NUR 2407; RASMUSSEN COLLEGE- RESPIRATORY
SYSTEM KEY POINTS LATEST STUDY GUIDE 2026
• Ventilation-perfusion mismatch:
Shunting = blood passes alveoli without gas exchange (e.g.,
hemothorax, pneumothorax, intrapulmonary fistulas).
Dead space = no perfusion (e.g., pulmonary embolus).
• Oxyhemoglobin curve shifts:
Left shift = ↑ O₂ affinity (alkalemia, hypothermia).
Right shift = ↓ O₂ affinity (acidosis, ↑ 2,3-DPG, hyperthermia).
• Acid-base compensation:
Buffers act immediately; lungs respond in hours; kidneys in 2–3 days
(full compensation).
• ABG analysis:
High pH + high HCO₃⁻ = metabolic alkalosis.
• Respiratory alkalosis:
Causes include hypoxia, hyperventilation, fever, anemia, pregnancy.
Not diarrhea (that causes metabolic acidosis).
• Sputum:
Green/musty = Pseudomonas; rust = pneumococcal pneumonia;
pink frothy = pulmonary edema; gray/white = emphysema.
• Pleuritic pain:
Gradual = TB, malignancy; sudden = pneumothorax, pneumonia,
embolism.
• Physical signs:
Barrel chest = emphysema; cyanosis = late hypoxia.
Pneumothorax percussion = tympany.
Cheyne-Stokes = crescendo-decrescendo with apnea.
• Breath sounds:
Bronchovesicular = near sternum; vesicular = lung fields; bronchial
= trachea.
• Oxygen therapy:
Low-flow for stable clients (normal RR).
• Fremitus:
Decreased with atelectasis, pneumonia, fibrosis, infarction; increased
with pneumothorax/emphysema.
SYSTEM KEY POINTS LATEST STUDY GUIDE 2026
• Ventilation-perfusion mismatch:
Shunting = blood passes alveoli without gas exchange (e.g.,
hemothorax, pneumothorax, intrapulmonary fistulas).
Dead space = no perfusion (e.g., pulmonary embolus).
• Oxyhemoglobin curve shifts:
Left shift = ↑ O₂ affinity (alkalemia, hypothermia).
Right shift = ↓ O₂ affinity (acidosis, ↑ 2,3-DPG, hyperthermia).
• Acid-base compensation:
Buffers act immediately; lungs respond in hours; kidneys in 2–3 days
(full compensation).
• ABG analysis:
High pH + high HCO₃⁻ = metabolic alkalosis.
• Respiratory alkalosis:
Causes include hypoxia, hyperventilation, fever, anemia, pregnancy.
Not diarrhea (that causes metabolic acidosis).
• Sputum:
Green/musty = Pseudomonas; rust = pneumococcal pneumonia;
pink frothy = pulmonary edema; gray/white = emphysema.
• Pleuritic pain:
Gradual = TB, malignancy; sudden = pneumothorax, pneumonia,
embolism.
• Physical signs:
Barrel chest = emphysema; cyanosis = late hypoxia.
Pneumothorax percussion = tympany.
Cheyne-Stokes = crescendo-decrescendo with apnea.
• Breath sounds:
Bronchovesicular = near sternum; vesicular = lung fields; bronchial
= trachea.
• Oxygen therapy:
Low-flow for stable clients (normal RR).
• Fremitus:
Decreased with atelectasis, pneumonia, fibrosis, infarction; increased
with pneumothorax/emphysema.
