Respiratory and Urinary System Nursing Flashcards from Lecture Notes (Question and Answer)

A comprehensive set of practice questions (Q&A flashcards) covering respiratory assessment, lung volumes and capacities, V/Q relationships, pneumonia classifications, oxygen delivery systems, TB control, and urinary system topics from the notes.

What is apnea?

Temporary cessation of breathing.

What is bronchophony?

Abnormal increase in clarity of transmitted voice sounds heard when auscultating the lungs.

What is bronchoscopy?

Direct examination of the larynx, trachea, and bronchi using an endoscope.

What are cilia?

Short, fine hairs that propel mucus and foreign substances away from the lungs toward the larynx.

Define compliance in respiratory physiology.

A measure of the force required to expand or inflate the lungs.

What are crackles?

Nonmusical, discontinuous popping sounds during inspiration due to delayed reopening of airways.

What is dyspnea?

A subjective experience of uncomfortable or painful breathing, also known as shortness of breath.

What is egophony?

Abnormal change in tone of voice heard when auscultating the lungs.

Define fremitus.

Vibrations of speech felt as tremors of the chest wall during palpation.

What is hemoptysis?

Expectoration of blood from the respiratory tract.

What is hypoxemia?

Decrease in arterial oxygen tension in the blood.

What is hypoxia?

Decrease in oxygen supply to the tissues and cells.

What is obstructive sleep apnea?

Temporary absence of breathing during sleep due to transient upper airway obstruction.

What is orthopnea?

Shortness of breath when lying flat; relieved by sitting or standing.

What does oxygen saturation measure?

Percentage of hemoglobin that is bound to oxygen.

What is physiologic dead space?

Portion of the tracheobronchial tree that does not participate in gas exchange.

What is pulmonary diffusion?

Exchange of gas molecules (O2 and CO2) from areas of high to low concentration.

What is pulmonary perfusion?

Blood flow through the pulmonary vasculature.

What is respiration in respiratory physiology?

Gas exchange between atmospheric air and the blood and between the blood and body cells.

What are rhonchi?

Deep, low-pitched snoring sounds due to partial airway obstruction.

What is stridor?

Continuous, high-pitched musical sound on inspiration due to upper airway obstruction.

What is tachypnea?

Abnormally rapid respirations.

Define tidal volume (VT/TV).

Volume of air inspired and expired with each breath during normal breathing, about 500 mL.

What is inspiratory reserve volume (IRV)?

Maximum volume of air that can be inhaled after a normal inspiration.

What is inspiratory capacity (IC)?

Maximum volume of air inhaled after normal expiration; IC = TV + IRV.

What is functional residual capacity (FRC)?

Volume of air remaining in the lungs after a normal expiration; FRC = ERV + RV.

What is residual volume (RV)?

Volume of air remaining in the lungs after a maximum expiration.

What is vital capacity (VC)?

Maximum volume of air exhaled from a point of maximum inspiration; VC = TV + IRV + ERV.

What does a decrease in vital capacity (VC) indicate?

Possible neuromuscular disease, fatigue, atelectasis, pulmonary edema, COPD, or obesity.

What is inspiratory capacity (IC) sensitive to?

Restriction; may also be decreased in obesity.

Functional residual capacity (FRC) is increased in which condition?

COPD.

Functional residual capacity (FRC) is decreased in which conditions?

ARDS and obesity.

What is total lung capacity (TLC)?

Volume of air in the lungs after a maximum inspiration; TLC = TV + IRV + ERV + RV.

How can TLC change in disease?

Decreased in restrictive diseases; increased in COPD.

What is the normal ventilation–perfusion ratio (V/Q)?

1:1; ventilation matches perfusion.

What is a shunt in V/Q terms?

Low V/Q; perfusion exceeds ventilation; blood bypasses gas exchange.

What is dead space in V/Q terms?

High V/Q; ventilation exceeds perfusion; poor gas exchange due to lack of blood flow.

What is a silent unit?

Absence or severe reduction of both ventilation and perfusion; seen in pneumothorax or severe ARDS.

What is the P50 in the oxyhemoglobin dissociation curve?

Partial pressure of O2 at 50% Hb saturation.

What does a rightward shift of the oxyhemoglobin dissociation curve indicate?

Decreased affinity of Hb for O2, easier unloading of O2 to tissues.

What does a leftward shift of the curve indicate?

Increased affinity of Hb for O2, harder unloading of O2 to tissues.

What PaO2 levels are considered normal, relatively safe, and dangerous?

Normal: >70 mm Hg; Relatively safe: 45–70 mm Hg; Dangerous: <40 mm Hg.

