse gather in order to determine function? a. Use a tuning fork to determine bone conduction. b. Ask the client to smell and identify a variety of scents. c. Ask the client to open and close the eyes. d. Ask the client to stick the tongue out and say "ah."

Answer: b Cognitive Level: Apply Explanation: Nerve endings in the septum and nasal passages are responsible for the sense of smell. The olfactory nerve (cranial nerve I) carries these nerve impulses to the brain. A client who is unable to identify scents will likely have a defective cranial nerve I.

What intervention provided by the nurse would assist the client with early chronic obstructive lung disease to improve efficiency of lung function? a. Administer breathing treatment with a bronchodilator. b. Provide smoking cessation information. c. Perform chest physiotherapy. d. Encourage coughing and deep breathing.

Answer: b Cognitive Level: Apply Explanation: Smoking can decrease the efficiency of the respiratory system. Nicotine causes a decrease in bronchial diameter, constriction of blood vessels, paralysis of cilia (which assists in moving foreign particles out of the respiratory tract), and it can destroy lung tissue itself over time. These factors can all result in a decrease in gas exchange.

A client has a positive tuberculin skin test. What action by the nurse is appropriate? a. Administer another tuberculin skin test. b. Administer a tine test. c. Send the client for a chest x-ray. d. Prepare the client for a bronchoscopy.

Answer: c Cognitive Level: Apply Explanation: A person who is a positive reactor usually remains so for life. Thus, once positive, the TST test is usually not repeated. If a person has a positive reaction to the testing, a CXR and a sputum culture should be done to determine if the lungs are affected. In addition, some individuals may develop a severe allergic reaction to the test. Another tuberculin skin test is unnecessary. The tine test is another form of a tuberculin test that is not required after a positive tuberculin. The bronchoscopy is not required at this time and may be considered after the chest x-ray results are returned if there are lesions present.

The nurse is preparing a client for a bronchoscopy. What nursing actions are essential prior to the procedure? Select all that apply. a. Administer an enema. b. Detail the complications that can occur. c. Give mouth care. d. Observe for any loose teeth. e. Explain the procedure.

Answer: c, d, e Cognitive Level: Apply Explanation: Food and fluids are withheld for 6 to 8 hours before a bronchoscopy. Give mouth care immediately before the procedure to prevent bacteria from being introduced into the lungs. Explain the procedure to the client, who will most likely remain awake. Be sure that any dentures are removed. Note any loose natural teeth because the bronchoscope may loosen or dislodge a tooth, which could lead to aspiration. An enema administered pre-procedure is not required and has no benefit for the client. The care provider performing the procedure is responsible for detailing the complications prior to the client signing the informed consent.

A client is eating supper and begins coughing. What is the appropriate first action by the nurse? a. Insert fingers into the mouth to do a blind sweep and remove object. b. Lay the client flat and perform chest thrusts. c. Pat the client on the back to assist with dislodging the foreign body. d. Do nothing. Coughing will usually dislodge the foreign body.

Answer: d Cognitive Level: Apply Explanation: If a portion of food accidentally becomes lodged in the larynx, coughing can usually dislodge it. If not, the air passage may be blocked; such a blockage can be fatal unless proper emergency treatment is given. Nurses are given special training in treating obstructed airways and cardiopulmonary resuscitation.

The nurse is preparing a client for abdominal surgery. What action by the nurse can prevent postoperative atelectasis? a. Suction the client every 2 hours. b. Administer supplemental oxygen. c. Administer an inhaled bronchodilator. d. Instruct the client about the use of incentive spirometry.

Answer: d Cognitive Level: Apply Explanation: The healthcare provider will probably order breathing exercises to help the client build up respiratory capacity. These are usually done with the aid of the incentive spirometer. Instructions will depend on the particular type of device the client uses. A major reason for postoperative incentive spirometry is to prevent atelectasis (deflated or collapsed alveoli), which can potentially obstruct small or large sections of pulmonary tissues. A client should not be suctioned every 2 hours but only as needed because it deprives the tissues of needed oxygen. Administering supplemental oxygen does not prevent alveolar collapse. Administering an inhaled bronchodilator will open the air passages but does not prevent alveolar collapse in a postsurgical client.

___________________ is inability to use one's voice due to distress or injury to the larynx.

Aphonia

_______________ is a period of no respirations.

Apnea

Suffocation; deficiency of oxygen

Asphyxiation

A disease marked by breathing difficulty, caused by spasmodic contractions of the bronchial tubes; bronchial asthma

Asthma

What is the difference between COPD and Asthma?

