MED SURG 2 EXAM 2
REVIEW (respiratory
system) CHAPTER 29
(2022 Solution)
• Pulmonary function test- measures the amount of air remaining in the lungs after normal
expiration.
Tidal volume (VT) Air inspired and expired in one 400–600 mL at
breath rest
Residual volume (RV) Air remaining in lungs after maximum 1,000–1,500 mL
exhalation
Functional residual capacity Air remaining in lungs after normal expiration1,800–2,300 mL
(FRC)
• Dyspneic scale: if pt experiences 7 out of 10
o 1ST: place the pt in a FOWLER’S position. Or tripod position (sit in a chair while
leaning forward and placing their elbows on their knees or an over-the-bed table)
• If you hear adventitious breath sounds on one side- ASCULTATE THE OTHER SIDE
AND COMPARE TO DETERMINE IF ABNORMAL.
Coarse crackles Fluid or secretions inMoist bubbling sound, heardPulmonary edema,
(sometimes called airways on inspiration or bronchitis,
rales) expiration pneumonia
Fine crackles (rales) Alveoli popping Velcro being torn apart, Heart failure, atelectasis
open heard at end of inspiration
on inspiration
Wheezes Narrowed airways Fine high-pitched violinAsthma sound,
mostly on expiration
Stridor Airway obstruction Loud crowing noise heard obstruction from tumor or
without stethoscope foreign body
Pleural friction rub Inflamed pleura Sound of leather rubbing Pleurisy, lung cancer,
rubbing together together; grating sound pneumonia, pleural
irritation
• If pt has a high PACO2 of 73? 1 SIT PT IN A FOWLER’S POSISTION to assist with
ST
ventilation while someone calls the HCP.
• The NORMAL PACO2= 35-45. If elevated that means the patient is holding onto
CO2 and is shallow breathing.
• FOWLER’S position gives the pt maximum lung capacity.
• Nonrebreather mask- one or both side vents closed to limit the mixing of room air
with oxygen. The vents open to allow exhalation but remain closed on inhalation. The
reservoir bag has a valve to store oxygen for inhalation but does not allow entry of
exhaled air. It is used to deliver oxygen concentrations of 70% to 100%. Patient is
, breathing 100% oxygen.
• MDI inhaler-using it more than prescribed can cause rebound bronchoconstriction,
which results in worsening symptoms and/or death. Adrenergic bronchodilators
can
REVIEW (respiratory
system) CHAPTER 29
(2022 Solution)
• Pulmonary function test- measures the amount of air remaining in the lungs after normal
expiration.
Tidal volume (VT) Air inspired and expired in one 400–600 mL at
breath rest
Residual volume (RV) Air remaining in lungs after maximum 1,000–1,500 mL
exhalation
Functional residual capacity Air remaining in lungs after normal expiration1,800–2,300 mL
(FRC)
• Dyspneic scale: if pt experiences 7 out of 10
o 1ST: place the pt in a FOWLER’S position. Or tripod position (sit in a chair while
leaning forward and placing their elbows on their knees or an over-the-bed table)
• If you hear adventitious breath sounds on one side- ASCULTATE THE OTHER SIDE
AND COMPARE TO DETERMINE IF ABNORMAL.
Coarse crackles Fluid or secretions inMoist bubbling sound, heardPulmonary edema,
(sometimes called airways on inspiration or bronchitis,
rales) expiration pneumonia
Fine crackles (rales) Alveoli popping Velcro being torn apart, Heart failure, atelectasis
open heard at end of inspiration
on inspiration
Wheezes Narrowed airways Fine high-pitched violinAsthma sound,
mostly on expiration
Stridor Airway obstruction Loud crowing noise heard obstruction from tumor or
without stethoscope foreign body
Pleural friction rub Inflamed pleura Sound of leather rubbing Pleurisy, lung cancer,
rubbing together together; grating sound pneumonia, pleural
irritation
• If pt has a high PACO2 of 73? 1 SIT PT IN A FOWLER’S POSISTION to assist with
ST
ventilation while someone calls the HCP.
• The NORMAL PACO2= 35-45. If elevated that means the patient is holding onto
CO2 and is shallow breathing.
• FOWLER’S position gives the pt maximum lung capacity.
• Nonrebreather mask- one or both side vents closed to limit the mixing of room air
with oxygen. The vents open to allow exhalation but remain closed on inhalation. The
reservoir bag has a valve to store oxygen for inhalation but does not allow entry of
exhaled air. It is used to deliver oxygen concentrations of 70% to 100%. Patient is
, breathing 100% oxygen.
• MDI inhaler-using it more than prescribed can cause rebound bronchoconstriction,
which results in worsening symptoms and/or death. Adrenergic bronchodilators
can
