Chapter 49: Care of the Patient with a Respiratory Disorder

A comprehensive set of Q&A flashcards covering respiratory anatomy, physiology, assessment, diagnostics, and common disorders from the lecture notes.

What is external respiration?

The exchange of oxygen (O2) and carbon dioxide (CO2) between the lungs and the environment.

What is internal respiration?

The exchange of O2 and CO2 at the cellular level.

Which two systems work together to deliver O2 to cells and remove CO2?

The respiratory and cardiovascular systems.

Where do gases diffuse into the blood during respiration?

Across the alveolar–capillary membrane into the blood.

What is the function of surfactant?

It reduces surface tension and prevents alveolar collapse.

Name the components of the upper respiratory tract as listed in the notes.

Nose, Pharynx, Larynx, Trachea.

Name the components of the lower respiratory tract as listed in the notes.

Bronchial tree, Right and Left bronchi, Bronchioles, Alveoli.

What is the role of cilia in the respiratory system?

To move mucus and trapped particles out of the airways.

Where does O2 bind in the body?

Hemoglobin in red blood cells within the alveolar capillaries.

What happens to CO2 after tissue gas exchange?

It is carried by the blood back to the lungs and exhaled.

Through which vessels does O2-rich blood return to the left atrium after gas exchange?

Pulmonary veins.

CO2 diffuses from the blood into which structure for exhalation?

The alveoli.

What is the typical value of transpulmonary pressure mentioned in the notes?

About 4 mm Hg.

What is the intrapleural pressure?

-4 mm Hg.

What is the intra-alveolar pressure at rest?

0 relative pressure (equal to atmospheric pressure, 760 mm Hg).

What is the normal respiratory rate range?

14 to 20 breaths per minute.

Which brain structures regulate breathing?

Medulla oblongata and Pons.

What stimulates chemoreceptors to regulate breathing?

Increased CO2, decreased O2, and increased acidity (lower pH).

What is hypoxic drive?

Breathing drive triggered by low oxygen levels, especially when CO2 drive is blunted (as in COPD).

Name two subjective data elements collected in respiratory assessment.

Shortness of breath (SOB) and cough (onset/duration).

Name two objective data elements collected in respiratory assessment.

Respiratory rate (RR) and oxygen saturation (O2 sat).

What is the modern term for rhonchi?

Sibilant wheezes.

What are crackles in lung auscultation?

Crackling sounds indicating fluid or secretions in airways/alveoli.

What are signs of hypoxia?

Cyanosis; gray or pale skin; decreased O2 saturation; confusion; irritability.

Name two imaging tests used for respiratory diagnosis.

Chest X-ray and Spiral CT (also V/Q scan).

What is the purpose of a V/Q scan?

To assess ventilation–perfusion and help diagnose pulmonary embolism.

What is the purpose of pulmonary function testing (PFTs)?

To assess lung volume, ventilation, spirometry, and gas exchange.

What is the purpose of a sputum specimen?

Culture and sensitivity to identify pathogens; collected with the first productive morning cough.

What is thoracentesis?

Aspiration of fluid from the pleural space, diagnostic or therapeutic.

What is the normal PaO2 range?

80–100 mm Hg.

What is the normal PaCO2 range?

35–45 mm Hg.

What is the normal pH range in ABGs?

7.35–7.45.

What is the normal HCO3- range?

22–28 mEq/L.

What is the normal SaO2?

About 95%.

Epistaxis is the medical term for what?

Bleeding from the nose (nosebleed).

What is a deviated septum?

Septum deviates from midline; assess airway patency.

What are common treatments for Allergic Rhinitis?

Antiallergy medications, antihistamines, intranasal corticosteroids, leukotriene receptor antagonists, cough suppressants, and nasal decongestants.

How is Obstructive Sleep Apnea treated?

Lifestyle modifications; CPAP (continuous positive airway pressure) for moderate to severe cases.

What nursing priorities exist for a Laryngectomy patient?

Airway maintenance, suction, stoma care; monitor nutrition and I&O; communication strategies; infection prevention.

What is an early sign of cancer of the larynx?

Persistent hoarseness.

Pneumonia is defined as what?

An inflammatory process of the respiratory bronchioles and alveolar spaces caused by infection; higher risk in infants and older adults.

Name some pneumonia risk groups.

Infants, older adults, those with impaired defense mechanisms (e.g., immune compromise, alcoholism, diabetes), and those at risk of aspiration.

What are common pneumonia nursing interventions?

Conserve energy; high Fowler’s position; assist with expectoration; increase fluids; nourishment; suctioning; bronchodilators and mucolytics as ordered.

What is a pleural effusion?

Accumulation of fluid in the pleural space; empyema if infected.

What is pneumothorax and its typical treatment?

Air in the pleural space causing lung collapse; treated with chest tube drainage.

What percentage of lung cancers are related to smoking?

Approximately 87%.

What are common diagnostic exams for lung cancer?

CT (OCT in notes), PET scan, MRI, sputum analysis, mediastinoscopy.

What are the main medical treatments for lung cancer?

Surgery, radiation, and chemotherapy.

What does COPD stand for and what diseases does it include?

Chronic Obstructive Pulmonary Disease; includes emphysema and chronic bronchitis.

What are the classic ‘pink puffer’ features of emphysema?

CO2 retention with pink complexion, pursed-lip breathing, dyspnea, hyperresonance, orthopnea, barrel-shaped chest, prolonged expiratory time, thin appearance, anxious, uses accessory muscles.

What are the classic ‘blue bloater’ features of chronic bronchitis?

Cyanotic or dusky color, recurrent productive cough, hypoxia, hypercapnia, respiratory acidosis, polycythemia, edema, digital clubbing.