Exam NR603 - Week 3 iHuman ( Joseph camella 66 years, Dyspnea, Exams of Nursing

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Exam NR603 - Week 3 iHuman ( Joseph

camella 66 years, Dyspnea

What is dead space? - ANSWER>>>Passageways that contain air that is not available for gas exchange: trachea and bronchi

What are bronchi? - ANSWER>>>The two tubes which split from the trachea and carry air into the lungs

What are bronchioles? - ANSWER>>>smaller branches of the bronchi

What are alveoli? - ANSWER>>>tiny air sacs in the lungs that stem from the bronchioles; where gas exchange occurs

What is the trachea? - ANSWER>>>Windpipe, tubular passageway for air from the mouth to the bronchi

What is the acinus? - ANSWER>>>a functional respiratory unit that consists of the bronchioles, alveolar ducts, alveolar sacs, and the alveoli

What is the thorax? - ANSWER>>>chest

What is the jugular notch? - ANSWER>>>central indentation in superior border of manubrium; also known as the suprasternal notch

What is the angle of Louis? - ANSWER>>>the sternal angle where the 2nd rib attaches

Locate the following landmarks of the thoracic cage: jugular notch manubrium sternal angle body of sternum xiphoid process ribs - ANSWER>>>-

What drives respiration? - ANSWER>>>carbon dioxide levels

What is the basic process of breathing and respiration? - ANSWER>>>Oxygen rich air is inhaled which reaches the alveoli. Carbon dioxide rich blood is brought to the alveoli. Gas exchange occurs of carbon dioxide and oxygen. Circulatory system now is oxygen enriched, and the carbon dioxide is exhaled from the lungs.

What subjective data should the nurse collect during a respiratory assessment? - ANSWER>>>1. Cough: do you have a cough? when did it start? gradual or sudden? how long have you had it? how often?

At any special time of day or just on arising? Cough wake you up at night? Do you cough up any phlegm or sputum? How much? What color is it? Cough up any blood? Does it look like streaks or frank blood? Does the sputum have a foul odor? How would you describe your cough: hacking, dry, barking, hoarse, congested, bubbling? Does activity make it better or worse? Does it come with activity, position, fever, talking, congestion, anxiety? Which treatments have you tried? Does the cough bring anything like chest pain, ear pain? Is it tiring?

2. Shortness of breath: Any SOB and how long does it last and when did it start and what brings it on? How severe? How long does it last? Is it affected by position? Occur certain time? Episodes associated with night sweats? Cough, chest pain, bluish color around lips or nails? Wheezing sound?

Episodes related to food, pollen, dust, animals, season, emotion, exercise? What do you do in a hard-breathing attack? Take special position or use oxygen, inhaler, meds, pursed lip breathing? How does it affect your work or home activities?

3. Chest pain with breathing: point to it, when start, describe pain, brought on by coughing, trauma, infection, fever, deep breathing, unequal chest inflation? What have you done to treat it?
4. History of respiratory infections: lung diseases like bronchitis, emphysema, asthma, pneumonia? Any frequent or unusually severe colds? Family history of allergies, TB, asthma?
5. Smoking history: what age did you start? How many packs a day? For how long? Have you tried to quit, what do you think help and why did you think it didn't help? What activities do you associate with smoking? Live with smokers?
6. Environmental exposure: any environmental conditi

What objective data should be collected during a respiratory assessment? - ANSWER>>>Vital signs: respiratory rate and oxygen saturation

Inspection: ABC, posture, shape, position, skin color appropriate for race, LOC, respirations, use of accessory muscles, dyspnea, nasal flaring, pursed lip breathing

Palpation: symmetrical chest expansion, palpate to look for crepitus, tenderness, masses, temperature

Percussion* not usually used, but can be used to note any asymmetry. Also used to hear resonance, low pitched clear sounds heard over healthy lung tissue

Auscultation: decreased or increased breath sounds, stridor, crackles, wheezes

What respiratory information should be collected when measuring vital signs? - ANSWER>>>respiratory rate and oxygen saturation

What respiratory information should be collected when inspecting the patient? - ANSWER>>>ABCs, posture, shape, position, skin color, LOC, respirations, accessory muscles, dyspnea, pursed lip breathing, nasal flaring

Tachypnea - ANSWER>>>rapid, shallow breathing

Where does the nurse place their hands when palpating for symmetrical lung expansion? - ANSWER>>>T9-T

Bradypnea - ANSWER>>>slow breathing

What conditions are associated with a RR of <10? - ANSWER>>>drug induced depression, increased ICP, diabetic coma

Hyperventilation - ANSWER>>>increased rate and depth of breathing

What conditions are associated with hyperventilation? - ANSWER>>>ketoacidosis Kussmaul respirations, ASA overdose producing respiratory alkalosis to compensate for acidosis

Hypoventilation - ANSWER>>>decreased rate and depth of breathing

Cheyne-Stokes breathing - ANSWER>>>Wax and wane in a regular pattern, increasing in rate and depth and then decreasing

What conditions are associated with Cheyne-Stokes breathing? - ANSWER>>>severe heart failure, renal failure, drug overdose, increased ICP

What does the nurse look for when palpating during a respiratory assessment? - ANSWER>>>symmetrical chest expansion; palpate for crepitus, tenderness, masses, temperature

What does the nurse look for when percussing during a respiratory assessment? - ANSWER>>>Not generally used. If used, note asymmetry. Resonance, low pitched clear sounds heard over healthy lung tissue

What does the nurse look for when auscultating during a respiratory assessment? - ANSWER>>>Normal breath sounds: bronchial, bronchovesicular, vesicular

Abnormal breath sounds: decreased or increased, stridor, crackles, wheezes

What is stridor? What may cause it and what does it sound like? - ANSWER>>>impending collapse or closure of the trachea; happens in people who are choking; crowing noise. Code blue. Pt presents as anxious, restless.

What are crackles? What may cause it and what does it sound like? - ANSWER>>>fine or coarse bubbling/crackling noises caused by fluid in lungs

What are wheezes? What may cause it and what does it sound like? - ANSWER>>>high pitched sounds with musical quality, typically heard on expiration; can be heard in people with asthma, emphysema

What is barrel chest? - ANSWER>>>Increased anterior-posterior to transverse diameter of chest, closer to 1:1 ratio; result of chronic hyperinflation of lungs like in COPD

What is scoliosis? - ANSWER>>>S-shaped curvature of the spine. Unequal shoulder and scapular height, unequal hip levels, rib interspaces flared on convex side. More prevalent in adolescent-aged girls. May reduce lung volume.

What is kyphosis? - ANSWER>>>hunchback, leaning forward, exaggerated posterior curvature of the thoracic spine, hyperextension of head, impairs cardiopulmonary function

What is lordosis? - ANSWER>>>Swayback in the lumbar region

What are bronchial sounds? - ANSWER>>>produced by air rushing through large passageways such as the trachea and larynx; harsh, hollow, tubular sounds

What are bronchovesicular sounds? - ANSWER>>>Heard over the major bronchi and are typically moderate in pitch and intensity, mixed quality

What are vesicular sounds? - ANSWER>>>soft and low pitched, over peripheral lung fields where air flows through smaller bronchioles and alveoli; rustling like sound of wind in trees

What areas does the nurse place their stethoscope during auscultation of the respiratory system? - ANSWER>>>p. 423, 425

What are decreased breath sounds? - ANSWER>>>bronchial tree obstructed, loss of elasticity in lung and decreased force of inspired air, anything obstructing sound between lung and stethoscope like pleural thickening or fluid in pleural space

What are increased breath sounds? - ANSWER>>>sounds are louder than they should be