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Respiratory Pathologies Hypoxemia Mechanisms
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1
Question
What is the primary pathological process in emphysema?
Answer
Chronic progressive destruction of alveolar walls and loss of lung elasticity
2
Question
What causes the barrel chest appearance in emphysema?
Answer
Air trapping in the lungs
3
Question
What are classic respiratory findings in emphysema?
Answer
Prolonged expiration and use of accessory muscles
4
Question
Why do emphysema patients have a pink skin tone?
Answer
Pink puffer due to compensatory mechanisms despite decreased SpO2
5
Question
What is the target oxygen saturation during acute exacerbation of emphysema?
Answer
≥90%
6
Question
What is the most effective intervention to slow emphysema progression?
Answer
Smoking cessation
7
Question
What health teachings are recommended for emphysema patients?
Answer
Encourage vaccination and energy conservation
8
Question
What is thoracentesis used for in pleural effusion?
Answer
Insertion of needle into pleural space to remove fluid from large effusions
9
Question
What is the high risk complication after thoracentesis?
Answer
Pneumothorax causing sudden dyspnea, chest pain, decreased breath sounds
10
Question
What nursing actions follow thoracentesis?
Answer
Assess respiratory status, monitor for pneumothorax, apply sterile dressing, monitor SpO2 and breath sounds
11
Question
What indicates patency in a chest tube water seal chamber?
Answer
Tidaling with respirations
12
Question
What does continuous bubbling in a chest tube water seal chamber indicate?
Answer
Air leak in the system; check connections, tape or replace, notify if unresolved
13
Question
What should be monitored in chest tube patients for complications?
Answer
Sudden increase in RR, decreased breath sounds, subcutaneous emphysema, changes in drainage
14
Question
What is a key rule for chest drainage systems?
Answer
Keep below chest level; never clamp without an order
15
Question
What causes hemothorax in chest trauma?
Answer
Blunt trauma with rib fractures lacerating pleura or lung tissue
16
Question
What is the earliest event in hemothorax?
Answer
Disruption of pleura or lung parenchyma causing bleeding into pleural space
17
Question
What is the mechanism of hypoxemia in hemothorax?
Answer
Impaired ventilation and gas exchange due to alveoli filled with blood
18
Question
What can great vessel injury in chest trauma lead to?
Answer
Circulatory collapse and shock
19
Question
What are potential outcomes of untreated severe hemothorax?
Answer
Severe hypoxemia and multi-organ failure
20
Question
How do sedatives cause hypoxemia in CNS depression?
Answer
Depress medullary respiratory center leading to hypoventilation and reduced O2 intake
21
Question
What is the earliest ABG change in sedative overdose?
Answer
Hypercapnia with hypoxemia and acidemia
22
Question
What causes respiratory acidosis in sedative overdose?
Answer
CO2 accumulation in blood from hypoventilation
23
Question
What are consequences of untreated sedative overdose?
Answer
Progressive hypoxemia, multi-organ dysfunction, and death
24
Question
What causes hypoxemia in pneumonia?
Answer
Impaired diffusion due to alveolar exudate; consolidation replaces air with exudate
25
Question
What are the first responders in alveolar inflammation during pneumonia?
Answer
Neutrophils and macrophages
26
Question
What can severe pneumonia lead to?
Answer
Respiratory acidosis and organ dysfunction from decreased compliance and gas exchange
27
Question
What are symptoms of spontaneous pneumothorax?
Answer
Sudden dyspnea, absent breath sounds, hyperresonance
28
Question
What causes spontaneous pneumothorax?
Answer
Loss of negative intrapleural pressure in tall men
29
Question
What is the hypoxemia mechanism in pneumothorax?
Answer
V/Q mismatch due to collapsed alveoli
30
Question
What is a life-threatening feature of tension pneumothorax?
Answer
Compression of great vessels, tracheal deviation, obstructive shock