A patient exhibiting respiratory distress as well as a tracheal shift should be evaluated for
pneumothorax.
A patient who reports an intestinal fistula also reports feeling “weak and dizzy” when she stands. While taking her blood pressure she becomes temporarily unresponsive but quickly regains consciousness when put into a supine position. What nursing interventions will the nurse implement before calling the physician?
Give her water or juice and some salty crackers and ask if she has had any diarrhea or vomiting.
Early manifestations of a developing metabolic acidosis include
headache.
Pneumocystitis is a term that refers to a
fungal pneumonia secondary to HIV
Clinical manifestations of moderate to severe hypokalemia include
muscle weakness and cardiac dysrhythmias.
Hypernatremia may be caused by
decreased antidiuretic hormone secretion
Respiratory acidosis may be caused by
hypoventilation.
What age group has a larger volume of extracellular fluid than intracellular fluid?
Infants
Diarrhea causes
metabolic acidosis.
Chronic bronchitis often leads to cor pulmonale because of
increased pulmonary vascular resistance.
Renal compensation for respiratory acidosis is evidenced by
elevated bicarbonate ion concentration.
A patient has been hospitalized several times in 6 months with severe ECV depletion and hypokalemia resulting from chronic laxative abuse. Which blood gas results should be relayed to the physician?
pH in high part of normal range, PaO2 normal, PaCO2 high, bicarbonate high
Asthma is categorized as a(n)
obstructive pulmonary disorder.
If an individual has a fully compensated metabolic acidosis, the blood pH is
in the normal range.
The arterial blood gas pH = 7.52, PaCO 2 = 30 mm Hg, HCO 3 – = 24 mEq/L demonstrates
respiratory alkalosis.
The inward-pulling force of particles in the vascular fluid is called _____ pressure.
capillary osmotic
Croup is characterized by
a barking cough.
Which disorder is caused by inhalation of organic substances?
Hypersensitivity pneumonitis
The patient who requires the most careful monitoring for development of metabolic acidosis is a patient who
has had diarrhea for over a week.
Vomiting of stomach contents or continuous nasogastric suctioning may predispose to development of
metabolic acid deficit.
Widespread atelectasis, non-cardiogenic pulmonary edema, and diffuse, fluffy alveolar infiltrates on chest radiograph are characteristic of
acute respiratory distress syndrome.
COPD leads to a barrel chest, because it causes
air trapping.
Empyema is defined as an
infection in the pleural space
Emphysema results from destruction of alveolar walls and capillaries, which is because of
release of proteolytic enzymes from immune cells.
Diarrhea and other lower intestinal fluid losses will contribute to
metabolic acidosis.
Accumulation of fluid in the pleural space is called
pleural effusion.
The primary cause of infant respiratory distress syndrome is
lack of surfactant.
When a parent of a toddler recently diagnosed with pneumococcal pneumonia asks why their child is so much sicker than a classmate was when they were diagnosed with pneumonia, the nurse replies
It sounds like your child has a case of bacterial pneumonia, while the classmate had viral pneumonia.
Two primary acid-base disorders that are present independently are referred to as
mixed acid-base imbalance.
A patient with flail chest will demonstrate
outward chest movement on expiration.
Individuals who have chronic bronchitis most often have
a productive cough.
The finding of ketones in the blood suggests that a person may have
metabolic acidosis.
Respiratory acidosis is associated with
increased carbonic acid
When a parent asks how they will know if their 2-month-old baby, who is throwing up and has frequent diarrhea, is dehydrated, the nurse’s best response is
“If the soft spot on the top of his head feels sunken in and his mouth is dry between his cheek and his gums, then he is probably dehydrated."
A person who experiences a panic attack and develops hyperventilation symptoms may experience
numbness and tingling in the extremities.
A restrictive respiratory disorder is characterized by
decreased residual volume.
Air that enters the pleural space during inspiration but is unable to exit during expiration creates a condition called
tension pneumothorax.
The body compensates for metabolic alkalosis by
hypoventilation.
The imbalance that occurs with oliguric renal failure is
hyperkalemia.
Total body water in older adults is
decreased because of increased adipose tissue and decreased muscle mass.
A major cause of treatment failure in tuberculosis is
noncompliance.
A patient with a productive cough and parenchymal infiltrates on x-ray is demonstrating symptomology of
bacterial pneumonia.
All obstructive pulmonary disorders are characterized by
resistance to airflow
Bacterial pneumonia leads to hypoxemia due to
accumulation of alveolar exudates.
