lOMoAR cPSD| 67691079
NURS 5315 MODULE 6 EXAM QUESTIONS
AND ANSWERS
Aging and the pulmonary system - Answer The pulmonary system loses elastic recoil,
chest wall stiffens and an increase in flow resistance. Alveolar wall tissue decreases
with age leaving less surface area for gas exchange. Compliance decreases bc joints
become stiffer and ribs become ossified. Respiratory endurance decreases 20% by age
70 which leads to decreased vital capacity, increase residual volume and decreased
ventilation perfusion ratio. Also have a decrease compensatory response.
Infant and children pulmonary system - Answer Infant's tonsils are greater than a child.
Infants are nose breathers until 2-3 months of age. Alveoli increase in numbers up to 58
years of life. Surfactant is produced by 20-24 week gestation and is secreted in the
airways by 30 weeks gestation. Compliance is high in infants. Children will display
diaphragmatic breathing. O2 consumption is greater d/t high metabolic rate and children
have less glycogen reserves
Ventilation - Answer Movement of air in and out of the lungs. The brain stem controls
ventilation. The Dorsal resp. group and ventral resp. group(VRG) are in the medulla and
control breath patterns.
Pulmonary embolus risk factor and causes - Answer occlusion of blood flow in the
pulmonary artery. Commonly results from DVT, but can also be from tissue fragments,
foreign body, air bubble, fat embolus, fracture or amniotic fluid. Risk factors include any
factor that increases risk for DVT or creates a hypercoagulable state.
PE S&S - Answer chest pain, syncope, cough, dyspnea, tachycardia, anxiety,
hemoptysis
PE patho - Answer When the embolus lodges in the pulmonary circulation it triggers the
release of serotonin, histamine, catecholamines, angiotensin II inflammatory mediators,
and toxic oxygen free radicals. This causes vasoconstriction which further impedes
blood flow. This causes an increase in the pulmonary artery pressure and can lead to
right ventricular dilation and increased afterload. The decrease or absent blood flow to a
portion of the lung leads to a V/Q mismatch and a decrease in surfactant production.
This causes atelectasis and hypoxemia. The clot may cause lung infarction, decreased
cardiac output, shock and death.
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Saddle embolus - Answer a PE which sits of the bifurcation of the pulmonary artery. can
occlude all blood flow to lungs.
Pulmonary edema causes - Answer Accumulation of water in the pulmonary sacs that
prevents the proper exchange of gases. Most common cause is left sided heart failure
but can also be from ARDS, inhalation of toxic gases, increased pulmonary venous
pressure and damaged alveolar capillaries and re-expansion pulmonary edema.
Pulmonary edema S&S - Answer chest pain, dyspnea, orthopnea or paroxysmal
nocturnal dyspnea, hypoxemia, pulmonary rales, dullness to percussion, S3 heart
sound and frothy sputum
Re-expansion pulmonary edema patho - Answer after relieving airway obstruction.
Inspiration against an occluded airway creates excessive intrathoracic negative
pressure which leads to increased venous return to the right side of the heart and a
decreased outflow of blood from the left side of the heart. This creates increased
pulmonary blood volume and pressure which causes the pulmonary edema.
Primary(spontaneous) pneumothorax - Answer occurs in 20-40 yr old people from a
bleb(blister like) rupture usually in the apexes of the lung of people with emphysema
which allows air into the pleural space. Smoking increases the risk. There is a genetic
component.
Secondary pneumothorax - Answer Caused from trauma such as rib fracture, stab or
bullet wounds or surgical procedure
Tension pneumothorax - Answer occurs when air becomes trapped in the thoracic cavity
and cannot escape. Site of injury acts as a one way valve and only lets air in. may
experience complete lung collapse. S&S deviated trachea, SOB, and hypotension
Iatrogenic pneumothorax - Answer most commonly caused by transthoracic needle
aspiration
pneumothorax S&S - Answer sudden pleural pain, tachypnea, dyspna, decreased
breath sounds, and hyperresonance to percussion
Pleural effusion - Answer Presence of fluid in the pleural space from blood vessels or
lymphatic vessels beneath the pleural. occasionally from an abcess. Can be
pus(empyema), blood(hemothorax) or chyle(lymphatic fluid-chylothorax). Small
effusions may go undetected and the lymphatic system will remove the fluid. Large
effusions are characterized by dyspnea, pleural pain, compression atelectasis with
impaired ventilation, mediastinal shift, decreased breath sounds, dullness with
percussion and pleural friction rub
NURS 5315 MODULE 6 EXAM QUESTIONS
AND ANSWERS
Aging and the pulmonary system - Answer The pulmonary system loses elastic recoil,
chest wall stiffens and an increase in flow resistance. Alveolar wall tissue decreases
with age leaving less surface area for gas exchange. Compliance decreases bc joints
become stiffer and ribs become ossified. Respiratory endurance decreases 20% by age
70 which leads to decreased vital capacity, increase residual volume and decreased
ventilation perfusion ratio. Also have a decrease compensatory response.