Asthma is reversible

A complete or partial collapse of a lung or a lobe of a lung due to the collapse of the alveoli (tiny air sacs)

Atelectasis

The incentive spirometer helps prevent

Atelectasis

Connecting the nasopharynx to the middle ear

Auditory tubes

A profuse amount of purulent sputum, thick yellow or green, is a sign of a ____________ infection.

Bacterial

_________________ chest is characterized by an increase in the anteroposterior diameter of the thorax and is a result of over inflation of the lungs.

Barrel

How can venous stasis promote a pulmonary embolus?

Because a thrombus can form and dislodge and go to the lungs

When a client has a fractured sternum or ribs, why are the respirations so shallow ? What acid base imbalance will this put them at risk for?

Because it hurts / Respiratory acidosis

Why does the client with flail chest develop paradoxical chest wall movement?

Because of the broken ribs

There is a possibility with a thoracentesis that a pneumothorax could occur. Why ?

Because the doctor could puncture all the way into the lungs

How can dehydration promote an embolus?

Blood becomes thick and could form a clot

What is a hemothorax ?

Blood in the pleural space

The term for a respiratory rate that is too low is

Bradypnea

______________ is a slower-than-normal respiration rate (<10 breaths per minute)

Bradypnea

Tubular-shaped air passages that connect the trachea and lungs (sing: bronchus)

Bronchi

Chronic dilation of the bronchi, with large amounts of sputum production

Bronchiectasis

Smaller bronchi

Bronchiole

Inflammation of the bronchi

Bronchitis

COPD client improve ventilation and overcome hypoxia?

Bronchodilators Expectorants Liquefying Agents Increased fluids 1,000-2,000 mL/d Continuous O2 Fowler's or Orthopneic Small frequent meals

Helps to observe lung tissue or to remove mucous plugs or foreign objects.

Bronchoscopy

The visual examination of the bronchi using a bronchoscope

Bronchoscopy

Breathing into a paper bag during hyperventilation will increase levels of

CO2

What is the device that maintains continuous pressure in the airway to prevent apnea?

CPAP

A cause of impairment of internal respiration is a build up of _____________within the cell.

Carbon Dioxide

Acidosis is the result of excess

Carbon Dioxide

Internal respiration is also known as _______________ respiration.

Cellular

Exchange of oxygen for carbon dioxide within the cells

Cellular respiration

Hair-like threads that sweep materials across a cel

Cilia

When blood or air or fluid accumulates in the pleural space, what is going to happen to the lung?

Collapse

When the pleural space fills with fluid, what happens to the lungs ?

Collapse

What is CPAP?

Continuous positive airway pressure

Inspiration equals ______________ of the diaphragm.

Contraction

Name a protected reflexes from the respiratory system

Cough Sneeze Yawn

_____________ suggest conditions such as pneumonia, bronchitis, and congestive heart failure.

Crackles

What happens to the lungs due to smoking?

Decreases lung tubes

The muscular partition between the thoracic and abdominal cavities, important in breathing; a type of female contraceptive device; a part of a stethoscope.

Diaphragm

__________________ is the dome-shaped muscle separating the thoracic and abdominal cavities.

Diaphragm

With a fractured sternum or ribs, why do we give non-narcotic analgesics?

Do not want to depress the respirations even more

Difficulty in breathing

Dyspnea

Term which describes difficulty breathing

Dyspnea

___________ is difficulty breathing.

Dyspnea

What are possible alterations in Respiratory Status

Dyspnea Orthopnea Tachypnea Hyperpnea Bradypnea Hypoventilation Hyperventilation Cheyne-Stokes breathing *Biot respirations Apnea Central apnea Obstructive apnea *Mixed apnea Adult sleep apnea Kussmaul respirations

Name some complications of suctioning

Dysrhythmia Desaturation

Accumulation of pus in a body cavity, often the pleural (lung) cavity

Empyema

Cartilage that covers the entrance to the larynx

Epiglottis

Guarding the entrance of the larynx

Epiglottis

Nosebleed

Epistaxis

__________________ is a nose bleed.

Epistaxis

What are the functions of the esophagus?

Esophagus: Transports food from the pharynx tothe stomach

Normal respiration

Eupnea

Term which describes normal respiration

Eupnea

__________ is known as normal respirations.

Eupnea

How often should a clients nares be checked if they are wearing a nasal cannula?

