Respiratory System Quiz

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Questions and Answers

What occurs in response to negative pressure in the thoracic cavity?

Pneumothorax

Dyspnea

Inhalation (correct)

Exhalation

Which of the following symptoms would most likely indicate an issue with the respiratory system during inspection?

Asymmetrical chest movement (correct)

Normal respiratory rhythm

Elevated liver enzymes

Increased heart rate

Which acid–base imbalance results from decreased respiratory function?

Metabolic alkalosis

Respiratory acidosis (correct)

Metabolic acidosis

Respiratory alkalosis

What is the primary purpose of auscultation in respiratory assessment?

Identifying breath sounds Signup and view all the answers

Which adventitious breath sound is generated by narrowed inflamed airways?

Wheezes Signup and view all the answers

Which diagnostic test is most appropriate for assessing the structure of the lungs and detecting issues such as tumors or infections?

Chest x-ray Signup and view all the answers

What vital sign is indicative of worsening respiratory distress in Mr. Granger?

O2 saturation of 86% on room air Signup and view all the answers

In assessing a patient with suspected respiratory acidosis, which of the following findings would you expect?

Hypoventilation Signup and view all the answers

What is a common complication of COPD exacerbations that increases shortness of breath?

Pneumonia Signup and view all the answers

What key piece of data is least likely to be collected from a patient presenting with respiratory distress?

History of digestive disorders Signup and view all the answers

What is one of the immediate benefits of quitting smoking after 20 minutes?

Heart rate drops back to normal Signup and view all the answers

Which method is NOT considered a therapeutic measure for smoking cessation?

Acupuncture Signup and view all the answers

What is the risk associated with administering high-flow oxygen therapy for more than 24 hours?

Oxygen toxicity Signup and view all the answers

Which position is recommended for a patient with respiratory distress to optimize lung function?

Fowler Signup and view all the answers

Which symptom indicates the risk of oxygen toxicity?

Dry cough Signup and view all the answers

What is a common nursing diagnosis for a patient with a tracheostomy?

Ineffective Airway Clearance Signup and view all the answers

In which scenario would a partial rebreather mask be most beneficial?

In delivering high concentration oxygen to COPD patients Signup and view all the answers

What is a key strategy for using a metered-dose inhaler effectively?

Holding breath for 5 seconds after inhaling Signup and view all the answers

Study Notes

Respiratory System Function, Data Collection, and Therapeutic Measures

Learning Outcomes: Describe normal structures and functions of the respiratory system. Identify how aging affects the respiratory system. List data to collect when caring for a patient with a respiratory disorder. Recognize expected findings when inspecting and auscultating the chest. Identify common diagnostic tests to diagnose respiratory disorders. Assist in planning nursing care for patients undergoing diagnostic tests. Discuss therapeutic measures for patients with respiratory disorders.

Review of Anatomy and Physiology

Trachea: A rigid tube in front of the esophagus, about 4.5 inches long and 1 inch wide. C-shaped cartilage rings support and prevent collapse during inhalation. Open part of "C" faces posteriorly allowing room for the esophagus during swallowing. Extends from larynx to the carina (cartilaginous ridge).
Bronchial Tree: The trachea branches into two primary bronchi at the carina. Supported by C-shaped cartilage initially. Right bronchus is wider and more vertical than left, making it more likely for inhaled objects to lodge there. The primary bronchi branch into secondary bronchi (one for each lobe), then tertiary bronchi. Bronchioles are smaller airways lacking cartilage, then alveolar ducts, leading to clusters of alveoli (primary site for gas exchange).
Right Lung: Shorter, broader, and larger than left. Has three lobes (superior, middle, and inferior) and primarily handles gas exchange (55%). Contains horizontal and oblique fissures. Base rests on the diaphragm.
Left Lung: Two lobes (superior and inferior) due to the heart's position. Contains an oblique fissure. Apex extends above the first rib. Base rests on the diaphragm.
Inspiration: External intercostal muscles pull ribs up and out, widening the thoracic cavity. Diaphragm contracts, flattens, and drops, pressing abdominal organs downward, enlarging thoracic cavity. Air rushes in to equalize pressure.
Expiration: Internal intercostal muscles pull ribs down as external intercostals relax. Diaphragm relaxes, bulging upward, and pressing against the base of lungs, reducing the thoracic cavity size. Air is pushed out of lungs.

Acid-Base Balance

Respiratory acidosis: Caused by hypoventilation (slow breathing).
Respiratory alkalosis: Caused by hyperventilation (rapid breathing).

