NURSING 6560 EXAM 3 MEDSURG
Chapter 20:
1. Tonsils and adenoids: chain of lymph nodes guarding the body from invasion
by organisms entering the nose and the throat.
Question from ppt:
T or F: The purpose of the cilia is to move the mucus back to the pharynx
TRUE
2. A prominent function of the sinuses is to serve as a resonating chamber in speech.
The sinuses are a common site of infection.
3. Perfusion is influenced by alveolar pressure. The pulmonary capillaries are sandwiched
between adjacent alveoli and, if the alveolar pressure is sufficiently high, the
capillaries are squeezed. Pulmonary hypertension, in which the capillaries in the
alveoli are squeezed excessively
Question from ppt:
What is gas exchange between the lungs and blood and between the blood and tissues?
Respiration
4. Egophony: abnormal change in tone of voice that is heard when auscultating the lungs.
Describes voice sounds that are distorted. It is best appreciated by having the patient
repeat the letter E. The distortion produced by consolidation transforms the sound into
a clearly heard A rather than E
5. Assessment: Abnormal (adventitious) breath
sounds: Crackles
Wheezes
Friction rub
6. Assessment findings consistent with a pleural effusion include affected lung fields
being dull to percussion, absence of breath sounds and a pleural friction rub may also
be present
Pneumonia- egophony, which can be best assessed by instructing the client to repeat the
letter E. The distortion produced by consolidation transforms the sound into a clearly
heard A rather than E
Emphysema-breath sounds are faint or often completely inaudible and the expiratory
phase is prolonged
7. Tidal volume (TV)-volume of air inspired and expired with a normal breath
, 8. Health History: Dyspnea-(subjective feeling of difficult or labored breathing,
breathlessness, shortness of breath), how severe is the shortness of breath? On a scale
of 1 to 10, if 1 is not at all breathless and 10 is very breathless, how hard is it to
breathe?
9. Diagnostic Tests Pulmonary function tests refer to Table 20-9-routinely used in
patients with chronic respiratory disorders to aid diagnosis. They are performed to
assess respiratory function and to determine the extent of dysfunction, response
to therapy and screening. PFT measures how much air moves in and out of your
lungs when you breathe
Sputum tests-sputum samples ideally are obtained early in the morning before the
patient has had anything to eat or drink
Chapter 21:
1. Oxygen Toxicity Prevention PEEP or CPAP prevent or reverse atelectasis and
allow lower oxygen percentages to be used
Question from ppt: The primary oxygen administration method for a patient with COPD is
nasal cannula T or F? False – Venturi mask
Is the following statement true or false? The patient should be encouraged to use an
incentive spirometer approximately 10 breaths per hour between treatments while awake:
TRUE
2. Mini-Nebulizer therapy nursing care refer to chart 21-4 Diaphragmatic breathing
(see Chart 21-4) is a helpful technique to prepare for proper use of the small-volume
nebulizer
3. Endotracheal intubation: Endotracheal and tracheostomy tubes have several
disadvantages. The tubes cause discomfort. The cough reflex is depressed
because glottis closure is hindered.
4. Tracheostomy: When a tracheostomy or endotracheal tube is in place, it is usually
necessary to suction the patient’s secretions because of the decreased effectiveness
of the cough mechanism
5. Tracheostomy: Permits the long-term use of mechanical ventilation
6. Maintain patency by proper suctioning-tracheal suctioning is performed when
adventitious breath sounds are detected or whenever secretions are obviously
present
7. Criteria for weaning-stable vital signs and arterial blood gases are also
important predictors of successful weaning.
8. Chest drainage-fluctuation of the water level in the water seal shows effective
connection between the pleural cavity and the drainage chamber and indicates that
the drainage system remains patent.
9. Improving airway clearance-if the client is retaining secretions, the nurse should
first encourage the client to cough before performing more invasive interventions
Chapter 20:
1. Tonsils and adenoids: chain of lymph nodes guarding the body from invasion
by organisms entering the nose and the throat.
Question from ppt:
T or F: The purpose of the cilia is to move the mucus back to the pharynx
TRUE
2. A prominent function of the sinuses is to serve as a resonating chamber in speech.
The sinuses are a common site of infection.
3. Perfusion is influenced by alveolar pressure. The pulmonary capillaries are sandwiched
between adjacent alveoli and, if the alveolar pressure is sufficiently high, the
capillaries are squeezed. Pulmonary hypertension, in which the capillaries in the
alveoli are squeezed excessively
Question from ppt:
What is gas exchange between the lungs and blood and between the blood and tissues?
Respiration
4. Egophony: abnormal change in tone of voice that is heard when auscultating the lungs.
Describes voice sounds that are distorted. It is best appreciated by having the patient
repeat the letter E. The distortion produced by consolidation transforms the sound into
a clearly heard A rather than E
5. Assessment: Abnormal (adventitious) breath
sounds: Crackles
Wheezes
Friction rub
6. Assessment findings consistent with a pleural effusion include affected lung fields
being dull to percussion, absence of breath sounds and a pleural friction rub may also
be present
Pneumonia- egophony, which can be best assessed by instructing the client to repeat the
letter E. The distortion produced by consolidation transforms the sound into a clearly
heard A rather than E
Emphysema-breath sounds are faint or often completely inaudible and the expiratory
phase is prolonged
7. Tidal volume (TV)-volume of air inspired and expired with a normal breath
, 8. Health History: Dyspnea-(subjective feeling of difficult or labored breathing,
breathlessness, shortness of breath), how severe is the shortness of breath? On a scale
of 1 to 10, if 1 is not at all breathless and 10 is very breathless, how hard is it to
breathe?
9. Diagnostic Tests Pulmonary function tests refer to Table 20-9-routinely used in
patients with chronic respiratory disorders to aid diagnosis. They are performed to
assess respiratory function and to determine the extent of dysfunction, response
to therapy and screening. PFT measures how much air moves in and out of your
lungs when you breathe
Sputum tests-sputum samples ideally are obtained early in the morning before the
patient has had anything to eat or drink
Chapter 21:
1. Oxygen Toxicity Prevention PEEP or CPAP prevent or reverse atelectasis and
allow lower oxygen percentages to be used
Question from ppt: The primary oxygen administration method for a patient with COPD is
nasal cannula T or F? False – Venturi mask
Is the following statement true or false? The patient should be encouraged to use an
incentive spirometer approximately 10 breaths per hour between treatments while awake:
TRUE
2. Mini-Nebulizer therapy nursing care refer to chart 21-4 Diaphragmatic breathing
(see Chart 21-4) is a helpful technique to prepare for proper use of the small-volume
nebulizer
3. Endotracheal intubation: Endotracheal and tracheostomy tubes have several
disadvantages. The tubes cause discomfort. The cough reflex is depressed
because glottis closure is hindered.
4. Tracheostomy: When a tracheostomy or endotracheal tube is in place, it is usually
necessary to suction the patient’s secretions because of the decreased effectiveness
of the cough mechanism
5. Tracheostomy: Permits the long-term use of mechanical ventilation
6. Maintain patency by proper suctioning-tracheal suctioning is performed when
adventitious breath sounds are detected or whenever secretions are obviously
present
7. Criteria for weaning-stable vital signs and arterial blood gases are also
important predictors of successful weaning.
8. Chest drainage-fluctuation of the water level in the water seal shows effective
connection between the pleural cavity and the drainage chamber and indicates that
the drainage system remains patent.
9. Improving airway clearance-if the client is retaining secretions, the nurse should
first encourage the client to cough before performing more invasive interventions