Every 8 hours

Tidal volume is defined as the volume of air inhaled and ___________ with each breath.

Exhaled

Exhalation of air from the lungs; sometimes used to refer to death

Expiration

Breathing out is known as ____________.

Expiration or exhalation

Lung breathing

External Respiration

What to do with a client that had had a laryngectomy and is needing O2?

Face mask at site of trachea T-piece Suction them Speech therapy

T/F The nurse should discourage coughing in the patient who is short of breath.

False

T/F The chest size decreases on inspiration

False expiration

Any time you are pulling fluid from a client's body, you are putting the client at risk for going into a fluid volume deficit or fluid volume excess. Why?

Fluid volume deficit - because vascular space could deplete

A client has been admitted to the healthcare center with a sinus problem. What are the sinuses, and how do they get infected?

Four cavities called sinuses are found on each side of the nasal area (a total of eight sinuses). Mucosa that is continuous with the nasal mucosa lines these sinuses. Sinuses lighten the skull and provide resonance for the voice. The names of the sinuses correspond with the facial bones in which they are situated. The two largest sinuses are the frontal sinuses (one on each side above the eye socket) and the maxillary sinuses (one on each side of the nose,in conjunction with the maxillary bone). The ethmoidal sinuses lie between the eyes, and the sphenoidal sinuses lie on each side of the nasal cavity in he area of the orbit (eye socket). The sinuses drain directly into the nasal cavities, which drain into the throat. Because of the direct connection between the sinus cavities and the nasal mucosa, infection in one area can easily spread to another.

A nurse auscultates harsh and cracking, sounding like two pieces of leather being rubbed together. The nurse would document this as pleural _____________ rub.

Friction

________________ chest is a depression in the lower portion if the patient's sternum.

Funnel

A group of illnesses caused by group A streptococci, such as strep throat, impetigo, necrotizing fasciitis, or streptococcal toxic shock syndrome

Group A Streptococci

Oxygen diffuses into the capillaries and is bound to ____________.

Hemoglobin

Post op tonsillectomy complication is ____________________.

Hemorrhage

Fluid or blood pooling in the pleural cavity; also called pleural effusion

Hemothorax

Which test result would indicate the cause of a clients increased respiration

High carbon dioxide

Specific fungal infection

Histoplasmosis

_____________ is a sign of acute laryngitis.

Hoarseness

What would happen if the water seal in the chest system is broken?

Hook it back up unless you happen to have a sterile connector in the room. Then you would use a brand new sterile connector

Abnormally fast and deep breathing, usually caused by anxiety, resulting in reduction of carbon dioxide and an increase in oxygen

Hyperventilation

Low blood oxygen level is known as _____________.

Hypoxemia

Supplemental oxygen may eliminate _____________.

Hypoxia

When a client has a pulmonary embolus, why does their pulse go up?

Hypoxia

A device used to force the client to concentrate on inspiration and promote full inflation of the lungs, while providing immediate feedback; used particularly after surgery and in lung disorders

Incentive spirometer

With a pulmonary embolus, the client will have fever and their WBC count will go up. Why?

Inflammation

Inhalation; drawing air into the lungs

Inspiration

Breathing air in is known as ___________.

Inspiration or inhalation

Muscles located between the ribs

Intercostal muscles

These are two forms of respiration ___________and ______________.

Internal and External

Cellular breathing

Internal respiration

What are the major causes of epistaxis?

Irritation or injury to a small mass of capillaries on the nasal septum can cause epistaxis or nosebleed.Hypertension is another major cause of epistaxis, in which the bleeding is more likely to be severe.Certain blood disorders, cancer, and rheumatic fever are other possible causes.

When a client has a pulmonary embolus, the blood pressure is going to go up into their lungs. What effect will that have on the right side of the heart?

It will increase the workload on the right side of the heart

Besides the lungs, who is a compensator organ for acid-base balance?

Kidneys

_________________ is the elevation of the scapula and a corresponding S-shaped spine, limits lung expansion within the thorax.

Kyphoscoliosis

Surgical removal of the larynx; the person is then called a laryngectomee

Laryngectomy

Lowest portion of the pharynx, extending from the epiglottis to the opening of the larynx and esophagus. It is divided to provide separate passages for food and air

Laryngopharynx

Box-like structure of cartilage in the midline of the neck; also called voice box

Larynx

Risk factors for _____________ cancer is alcohol intake.

