Lower Respiratory Disorders Quiz
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Questions and Answers

What pathology significantly affects the elasticity of the lungs?

  • Asthma
  • Pulmonary edema
  • Chronic bronchitis
  • Fibrosis (correct)

    • Which of the following is true about the anatomical structure of the lungs?

  • Both lungs have an equal number of segments.
  • The left lung is larger than the right lung.
  • The left lung has one more lobe than the right lung.
  • The right lung has a straighter main bronchus angle. (correct)

    • How would stimulating the carina in a sedated patient typically respond?

  • Elicit no response.
  • Induce a gag reflex.
  • Produce a cough reflex. (correct)
  • Cause respiratory arrest.

    • What is the significance of the anterior trachea's cartilaginous rings?

    <p>They provide structural support to keep the trachea open.</p> Signup and view all the answers

    What risk is associated with inadvertent intubation of the right main bronchus?

    <p>Hypoxemia from reduced ventilation to the left lung.</p> Signup and view all the answers

    What is the primary function of the upper respiratory tract?

    <p>Protection of lower airways and filtering air</p> Signup and view all the answers

    Which of the following correctly differentiates between hypoxia and hypoxemia?

    <p>Hypoxia refers to low oxygen in tissues, while hypoxemia refers to low oxygen in blood.</p> Signup and view all the answers

    Which scenario describes hypercapnic respiratory failure?

    <p>Inadequate carbon dioxide removal leading to elevated levels in the bloodstream.</p> Signup and view all the answers

    Which of the following describes the concept of a V/Q mismatch?

    <p>Inadequate ventilation despite adequate perfusion.</p> Signup and view all the answers

    What is an important nursing intervention for managing a patient in respiratory failure?

    <p>Administering oxygen as prescribed to address hypoxemia.</p> Signup and view all the answers

    What is the primary role of the carina in the respiratory system?

    <p>Airway landmark for bronchial division.</p> Signup and view all the answers

    What characterizes Acute Respiratory Distress Syndrome (ARDS)?

    <p>Increased pulmonary capillary permeability leading to respiratory failure.</p> Signup and view all the answers

    Which factor is NOT considered a common pathology contributing to respiratory failure?

    <p>Chronic fatigue syndrome</p> Signup and view all the answers

    What is the effect of a decrease in pH on the oxygen dissociation curve?

    <p>Shifts the curve to the right</p> Signup and view all the answers

    Which of the following conditions is associated with a rightward shift of the oxygen dissociation curve?

    <p>Increase in 2,3 DPG</p> Signup and view all the answers

    At a partial pressure of oxygen (paO2) of 60 mmHg, what is the typical oxygen saturation level?

    <p>90%</p> Signup and view all the answers

    In which scenario would hemoglobin be less likely to release oxygen?

    <p>Low 2,3 DPG levels</p> Signup and view all the answers

    What best describes the impact of carboxyhemoglobin on hemoglobin's ability to transport oxygen?

    <p>Decreases oxygen affinity</p> Signup and view all the answers

    Which of the following factors is NOT known to shift the oxygen dissociation curve to the left?

    <p>Increased pCO2</p> Signup and view all the answers

    Which patient condition would likely lead to a rightward shift in the oxygen dissociation curve?

    <p>All of the above</p> Signup and view all the answers

    What percentage of oxygen is typically bound to hemoglobin in normal circumstances?

    <p>97%</p> Signup and view all the answers

    Which condition is characterized by impaired oxygen carrying capacity due to a change in the iron state in hemoglobin?

    <p>Methemoglobin</p> Signup and view all the answers

    What is a common misconception about pulse oximetry readings in cases of carbon monoxide exposure?

    <p>It cannot distinguish between carbon monoxide and oxygen, potentially showing 100% spO2.</p> Signup and view all the answers

    In a respiratory assessment, which finding is NOT typically evaluated during physical examination?

    <p>Past health history</p> Signup and view all the answers

    Which of the following indicates an abnormal response during respiration assessments?

    <p>Trachea deviation to one side</p> Signup and view all the answers

    What does increased tactile fremitus indicate in a lung examination?

    <p>Consolidation in lung tissue</p> Signup and view all the answers

    Which observation is regarded as normal during a respiratory assessment?

    <p>Symmetrical chest expansion</p> Signup and view all the answers

    Which chest configuration is particularly associated with chronic obstructive pulmonary disease (COPD)?

    <p>Barrel chest</p> Signup and view all the answers

    What does the presence of intercostal retractions suggest about a patient's respiratory status?

    <p>Severe respiratory distress</p> Signup and view all the answers

    What sound is indicative of fluid-filled lungs or early signs of pulmonary edema?

    <p>Fine crackles</p> Signup and view all the answers

    What type of breath sound is characterized by a continuous high-pitched squeaking sound and is first evident on expiration?

    <p>Wheezes</p> Signup and view all the answers

    Which percussion sound is typically heard over hyperinflated lungs in chronic obstructive lung disease?

    <p>Hyperresonance</p> Signup and view all the answers

    What is the thoracic configuration associated with chronic emphysema and characterized by a horizontal rib positioning?

    <p>Barrel chest</p> Signup and view all the answers

    What abnormal breath sound occurs due to partial obstruction of the larynx or trachea?

    <p>Stridor</p> Signup and view all the answers

    Which objective assessment would indicate severe hypoxemia in a patient?

    <p>paO2 of 60 mmHg</p> Signup and view all the answers

    What thoracic condition features a forward protrusion of the sternum without the need for surgery unless severe?

