Nurs 341 Exam 3 – Questions With Reviewed Solutions
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Sherpath: Diabetes Mellitus Chapter 21 Test Case Study 4 (Short
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Terms in this set (701)
Carbon Dioxide (CO2) The waste gas created in the tissues that moves from the
blood into the alveoli so that it can be exhaled
Purposes of breathing * Provides O2 for tissue perfusion so that cells have enough
O2 to take part in metabolism
* Removes CO2, the major waste product of metabolism
Upper Airways Nose
Sinuses
Pharynx
Larynx
Turbinates 3 bony projects that protrude into the nasal cavities from the
walls of the interior portion of the nose; They increase the
total surface are for filtering, heating, & humidifying inspired
air
Nasopharynx Contains the adenoids & the opening of the eustachian tube
Oropharynx Contains the palatine tonsils
Laryngopharynx Extends from base of tongue to esophagus; it is the critical
dividing point where solid food & fluids are separated from air
Larynx the "voice box"; located above the trachea
Cricothyroid membrane The site used in an emergency for access to the lower airways
(aka a tracheostomy)
Lower Airways Trachea
Bronchi
Bronchioles
Alveolar ducts
Alveoli
When a foreign object is aspirated from the The right bronchus
throat, where does it usually enter?
Lobar bronchi *Cartilage is ring-shaped and RESISTS collapse
*Lined with a ciliated, mucus-secreting membrane
,Bronchioles Have no cartilage and depend entirely on the elastic recoil of
the lung to remain patent
Alveoli The basic units of gas exchange
Surfactant A fatty protein that reduces surface tension in the alveoli;
without it, atelectasis occurs
Right Lung *Responsible for about 60-65% of respiratory function
*Any problem with this lung inteferes with oxygenation to a
greater degree than a problem in the other lung
Formula for calculation of "pack years" # of packs smoked per day X # of yrs. pt. has smoked
A cough can be a side of effect of this ACE inhibitors
group of prescribed drugs
Histoplasmosis and Coccidioidomycosis Fungal diseases
What is a main sign of lung disease? Cough
Normal amount of sputum production per 3 ounces (90mL)
day
Hemoptysis Blood in the sputum; Most often seen in patients with chronic
bronchitis or lung cancer
Paroxysmal nocturnal dyspnea Intermittent dyspnea sleep; The pt. has a sudden onset of
breathing difficulty severe enough to awaken them from
sleep; Often occurs with chronic lung disease & left-sided
heart failure
Orthopnea Shortness of breath that occurs when lying down but is
relieved by sitting up; Often occurs with chronic lung disease
& left-sided heart failure
Appearance of nasal mucous membrane in Pale, engorged, and bluish gray
patient with Allergic Rhinitis
Septal deviation Some degree of it is common in most adults & appears as an S
shape, tilting toward 1 side or the other
Perforated Septum A condition commonly found in cocaine users; It is present if a
light shines through the perforation into the opposite nostril
upon assessment
Nasal Polyps A common cause of obstruction; Pale, shiny, gelatinous lumps
or "bags" attached to the turbinates; Assess by blocking 1 naris
at a time to check whether air moves through the unblocked
side easily
Tender lymph nodes in neck Usu. movable & suggest inflammation
Malignant lymph nodes in neck Often hard & are fixed to the surrounding tissue
,These disorders push the trachea AWAY *Tension pneumothorax
from the affected area *Large pleural effusion
*Mediastinal mass
*Neck tumors
These disorders pull the trachea TOWARD **Pneumonectomy
the affected area **Fibrosis
**Atelectasis
Pneumothorax Partial or complete collapse of the lung due to air or gas in
the pleural space
Crepitus Air trapped in & under the skin aka as subcutaneous
emphysema; it is FELT as a crackling sensation beneath the
fingertips
Tactile (vocal) fremitus A vibration of the chest wall produced with the pt. speaks; This
vibration is increased w/pneumonia & abscesses
Adventitious sounds Additional breath sounds superimposed on normal sounds;
indicate pathologic changes in the lung
PaO2 80-100 mm Hg
pH 7.35 - 7.45
PaCO2 35-45
HCO3 21-28 mEq/L
SpO2 95% - 100%
Pulmonary embolism The blockage of a pulmonary artery by fat, air, tissue tumor, or
a thrombus that usu. arises from a peripheral vein
Pulmonary Function Tests (PFTs) These tests evaluate lung function & breathing problems;
During these tests the patient breaths through the mouth only
Functional Residual Capacity A PFT to determine the amount of air remaining in the lungs
after NORMAL EXpiration
Total Lung Capacity A PFT to determine the amount of air in the lungs at the end of
MAXIMUM INhalation
Residual Volume A PFT to determine the amount of air remaining in the lungs at
the end of a full, FORCED EXhalation
Bronchoscopy An invasive diagnostic assessment; Used to diagnose &
manage pulmonary diseases
Methemoglobin -Normal blood level is less than 1%
-Cyanosis occurs w/levels between 10-20%
-Anxiety, tachycardia, and lethargy develop at 20-50%
-Death can occur when levels reach 50-70%
, Methemoglobinemia The conversion of normal hemoglobin to methemoglobin, an
altered iron state that does not carry O2 resulting in tissue
hypoxia
Treatment for Methemoglobinemia Supplemental oxygen & IV adm. of 1% methylene blue
Benzocaine spray A topical anesthetic to numb the oropharynx that is used
cautiously, if at all, because it can induce methemoglobinemia
When to suspect methemoglobinemia? If patient becomes cyanotic after receiving a topical
anesthetic, does not respond to supplemental O2, & blood is a
characteristic chocolate brown in color
Thoracentesis An invasive diagnostic assessment involving the aspiration of
pleural fluid or air from the pleural space; Can be used for
diagnosis or treatment
Which of these clients will the charge nurse Client with pleural effusion who has had 1200 mL removed by
on the medical unit assign to an RN who has thoracentesis
floated from the postanesthesia care unit
(PACU)?
