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Questions and Answers

What is the primary purpose of using an anterior chest tube?

  • To drain fluid from the pleural space
  • To remove air from the pleural space (correct)
  • To prevent blood accumulation in the lungs
  • To monitor for lung infections
  • What should be monitored for when using a chest tube?

  • Accumulations of air and fluid (correct)
  • Levels of oxygen saturation
  • Patient's heart rate
  • Signs of asthma attacks
  • Why should the drainage system be kept below the level of the chest?

  • To facilitate air flow in the lungs
  • To promote drainage and prevent backflow (correct)
  • To minimize discomfort to the patient
  • To prevent infection
  • What is the recommended action if drainage from the chest tube needs to be changed?

    <p>Use a clamp only if prescribed by HCP</p> Signup and view all the answers

    What should be avoided regarding the handling of a chest tube according to agency policy?

    <p>Clamping the tube without a prescription</p> Signup and view all the answers

    What does excessive bubbling in the chest tube system indicate?

    <p>An air leak in the chest tube system</p> Signup and view all the answers

    What is a key responsibility of the nurse when performing chest physiotherapy (CPT)?

    <p>Perform CPT in the morning or 2 to 3 hours after meals</p> Signup and view all the answers

    What could happen if the suction control chamber is not regulated correctly?

    <p>Lung tissue could be sucked into the chest tube</p> Signup and view all the answers

    When is it appropriate to stop chest physiotherapy (CPT)?

    <p>When the patient reports discomfort or pain</p> Signup and view all the answers

    What is the primary purpose of chest physiotherapy (CPT)?

    <p>To loosen and mobilize secretions in the lungs</p> Signup and view all the answers

    What should be done if a client is receiving tube feeding before starting CPT?

    <p>Stop tube feeding and aspirate for residual</p> Signup and view all the answers

    What does gentle bubbling in the suction control chamber indicate?

    <p>Proper negative pressure application</p> Signup and view all the answers

    What is a characteristic of a dry suction system for chest drainage?

    <p>The absence of bubbling denotes proper function</p> Signup and view all the answers

    What is often the first symptom to appear in acute viral rhinitis?

    <p>Sore throat</p> Signup and view all the answers

    Which of the following microorganisms is NOT commonly associated with acute rhinosinusitis?

    <p>Escherichia coli</p> Signup and view all the answers

    What contributes to the obstruction of sinus cavities in chronic sinusitis?

    <p>Nasal congestion</p> Signup and view all the answers

    In the case of chronic sinusitis, what kind of factors can be involved?

    <p>Multifactorial factors</p> Signup and view all the answers

    Which symptom is typically not associated with acute viral rhinitis?

    <p>Severe headache</p> Signup and view all the answers

    What is the main purpose of using nasal steroids in treatment?

    <p>To reduce inflammation</p> Signup and view all the answers

    What is a likely consequence of untreated viral upper respiratory infections?

    <p>Increased risk of sinus infections</p> Signup and view all the answers

    What immediate effect does nasal congestion have on sinus cavities?

    <p>Prevents mucus drainage</p> Signup and view all the answers

    What mechanism stops the process of inspiration?

    <p>Stretch receptors stop sending signals to inspiratory neurons</p> Signup and view all the answers

    Where is the respiratory center primarily located?

    <p>In the medulla</p> Signup and view all the answers

    How do chemoreceptors in the carotid arteries respond when there is a low level of oxygen?

    <p>They stimulate the medulla</p> Signup and view all the answers

    What happens when arterial blood pH rises?

    <p>Hyperventilation occurs</p> Signup and view all the answers

    What is the main process through which gases are exchanged in the lungs?

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

    What role does blood PaCO2 play in respiration control?

    <p>It stimulates the medulla when elevated</p> Signup and view all the answers

    Where does internal respiration occur primarily?

    <p>In the tissues of the body</p> Signup and view all the answers

    What effect does a decrease in arterial PaCO2 have on respiration?

    <p>It leads to decreased breathing efforts</p> Signup and view all the answers

    What is the main factor in achieving a proper diagnosis of vasomotor rhinitis?

    <p>Comprehensive history and physical assessment</p> Signup and view all the answers

    Which factors contribute to the pathophysiology of vasomotor rhinitis?

    <p>An imbalance of the sympathetic and parasympathetic nervous systems</p> Signup and view all the answers

    What role do histamines play in the symptoms of vasomotor rhinitis?

    <p>They cause arteriolar dilation and increase vascular permeability.</p> Signup and view all the answers

    What is believed to be the cause of vasomotor rhinitis?

    <p>The cause is not well understood but may involve dysregulation</p> Signup and view all the answers

    What type of immune response is initiated by the presence of allergens in vasomotor rhinitis?