Larynx

_____________ (voicebox) is a box-like structure made of cartilages held together by ligaments.

Larynx

What are the functions of the larynx?

Larynx: Serves as an air passageway between the pharynx and the trachea.

Cyanosis is a ____________ sign of hypoxia.

Late

What should you do if a client presents with a penetrating object to the chest?

Leave it in place

Removal of a lobe of the lung

Lobectomy

One of two cone-shaped organs that fills the chest cavity; the organ of respiration

Lung

Pink-tinged mucoid sputum suggests a __________ tumor.

Lung

Illustrates different views through which lesion, pneumonia, and other disorders can be located.

Lung perfusion scan

Noninvasive nuclear procedure used to diagnose disorders in the lungs and bronchi.

Magnetic resonance imaging

The cavity containing the heart; between the lungs and second and sixth ribs

Mediastinum

What part of the brain controls the respiratory center, depth and rate of respiration?

Medulla

__________________________ tuberculosis is a form of tuberculosis that is characterized by widespread dissemination into the body.

Miliary

What is flail chest?

Multiple rib fractures

Nostrils

Nares

Place in order

Nasal Cavity Nasopharynx Epiglottis Trachea

Section of the pharynx that extends from the nares to the uvula that is used for air passage only

Nasopharynx

A client who had been involved in a serious accident has suffered a puncture wound to the chest. Why is it important that this wound be closed immediately?

Normal breathing occurs as a result of nervous stimulation of the respiratory center in the brain's medulla. Because the lungs cannot move by themselves, the actions of the muscles surrounding them inflate and deflate them. The medulla send simpulses to the diaphragm and the intercostal muscles. The diaphragm is a dome-shaped muscle that separates the thoracic and abdominal cavities.It contracts and flattens to increase chest space and create a vacuum. The intercostal muscles are located between the ribs; they contract to lift and spread the ribs during inhalation, adding to the vacuum.Any interruption in the closed chest can be immediately life-threatening, because it disrupts the vacuum necessary for inspiration. Therefore, a puncture wound or other opening into the chest must be immediately closed, to prevent death.

Rhonchi and wheezes are associated with airway ______________.

Obstruction

______________ sleep apnea is characterized by lack of airflow due to pharyngeal occlusion.

Obstructive

Carrying nerve impulses to the brain

Olfactory nerve

Part of the pharynx extending from the uvula to the epiglottis that carries food to the esophagus and air to the trachea; commonly called the throat.

Oropharynx

A position a patient takes to make difficult breathing easier is known as _____________.

Orthopnea

The client with pneumonia should be kept in the ___________position.

Orthopneic

Inflammation or infection of the middle ear

Otitis media

What is the major difference between the two (PEEP and CPAP)?

PEEP exerts pressure at the end of exhalation and CPAP is pressure throughout the breathing cycle

A nasal fracture with bleeding is controlled with the use of nasal ______________.

Packing

Surgical puncture of a body cavity for the aspiration of fluid (often refers to abdominal paracentesis). (Removal of fluid from the thoracic cavity is called thoracentesis.)

Paracentesis

Outer layer of pleura that lines the chest cavity

Parietal Pleura

Inflammation of the pharynx

Pharyngitis

Tube-shaped passage for food and air

Pharynx

____________ is a tube like structure that connects the nasal and oral cavities to the larynx.

Pharynx

_________________ chest is a result of displacement of the sternum and includes an increase in the anteroposterior diameter.

Pigeon

Membrane covering the lungs and lining the walls of the chest cavity, as the parietal pleura

Pleura

The lungs consist of the __________and _________ layers.

Pleural Cavity Pleural Space

The layer surrounding the lung is called __________.

Pleural Space

Space between the two layers of the pleura; also called pleural space

Pleural cavity

When a client is having a thoracentesis, where is fluid being removed from?

Pleural space

Inflammation of the pleura

Pleurisy

What is the disorder described as sticking pain?

Pleurisy/Pleuritic Chest Pain

Client with HIV/Aids is at risk for what respiratory disorder?

Pneumocystis Carinii

Removal of an entire lung

Pneumonectomy

Lung inflammation, with consolidation and drainage

Pneumonia

A rare, but serious complication of thoracentesis

Pneumothorax

Collapse of a lung, due to air or gas in the chest cavity

Pneumothorax

What is PEEP?

