NR283 Exam 2 (week 3) Chamberlain Questions with 100% correct answers -Chamberlain

What is the role of alveoli and surfactant in respiration?

-alveoli: promotes the diffusion of gases into the blood

-surfactant: lubricates and allows alveoli to POP back open

ventilation definition and assessment

-mechanical movement of air in and out of the lungs

-assessment: ventilation rate, depth, quality

perfusion definition and assessment

-blood flow to the lungs

-assessment: CBC (complete blood count) and H&H (Hemoglobin & Hematocrit)

respiration

gas exchange

How is oxygen transported through the blood?

hemoglobin

Compliance

-Ability to expand

-move air in/out

-muscles, diaphragm, ribs

elasticity

-ability for lungs to return to relaxed state

-recoil

-eg. emphysema: retaining CO2 which causes lungs to not fully relax

resistance

-anything blocking the airway

-eg. aspiration

-elderly and kids are most at risk

work of breathing

-energy expended to breathe

-eg. COPD, broken ribs, heart failure need lots of energy to breathe

s/s of respiratory system

-dyspnea

-cough

-sputum

-hemoptysis

-kussmaul respirations

-cheyne-stokes

dyspnea

difficulty breathing or shortness of breath

cough

dry or productive

sputum

-green, yellow, brown

-painful

hemoptysis

coughing up blood

Kussmaul respirations

-use of accessory muscles to breathe

-starving for O2

Cheyne-Stokes

-end of life breathing

-breathe....apnea.....breathe

expansion disorders

-flail chest

-atelectasis

-pneumothorax

-pleural effusion

flail chest

-multiple broken ribs in a row

-cause: trauma

-s/s: contusions, edema, bleeding

atelectasis

-collapsed alveoli

-causes: after surgery, compressive, obstructive, loss of surfactant

-s/s are mild: dyspnea and decreased SPO2

-treatment: incentive spirometer

pneumothorax

-air in the pleural space

-collapsed lung: affected lung cannot expand

-absence of breath sounds on affected side

-treatment: chest tube

pleural effusion

-water in pleural space (lymph or blood)

-treatment: chest tube

obstructive breathing disorders

-Aspiration

-asthma

-COPD

aspiration

-"down the wrong tube"

-caused by food, mucus, fluid

-gunk in alveoli increases risk for pneumonia

who is most at risk for aspiration?

-elderly

-children

-intubated

-stroke victims

Asthma risk factors

-Asthma triangle (asthma, eczema, allergies, IgE)

-children

-family history

asthma

bronchospasm + increased mucus production

How does an asthma attack impact the pH of the body?

-hyperventilation from initial panic causes respiratory alkalosis

-blocked airways lead to respiratory acidosis (cant get CO2 out)

Drive to breathe: healthy

Rising CO2 causes brain to say "Breathe!"

Drive to breathe: COPD

Decreasing O2 levels cause brain to say "Breathe!"

what is the #1 cause fo COPD?

smoking

COPD (chronic obstructive pulmonary disease)

-preventable disease or genetically unlucky

-s/s: chronic productive cough, decreased SPO2

what genetic disorder leads to COPD?

Alpha 1 antitrypsin deficiency (cant maintain elasticity of the lungs)

Patho of COPD

-smoking or pollution leads to inflammation of airway epithelium

-releases chemical mediators (cytokines)

-cytokines cause breakdown of elastin which causes emphysema

-cytokines cause continuous bronchial inflammation which causes chronic bronchitis

Emphysema

-irreversible, progressive condition

-no elasticity=air trapping (CO2)

barrel chest definition and cause

-emphysema

-chest protrudes from expanded lungs

what is the tripod position and what is it related to?

-emphysema

-hands on knees and hunched forward

-makes it easier to exhale

why is emphysema permanent?

-air trapping leads to the destruction of the alveolar walls

what is a common sign of emphysema?

-clubbing from chronic hypoxia (decreased SPO2)

Chronic bronchitis

-chronic inflammation + increased mucus

-no microorganisms

what criteria needs to be met to be considered to have chronic bronchitis?

cough for 3 months of the year for 2 years in a row

Chronic bronchitis: normal mucus vs. abnormal mucus

-clear -> yellowish = healthy

-green -> infection (complication)

what is a common sign of chronic bronchitis and why?