    <p>A two-phase immune response</p> Signup and view all the answers

    Which conditions are associated with increased mucus secretion during vasomotor rhinitis?

    <p>Imbalance among mediators leading to capillary leakage</p> Signup and view all the answers

    Which nervous system primarily regulates mucous secretions in the context of vasomotor rhinitis?

    <p>Parasympathetic nervous system</p> Signup and view all the answers

    During the late-phase inflammatory response in vasomotor rhinitis, what recurring symptom is most common?

    <p>Nasal congestion</p> Signup and view all the answers

    Study Notes

    Chest Tube Drainage

    • Purpose of anterior chest tube: Relieve pressure in the pleural space, remove air or fluid
    • Monitoring factors: Drainage amount, color, and consistency. Also, lung sounds, vital signs, and respiratory rate.
    • Drainage system placement: Keep the drainage system below the level of the chest to prevent backflow of drainage into the pleural space.
    • Drainage change: When the drainage bottle needs to be changed, maintain a closed system to prevent air from entering the pleural space.
    • Handling precautions: Avoid milking or stripping the chest tube, as this can cause tissue injury.
    • Excessive bubbling: Indicates a possible air leak in the system.
    • CPT responsibilities: The nurse should ensure positioning and monitor the client's response to the procedure.

    Chest Physiotherapy (CPT)

    • Regulation of suction chamber: Incorrect suction control chamber regulation could lead to too much or too little suction, potentially causing complications.
    • Stopping CPT: Stop CPT when the client experiences fatigue or if the procedure is ineffective.
    • Purpose of CPT: To loosen and remove secretions from the airway.
    • Pre-CPT considerations: If a client is receiving tube feeding, hold the feeding for 30-60 minutes prior to starting CPT.
    • Gentle bubbling: Indicates that the suction is working correctly.
    • Dry suction system: Features a closed system where suction is achieved without the use of water.

    Acute Viral Rhinitis

    • First symptom: Often, the first symptom to appear is a runny nose.
    • Microorganisms not associated: Mycobacterium tuberculosis is usually not associated with acute rhinosinusitis.
    • Sinus cavity obstruction: Swelling of the nasal mucosa due to inflammation can obstruct sinus cavities.
    • Factors in chronic sinusitis: Allergies and anatomical abnormalities can contribute to chronic sinusitis.

    Treatment of Viral Rhinitis

    • Symptom not associated: A fever is typically not associated with acute viral rhinitis.
    • Purpose of nasal steroids: Nasal steroids reduce inflammation and swelling, easing symptoms.
    • Uncontrolled infection consequence: Untreated viral upper respiratory infections can lead to complications like sinusitis or otitis media.

    Respiratory System Physiology

    • Congestion effect: Nasal congestion immediately obstructs the sinus cavities, leading to pressure and discomfort.
    • Inspiration stopping mechanism: Inspiration is stopped by the relaxation of the diaphragm and external intercostal muscles.
    • Respiratory center location: The respiratory center is primarily located in the medulla oblongata.
    • Chemoreceptor response to low oxygen: Chemoreceptors in the carotid arteries increase breathing rate in response to low oxygen levels.
    • Elevated blood pH: When arterial blood pH rises, respirations decrease to retain CO2 and lower pH back to normal.
    • Gas exchange process: Gas exchange in the lungs occurs through diffusion due to pressure gradients.
    • PaCO2 role: Blood PaCO2 plays a primary role in controlling respiration by influencing the respiratory center.
    • Internal respiration site: Internal respiration occurs primarily at the cellular level, where oxygen is used and CO2 is produced.
    • Decreased PaCO2 effect: A decrease in arterial PaCO2 reduces breathing rate.

    Vasomotor Rhinitis

    • Diagnosis factor: The main factor for diagnosing vasomotor rhinitis is excluding other potential causes.
    • Pathophysiology contributing factors: Vasomotor rhinitis is often associated with vascular alterations, neurogenic involvement, and alterations in the sympathetic nervous system.
    • Histamine role: Histamines contribute to nasal congestion, sneezing, and itching experienced in vasomotor rhinitis.
    • Cause: The exact cause of vasomotor rhinitis is unknown but may be related to environmental triggers, hormonal changes, or other factors.
    • Allergen response: Allergens trigger an immune response in the nasal mucosa, causing inflammation.
    • Mucus secretion association: Increased mucus secretion is associated with conditions like viral infections, allergies, and anatomical irregularities.
    • Mucus regulation: The autonomic nervous system, primarily the parasympathetic nervous system, regulates mucous secretions.
    • Recurring symptom: Recurring nasal congestion is the most common late-phase inflammatory symptom in vasomotor rhinitis.

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