Respiratory Assessment Quiz
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Questions and Answers

What genetic condition is mentioned that can predispose individuals to lung diseases?

Alpha1 antitrypsin deficiency

What occupational exposure is particularly associated with respiratory problems when airborne?

Asbestos

What pink and moist feature of the mouth indicates satisfactory hydration?

Healthy mucosa

What is the clinical significance of clubbing of fingers?

<p>It can indicate chronic respiratory issues.</p> Signup and view all the answers

What respiratory pattern is defined as having more than 20 breaths per minute?

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

What observation technique can help accurately assess a patient's respiratory effort?

<p>Counting respirations discreetly while checking pulse.</p> Signup and view all the answers

What potential condition does cyanosis indicate?

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

During a neck assessment, what should be palpated?

<p>Lumps or bumps</p> Signup and view all the answers

What should be evaluated for symmetry during thorax assessment?

<p>Respiratory movement of the hands</p> Signup and view all the answers

What is one method to assess the patient's speech during physical examination?

<p>Check if they can speak in complete sentences without stopping.</p> Signup and view all the answers

What is the primary function of venous blood as it travels to the lungs?

<p>To exchange carbon dioxide for oxygen.</p> Signup and view all the answers

What medication is commonly used to dissolve clots in cases of pulmonary embolism?

<p>TPA (tissue plasminogen activator).</p> Signup and view all the answers

How does pulmonary embolism affect the body's respiratory function?

<p>It blocks blood flow in the pulmonary artery, causing severe pain and potential life-threatening conditions.</p> Signup and view all the answers

List two symptoms that should be evaluated in a patient presenting with a respiratory infection.

<p>Cough and pain.</p> Signup and view all the answers

What exacerbating environmental factor is noted for individuals with respiratory issues living in California?

<p>Smoke from wildfires.</p> Signup and view all the answers

Why is it essential to determine a patient's history of respiratory conditions?

<p>To identify potential exacerbating factors that could worsen their current symptoms.</p> Signup and view all the answers

What types of questions should a nurse ask regarding a patient's cough?

<p>Whether the cough is productive or nonproductive and its heaviness.</p> Signup and view all the answers

In assessing a patient with dyspnea, which prior ailments should be particularly noted?

<p>COPD and asthma.</p> Signup and view all the answers

What should a detailed patient history include regarding their allergy status?

<p>Allergies to environmental triggers such as grass and pollen.</p> Signup and view all the answers

How might TPA treatment paradoxically affect other injuries in the body?

<p>It can break down clots that stabilize other injuries.</p> Signup and view all the answers

What saturation levels should nurses ideally observe in pulse oximetry readings for patient safety?

<p>Nurses should ideally observe saturation levels between 95-99%.</p> Signup and view all the answers

How does capnography assist in the management of patients on PCA pumps?

<p>Capnography monitors PCO₂ levels to ensure they don't fall below a safe level, alerting nurses to intervene if necessary.</p> Signup and view all the answers

List the first two steps in the sputum collection procedure for a coughing patient.

<ol> <li>Collect sputum for cultures. 2. Identify the microorganism to determine appropriate treatment.</li> </ol> Signup and view all the answers

Explain the treatment approach for viral pneumonia compared to bacterial pneumonia.

<p>Viral pneumonia is typically treated with symptom management, while bacterial pneumonia is treated with antibiotics.</p> Signup and view all the answers

What is one reason why treating viral infections is generally more challenging than treating bacterial infections?

<p>Treating viral infections often means killing host cells, as viruses live inside them.</p> Signup and view all the answers

What abnormalities can a chest X-ray detect in relation to pneumonia or TB?

<p>A chest X-ray can detect consolidations in the lungs and walled-off nodules indicating TB.</p> Signup and view all the answers

What does it mean if a chest X-ray shows fluid buildup in the pleural spaces?

<p>It indicates potential abnormalities such as pneumonia or other lung-related issues.</p> Signup and view all the answers

What is the role of the diaphragm in breathing, and how does a high neck injury affect its function?

