Ventilation-Perfusion Mismatch Assessment
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Questions and Answers

What defines acute respiratory failure in relation to arterial blood gases?

  • PaO2 greater than 50 mmHg
  • PaCO2 less than 50 mmHg
  • PaO2 less than 50 mmHg and PaCO2 greater than 50 mmHg and arterial pH less than 7.35 (correct)
  • Arterial pH greater than 7.35
  • Which condition can lead to decreased respiratory drive?

  • Pleural effusion
  • Cerebral hemorrhage (correct)
  • Chronic bronchitis
  • Pulmonary embolism
  • Which assessment finding is indicative of acute respiratory failure?

  • Restlessness (correct)
  • Increased urine output
  • Hypotension
  • Bradycardia
  • What is the most significant risk factor for developing COPD?

    <p>Cigarette smoking</p> Signup and view all the answers

    In the treatment of acute respiratory failure, which intervention is NOT typically included?

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

    What condition could cause dysfunction of the lung parenchyma affecting ventilation?

    <p>Chest trauma</p> Signup and view all the answers

    Which nursing intervention is essential for a patient with acute respiratory failure?

    <p>Maintain patent airway</p> Signup and view all the answers

    What type of disorders falls under the category of COPD?

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

    What is the primary cause of bronchiectasis?

    <p>Bacterial infection or recurrent lower respiratory tract infections</p> Signup and view all the answers

    What is a common symptom of bronchiectasis?

    <p>Chronic cough with production of mucopurulent sputum</p> Signup and view all the answers

    Which dietary recommendation helps limit carbon dioxide production in COPD management?

    <p>Low carbohydrate diet</p> Signup and view all the answers

    Which type of pharmacotherapy is primarily characterized by its anti-inflammatory effect?

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

    What defines a tension pneumothorax?

    <p>Air enters the pleural space with each inspiration but cannot escape</p> Signup and view all the answers

    Why should a high concentration of oxygen not be administered in COPD management?

    <p>The drive for breathing may be depressed</p> Signup and view all the answers

    What assessment finding is characteristic of pneumothorax?

    <p>Decreased breath sounds on the affected side</p> Signup and view all the answers

    What technique is used for bronchial hygiene measures?

    <p>CPT - percussion, vibration, postural drainage</p> Signup and view all the answers

    What is the recommended position to promote maximum lung expansion for patients experiencing dyspnea?

    <p>Fowler’s position</p> Signup and view all the answers

    What condition is described when some alveolar regions are well ventilated but poorly perfused?

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

    What symptom is characterized by the expectoration of blood from the respiratory tract?

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

    Which test measures gas pressures and pH of an arterial sample to evaluate lung gas exchange?

    <p>ABG analysis</p> Signup and view all the answers

    What is the normal range for PaCO2 in an arterial blood gas analysis?

    <p>35-45 mmHg</p> Signup and view all the answers

    What type of cyanosis indicates low oxygenation levels seen in the core areas of the body, such as the tongue and lips?

    <p>Central cyanosis</p> Signup and view all the answers

    What is the main purpose of sputum analysis?

    <p>To diagnose respiratory diseases</p> Signup and view all the answers

    Which color and consistency of sputum would most likely indicate a bacterial pneumonia infection?

    <p>Thick, yellow or green</p> Signup and view all the answers

    What immediate nursing intervention should be taken for a patient initially presenting with epistaxis?

    <p>Position the patient upright, leaning forward</p> Signup and view all the answers

    In which position should a patient be placed for a bronchoscopy procedure?

    <p>Sitting upright in a chair</p> Signup and view all the answers

    Which nursing intervention is crucial when managing cyanosis in a patient?

    <p>Implement oxygen therapy</p> Signup and view all the answers

    What is a vital pre-test consideration for pulmonary function tests?

    <p>No smoking for 3 days</p> Signup and view all the answers

    Which condition is indicated by profuse, pink, frothy sputum production?

    <p>Pulmonary edema</p> Signup and view all the answers

    Which of the following would NOT be a primary goal for a client with oxygenation problems?

    <p>Maintain hypoventilation</p> Signup and view all the answers

    What is a common cause of hemoptysis?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What is the recommended position for a patient after thoracentesis to allow lung expansion?

    <p>Semi-Fowler’s position</p> Signup and view all the answers

    What non-invasive method is used to continuously monitor hemoglobin oxygen saturation?

    <p>Pulse oximetry</p> Signup and view all the answers

    Dry cough and deep breathing exercises primarily assist in what aspect of respiratory care?

    <p>Removing secretions from the airway</p> Signup and view all the answers

    What is the most common organism responsible for tonsillitis?

    <p>Group A beta hemolytic streptococcus</p> Signup and view all the answers

    Which assessment finding is NOT typically associated with pharyngitis?

    <p>Foul-smelling breath</p> Signup and view all the answers

    Which nursing intervention is essential for promoting comfort in a patient with tonsillitis?