Positive end expiratory pressure

Method of drainage that uses position and gravity to drain secretions and mucus from a person's lungs

Postural drainage

What are the preventive measures against tuberculosis?

Preventive measures against tuberculosis include the following: •Educating the public about good general health practices. •Burning all used tissues containing sputum or other infectious waste. •Following community guidelines for the disposal of biohazardous waste. •Starting early treatment to stop further spread of the disease. •Regular follow-up with all persons who have had active tuberculosis. •Screening of members of high-risk groups, suchas immigrants and medically under served low income populations. •Conducting the PPD tuberculin test in long-term residents of nursing homes, mental institutions,and correctional facilities. •Conducting yearly screening of healthcare workers.

The client with TB should eat a diet high in __________and _________.

Protein, Vitamin A and C

External respiration is also know as ____________ respiration

Pulmonary

Bronchoalveolar lavage is used to diagnosis

Pulmonary TB

Abnormal, permanent enlargement of the alveoli and alveolar ducts with destruction of the alveolar walls

Pulmonary emphysema

What critical numbers would you report related to oxygenation and drainage in a closed chest drainage system?

Pulse ox of 90%; drainage is 100mL or greater

When a client has chest tubes, hopefully the lungs will do what?

Re-expand

What is the purpose of a thoracentesis?

Removal of fluid from the pleural space

When a client is diagnosed with Thoracentesis for which of the following should you NOT notify the physician?

Resp 22 B/P 142/86 Respirations deep and regular

The total process of the exchange of oxygen and carbon dioxide between the air and body cells. (External respiration denotes the exchange of gases in the lungs; internal respiration denotes exchange of gases between the blood and body cells)

Respiration

What are the processes of respiration?

Respiration refers to three processes: ventilation(breathing), gas exchange (in the alveoli of the lungs and in the cells of the body), and transportation of oxygen and carbon dioxide (for metabolism,body processes, and waste removal).

The R in ROME (Acid Base Mnemonic) stands for____________?

Respiratory- All focus on CO2 Opposite pH increased and PCO2 decreased= Alkalosis pH decreased and PCO2 increased= Acidosis Metabolic Equal pH increased and HCO3 increased= Alkalosis pH decreased and HCO3 decreased= Acidosis

Inflammation of the mucous membrane lining the nasal cavity

Rhinitis

Plastic surgery/repair of the nose

Rhinoplasty

Depending on the severity of the pharyngitis and the degree of pain, warm _____________ gargles or throat irrigations are used.

Saline

When a client has a pulmonary embolus, describe their chest pain.

Sharp and stabbing

A cavity or channel, often refers to the paranasal sinuses; may also refer to fistula (a sinus tract)

Sinus

A client with _______________may experience vocal resonance changes and changes in weight of skull.

Sinus infection

Providing the resonance for the voice

Sinuses

Place in the order of appearance in the respiratory tract.

Sinuses Epiglotis Larynx Trachea

Inflammation of the sinuses

Sinusitis

_______________ samples ideally are obtained early in the morning before the patient has had anything to eat or drink.

Sputum

Suffocation resulting from externally applied pressure to the throat

Strangulation

Infection caused by the streptococcus bacterium that is common in children and responds well to antibiotic therapy if treated promptly; otherwise, it may develop more serious complications such as rheumatic fever, rheumatic heart disease, and nephritis

Strep throat

What are the common structural disorders of the nose?

Structural disorders of the nose include deviated septum and nasal polyps. A deviation in the nasal septum is a structural disorder of the nose. This can cause blockage in the air passage of one or both of the nostrils. If left uncorrected, the deformity can cause sinusitis. Nasal polyps are tumors found in the nose. Nasal polyps can obstruct breathing and sinus drainage.

Stoppage of breathing; asphyxia.

Suffocation

Surface-active agent, such as soap; a mixture of phospholipids (mostly lecithin and sphingomyelin) in the respiratory passages, used as a test for fetal maturity

Surfactant

___________________ preserves the elastic property of the lung tissue, reduces friction of the lung tissue, and improves overall lung function.

Surfactant

A patient who frequently coughs after eating and drinking should have a ______________ assessment to determine the cause.

Swallowing

What type of line will be put into the client to monitor the right side of the heart?

Swan-Ganz catheter

What is most common cause of snoring

Swollen adenoids

Normal anteroposterior diameter to the lateral diameter is 1:2. True or False?