Effects of Aging

Cilia: Hair-like projections in the bronchi, damaged with age. Reduced effectiveness in removing microbes and debris causing increased risk of infections.
Respiratory Muscles: Weakened and atrophied with age.
Lung Tissue: Reduced elastic recoil with age, making coughing less effective at clearing airways and increasing risk of air trapping.
Alveolar Macrophages: Reduced effectiveness reducing infection risk.
Alveoli: Number of alveoli decreases with age.
Cough Reflex: Less effective at clearing airways.
Gas Exchange: Reduced with age causing decreased oxygen intake.

What's Up?

Where is it? (Location of the problem)
How does it feel? (Patient's description of symptoms)
Aggravating and alleviating factors (What makes it better or worse)
Timing (When did it start, how often)
Severity (How bad are the symptoms)
Useful other data (Other pertinent information)
Patient's perception (How the patient feels about the problem)

Inspection

Symmetry: Check for equal chest expansion on both sides
Dyspnea: Difficulty breathing
Use of accessory muscles: Observing for use of neck muscles with breathing.
Color: Assessment of skin color (cyanosis, pallor)
Respiratory rate and rhythm: Evaluate pattern and counting breaths
Chest shape: Look for deformities

Auscultation

Normal breath sounds: Listening for normal sounds during regular breathing
Adventitious sounds: Listening for abnormal breath sounds.
Compare bilaterally: Compare each side of the lungs.

Adventitious Breath Sounds

Crackles (coarse or fine)
Wheezes
Stridor
Friction rub
Diminished
Absent

Laboratory Tests

Complete blood count (CBC): Measures blood components.
Arterial blood gases (ABGs): Measures oxygen and carbon dioxide levels in the blood.
D-dimer: Measures fibrin degradation products which are released when blood clots dissolve.
Culture and sensitivity: Bacteria/fungus cultured, and sensitivity tested against antibiotics/anti-fungals.
Oxygen saturation: Measures the percentage of hemoglobin carrying oxygen.
Capnography: Measures carbon dioxide concentration in exhaled air.

Diagnostic Tests

Chest x-ray
Computed tomography (CT)
Ventilation-perfusion scan
Pulmonary function studies
Pulmonary angiography
Bronchoscopy

Therapeutic Measures

Smoking Cessation:
- Behavior modification
- Counseling
- Setting quit date
- Nicotine replacement
- Drug therapy
- Hypnosis
- Physical activity
- E-cigarettes
Breathing Exercises: Deep breathing and coughing; Huff coughing.
Positioning: Fowler's position, Semi-Fowler's position, "Good lung down" position.
Oxygen Therapy: Nasal cannula, oxygen masks (simple, partial rebreather, nonrebreather, Venturi).

COPD Oxygen Therapy Risk

Oxygen toxicity: High-flow oxygen therapy for longer than 24 hours in COPD patients, can cause problems.
CO2 Retainers: COPD patients retaining CO2, careful with nasal cannula oxygen.
Symptoms: Dry cough, chest pain, numbness in extremities, lethargy, or nausea

Metered-Dose Inhalers

Medication types: Determine what medication
Spacer: Use to improve medication delivery.
Teaching: Education on proper use of inhalers.
Multiple inhalers: Instructions on using multiple inhalers.

Incentive Spirometer

Use for patients: Helps patients practice deep breathing.
Instructions for patients: Expands chest and lungs (creates positive pressure).

Tracheostomy

Nursing care: Suctioning, cleaning, communication, teaching.
Infection prevention: Crucial
Communication: Critical for patients with tracheostomy
Diagnosis: Ineffective airway clearance, risk for infection, impaired verbal communication, disturbed body image, deficient knowledge.

CPAP and BiPAP

Indications: Determine usage if necessary.
Nursing care: Implement appropriate care, and watch for problems or concerns with therapy.
CPAP explanation: Provides continuous positive airway pressure.

Case Study #1 (Mr. Granger)

Symptoms: COPD, increased shortness of breath (dyspnea), fever, cough, crackles in lungs, low oxygen saturation (86% at room air).
Diagnosis (Implied): Cold and likely worsening COPD.
Treatment: Increased oxygen, likely sent to ER for further assessment / treatment.
Hand-Off Report: Use ISBARR to give details about patient's history, symptoms, vital signs, and treatment response.

Question #3

What happens with negative pressure? Inhalation occurs. There is negative pressure in your lungs, causing the lungs to inflate and take in air.

Question #4

Acid-base imbalance with decreased respiration? Respiratory acidosis.

Question #5

Adventitious sound from narrowed airways? Stridor.

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Description

Test your knowledge on the respiratory system's functions and issues. This quiz covers topics such as negative pressure in the thoracic cavity, symptoms of respiratory problems, and acid-base imbalances due to decreased respiratory function. Perfect for students studying human physiology.