<p>The diaphragm facilitates breathing by contracting and relaxing to change lung volume. A high neck injury (C1 or C2 level) inhibits the brainstem's ability to control the diaphragm, necessitating a ventilator.</p> Signup and view all the answers

Describe the process of inspiration and its effect on lung pressure.

<p>Inspiration occurs when the diaphragm contracts, lowering itself and expanding the chest cavity. This increases lung volume and decreases pressure, causing air to rush in.</p> Signup and view all the answers

How does expiration occur and what role does the diaphragm play in this process?

<p>Expiration is a passive process initiated as the diaphragm relaxes, allowing chest and abdominal pressure to push air out of the lungs. The thoracic cavity decreases, leading lung pressure to exceed atmospheric pressure.</p> Signup and view all the answers

What is respiration, and how is gas exchanged in the alveoli?

<p>Respiration is the exchange of oxygen and carbon dioxide at the alveoli, where oxygen is absorbed into the blood while carbon dioxide is exhaled. This is facilitated by capillary membranes surrounding each alveolus.</p> Signup and view all the answers

Define 'dead space' in the respiratory system and its significance in pulmonary function tests (PFTs).

<p>'Dead space' refers to areas like the trachea where no gas exchange occurs, which is significant in PFTs as it helps assess ventilation perfusion mismatch. PFTs quantify the air that is ventilated versus that used for gas exchange.</p> Signup and view all the answers

What anatomical differences exist between the right and left lung, and why do these differences matter?

<p>The right lung has three lobes (upper, middle, lower) while the left lung has two lobes to accommodate the heart. These anatomical differences are crucial for understanding respiratory assessments and auscultation placement.</p> Signup and view all the answers

Explain the function and importance of mucus-secreting cells in the lungs.

<p>Mucus-secreting cells in the lungs protect against foreign particles by trapping them. They play a vital role in respiratory health, especially during environmental stress, like wildfires.</p> Signup and view all the answers

How does the phrenic nerve stimulate breathing, and what happens during stimulation?

<p>The phrenic nerve stimulates the diaphragm to contract, which lowers the diaphragm and expands the chest cavity, leading to air influx into the lungs. This neural control is essential for the automatic breathing process.</p> Signup and view all the answers

How do cilia assist the respiratory system in dealing with foreign particles?

<p>Cilia sweep debris and mucus out of the lungs, helping to expel foreign particles.</p> Signup and view all the answers

What role do goblet cells play in the mucus and cilia system?

<p>Goblet cells produce mucus to trap germs and particles, aiding in their removal.</p> Signup and view all the answers

Describe the structure and significance of alveoli in the respiratory system.

<p>Alveoli are tiny, highly vascularized structures where oxygen and carbon dioxide exchange occurs.</p> Signup and view all the answers

What happens during inhalation and exhalation in relation to the diaphragm?

<p>During inhalation, the diaphragm moves downward to expand the lungs; during exhalation, it relaxes and moves upward.</p> Signup and view all the answers

Explain the importance of maintaining healthy cilia for lung function.

<p>Healthy cilia are necessary to efficiently sweep out mucus and harmful substances from the lungs.</p> Signup and view all the answers

What is the pleural space and why is it significant?

<p>The pleural space is between the lungs and chest wall, allowing for lung expansion and contraction.</p> Signup and view all the answers

What are the consequences of fluid accumulation in the pleural space, and how can it be treated?

<p>Fluid accumulation can cause pain and impede breathing, treated by thoracentesis to drain the fluid.</p> Signup and view all the answers

How does exposure to smoke affect the function of cilia?

<p>Exposure to smoke damages cilia, impairing their ability to clear mucus and debris from the lungs.</p> Signup and view all the answers

Differentiate between the parietal pleura and visceral pleura.

<p>The parietal pleura lines the chest wall, while the visceral pleura covers the lungs directly.</p> Signup and view all the answers

Why is the process of breathing considered passive except in certain injury cases?

