.hyperventilation, if

1 .hyperventilation, if someone is blow-ing off too much CO2 they become more Alkaline, respiratory alkalosis 2 .if a patient's lung are not functioning very well and they are unable to re-move or blow off CO2 very well, the CO2 will build up in their system be-coming acidic, respiratory acidosis 3 .Perfusion is adequate arterial blood flow through the peripheral tissues (peripheral perfusion) and blood that is pumped by the heart to oxygenate major body organs (central perfusion) 4 .upper respiratory tract nose, sinuses, pharynx, larynx 5 .Lower respiratory tract Lungs,Trachea, two mainstem bronchi, lobar, segmen- tal, and subsegmental bronchi; bronchioles; alveolar ducts; alveoli 6 .common cause of respiratory ail-ments Cigarette smoke 7 .Nursing care of a patient experienc-ing upper respira-tory system disor-ders maintaining a patent airway to allow adequate ventila- tion and oxygenation.Along with a focused respiratory assessment, the nurse will utilize information obtained from the patient and family during the admission history interview. Informa-tion regarding the patient's history of upper respiratory disorders, smoking, and environmental exposures will

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MDC 3 EXAM 2 1 / 4

be utilized to determine the necessary testing and treat- ment 8 .Normal Changes in Aging Adults Alveoli function decreases Ability to cough decreasesLungs loose residual volume, vital capacity and gas exchange decreases.Respiratory muscles atrophyVascular resistance increases, capillary flow decreasesSusceptibility to infection increases.9 .The turbinatesthree bones that protrude into the nasal cavities from the internal portion of the noseincrease the total surface area for filtering, warming, and humidifying inspired air before it passes into the nasopharynx.10 .The paranasal si- nuses air-filled cavities within the bones that surround the nasal passages Lined with ciliated membrane, the sinuses provide res-onance to speech, decrease the weight of the skull, and act as shock absorbers in the event of facial trauma..11 .Fremitus refers to vibratory tremors that can be felt through the chest by palpation, In-creased fremitus may indicate compression or consolidation of lung tissue, as occurs in pneumonia.12 .Lung sounds Bronchial BronchovesicularVesicular 13 .Adventitious sounds Crackles WheezesRhonchusPleural friction rub

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14 .Other Indicators of Respiratory Ade-quacy Cyanosis, decreased capillary refill, clubbing of nails in fingers, level of consciousness, Chest Circumference, Anxiety, Dyspnea Orthopnea, General Appearance 15 .Diagnostic Assess- ment of lungs Laboratory assessment

• RBC- ABG- is a blood gas and this tells us the acid base balance of the patient- Sputum- can tell us if microorganisms are growing in the lung - describe color, clarity, and any odor

Imaging assessment

• x-rays-Xrays show us areas of opaque which usually indicate pneumonia/consolidation of fluid-CT- computed tomography. Lung nodules, areas of fluid buildup Other noninvasive diagnostic assessments
• Pulse oximetry-circulating O2- tells us oxygen levels

in the tissues- usually fingers, toes, or earlobes

• Capnometry and capnography-how much CO2 is

leaving the lungs.-PFTs-Lung function- tell us how well the lungs function at moving air in and out- Exercise testing-Exercise tolerance 16 .Invasive Diagnos- tic Assessment - Endoscopic examinations -Bronchoscopy- is a camera that looks at the airway passages-Thoracentesis- can remove fluid buildup from the lung-Lung biopsy- is used to diagnose some lung diseases or cancer 17 .Which assessment finding for an older adult patient does the nurse ascribe A.Tightening of the vocal cords B.Decrease in residual volumeC.Decrease in the anteroposterior diameterD.Decrease in respiratory muscle strength

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to the natural aging process?

• As a person ages, vocal cords become slack, chang-

ing the quality and strength of the voice; the anteropos-terior diameter increases; respiratory muscle strength decreases; and the residual volume increases.18 .The nurse knows that under normal physiologic condi-tions of tissue per-fusion, a patient will have what per-cent of oxygen dis-sociate from the hemoglobin mole-cule?A.25%

B.50%C.75%D.100%

ANS: B

Oxygen dissociates with the hemoglobin molecule based on the need for oxygen to perfuse tissues. Under normal conditions, 50% of hemoglobin molecules com-pletely dissociate their oxygen molecules when blood perfuses tissues that have an oxygen tension (concen-tration) of 26 mm Hg. This is considered a "normal" point at which 50% of hemoglobin molecules are no longer saturated with oxygen.19 .Which assessment finding does the nurse interpret that is associated most closely with lung disease?A.Cough B.DyspneaC.Chest painD.Sputum production

ANS: ACough is a main sign of lung disease. Dyspnea (difficul-

ty in breathing or breathlessness) is a subjective per-ception and varies among patients. A patient's feeling of dyspnea may not be consistent with the severity of the presenting problem. Sputum production may be as-sociated with coughing and indicate an acute or chronic lung condition. Chest pain can occur with other health problems, as well as with lung problems.20 .Head and Neck Cancer Squamous cell carcinoma and slow growing Begins with mucus that is chronically irritated, becom-

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