A. Client with allergic rhinitis scheduled for
skin testing
B. Client with emphysema who needs
teaching about pulmonary function testing
C. Client with pancreatitis who needs a
preoperative chest x-ray
D. Client with pleural effusion who has had
1200 mL removed by thoracentesis
An RN and an LPN/LVN are working Plan client and family teaching regarding upcoming
together to provide care for a client pulmonary function testing.
hospitalized with dyspnea who requires all
of these nursing actions. Which of these
actions is best accomplished by the RN?
A. Administer the purified protein derivative
(PPD) for tuberculosis testing.
B. Assess vital signs and the puncture site
after thoracentesis.
C. Monitor oxygen saturation using pulse
oximetry every 4 hours.
D. Plan client and family teaching regarding
upcoming pulmonary function testing.
A client has returned to the postanesthesia Monitor blood pressure and pulse.
care unit (PACU) after a bronchoscopy.
Which of these nursing tasks is best for the
charge nurse to delegate to the
experienced nursing assistant working in
PACU?
A. Assess breath sounds.
B. Check gag reflex.
C. Determine level of consciousness.
D. Monitor blood pressure and pulse.
Save
Students also studied
Sherpath: Diabetes Mellitus Chapter 21 Test Case Study 4 (Short
30 terms 24 terms 22 terms
jesssbee Preview kenanderson2017 Preview Brittany182
Terms in this set (701)
Carbon Dioxide (CO2) The waste gas created in the tissues that moves from the
blood into the alveoli so that it can be exhaled
Purposes of breathing * Provides O2 for tissue perfusion so that cells have enough
O2 to take part in metabolism
* Removes CO2, the major waste product of metabolism
Upper Airways Nose
Sinuses
Pharynx
Larynx
Turbinates 3 bony projects that protrude into the nasal cavities from the
walls of the interior portion of the nose; They increase the
total surface are for filtering, heating, & humidifying inspired
air
Nasopharynx Contains the adenoids & the opening of the eustachian tube
Oropharynx Contains the palatine tonsils
Laryngopharynx Extends from base of tongue to esophagus; it is the critical
dividing point where solid food & fluids are separated from air
Larynx the "voice box"; located above the trachea
Cricothyroid membrane The site used in an emergency for access to the lower airways
(aka a tracheostomy)
Lower Airways Trachea
Bronchi
Bronchioles
Alveolar ducts
Alveoli
When a foreign object is aspirated from the The right bronchus
throat, where does it usually enter?
