NUR 376 Patho Exam 2/ 170 Qs &
Correct Ans/ 2024-2025.
What is ventilation-perfusion imbalance? - Answer: -Air cannot flow into an
alveolus
-Blood flow around an alveolus is altered
-Most common etiology (cause) is blood clot in the lung also known as pulmonary
embolus.
Hypoxia stimulates pulmonary arterial:
a)vasoconstriction
b)vasodilation - Answer: a)vasoconstriction
Patients with chronic hypoxia can develop chronic pulmonary vasoconstriction,
which can result in pulmonary hypertension.
Page 1 of 77
,What role does hypercapnia and chemoreceptors play in gas exchange? - Answer:
-Central chemoreceptors located in the medulla sense changes in carbon dioxide
and blood pH
-An increase in CO2 (hypercapnia) or a decrease in pH (acidosis) stimulates the
central chemoreceptors, resulting in an increased rate of respirations
what is chronic hypercapnia? - Answer: High level of CO2 in the body or
bloodstream. Lungs can't fully expel CO2. A common finding in patients with
progressive hypoxic lung disease
Ideal PCO2: 35mmHg - 45mmHg.
D/t bradypnea. Signals brain's respiratory center (in medulla) to increase
breathing rate
Causes: asphyxiation, aspiration, asthma, COPD, pneumonia, pulmonary edema,
thoracic muscle paralysis, opiate toxicity
Symptoms: headache, drowsiness, intellectual impairment, disorientation ->
stupor and coma
** Distinct change in stimulus to breathe. Shifts from CO2 accumulation to
hypoxia as stimulus.*
what is chronic hypoxia? - Answer: Chronic lack of oxygen from respiratory
dysfunction. AKA Hypoxemia.
Ideal PO2: 90mmHg - 100mmHg.
Page 2 of 77
,Brain can handle hypoxia 5-6 min til brain cells die, kidney can sustain for 20 min
before nephrons die.
Under 60 mmHg, cellular aerobic metabolism ceases and anaerobic takes over ->
lactic acid At 60 mmHg Hgb starts to release oxygen molecules, pt is in severe
hypoxemia -> behavioral changes, restlessness, uncoordinated movements,
impaired judgment, delirium, stupor, coma
Compensation: increase ventilation, pulmonary arteriole vasoconstriction, kidneys
release erythropoetin -> pulmonary hypertension -> right ventricular hypertrophy
-> right ventricular failure (cor pulmonale)
what is an obstructive disorder? restrictive?
Incorporate: -SABA
-LABA - Answer: -characterized by an increase in resistance to airflow from the
trachea and larger bronchi to the terminal and respiratory bronchioles.
-characterized by reduced expansion of lung tissue, with decreased total lung
capacity (TLC).
Short acting beta agonists: ex: Albuterol (used as rescue meds, work rapidly,
usually within minutes, to open the airways and provide relief during asthma
attacks or other respiratory distress.)
Long acting beta agonists: ex: Salmeterol (used as part of combination therapy,
especially when combined with inhaled corticosteroids (ICS), to provide both
bronchodilation and anti-inflammatory effects for the long-term management of
respiratory conditions.)
Page 3 of 77
, What are the general risk factors for pulmonary disorders/diseases? - Answer: -
Smoking, including second hand smoke
-occupational exposure to toxic agents such as mineral dust, coal, silica, farming
and landscaping materials, and reactive chemicals such as toluene
-asbestos exposure
what is orthopnea? - Answer: Difficulty breathing when laying flat
what is clubbing? - Answer: a painless enlargement of the terminal phalanges of
the fingers and toes that develops over time. (chronic hypoxia)
What diseases would you hear wheezes? Crackles? - Answer: Wheezes and
crackles:
-Pulmonary Edema
-COPD
-Pneumonia
-Bronchiectasis
Wheezing:
-Asthma
What are the signs of lung pathophysiology? - Answer: 1) Dyspnea
2) Cough
3) Hemoptysis
Page 4 of 77
Correct Ans/ 2024-2025.