<p>Breathing is usually automatic as the diaphragm controls air flow without conscious effort.</p> Signup and view all the answers

Study Notes

Respiratory Assessment

  • Functions of the Respiratory System:

    • Ventilation (inspiration and exhalation)
    • Respiration (gas exchange)
    • Acid-base balance
    • Speech
    • Sense of smell
    • Fluid balance

  • Ventilation:

    • Air moves in and out of the respiratory system
    • Inspiration and exhalation

  • Respiration:

    • Gas exchange of oxygen and carbon dioxide at the alveolar level
    • Oxygenated blood transported to tissues (perfusion)
    • Deoxygenated blood returned to lungs for reoxygenation

  • Acid-Base Balance:

    • Respiratory system involved in acid-base balance
    • Exchange of carbon dioxide for oxygen in the lungs
    • Renal system also plays a role (secreting bicarbonate)

  • Speech:

    • Air movement through vocal cords allows for vocalization

  • Sense of Smell:

    • Air movement through the nose enables detection of odors
    • Inability to smell can affect sense of taste

  • Fluid Balance:

    • Water excreted as vapor during exhalation maintains fluid balance

Anatomy of the Respiratory System

  • Head Region:

    • Adenoids
    • Eustachian tubes (connected to ears)
    • Tonsils
    • Pharynx

  • Nasal Cavity:

    • Multiple chambers

  • Upper Respiratory Tract:

    • Hyoid bone
    • Glottis
    • Cricoid cartilage
    • Air travels from nose through these structures to bronchi

  • Lower Respiratory Tract:

    • Bronchi branch into smaller airways (treelike)
    • Alveoli location of gas exchange (arteries and veins facilitate exchange of oxygen and carbon dioxide)

Sinus Anatomy and Issues

  • Sinuses: Frontal sinuses inflamed during sinus infections
  • Pain: Pain across forehead due to excess mucus in sinuses (rigid cavity)

Key Structures for Palpation

  • Epiglottis: Located at the top
  • Hyoid Bone: Can be felt for self-assessment
  • Trachea: Its ridges and cartilages can be felt moving down the neck
  • True vocal cords: Responsible for sound production
  • False vocal cords/vestibular folds: Holds true vocal cords in place, crucial for opening and closing during speaking

Physiology of the Respiratory System

  • Inspiration: Diaphragm contracts, lowering it, expanding chest cavity, reducing pressure in lungs, air rushes in
  • Expiration: Diaphragm relaxes, increasing pressure in lungs, air exits, passive process
  • Respiration: Exchange of oxygen and carbon dioxide at the alveolar level
  • Alveoli: Gas exchange occurs in alveolar ducts, alveolar sacs (lined with alveoli), and respiratory bronchioles
  • Deoxygenated blood: From systemic system exchanged for oxygen in the alveoli.
  • Oxygenated blood: Transported to body tissues via red blood cells.
  • Carbon dioxide: Exhaled from the body

Dead Space

  • Areas in respiratory tract where no gas exchange occurs
  • Important in pulmonary function tests (PFTs) to measure air volume

Anatomy Review

  • Right lung: Three lobes (upper, middle, and lower)
  • Left lung: Two lobes

Mucus and Cilia

  • Mucus layer Traps debris and particles
  • Cilia (mucociliary layer) Sweeps away trapped particles and germs in the lungs
  • Goblet cells Attack germs if present

Respiratory Structures

  • Bronchioles divide into terminal branches
  • Alveoli are tiny, highly vascularized structures for gas exchange

Pleural Space

  • Parietal pleura: Outer layer lining the chest wall
  • Visceral pleura: Inner layer directly covering the lungs

Factors that Exacerbate or Improve Symptoms

Current Medications

  • Medications for asthma or COPD used daily

Allergies

  • Allergies to grass, pollens, other environmental triggers
  • Worsening of conditions due to pollution or air quality

Family and Occupational History

  • Family history of COPD, genetic conditions like alpha-1 antitrypsin deficiency
  • Occupational exposure to asbestos, chemicals, or other lung irritants

