Podcast
Questions and Answers
Which of the following best describes the primary dependence of the respiratory system's function of gas exchange?
Which of the following best describes the primary dependence of the respiratory system's function of gas exchange?
- The lungs' ability to contract and expand, influenced by musculoskeletal and neurologic functions. (correct)
- The patient's emotional state and anxiety levels.
- The efficiency of the circulatory system in transporting gases.
- The presence of adventitious sounds during auscultation.
A patient reports experiencing dyspnea. What specific information should the nurse prioritize gathering to understand the patient's condition?
A patient reports experiencing dyspnea. What specific information should the nurse prioritize gathering to understand the patient's condition?
- The patient's complete medical history, including past surgeries.
- A detailed description of the patient's dietary habits and recent meals.
- Onset, duration, precipitating factors, and relief measures related to the dyspnea. (correct)
- The patient's social history, including their occupation and living situation.
When assessing a patient's cough, which detail provides the MOST useful information for differentiating between potential respiratory issues?
When assessing a patient's cough, which detail provides the MOST useful information for differentiating between potential respiratory issues?
- The patient's family history of respiratory illnesses.
- Whether the cough is productive or nonproductive and the characteristics of any expectorated mucus. (correct)
- The frequency of coughing episodes throughout the day.
- The patient's subjective rating of the cough's intensity on a scale of 1 to 10.
During auscultation, a nurse identifies high-pitched, squeaking sounds indicative of sibilant wheezes. What is the MOST likely cause of this finding?
During auscultation, a nurse identifies high-pitched, squeaking sounds indicative of sibilant wheezes. What is the MOST likely cause of this finding?
What does observing retraction of the chest wall between the ribs and under the clavicle during inspiration MOST likely indicate?
What does observing retraction of the chest wall between the ribs and under the clavicle during inspiration MOST likely indicate?
Which assessment finding is MOST indicative of hypoxemia?
Which assessment finding is MOST indicative of hypoxemia?
A patient is observed to have flared nostrils. What does this observation MOST likely suggest about the patient's respiratory status?
A patient is observed to have flared nostrils. What does this observation MOST likely suggest about the patient's respiratory status?
What is the PRIMARY differentiating characteristic between sibilant wheezes and sonorous wheezes?
What is the PRIMARY differentiating characteristic between sibilant wheezes and sonorous wheezes?
A nurse auscultates crackles in a patient's lungs. Which pathophysiological process is MOST likely occurring?
A nurse auscultates crackles in a patient's lungs. Which pathophysiological process is MOST likely occurring?
Upon assessing a patient, the nurse notes unequal chest expansion. What potential pulmonary complication should the nurse suspect?
Upon assessing a patient, the nurse notes unequal chest expansion. What potential pulmonary complication should the nurse suspect?
What is the primary function of the respiratory system?
What is the primary function of the respiratory system?
What does dyspnea refer to?
What does dyspnea refer to?
What is the purpose of auscultating lung fields during a respiratory assessment?
What is the purpose of auscultating lung fields during a respiratory assessment?
Which of the following is a sign of respiratory distress?
Which of the following is a sign of respiratory distress?
What causes sibilant wheezes?
What causes sibilant wheezes?
Which of the following best describes sonorous wheezes?
Which of the following best describes sonorous wheezes?
When are crackles most commonly heard?
When are crackles most commonly heard?
What causes pleural friction rubs?
What causes pleural friction rubs?
What does unequal chest expansion indicate?
What does unequal chest expansion indicate?
What does retraction of the chest wall typically indicate?
What does retraction of the chest wall typically indicate?
Flashcards
Respiratory System Function
Respiratory System Function
Exchange of oxygen and carbon dioxide at the alveolus-capillary level, dependent on the lungs’ ability to contract and expand.
Dyspnea
Dyspnea
Subjective experience of breathing difficulty; patient's perception.
Orthopnea
Orthopnea
Abnormal condition where a person must sit or stand to breathe deeply or comfortably.
Adventitious Sounds
Adventitious Sounds
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Sibilant Wheezes
Sibilant Wheezes
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Sonorous Wheezes
Sonorous Wheezes
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Crackles (Rales)
Crackles (Rales)
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Pleural Friction Rubs
Pleural Friction Rubs
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Hypoxia
Hypoxia
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What is dyspnea?
What is dyspnea?
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What to observe during respiratory assessment?
What to observe during respiratory assessment?
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What are sibilant wheezes?
What are sibilant wheezes?
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Unequal chest expansion meaning?
Unequal chest expansion meaning?
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What is chest wall retraction?
What is chest wall retraction?
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Study Notes
- The respiratory system enables gas exchange, specifically oxygen and carbon dioxide, at the alveolar-capillary level.
- The musculoskeletal and neurological systems influence the lungs' capacity to contract and expand, which is essential for gas exchange.
- A respiratory assessment is a component of a patient's general health evaluation.
- Patients with acute or chronic respiratory or cardiac conditions, individuals with respiratory impairment histories from trauma or allergies, and those who have undergone surgery/anesthesia require more thorough respiratory assessments.
- Respiratory responses can be impacted by a patient's anxiety or stress, which should be taken into account.
- Obtaining subjective data involves encouraging patients to describe symptoms such as shortness of breath, dyspnea on exertion, or cough.
- Dyspnea is a subjective experience.
- Consider the onset, duration, precipitating factors, and relief measures when collecting data on breathing difficulties.
- Gather comprehensive details on coughs, including whether they are productive or non-productive, harsh/dry/hacking, along with the color and amount of expectorated mucus.
- When possible, document the patient's descriptions as direct quotes.
- Observation is the first step in gathering objective data.
- Measure respiratory rate and oxygen saturation.
- Take note of the patient's expression, chest movement, and respirations for visual cues.
- Anxious facial expressions can be indicative of respiratory distress, even in the absence of verbal communication.
- Nasal flaring suggests laboured breathing.
- Note the patient’s skin color and turgor.
- Look for obvious respiratory distress, wheezes, or orthopnea.
- Auscultate all lung fields on both the anterior and posterior sides, comparing both sides bilaterally.
- Identify any adventitious sounds.
- Adventitious sounds are abnormal sounds superimposed on breath sounds.
- Sibilant wheezes are musical, high-pitched sounds resulting from air movement through narrowed bronchioles.
- Sonorous wheezes are low-pitched, loud, coarse, snoring sounds, often audible during expiration.
- Crackles are short, discrete, interrupted crackling or bubbling sounds commonly heard during inspiration.
- Crackles are related to inflammation or infection in the small bronchi, bronchioles, and alveoli.
- Pleural friction rubs are low-pitched, grating, or creaking sounds caused by inflamed pleural surfaces rubbing together during respiration.
- Chest movement should be assessed to ensure equal expansion on both sides.
- Unequal chest expansion may indicate issues like a collapsed lung.
- Retraction of the chest wall between the ribs and under the clavicle during inspiration signifies potential late-stage respiratory distress.
- Be vigilant for signs and symptoms of hypoxia.
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