Week 3: Alterations in Pulmonary Function questions
with complete solutions
Restrictive disease manifestations Correct Ans: - Increased RR
- Decreased tidal volume (VT)
- Normal to decreased PaO2
- Shortness of Breath
- Cough
- Chest Pain/discomfort
- Fatigue
- History of weight loss
The nurse should anticipate that the chest tube for a client recovering
from a pneumothorax will be removed when:
A. Chest drainage decreases to 125 mL in 24 hours.
B. Chest x-ray shows atelectasis has resolved.
C. Water-seal chamber no longer fluctuates with breathing.
D. Breath sounds are present bilaterally in apical lobes. Correct Ans: C.
Cessation of fluctuation in the water seal chamber when drainage system
no longer attached to suction is an indication of re-expansion. A. is
incorrect: there may have been little drainage if the chest tube was
removing air, not blood; typically want less than 100 mL in 24 hours
prior to removal. B. is incorrect - pneumothorax is a collapse of the
lung: partial or complete not the alveoli; D. is incorrect: presence of
breath sounds would need to be in all lobes
,Obstructive disease manifestations Correct Ans: - Mucus hypersecretion
- Wheezes/rhonchi
- Dyspnea
- Diminished breath/heart sounds
- Barrel chest (increased AP diameter)
- Progressive hypercapnia/resp. acidosis
- Use of accessory muscles
- Increased expiratory time
Physical respiratory assessment Correct Ans: - Observe/inspect
- Auscultation
- Palpation/symmetry
- Percussion
- Hemodynamics (BP, CVP, Pulmonary Artery Pressure, O2)
Respiratory history assessment Correct Ans: - Current problem
- History of respiratory disease
- Lifestyle
- Cough
- Pain
- Medications
- Risk factors
, ARDS risk factors/causes Correct Ans: - Pneumonia
- Gastric aspiration
- Near drowning
- Direct severe chest contusion
- Inhalation injury
- Sepsis
- Acute pancreatitis
- Drug overdose
- Severe traumatic injury with shock
Causes:
- Trauma
- Pulmonary infection/aspiration
- Prolonged ventilator assistance
- MOD, SIRS
- Shock
- Fat emboli
- Sepsis
Alveolar changes in ARDS Correct Ans: - Phase 1: Injury reduces blood
flow in the lungs
with complete solutions
Restrictive disease manifestations Correct Ans: - Increased RR
- Decreased tidal volume (VT)
- Normal to decreased PaO2
- Shortness of Breath
- Cough
- Chest Pain/discomfort
- Fatigue
- History of weight loss
The nurse should anticipate that the chest tube for a client recovering
from a pneumothorax will be removed when:
A. Chest drainage decreases to 125 mL in 24 hours.
B. Chest x-ray shows atelectasis has resolved.
C. Water-seal chamber no longer fluctuates with breathing.
D. Breath sounds are present bilaterally in apical lobes. Correct Ans: C.
Cessation of fluctuation in the water seal chamber when drainage system
no longer attached to suction is an indication of re-expansion. A. is
incorrect: there may have been little drainage if the chest tube was
removing air, not blood; typically want less than 100 mL in 24 hours
prior to removal. B. is incorrect - pneumothorax is a collapse of the
lung: partial or complete not the alveoli; D. is incorrect: presence of
breath sounds would need to be in all lobes
,Obstructive disease manifestations Correct Ans: - Mucus hypersecretion
- Wheezes/rhonchi
- Dyspnea
- Diminished breath/heart sounds
- Barrel chest (increased AP diameter)
- Progressive hypercapnia/resp. acidosis
- Use of accessory muscles
- Increased expiratory time
Physical respiratory assessment Correct Ans: - Observe/inspect
- Auscultation
- Palpation/symmetry
- Percussion
- Hemodynamics (BP, CVP, Pulmonary Artery Pressure, O2)
Respiratory history assessment Correct Ans: - Current problem
- History of respiratory disease
- Lifestyle
- Cough
- Pain
- Medications
- Risk factors
, ARDS risk factors/causes Correct Ans: - Pneumonia
- Gastric aspiration
- Near drowning
- Direct severe chest contusion
- Inhalation injury
- Sepsis
- Acute pancreatitis
- Drug overdose
- Severe traumatic injury with shock
Causes:
- Trauma
- Pulmonary infection/aspiration
- Prolonged ventilator assistance
- MOD, SIRS
- Shock
- Fat emboli
- Sepsis
Alveolar changes in ARDS Correct Ans: - Phase 1: Injury reduces blood
flow in the lungs