What is ventilation-perfusion imbalance? - Answer: -Air cannot flow into an
alveolus
-Blood flow around an alveolus is altered
-Most common etiology (cause) is blood clot in the lung also known as pulmonary
embolus.
Hypoxia stimulates pulmonary arterial:
a)vasoconstriction
b)vasodilation - Answer: a)vasoconstriction
Patients with chronic hypoxia can develop chronic pulmonary vasoconstriction,
which can result in pulmonary hypertension.
Page 1 of 77
,What role does hypercapnia and chemoreceptors play in gas exchange? - Answer:
-Central chemoreceptors located in the medulla sense changes in carbon dioxide
and blood pH
-An increase in CO2 (hypercapnia) or a decrease in pH (acidosis) stimulates the
central chemoreceptors, resulting in an increased rate of respirations
what is chronic hypercapnia? - Answer: High level of CO2 in the body or
bloodstream. Lungs can't fully expel CO2. A common finding in patients with
progressive hypoxic lung disease
Ideal PCO2: 35mmHg - 45mmHg.
D/t bradypnea. Signals brain's respiratory center (in medulla) to increase
breathing rate
Causes: asphyxiation, aspiration, asthma, COPD, pneumonia, pulmonary edema,
thoracic muscle paralysis, opiate toxicity
Symptoms: headache, drowsiness, intellectual impairment, disorientation ->
stupor and coma
** Distinct change in stimulus to breathe. Shifts from CO2 accumulation to
hypoxia as stimulus.*
what is chronic hypoxia? - Answer: Chronic lack of oxygen from respiratory
dysfunction. AKA Hypoxemia.
Ideal PO2: 90mmHg - 100mmHg.
Page 2 of 77
,Brain can handle hypoxia 5-6 min til brain cells die, kidney can sustain for 20 min
before nephrons die.
Under 60 mmHg, cellular aerobic metabolism ceases and anaerobic takes over ->
lactic acid At 60 mmHg Hgb starts to release oxygen molecules, pt is in severe
hypoxemia -> behavioral changes, restlessness, uncoordinated movements,
impaired judgment, delirium, stupor, coma
Compensation: increase ventilation, pulmonary arteriole vasoconstriction, kidneys
release erythropoetin -> pulmonary hypertension -> right ventricular hypertrophy
-> right ventricular failure (cor pulmonale)
what is an obstructive disorder? restrictive?
Incorporate: -SABA
-LABA - Answer: -characterized by an increase in resistance to airflow from the
trachea and larger bronchi to the terminal and respiratory bronchioles.
-characterized by reduced expansion of lung tissue, with decreased total lung
capacity (TLC).
Short acting beta agonists: ex: Albuterol (used as rescue meds, work rapidly,
usually within minutes, to open the airways and provide relief during asthma
attacks or other respiratory distress.)
Long acting beta agonists: ex: Salmeterol (used as part of combination therapy,
especially when combined with inhaled corticosteroids (ICS), to provide both
bronchodilation and anti-inflammatory effects for the long-term management of
respiratory conditions.)
Page 3 of 77
, What are the general risk factors for pulmonary disorders/diseases? - Answer: -
Smoking, including second hand smoke
-occupational exposure to toxic agents such as mineral dust, coal, silica, farming
and landscaping materials, and reactive chemicals such as toluene
-asbestos exposure
what is orthopnea? - Answer: Difficulty breathing when laying flat
what is clubbing? - Answer: a painless enlargement of the terminal phalanges of
the fingers and toes that develops over time. (chronic hypoxia)
What diseases would you hear wheezes? Crackles? - Answer: Wheezes and
crackles:
-Pulmonary Edema
-COPD
-Pneumonia
-Bronchiectasis
Wheezing:
-Asthma
What are the signs of lung pathophysiology? - Answer: 1) Dyspnea
2) Cough
3) Hemoptysis
Page 4 of 77