What landmarks define the angle of Louis?

Location where the manubrium meets the body of the sternum, marking the second rib.

Which lines are used as vertical thoracic landmarks?

Midsternal line, midclavicular line, anterior, midaxillary, posterior axillary lines, scapular line, vertebral line.

What is the line that divides the left lung’s lobes anteriorly vs posteriorly?

Fourth thoracic spinous process posteriorly; line crosses fifth rib in the midaxillary line and meets the sixth rib at the sternum.

What are the five key elements of the ventilator-associated pneumonia (VAP) bundle?

1) Elevation of the head of the bed to 30-45°, 2) daily sedation vacations and readiness to extubate, 3) peptic ulcer prophylaxis, 4) DVT prophylaxis, 5) daily oral care with chlorhexidine.

What is CAP?

Community-acquired pneumonia: pneumonia occurring in the community or within 48 hours of hospital admission in patients without health care–associated risk factors.

What is HCAP?

Health care–associated pneumonia: pneumonia in a nonhospitalized patient with extensive health care contact (e.g., recent hospitalization, nursing home, IV therapy, etc.).

What is HAP?

Hospital-acquired pneumonia: pneumonia occurring ≥48 hours after hospital admission not incubating at admission.

What is VAP?

Ventilator-associated pneumonia: pneumonia that develops ≥48 hours after endotracheal intubation.

Name a few common CAP pathogens.

Streptococcus pneumoniae, Haemophilus influenzae, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Legionella species.

What is a common organism associated with hospital-acquired pneumonia in the ICU?

Pseudomonas aeruginosa.

What is an important nursing intervention to prevent VAP?

Head-of-bed elevation, sedation vacations, oral care, DVT prophylaxis, and PU prophylaxis as part of the VAP bundle.

What is a UTI?

Infection of the urinary tract, indicated by symptoms plus bacteriuria or pyuria on urinalysis.

What bacteria count defines bacteriuria for UTI using a clean-catch specimen?

100,000 colony-forming units per mL (CFU/mL).

What is postvoid residual (PVR) and its normal value indicating adequate bladder emptying?

PVR < 50 mL indicates adequate bladder emptying; >100 mL suggests impaired emptying.

Which pediatric assessment tool is used to detect delirium in pneumonia patients?

Confusion Assessment Method (CAM).

What are transient, stress, urge, mixed, overflow, functional, reflex, and total incontinence?

Types of urinary incontinence ranging from temporary causes (transient) to structural or neurological causes (stress, urge, mixed, overflow, functional, reflex, total).

What is incontinence-associated dermatitis (IAD)?

Moisture-related skin damage from excessive contact with urine or feces.

What is a voiding diary used for?

To record frequency, timing, and amount of voiding to identify patterns and triggers for incontinence.

What is postvoid residual (PVR) measurement via bladder ultrasound used for?

To assess bladder emptying; a PVR >100 mL indicates incomplete emptying.

What is the recommended hydration for patients with pneumonia?

Encourage fluid intake (e.g., at least 2 L/day) to aid secretion clearance and overall hydration.

What device delivers the highest O2 concentration among low-flow devices?

Nonrebreather mask (low-flow) with reservoir bag.

What is the advantage of a high-flow nasal cannula (HFNC)?

Delivers heated, humidified oxygen at high flow (up to 60 L/min) with potential positive airway pressure benefits and improved tolerance.

What is the main difference between Venturi masks and other fixed-output devices?

Venturi masks provide a fixed FiO2 by using a Venturi system to mix air and oxygen, producing a precise oxygen concentration.

What are signs of pneumonia that nurses should monitor?

Fever, chills, night sweats, pleuritic chest pain, fatigue, tachypnea, coughing with purulent sputum, and changes on chest exam or imaging.

What should you do if a patient shows signs of respiratory depression after opioid administration?

Monitor respiratory rate and depth, assess oxygenation (SpO2/PaO2), withhold or adjust opioids and notify the provider as needed.

What is the role of CPT (chest physiotherapy) in pneumonia care?

Loosen and mobilize secretions through postural drainage, percussion, vibration, and coughing techniques; aids secretion clearance.

What is the purpose of nasal suctioning in pneumonia care?

Remove secretions to improve airway patency and gas exchange.

What is the clinical significance of blue-tinged cyanosis?

Cyanosis is a late sign of hypoxia and indicates high levels of unoxygenated hemoglobin (>5 g/dL).

What is the role of oxygen therapy in pneumonia management?

Maintain adequate oxygenation, adjust FiO2 to keep SpO2 within target range, monitor patient response.