Infant and children pulmonary system - Answer Infant's tonsils are greater than a child.
Infants are nose breathers until 2-3 months of age. Alveoli increase in numbers up to 58
years of life. Surfactant is produced by 20-24 week gestation and is secreted in the
airways by 30 weeks gestation. Compliance is high in infants. Children will display
diaphragmatic breathing. O2 consumption is greater d/t high metabolic rate and children
have less glycogen reserves
Ventilation - Answer Movement of air in and out of the lungs. The brain stem controls
ventilation. The Dorsal resp. group and ventral resp. group(VRG) are in the medulla and
control breath patterns.
Pulmonary embolus risk factor and causes - Answer occlusion of blood flow in the
pulmonary artery. Commonly results from DVT, but can also be from tissue fragments,
foreign body, air bubble, fat embolus, fracture or amniotic fluid. Risk factors include any
factor that increases risk for DVT or creates a hypercoagulable state.
PE S&S - Answer chest pain, syncope, cough, dyspnea, tachycardia, anxiety,
hemoptysis
PE patho - Answer When the embolus lodges in the pulmonary circulation it triggers the
release of serotonin, histamine, catecholamines, angiotensin II inflammatory mediators,
and toxic oxygen free radicals. This causes vasoconstriction which further impedes
blood flow. This causes an increase in the pulmonary artery pressure and can lead to
right ventricular dilation and increased afterload. The decrease or absent blood flow to a
portion of the lung leads to a V/Q mismatch and a decrease in surfactant production.
This causes atelectasis and hypoxemia. The clot may cause lung infarction, decreased
cardiac output, shock and death.
messages.downloaded_by
, lOMoAR cPSD| 67691079
Saddle embolus - Answer a PE which sits of the bifurcation of the pulmonary artery. can
occlude all blood flow to lungs.
Pulmonary edema causes - Answer Accumulation of water in the pulmonary sacs that
prevents the proper exchange of gases. Most common cause is left sided heart failure
but can also be from ARDS, inhalation of toxic gases, increased pulmonary venous
pressure and damaged alveolar capillaries and re-expansion pulmonary edema.
Pulmonary edema S&S - Answer chest pain, dyspnea, orthopnea or paroxysmal
nocturnal dyspnea, hypoxemia, pulmonary rales, dullness to percussion, S3 heart
sound and frothy sputum
Re-expansion pulmonary edema patho - Answer after relieving airway obstruction.
Inspiration against an occluded airway creates excessive intrathoracic negative
pressure which leads to increased venous return to the right side of the heart and a
decreased outflow of blood from the left side of the heart. This creates increased
pulmonary blood volume and pressure which causes the pulmonary edema.
Primary(spontaneous) pneumothorax - Answer occurs in 20-40 yr old people from a
bleb(blister like) rupture usually in the apexes of the lung of people with emphysema
which allows air into the pleural space. Smoking increases the risk. There is a genetic
component.
Secondary pneumothorax - Answer Caused from trauma such as rib fracture, stab or
bullet wounds or surgical procedure
Tension pneumothorax - Answer occurs when air becomes trapped in the thoracic cavity
and cannot escape. Site of injury acts as a one way valve and only lets air in. may
experience complete lung collapse. S&S deviated trachea, SOB, and hypotension
Iatrogenic pneumothorax - Answer most commonly caused by transthoracic needle
aspiration
pneumothorax S&S - Answer sudden pleural pain, tachypnea, dyspna, decreased
breath sounds, and hyperresonance to percussion
Pleural effusion - Answer Presence of fluid in the pleural space from blood vessels or
lymphatic vessels beneath the pleural. occasionally from an abcess. Can be
pus(empyema), blood(hemothorax) or chyle(lymphatic fluid-chylothorax). Small
effusions may go undetected and the lymphatic system will remove the fluid. Large
effusions are characterized by dyspnea, pleural pain, compression atelectasis with
impaired ventilation, mediastinal shift, decreased breath sounds, dullness with
percussion and pleural friction rub