TRUE

______________ is a respiratory rate of greater than 24 breaths per minute.

Tachypnea

What life threatening complication can occur if you clamp a chest tube?

Tension pneumothorax

What are the effects of aging on the respiratory system?

The effects of aging on the respiratory system are as follows: organs lose elasticity; chest walls become stiffer; lungs cannot expand as much; less air is exchanged with each breath; and there is greater susceptibility to respiratory disorders.

A nurse on his rounds notices that a client who had been eating her food rather hastily has begun to cough. What could the reason be for her cough?

The larynx serves as an air passageway between the pharynx and the trachea. Although the pharynx acts as a dual passageway for air and food, only air is allowed to pass into the larynx. A lid or cover of cartilage, called the epiglottis ("trap door cartilage"),guards the entrance to the larynx. The epiglottis automatically closes when a person swallows,preventing food from entering the lower respiratory passage. If a person is eating hastily, food can accidentally lodge itself in the larynx. Coughing helps to dislodge the food from the larynx.

What has happened when a client needs a chest tube?

The lung is collapsed

What are the symptoms of chronic sinusitis?

The major symptoms of chronic sinusitis are cough due to postnasal drip, chronic headaches in the affected area, facial pain, nasal stuffiness, and fatigue.

What are the signs and symptoms of influenza?

The major symptoms of influenza are sudden illness with muscle pain, fever, headache, sensitivity to light, burning eyes, and chills. Sneezing, coughing,nasal discharge, sore throat, and vomiting are also found in affected clients. Fever ranging from 100°F to 103°F lasts for 2 to 3 days. Other symptoms,especially cough, may persist for several weeks after the person has had the flu.

What is the nasal septum, and what is its function?

The nasal septum, a structure consisting of bone and cartilage, divides the internal nose into two sides or cavities. The nerve endings in the septum and in the nasal passages are responsible for the sense of smell.

What is the pleural space?

The potential space between the visceral and parietal pleural

What is a tension pneumothorax?

The pressure has accumulated in the pleural space and has collapsed the lung and pushed everything to the opposite side

What are the two types of respiration?

The two types of respiration are external respiration(exchange of oxygen for carbon dioxide within the alveoli of the lungs) and internal or cellular respiration (exchange of oxygen for carbon dioxide within the cells).

Surgical puncture and drainage of the thoracic (chest) cavity

Thoracentesis

Incision into the thorax or chest cavity

Thoracotomy

When a client has an open pneumothorax, you are supposed to put a piece of petroleum gauze over the area. How many sides are taped down ? Why do we leave one side open?

Three taped down - the fourth side acts as an air vent. There is a chance there is some air that will need to come out so you will have to leave a way for it to come out.

Helps to determine which medication is most effective against an infecting organism.

Throat culture

Which test for TB involves the utilization of an impregnated steel disc?

Tine Test

With a fractured sternum or ribs, why is the cliwnt put on a ventilator with PEEP?

To expand the chest to realign ribs

Why is the CDU kept below the level of the chest?

To prevent gravity flow of drainage into the pleural space

Chest systems have a water seal. What is the purpose of the water seal and what would happen if there was not a water seal?

To promote one-way flow of air out of the pleural space. If there was no water seal of if the water seal was broken, air from the outside environment could go backwards into the pleural space and re-collapse the lung.

The _____________ encircle the throat and guard the body from invasion by organisms entering the nose and throat.

Tonsils

The _________________guard the body from invasion of organisms entering the nose and throat?

Tonsils

The _________ is a hollow tube that transports air from the laryngeal pharynx to the bronchi.

Trachea

The windpipe, through which food and air pass

Trachea

What are the functions of the trachea?

Trachea: Air passes from the larynx into the trachea. Mucus in the trachea traps inhaled foreign particles, which the waves of cilia carryout of the respiration tract through the pharynx.

With a mediastinal shift, what will happen to the trachea ?

Tracheal deviation

Surgical creation of an opening into the trachea through the neck

Tracheostomy

T/F A puncture would or other opening into the chest must be immediately plugged

True

T/F Carbon dioxide can be transported from the body in combination with proteins.

True

A communicable disease caused by the tubercle bacillus (any organ may be affected, but it primarily affects the lung in human beings)

Tuberculosis

How many sets of tonsils can be found in the oropharynx, and where are they located?

Two sets of tonsils are in the oropharynx. The two palatine tonsils are located posteriorly, on each side of the oral cavity. The palatine tonsils are the ones commonly removed during tonsillectomy. The lingual tonsils are located at the base of the tongue.Both sets of tonsils aid in destroying foreign substances that are inhaled or ingested.

