NUR 502 Advanced Pathophysiology – Review Topics for
Chapter 5 & 6 | Questions and Answers Latest Updated
(Graded A+)-STU
Review Topics for Chapter 5 & 6 (Pulmonary Function; Fluid, Electrolyte,
and Acid-Base Homeostasis)
1. What is status asthmaticus? How can patients’ symptoms present?
Status asthmaticus is a life threatening, prolonged asthma attack that does not respond to
usual treatment. Maintaining a patent airway is critical as intubation may be necessary.
• Acid base imbalances (respiratory alkalosis) can develop from expelling too much
carbon dioxide because of tachypnea and hypoxemia
• Respiratory muscles fatigue eventually as the obstruction of airflow and
hyperinflation continues, causing CO2 retention and respiratory acidosis
2. What is the presentation of a spontaneous pneumothorax?
Spontaneous pneumothorax occurs when a small air blister on the top of the lung (bleb)
ruptures. Blebs cause a weakness in the lung tissue.
• Sudden chest pain over the affected lung, chest tightness, anxiety, dyspnea,
tachypnea, tachycardia, decreased breath sounds and hyperresonance over the
affected lung
• chest expansion may be asymmetrical
3. What causes Airway narrowing and obstruction?
Croup usually begins as an upper respiratory infection with rhinorrhea, fever, and sore
throat. Can progress to seal-like barking cough because of laryngeal swelling and airway
narrowing and obstruction can occur.
4. What is a likely physical exam finding to support the most common cause of
obstructive sleep apnea syndrome in children? Noted mouth breathing and enlarged
tonsils
5. What is the importance of surfactant?
Surfactant is a lipoprotein produced by alveoli cells that reduces surface tension in the
alveoli, which enhances pulmonary compliance (elasticity) and prevents the alveoli from
collapsing.
6. What is pleural effusion and how can you diagnose it?
Pleural effusion: accumulation of excess fluid in the pleural cavity. Can compress the
lung and limit expansion during inhalation. Develops because there is either excess
pleural fluid formed or decreased lymphatic removal.
• May complain of dyspnea and chest pain (usually sharp and worsens with
inhalation)
• Diagnostics include history, physical, chest X-ray, CT, ABGs and CBC
, • Thoracentesis is done to distinguish between transudative versus exudative
effusions
7. What is acute respiratory distress syndrome?
Acute respiratory distress syndrome (ARDS) is a sudden failure of the respiratory system
due to massive alveolar capillary membrane injury and acute lung inflammation.
Develops rapidly, often within 90 mins of a systemic inflammatory response or within 48
hours of a lung injury.
8. What is the cause of croup?
Laryngotracheobronchitis or croup, is a common viral infection in children 3 months to 3
years of age. Affects the larynx and trachea and leads to edema of the subglottic area and
may extend to the bronchi.
• Most common causes are parainfluenza viruses
• Begins as an upper respiratory infection with rhinorrhea, fever and sore throat.
Hoarseness and a sealike barking cough develop 1-2 days later because of
laryngeal swelling
9. What is the main difference between tuberculosis tests?
Interferon gamma assays used for TB testing are not affected by bacillus Calmette-Guerin
vaccinations, unlike skin TB tests
10. What is a Pulmonary Emboli? What happens to the alveoli?
Alveoli ventilate but do not perfuse.
11. When to use antibiotic for acute rhinosinusitis?
Sinusitis is an inflammation of one or more of the four paranasal sinuses. The maxillary
is the most commonly affected, followed by the ethmoid.
• Often caused by viruses, allergies, barotrauma, nasal/sinus tumors or irritants
• Treatment usually includes decongestants, nasal corticosteroid spray to shrink
swollen nasal membranes, analgesics and nasal irrigation with salt water until the
sinuses begin to drain
• Bacterial infections require antibiotic therapy
12. What education should be given regarding Legionnaires' disease?
Legionnaires’ disease is a specific type of pneumonia that is caused by legionella
pneumophilia. These bacteria thrive in warm, moist environments (air-conditioning
systems, standing fresh water, respiratory therapy equipment, whirlpools), and it is
acquired by inhaling the bacteria.
• Symptoms can take 10-14 days after exposure
• A urine test can be used to identify the presence of Legionnaires’ disease
13. What are the most common manifestations of acute epiglottitis in children?
Epiglottitis: life-threatening condition of the epiglottis, the protective cartilage lid
covering the trachea opening. The epiglottis quickly swells and blocks the air entering the
trachea.