    <p>Pectus carinatum</p> Signup and view all the answers

    Which subjective symptom is commonly associated with pulmonary embolism during a respiratory assessment?

    <p>Chest pain with breathing</p> Signup and view all the answers

    What is the normal range for pH in arterial blood gas measurements?

    <p>7.35 to 7.45</p> Signup and view all the answers

    What type of crackles would indicate significant pulmonary congestion?

    <p>Coarse crackles</p> Signup and view all the answers

    What change in the thorax is characterized by a lateral S-shaped curvature of the spine?

    <p>Scoliosis</p> Signup and view all the answers

    What sound is produced when roughened pleural surfaces rub together during breathing?

    <p>Pleural friction rub</p> Signup and view all the answers

    What term describes a marked sunken sternum that may require surgery if severe?

    <p>Pectus excavatum</p> Signup and view all the answers

    What is the normal oxygen saturation level in arterial blood gas values?

    <p>≥95%</p> Signup and view all the answers

    Study Notes

    Lower Respiratory Disorders & Respiratory Failure Overview

    • Session scheduled for 10:00 - 11:30 on Sept 6, 2024.
    • Class activities include course overview, discussions on nursing interventions, advanced airway management, and mechanical ventilation.
    • Key topics cover lower respiratory disorders, respiratory failure, artificial airways, and invasive ventilation.

    Learning Objectives

    • Understand respiratory system structures and functions.
    • Conduct a comprehensive respiratory assessment.
    • Differentiate hypoxia (deficiency in oxygen reaching tissues) and hypoxemia (deficiency of oxygen in blood).
    • Distinguish between hypoxemic (low oxygen levels) and hypercapnic (high carbon dioxide levels) respiratory failure.
    • Review V/Q relationships: normal unit, V/Q mismatch, shunt, and dead space.
    • Identify common pathologies leading to respiratory failure, e.g., venous thromboembolism and chest trauma.
    • Describe Acute Respiratory Distress Syndrome (ARDS).
    • Familiarize with non-invasive and invasive respiratory support concepts, including ventilation modes.
    • Analyze arterial blood gases.

    Upper Respiratory Tract Functions

    • Acts as a protective barrier for lower airways.
    • Main functions include warming, humidifying, and filtering the air.
    • Contains olfactory receptors necessary for the sense of smell; advanced airways may impair this function.

    Lower Respiratory Tract Functions

    • Carina is a key landmark separating right and left bronchus branches.
    • Ventilation refers to the air movement between atmosphere and alveoli, while respiration involves gas exchange.
    • Compliance indicates lung elasticity; decreased compliance complicates lung inflation (e.g., pulmonary edema).
    • Elastance is affected by conditions such as fibrosis and sarcoidosis.

    Key Anatomical Landmarks

    • Carina: Critical for assessing airway protection; stimulates cough reflex upon being touched.
    • Main Bronchi: Right bronchus is straighter, leading to higher aspiration risk.
    • Trachea: Anterior features cartilaginous rings; posterior consists of smooth muscle; understand implications of advanced airway use.

    Oxygenation, Ventilation, and Respiration Insights

    • Partial pressure of oxygen (PaO2) is crucial; a PaO2 of 60 mmHg indicates hypoxemic respiratory failure.
    • Hemoglobin saturation changes are minimal until PaO2 drops significantly; supplemental oxygen is vital in critical states.
    • Hemoglobin abnormalities (e.g., sickle cell, carboxyhemoglobin) impact oxygen carrying capacity and require careful monitoring.

    Respiratory Assessment Review

    • Subjective Data: Relevant past health and medication history, current health status, and symptom inquiry such as shortness of breath and pain with breathing.
    • Objective Data: Assess vital signs, chest wall configuration, symmetry, and signs of respiratory distress.

    Auscultation Findings

    • Fine Crackles: Sign of fluid in alveoli; indicates conditions like early pulmonary edema.
    • Coarse Crackles: Associated with airway obstruction; seen in severe pneumonia.
    • Wheezes: High-pitched sounds from airflow through narrowed airways.
    • Stridor: Indicative of upper airway obstruction; a concerning sign requiring immediate attention.
    • Pleural Friction Rub: Painful sound indicating pleural inflammation; no change with coughing.

    Thoracic Configurations

    • Normal thorax is elliptical; barrel chest indicates chronic lung disease.
    • Pectus carinatum (pigeon breast) and pectus excavatum (funnel chest) are structural deformities with varying implications.
    • Scoliosis and kyphosis can impair respiratory function, especially if severe.

    Focused Respiratory Assessment

    • Assess for shortness of breath, sputum production, pain, and cough type.
    • Conduct diagnostics such as arterial blood gases and chest radiographs.
    • Importance of monitoring respiratory pattern, chest wall symmetry, and skin integrity.

    Arterial Blood Gas Values

    • Normal ranges: pH 7.35-7.45, PaO2 80-100 mmHg, SpO2 ≥95%, PaCO2 35-45 mmHg.
    • Mixed venous blood gases provide insight into oxygen saturation and acid-base balance, critical in managing respiratory failure.

    Critical Values

    • PaO2 ≥70% and SpO2 ≥95% are generally considered adequate unless the patient is hemodynamically unstable or faces oxygen unloading issues.

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    Description

    This quiz covers lower respiratory disorders and respiratory failure as discussed in the synchronous session on September 6, 2024. Topics include nursing interventions, advanced airway management, and mechanical ventilation. Test your knowledge on critical concepts related to respiratory care.

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