What is the difference between CAP and HCAP in terms of patient populations?

CAP occurs outside healthcare settings; HCAP includes patients with extensive healthcare exposure and higher risk of resistant organisms.

What is the purpose of the PEEP concept in ventilation–perfusion discussions?

Not explicitly detailed in the notes above; focus is on V/Q matching, shunt, and dead space rather than PEEP specifics.

What are risk factors for TB transmission in healthcare settings?

Close contact with TB patient, immunocompromised status, homelessness, alcoholism, immigration, travel to high-prevalence areas, crowded facilities, and exposure to aerosol-generating procedures.

What should be included in infection-control precautions for suspected/confirmed TB patients?

Private room with negative pressure, six air exchanges per hour, N95 respirators for staff, and continuation of precautions until reduced infectiousness.

What are common pathogens in hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP)?

Pseudomonas aeruginosa, Staphylococcus aureus (including MRSA), Klebsiella species, Enterobacter, and other gram-negatives; pathogens vary by setting.

What is the clinical significance of wheezes in a patient with airway narrowing?

Wheezes indicate airway narrowing or partial obstruction and can be heard with asthma or COPD.

What is the definition of a pleural effusion in respiratory exams?

Fluid accumulation in the pleural space that separates air-filled lung from the chest wall, reducing transmitted breath sounds.

What is a pneumothorax?

Air in the pleural space causing lung collapse; pleural air causes hyperresonance and decreased breath sounds.

What are crackles and their etiologies?

Discontinuous popping sounds; coarse crackles arise from large airways; fine crackles from alveoli, especially in interstitial disease or pneumonia.

What is a tracheal breath sound typically like?

Inspiration and expiration are about equal and very loud, heard over the trachea.

What is a bronchial breath sound?

Loud, high-pitched sounds normally heard over the trachea; can be transmitted to newer areas with consolidation.

What is a vesicular breath sound?

Normal breath sound: soft, low-pitched, heard over most of the lung fields during inspiration longer than expiration.

What is the role of proteinuria in kidney disease risk assessment?

Proteinuria indicates kidney disease and is used in evaluating renal function and progression.

What is autosomal dominant polycystic kidney disease (ADPKD) risk in genetics?

ADPKD is a known genetic kidney disorder; family history is important in assessment.

What is the clinical utility of bladder ultrasound in urinary care?

Noninvasive measurement of bladder volume and residual urine; helps assess urinary retention and reduce UTI risk.

What are common symptoms of a UTI?

Dysuria, urinary frequency or urgency, cloudy or foul-smelling urine, and sometimes hematuria.

What are risk factors for UTIs in older adults?

Catheters, immobility, urinary retention, incontinence, and age-related changes in bladder function.

What are behavioral interventions for urinary incontinence?

Bladder training, pelvic floor exercises, timed voiding, fluid management, and lifestyle modifications.

What is symptomatic management for UTIs with antibiotics?

Short-course antibiotics for lower UTIs; longer regimens for upper urinary tract infections.

What preventive measures reduce UTI risk after urinary instrumentation?

Aseptic technique, maintaining proper catheter care, and minimizing indwelling catheter use.

What is a urethral catheterization risk in UTIs?

Catheterization increases risk of introducing bacteria into the bladder, leading to UTI.

What is an appropriate nursing approach to patient education for urinary testing?

Explain tests clearly, assess understanding, ensure privacy, and reinforce test results and follow-up care.

What is the purpose of postprocedure instructions for urodynamic testing?

Prepare the patient for what to expect, manage discomfort, and address potential urinary symptoms after the test.

What is the definition of a respiratory tract infection that progresses to pneumonia?

Pneumonia resulting from infectious etiologies including bacteria, viruses, fungi, or aspiration; categorized by setting and pathogen.

What is the role of vaccination in pneumonia prevention?

Influenza vaccination and pneumococcal vaccines reduce risk and severity of pneumonia and related complications.

Which conditions increase the risk of drug-resistant pneumococcal infection?

Advanced age, alcoholism, prior beta-lactam therapy, immunosuppression, and multiple comorbidities.

What is the policy regarding isolation for suspected TB patients in healthcare settings?

Immediate initiation of AFB isolation precautions with private negative-pressure room and appropriate respirators; ongoing surveillance.

What is the significance of a PVR value >100 mL?

Indicates incomplete bladder emptying and potential urinary retention; may require further evaluation.

What is the importance of hydration in pneumonia care?

Hydration aids secretion clearance and supports overall recovery; balanced with comorbid conditions.