• High fever, sore throat, muffled quality speech (“hot potato voice”), dysphagia,
drooling with an open mouth, inspiratory stridor, hypoxemic signs, tripod position
14. What is the purpose of positive end-expiratory pressure setting on a ventilator?
Chapter 5 & 6 | Questions and Answers Latest Updated
(Graded A+)-STU
Review Topics for Chapter 5 & 6 (Pulmonary Function; Fluid, Electrolyte,
and Acid-Base Homeostasis)
1. What is status asthmaticus? How can patients’ symptoms present?
Status asthmaticus is a life threatening, prolonged asthma attack that does not respond to
usual treatment. Maintaining a patent airway is critical as intubation may be necessary.
• Acid base imbalances (respiratory alkalosis) can develop from expelling too much
carbon dioxide because of tachypnea and hypoxemia
• Respiratory muscles fatigue eventually as the obstruction of airflow and
hyperinflation continues, causing CO2 retention and respiratory acidosis
2. What is the presentation of a spontaneous pneumothorax?
Spontaneous pneumothorax occurs when a small air blister on the top of the lung (bleb)
ruptures. Blebs cause a weakness in the lung tissue.
• Sudden chest pain over the affected lung, chest tightness, anxiety, dyspnea,
tachypnea, tachycardia, decreased breath sounds and hyperresonance over the
affected lung
• chest expansion may be asymmetrical
3. What causes Airway narrowing and obstruction?
Croup usually begins as an upper respiratory infection with rhinorrhea, fever, and sore
throat. Can progress to seal-like barking cough because of laryngeal swelling and airway
narrowing and obstruction can occur.
4. What is a likely physical exam finding to support the most common cause of
obstructive sleep apnea syndrome in children? Noted mouth breathing and enlarged
tonsils
5. What is the importance of surfactant?
Surfactant is a lipoprotein produced by alveoli cells that reduces surface tension in the
alveoli, which enhances pulmonary compliance (elasticity) and prevents the alveoli from
collapsing.
6. What is pleural effusion and how can you diagnose it?
Pleural effusion: accumulation of excess fluid in the pleural cavity. Can compress the
lung and limit expansion during inhalation. Develops because there is either excess
pleural fluid formed or decreased lymphatic removal.
• May complain of dyspnea and chest pain (usually sharp and worsens with
inhalation)
• Diagnostics include history, physical, chest X-ray, CT, ABGs and CBC
, • Thoracentesis is done to distinguish between transudative versus exudative
effusions
7. What is acute respiratory distress syndrome?
Acute respiratory distress syndrome (ARDS) is a sudden failure of the respiratory system
due to massive alveolar capillary membrane injury and acute lung inflammation.
Develops rapidly, often within 90 mins of a systemic inflammatory response or within 48
hours of a lung injury.
8. What is the cause of croup?
Laryngotracheobronchitis or croup, is a common viral infection in children 3 months to 3
years of age. Affects the larynx and trachea and leads to edema of the subglottic area and
may extend to the bronchi.
• Most common causes are parainfluenza viruses
• Begins as an upper respiratory infection with rhinorrhea, fever and sore throat.
Hoarseness and a sealike barking cough develop 1-2 days later because of
laryngeal swelling
9. What is the main difference between tuberculosis tests?
Interferon gamma assays used for TB testing are not affected by bacillus Calmette-Guerin
vaccinations, unlike skin TB tests
10. What is a Pulmonary Emboli? What happens to the alveoli?
Alveoli ventilate but do not perfuse.
11. When to use antibiotic for acute rhinosinusitis?
Sinusitis is an inflammation of one or more of the four paranasal sinuses. The maxillary
is the most commonly affected, followed by the ethmoid.
• Often caused by viruses, allergies, barotrauma, nasal/sinus tumors or irritants
• Treatment usually includes decongestants, nasal corticosteroid spray to shrink
swollen nasal membranes, analgesics and nasal irrigation with salt water until the
sinuses begin to drain
• Bacterial infections require antibiotic therapy
12. What education should be given regarding Legionnaires' disease?
Legionnaires’ disease is a specific type of pneumonia that is caused by legionella
pneumophilia. These bacteria thrive in warm, moist environments (air-conditioning
systems, standing fresh water, respiratory therapy equipment, whirlpools), and it is
acquired by inhaling the bacteria.
• Symptoms can take 10-14 days after exposure
• A urine test can be used to identify the presence of Legionnaires’ disease
13. What are the most common manifestations of acute epiglottitis in children?
Epiglottitis: life-threatening condition of the epiglottis, the protective cartilage lid
covering the trachea opening. The epiglottis quickly swells and blocks the air entering the
trachea.
• High fever, sore throat, muffled quality speech (“hot potato voice”), dysphagia,
drooling with an open mouth, inspiratory stridor, hypoxemic signs, tripod position
14. What is the purpose of positive end-expiratory pressure setting on a ventilator?