    <p>Administer prescribed antibiotics</p> Signup and view all the answers

    What should be done post-operatively after a tonsillectomy to aid recovery?

    <p>Apply ICE collar to the neck</p> Signup and view all the answers

    What is a typical laboratory test used for diagnosing upper airway infections?

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

    Which of the following is an inappropriate action when managing a patient with pharyngitis?

    <p>Prescribing antibiotics without confirming the cause</p> Signup and view all the answers

    Which symptom is most likely associated with severe cases of tonsillitis?

    <p>Difficulty swallowing</p> Signup and view all the answers

    What action should a nurse take if a patient swallows frequently post-tonsillectomy?

    <p>Notify the physician</p> Signup and view all the answers

    Study Notes

    Ventilation-Perfusion Mismatch

    • Dead space: well-ventilated but poorly perfused alveolar regions.
    • Shunting: well-perfused but poorly ventilated regions.

    Laboratory Examination

    • Types include ABG analysis, sputum analysis, direct visualization (bronchoscopy), indirect visualization (CXR, CT, MRI), and pulmonary function tests.

    ABG Analysis

    • Evaluates gas exchange in lungs by measuring gas pressures and pH of arterial blood.
    • Normal values:
      • PaO2: 80-100 mmHg
      • PaCO2: 35-45 mmHg
      • pH: 7.35-7.45
      • HCO3: 22-26 mEq/L
      • O2 saturation: 98-100%
    • Pre-test: obtain a proper site and ready equipment.
    • Intra-test: collect 5 mL of arterial blood from brachial, femoral, or radial arteries.
    • Post-test: apply pressure for 5 mins, label, and ice the specimen.

    Sputum Analysis

    • Tests sputum for respiratory disease diagnosis, organism identification, and abnormal cells.
    • Pre-test: encourage increased fluid intake.
    • Intra-test: rinse mouth, take deep breaths, and ensure early morning sample.
    • Post-test: provide oral hygiene and label specimens correctly.

    Pulse Oximetry

    • Non-invasive method for continuous monitoring of hemoglobin oxygen saturation.
    • Used sensors on earlobe, forehead, fingertip, or nose bridge.

    Bronchoscopy

    • Direct inspection of trachea and bronchi via a flexible or rigid bronchoscope.
    • Used for locating lesions, removing foreign objects, and tissue specimen collection.
    • Pre-test: patient consent and NPO for 6 hours.
    • Intra-test: sedate the patient and ensure they are positioned correctly.
    • Post-test: NPO until gag reflex returns and monitor for hoarseness and complications.

    Thoracentesis

    • Aspiration of pleural fluid for analysis and relieving lung compression.
    • Pre-test: obtain consent.
    • Intra-test: position the patient appropriately and instruct not to move.
    • Post-test: position for lung expansion, perform CXR, and monitor respiratory status.

    Pulmonary Function Tests

    • Assesses lung volume, capacity, and ventilatory function.
    • Distinguishes between obstructive and restrictive diseases.
    • Pre-test: educate patients and limit smoking and food intake before tests.

    Common Respiratory Problems

    • Dyspnea: difficulty in breathing, linked to conditions like CHF and muscular dystrophies.
    • Coughing: protective reflex indicating various pulmonary conditions, including infections and tumors.
    • Cyanosis: a late sign of hypoxia, need to check for airway patency and provide oxygen therapy.

    Hemoptysis

    • Coughing up blood, often due to infections or lung cancer.
    • Requires airway management and possibly administering fibrin stabilizers.

    Epistaxis

    • Nosebleeds due to ruptured vessels, common at the anterior septum.
    • Causes include trauma, hypertension, and infections.
    • Interventions include positioning and direct pressure application.

    Upper Airway Infections

    • Common conditions include pharyngitis and tonsillitis, characterized by sore throat and fever.
    • Key pathogens include Group A β-hemolytic streptococcus.
    • Management involves antibiotics and hydration.

    Respiratory Failure

    • A critical condition marked by inadequate gas exchange, defined clinically by specific ABG values.
    • Common causes include CNS depression and thoracic abnormalities.
    • Symptoms include restlessness, cyanosis, and altered mental status.
    • Treatment may involve intubation and oxygen therapy.

    COPD

    • Characterized by persistent air passage obstruction; primary cause is cigarette smoking.
    • Management includes rest, increased fluid intake, and low carbohydrate diet strategies.

    Bronchiectasis

    • Normal bronchi dilation due to infection or congenital defects.
    • Symptoms encompass chronic cough and dyspnea.
    • Management focuses on hydration and maintaining airway clearance.

    Pneumothorax

    • Accumulation of air/fluid in pleural space leading to lung collapse.
    • Types include spontaneous, open, and tension pneumothorax, each requiring distinctive interventions and assessments.

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    Description

    This quiz explores the concepts of ventilation-perfusion mismatch, highlighting the conditions of deadspace and shunting. It covers various laboratory examinations such as ABG analysis, sputum analysis, and imaging techniques for evaluation. Test your knowledge on these critical components of respiratory assessment.

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