Chronic occupational lung disease is characterized by
causation from long-term inhalation of inorganic material.
a latent period before symptoms occur.
a progressive cough and dyspnea with exercise.
possible negative chest x-ray when symptom-free.
Clinical manifestations of hyponatremia include
confusion, lethargy, coma, and perhaps seizures.
Clinical manifestations of pleural effusion include
dyspnea.
diminished breath sounds.
a tracheal shift, if large.
Effects of hypernatremia on the central nervous system typically include
confusion.
Excessive antidiuretic hormone (ADH) secretion can cause _____ concentration.
decreased serum sodium
Hypernatremia may be caused by
decreased antidiuretic hormone secretion.
Manifestations from sodium imbalances occur primarily due to
cellular fluid shifts.
Neuromuscular disorders impair lung function primarily due to
weak muscles of respiration.
The hallmark manifestation of acute respiratory distress
hypoxemia.
What is the most likely explanation for a diagnosis of hypernatremia in an elderly patient receiving tube feeding?
Inadequate water intake
A patient diagnosed with chronic compensated heart failure reports that, "My feet swell if I eat salt but I don't understand why" The nurse's best response is
"Salt holds water in your blood and makes more pressure against your blood vessels, so fluid leaks out into your tissues and makes them swell."
A person with acute hypoxemia may hyperventilate and develop
respiratory alkalosis.
After evaluation, a child's asthma is characterized as "extrinsic." This means that the asthma is
associated with specific allergic triggers.
Which pulmonary function test result is consistent with a diagnosis of asthma?
Reduced forced expiratory volume in 1 second (FEV1)
What form of oral rehydration, bottled water or salty broth, is best suited for a patient who is demonstrating signs of clinical dehydration?
Salty soup, because it will provide some sodium to help hold the fluid in his blood vessels and interstitial fluid
Cystic fibrosis is associated with
bronchiectasis.
The ________ system compensates for metabolic acidosis and alkalosis.
respiratory
The process responsible for distribution of fluid between the interstitial and intracellular compartments is
osmosis.
Obstructive disorders are associated with
low expiratory flow rates.
The arterial blood gas pH = 7.52, PaCO2 = 30 mm Hg, HCO3 = 24 mEq/L demonstrates
respiratory alkalosis
Fully compensated respiratory acidosis is demonstrated by
pH 7.36, PaCO2 55, HCO3 36
Respiratory acidosis is associated with
increased carbonic acid
A person with acute hypoxemia may have hyperventilation and develop
respiratory alkalosis
The major buffer in the extracellular fluid is
bicarbonate
Renal compensation for respiratory acidosis is evidenced by
elevated bicarbonate ion concentration.
Uncompensated metabolic alkalosis would result in
increased pH, increased HCO3
Metabolic alkalosis is often accompanied by
hypokalemia
A 3 year old is diagnosed with starvation ketoacidosis. What signs and symptoms should you anticipate in your assessment?
Rapid, deep breathing, lethargy, abdominal pain
Osmoreceptors located in the hypothalamus control the release of:
Vasopressin (ADH)
Decreased neuromuscular excitability is often the result of
hypercalcemia and hypermagnesemia
Abnormalities in intracellular regulation of ensyme activity and cellular production of ATP are associated with
hypophosphatemia
The fraction of total body water (TBW) volume contained in the intracellular space in adults is
two-thirds
Clinical manifestations of severe symptomatic hypophosphatemia are cause by
deficiency of ATP
A person who overuses magnesium-aluminum antacids for a long period of time is likely to develop
hypophosphatemia
How do clinical conditions hat increase vascular permeability cause edema?
By allowing plasma proteins to leak into the interstitial fluid, which draws in excess fluid by increasing the interstitial fluid osmotic pressure
Which electrolyte imbalances cause increased neuromuscular excitability?
Hypocalcemia and hypomagnesemia
Copious amounts of foul-smelling sputum are generally associated with
Bronchiectasis
Intrinsic asthma is associated with
Respiratory infections and psychological factors
What is true about epiglottitis?
Can be caused by bacteria
Usually caused by H.Influenza type
B
Usually occurs in children
Characterized by pain with
swallowing
MEDICAL EMERGENCY AND REQUIRES IMMEDIATE INTERVENTION
A major risk factor for the development of active pulmonary tuberculosis (TB) disease is
immunosuppression
The most definitive diagnostic method for active tuberculosis is acquired via
sputum culture.