Mechanical process of respiration that moves air to and from the alveoli is known as _______________.

Ventilation

Supplying oxygen to the body through the lungs; breathing

Ventilation

A nurse is conducting a session on the respiratory system for a group of students. How will she explain what inhalation is ? What are the percentages of oxygen and carbon dioxide in exhaled air?

Ventilation (breathing) is the mechanical process of respiration that moves air to and from the alveoli. Ventilation is divided into inhalation and exhalation. Breathing air in is called inhalation or inspiration. The air that is exhaled contains approximately 16% oxygen and 4.5% carbon dioxide.

Layer of the pleura that covers the lungs

Visceral pleura

Two triangular-shaped membranous folds that extend from the front to back of the larynx that vibrate and produce sound as air passes over them

Vocal Cord

_________________ throughout the lung fields may indicate narrowed airways.

Wheezing

What is paradoxical chest wall movement?

When the chest does not rise and fall symmetrically; see-saw chest

How will Heparin help the client who has developed a pulmonary embolus?

Will decrease the formation of new clots and keep the clot that has already developed from getting any larger

___________________ is a response to a lack of oxygen or an accumulation of carbon dioxide.

Yawning

Lung capacity can vary with ________________.

age sex physical condition

Collapse of a lung due to obstruction by mucus or a foreign object is called _______________________.

atelectasis

The lower respiratory tract consists of ___________and____________.

bronchi and lungs

Coughing is the results of sensory receptors of the _________and_________to foreign particles.

bronchi and trachea

Hemoptysis is commonly caused by_______________________.

bronchiectasis

Pulmonary disease can _________the expansion of the lungs.

decrease

Profuse sweating at night is called nocturnal ___________________________.

diaphoresis

The ______________________ is a dome-shaped muscle that separates the thoracic and abdominal cavities.

diaphragm

During inspiration the diaphragm pulls

down

Asthma is an obstructive breathing disorder which can cause

dyspnea

What nursing intervention is important for a client with Emphysema

elevate HOB

A lid or cover of cartilages called the ________________ guards the entrance to the larynx.

epiglottis

Which respiratory structure prevents food from entering the respiratory tract

epiglottis

The exchange of oxygen for carbon dioxide within the alveoli of the lungs is called _____________________ respiration.

external

The process of respiration includes the exchange of gases between the ___________and body cells.

external environment

Oxygen diffuses into the capillaries and is bound to _____________ in the blood stream.

hemoglobin

The body compensates for respiratory alkalosis by causing

hyperventilation

Low oxygen level is called ___________.

hypoxia

Accessory muscle use in most indicative of respiratory distress in which age group

infants

The ability of the _______and ________to expand also influences lung volumes and capacity.

lungs and thorax

Involuntary control of respiratory rate and depth is done by which part of the body

medulla

Nearly all blood in the body travels through the lungs every ____________.

minute

The body relies on the nervous system to receive __________and ________ stimuli.

nervous and chemical

The ___________________________ is the part of the pharynx that extends from the uvula to the epiglottis.

oropharynx

The function of the _______________________ is to allow the lungs to move without causing pain or friction against the chest walls.

pleura

An inflammation of the double membrane covering the lungs is called ___________________________.

pleurisy

What is the term for "sticking pain"

pluerisy

Severe dyspnea, asymmetrical chest, drop in blood pressure, and mediastinal shift towards affected side indicate______________

pneumothorax

Name the procedure used to treat cystic fibrosis, which involves placing the client in the head downward position?

postural drainage

Functions of respiratory system carbon dioxide exchange and ________________.

protection

The client who has had a paracentesis is at risk for

shock

What position is the client lying in during a bronchoscopy?

side laying

The incentive ________________________ helps the client to perform respiratory exercises and to maintain lung function.

spirometer

The walls of the alveoli are lined with ____________.

surfactant

Fluid drainage from the site is an adverse reaction for which procedure

thoracentesis

Diagnosis of strep throat is made using which test

throat culture

Upper respiratory tract includes nose, pharynx, larnyx and ____________.

trachea

What is the tube which connects the upper and lower respiratory tracts?

trachea

In the event of a blocked airway a ___________ may be performed.

tracheostomy

The larynx is commonly called the _____________.

voice box

Carbonic acid is formed when carbon dioxide mixes with

water