Lobar bronchi *Cartilage is ring-shaped and RESISTS collapse
*Lined with a ciliated, mucus-secreting membrane
,Bronchioles Have no cartilage and depend entirely on the elastic recoil of
the lung to remain patent
Alveoli The basic units of gas exchange
Surfactant A fatty protein that reduces surface tension in the alveoli;
without it, atelectasis occurs
Right Lung *Responsible for about 60-65% of respiratory function
*Any problem with this lung inteferes with oxygenation to a
greater degree than a problem in the other lung
Formula for calculation of "pack years" # of packs smoked per day X # of yrs. pt. has smoked
A cough can be a side of effect of this ACE inhibitors
group of prescribed drugs
Histoplasmosis and Coccidioidomycosis Fungal diseases
What is a main sign of lung disease? Cough
Normal amount of sputum production per 3 ounces (90mL)
day
Hemoptysis Blood in the sputum; Most often seen in patients with chronic
bronchitis or lung cancer
Paroxysmal nocturnal dyspnea Intermittent dyspnea sleep; The pt. has a sudden onset of
breathing difficulty severe enough to awaken them from
sleep; Often occurs with chronic lung disease & left-sided
heart failure
Orthopnea Shortness of breath that occurs when lying down but is
relieved by sitting up; Often occurs with chronic lung disease
& left-sided heart failure
Appearance of nasal mucous membrane in Pale, engorged, and bluish gray
patient with Allergic Rhinitis
Septal deviation Some degree of it is common in most adults & appears as an S
shape, tilting toward 1 side or the other
Perforated Septum A condition commonly found in cocaine users; It is present if a
light shines through the perforation into the opposite nostril
upon assessment
Nasal Polyps A common cause of obstruction; Pale, shiny, gelatinous lumps
or "bags" attached to the turbinates; Assess by blocking 1 naris
at a time to check whether air moves through the unblocked
side easily
Tender lymph nodes in neck Usu. movable & suggest inflammation
Malignant lymph nodes in neck Often hard & are fixed to the surrounding tissue
,These disorders push the trachea AWAY *Tension pneumothorax
from the affected area *Large pleural effusion
*Mediastinal mass
*Neck tumors
These disorders pull the trachea TOWARD **Pneumonectomy
the affected area **Fibrosis
**Atelectasis
Pneumothorax Partial or complete collapse of the lung due to air or gas in
the pleural space
Crepitus Air trapped in & under the skin aka as subcutaneous
emphysema; it is FELT as a crackling sensation beneath the
fingertips
Tactile (vocal) fremitus A vibration of the chest wall produced with the pt. speaks; This
vibration is increased w/pneumonia & abscesses
Adventitious sounds Additional breath sounds superimposed on normal sounds;
indicate pathologic changes in the lung
PaO2 80-100 mm Hg
pH 7.35 - 7.45
PaCO2 35-45
HCO3 21-28 mEq/L
SpO2 95% - 100%
Pulmonary embolism The blockage of a pulmonary artery by fat, air, tissue tumor, or
a thrombus that usu. arises from a peripheral vein
Pulmonary Function Tests (PFTs) These tests evaluate lung function & breathing problems;
During these tests the patient breaths through the mouth only
Functional Residual Capacity A PFT to determine the amount of air remaining in the lungs
after NORMAL EXpiration
Total Lung Capacity A PFT to determine the amount of air in the lungs at the end of
MAXIMUM INhalation
Residual Volume A PFT to determine the amount of air remaining in the lungs at
the end of a full, FORCED EXhalation
Bronchoscopy An invasive diagnostic assessment; Used to diagnose &
manage pulmonary diseases
Methemoglobin -Normal blood level is less than 1%
-Cyanosis occurs w/levels between 10-20%
-Anxiety, tachycardia, and lethargy develop at 20-50%
-Death can occur when levels reach 50-70%
, Methemoglobinemia The conversion of normal hemoglobin to methemoglobin, an
altered iron state that does not carry O2 resulting in tissue
hypoxia
Treatment for Methemoglobinemia Supplemental oxygen & IV adm. of 1% methylene blue
Benzocaine spray A topical anesthetic to numb the oropharynx that is used
cautiously, if at all, because it can induce methemoglobinemia
When to suspect methemoglobinemia? If patient becomes cyanotic after receiving a topical
anesthetic, does not respond to supplemental O2, & blood is a
characteristic chocolate brown in color
Thoracentesis An invasive diagnostic assessment involving the aspiration of
pleural fluid or air from the pleural space; Can be used for
diagnosis or treatment
Which of these clients will the charge nurse Client with pleural effusion who has had 1200 mL removed by
on the medical unit assign to an RN who has thoracentesis
floated from the postanesthesia care unit
(PACU)?
A. Client with allergic rhinitis scheduled for
skin testing
B. Client with emphysema who needs
teaching about pulmonary function testing
C. Client with pancreatitis who needs a
preoperative chest x-ray
D. Client with pleural effusion who has had
1200 mL removed by thoracentesis
An RN and an LPN/LVN are working Plan client and family teaching regarding upcoming
together to provide care for a client pulmonary function testing.
hospitalized with dyspnea who requires all
of these nursing actions. Which of these
actions is best accomplished by the RN?
A. Administer the purified protein derivative
(PPD) for tuberculosis testing.
B. Assess vital signs and the puncture site
after thoracentesis.
C. Monitor oxygen saturation using pulse
oximetry every 4 hours.
D. Plan client and family teaching regarding
upcoming pulmonary function testing.
A client has returned to the postanesthesia Monitor blood pressure and pulse.
care unit (PACU) after a bronchoscopy.
Which of these nursing tasks is best for the
charge nurse to delegate to the
experienced nursing assistant working in
PACU?
A. Assess breath sounds.
B. Check gag reflex.
C. Determine level of consciousness.
D. Monitor blood pressure and pulse.