-chronically hypoxic

-pulmonary vessels vasoconstrict -> pulmonary hypertension (high pressure inside the pulmonary vessels)

vascular disorders

-pulmonary edema

-pulmonary embolism

pulmonary edema

-water in alveoli

-decreased gas exchange

causes of pulmonary edema

-increased hydrostatic pressure

-too much pressure inside vessels, travels to alveoli

-OR decreased osmotic pressure

s/s of pulmonary edema

-pink, frothy sputum

-SOB

-decreased SPO2

-crackles/rales heard in stethoscope

pulmonary embolism (PE)

-blood clot gets lodged in an artery in the lung, blocking blood flow to part of the lung

-dying tissue below block

causes of pulmonary embolism

-DVT: deep vein thrombosis

-embolus: travelling clot

s/s of pulmonary embolism

-chest/back pain

-tachycardia

-tachypnea (increased breathing)

-increased BP

-decreased SPO2 (70-80%)

-chronic or acute

what are the functions of the integumentary system?

-Protect the body

-Regulate temperature

-Immune surveillance

-Activate Vitamin D

-Touch and pressure

Aging and the Integumentary System

-Thinner, dryer, more wrinkled

-Slow healing

-Susceptible to tearing

-Loss of elastin

-Loss of flexibility

-Increased risk of infection

-Brittle nails

-Irregular pigmentation

-Poor wound healing

-Decreased immune response

-Decreased circulation

-Atrophy of glands

-Decreased nerve endings

-Compromised temperature regulation

What is NOT a primary function of the integumentary system?

A)Innate immunity

B)Production of melanin

C)Activation of Vitamin D

D)Regulation of electrolytes

Regulation of electrolytes

Aging skin experiences decreased circulation, fewer sebaceous glands, and decreased sweat production. This most directly puts the elderly at risk for:

A)Infection

B)Irregular moles

C)Skin cancer

D)Heat stroke

Heat stroke

What are common symptoms of aging relating to changes in the integument?

A)Decreased sensation and increased heat production

B)Decreased sensation and increased nail growth

C)Thin, waxy skin and decreased sensation

D)Thick, calloused skin and decreased sensation

Thin, waxy skin and decreased sensation

Because of age-related changes to the skin, the elderly are more likely to experience:

A)Cold feet and hands

B)Hot flashes

C)The complete inability to regulate their own temperature

D)Inability to sense warm and cold things

Cold feet and hands

The Common Cold

-Rhinovirus or coronavirus

-Self-limiting

-200 viruses

-Cough, congestion, headache

Acute Bronchitis

-Infection or inflammation of bronchi

-Self-limiting

-Usually viral

-Cough, fever, malaise

Influenza

-Can be fatal

-Viral

-Community or hospital-acquired

-Cold symptoms with fever, chills, sever fatigue

-Often leads to pneumonia

Pneumonia

-Infection of lower respiratory tract

-6th leading cause of death

-Age, immunity, alcoholism, malnutrition, smoking, intubation, nursing homes

-Commonly acquired or hospital acquired

-Aspiration

-Consolidation of lung tissue and infiltrates

-Cough, fever, malaise

Tuberculosis

-Highly contagious

-Droplets

-Leading cause of death by curable disease

-Latent or active

-Slow moving symptoms

what is contact dermatitis and what causes it?

-allergic skin rash

-type IV reaction to direct contact with a chemical or mechanical irritation to the skin

what is keratin and what is its function?

-protein found in skin, hair, and nails that prevents both loss of body fluid through the skin and entry of excessive water into the body

what is melanin and what is its function?

-A pigment that gives skin its color

-helps protect the skin from burning

What is urticaria and what causes it?

-also known as hives

-allergic response to ingestion of substances

-highly pruritic lesions

What is atopic dermatitis and what causes it?

-eczema

-allergic reaction that is often caused by an inherited tendency towards the reactions

what is psoriasis and what causes it?

-chronic inflammatory skin disorder

-genetic condition that results from the abnormal activation of T cells and an associated increase in cytokines in affected tissues. These immunologic changes then lead to excessive proliferation of keratinocytes and the symptoms of the disease