Social History

  • Smoking history currently or previously?
  • Travel history in different countries recently

Physical Examination

  • Speech: Ability to speak in full sentences, clarity

  • Clubbing of Fingers: Inspect for clubbing as a sign of chronic respiratory issues

  • Mouth: Inspection for sores, bleeding, masses, or obstructions

  • Mucosal Check: Pink, moist, cracked, sticky - possible dehydration

  • Neck Assessment: Check for swelling, and lumps,

  • Thorax Assessment: (Check for even expansion and listen to the lung sounds)

Patient History

  • Chronic conditions like COPD may present at lower oxygen levels,
  • Nurses need to understand expected readings

Vital Signs

  • Rate, depth, and effort used to breathe
  • Patients may alter their breathing if aware of observation.
  • Anything above 20 breaths per minute is tachypnea and below 12 is bradypnea

Fingernail Assessment

  • Normal shape, smooth, slightly curved

  • Clubbing in chronic conditions(COPD, Tuberculosis).

  • Results from oxygen deficiency, and develops slowly.

Physical Assessment

  • Back Inspection: Look for abnormalities(scoliosis), lung field shortenings (kyphosis),lordosis
  • Abdominal Issues (Hernia, aneurysms, etc) Reduced lung capacity

Palpation

  • Trachea: Midline and nontender
  • Crepitus: A sound like "snap, crackle, pop;’ similar to cereal; air escaping from the lungs, under the skin

Lung Auscultation

  • Listen to lungs, have the patient say “99”
  • Sound should be clear, not muffled
  • Uneven sound could indicate respiratory issues

Percussion

  • Percussion should be dull. Should not hear tympany or abnormal sounds.

Arterial Blood Gases (ABGs)

  • pH, PaCO2, HCO3, PaO2 normal ranges
  • COPD patients may have lower PaO2 levels around 88 to 89mmHg. This is still considered normal for them.

Oxygen Saturation

  • Normal SpO2: 95-100%
  • COPD patients may have lower SpO2 levels due to body adapting

Effects of Low Oxygen Saturation

  • Symptoms like confusion, dizziness, sweating, and malaise.

COPD Progression

  • Gradual worsening over time.
  • Patient adapts to the lowered oxygen levels.

Methods

  • Percutaneous biopsy: Tissue taken using a needle through the skin
  • Open procedure: Involves surgically opening the chest to obtain lung tissue
  • Lung wash: Fluid introduced into the lungs, then collected for lab analysis

Case Study Example

  • Mr. Thomas, patient with COPD, smoking history, hypertension, etc.

Pulmonary Function Tests

  • Measures lung capacity and function, via patient inhaling and exhaling into a tube. Helps evaluate lung volumes and volumes remaining after exhaling

Diagnostic Studies

  • Bronchoscopy: Visualization of respiratory tract down to secondary bronchi
  • Types: Flexible or rigid, used for specimen collection or endotracheal placement/removal of obstructions
  • Thoracentesis: Removing fluid/air from pleural space for diagnostic or therapeutic reasons
  • Lung Biopsy: Removing a small piece of lung tissue under a microscope for analysis

Types of Pneumonia

  • Viral Pneumonia: Usually resolves within 10 days, typically not treated with antibiotics
  • Bacterial Pneumonia: Treated with antibiotics
  • Fungal Pneumonia: Treated with antifungal medications.

Diagnostic Studies (e.g. Chest X-rays)

  • Chest X-rays: Identify lung, heart, or pleural cavity issues (like consolidation, enlarged heart, fluid buildup)..
  • Pneumonia/TB Detection: X-rays detect pneumonia and TB nodules in lung tissue

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Respiratory Assessment Lecture Transcription PDF

Description

Test your knowledge on respiratory assessment techniques, respiratory diseases, and related clinical signs. This quiz covers key concepts necessary for understanding respiratory conditions and their implications in patient care. Enhance your understanding of physical examination procedures and respiratory function.

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