Pathophysiology: Pulmonary I & II

pathophysiology-pulmonary-i-ii

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Question 1 of 1

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513062

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Clients with chronic obstructive lung disease (COPD) may experience airway closure at the end of normal instead of low lung volumes, which result in:

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Explanation

The pressure needed to overcome the tension in the wall of a sphere or an elastic tube is inversely related to its radius; therefore, the small airways close first, trapping some air in the alveoli. This trapping of air may be increased in older persons and persons with chronic lung disease owing to a loss in the elastic recoil properties of the lungs. In these persons, airway closure occurs at the end of normal instead of low lung volumes, trapping larger amounts of air that cannot participate in gas exchange. It does not result in airway constriction, release of catecholamines, or an increase in the physiological dead space.

513063

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Respiratory movement of air that does not participate in alveolar gas exchange is known as alveolar dead space. Dead space increases when alveolar/alveoli:

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Explanation

Alveolar dead space increases when ventilation exceeds perfusion, such as with an embolus obstructing blood flow to the lung area. The oxygen/CO2 gas content in the alveoli has no effect on increased dead space caused by hypoperfusion. Pulmonary edema and alveoli collapse adversely affect gas exchange but have no effect on increased dead space caused by a lack of blood flow.

513064

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Generalized acute hypoxia in lung tissue, when alveolar oxygen levels drop below 60 mm Hg, causes pulmonary:

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Explanation

Vasoconstriction of pulmonary vessels is a compensatory response to generalized lung tissue hypoxia. Embolus formation causes a localized hypoxic response. Vasospasms are not involved with the hypoxia response by lung tissue. Pulmonary hypertension is the result of chronic lung tissue hypoxia.

513065

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Following surgery, a client had a chest x-ray that reported some opacities in the lung bases likely due to atelectasis. Which of the following pathophysiologic processes will result from this condition?

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Explanation

With shunt, there is perfusion without ventilation, resulting in a low ventilation–perfusion ratio. This occurs in conditions such as atelectasis in which there is airway obstruction. Ventilation without perfusion (dead air space) is a consequence of impaired pulmonary circulation. Hypoxemia will result in vasodilation, not vasoconstriction.

513066

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Diffusion of gases in the lung is decreased, as in pulmonary edema or pneumonia, by causing an increase in alveolar:

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Explanation

Diffusion is adversely affected by any condition that impedes the movement of gas by thickening the capillary membrane. A decrease in gas pressure difference will slow gas exchange. Increased alveolar size and surface area and shunting will increase diffusion rate.

513067

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Which of the following clients are likely experiencing a shift to the right in the dissociation curve? Select all that apply.

Select the correct answer(s).

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Explanation

A shift to the right indicates that the affinity of hemoglobin for oxygen is decreased and the PO2 that is available to the tissues at any given level of hemoglobin saturation is increased. It usually is caused by conditions that produce an increase in tissue metabolism, such as fever or acidosis, or by an increase in PCO2. High altitude and conditions such as pulmonary insufficiency, heart failure, and severe anemia also cause the oxygen dissociation curve to shift to the right. A shift to the left indicates that the affinity of hemoglobin for oxygen is increased and the PO2 that is available to the tissues at any given level of hemoglobin saturation is decreased. It occurs in situations associated with a decrease in tissue metabolism, such as alkalosis, decreased body temperature, and decreased PCO2 levels.

513068

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While discussing carbon dioxide transport within the body, the instructor asks, “What enzyme helps carbon dioxide with water to form bicarbonate?” Which student response is correct?

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Explanation

Most of the carbon dioxide diffuses into the red blood cells, where it either forms carbonic acid or combines with hemoglobin. Carbonic acid (H2CO3) is formed when carbon dioxide combines with water (CO2 + H2O = H+ + HCO3–). The process is catalyzed by an enzyme called carbonic anhydrase, which is present in large quantities in red blood cells. Carbonic anhydrase increases the rate of the reaction between carbon dioxide and water approximately 5000-fold. Carbonic acid readily ionizes to form bicarbonate (HCO3–) and hydrogen (H+) ions.

513069

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A client arrives in the emergency department suffering a traumatic brain injury as a result of a car accident. While assessing this client, the nurse notices the client has an irregular breathing pattern consisting of prolonged inspiratory gasps interrupted by expiratory efforts. The underlying physiological principle for these signs would include:

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Explanation

Brain injury, which damages the connections between the pneumotaxic and apneustic centers, results in an irregular breathing pattern that consists of prolonged inspiratory gasps interrupted by expiratory efforts. If the occipital lobe was not functioning, the client would have no respiratory effort and require mechanical ventilation. Leaking of spinal fluid would not cause these respiratory signs. If nerves were severed to the lungs, the client would not be able in inflate/deflate the lungs with mechanical ventilation.

513070

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COPD clients live with persistently elevated PCO2 levels. Therefore, which assessment finding would likely initiate a stimulus for ventilation in this client population?

Select the correct answer(s).

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Explanation

The central chemoreceptors are extremely sensitive to short-term changes in blood PCO2 levels. An increase in the PCO2 of the blood produces an increase in ventilation that reaches its peak within a minute or so and then declines if the PCO2 level remains elevated. Thus, persons with chronically elevated blood PCO2 levels no longer respond to this stimulus for increased ventilation but rely on the stimulus provided by a decrease in arterial PO2 levels that is sensed by the peripheral chemoreceptors.

513071

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A client has experienced a bout of coughing after aspirating some of his secretions. The client's coughing was triggered by which of the following?

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Explanation

The cough reflex is initiated by receptors located in the tracheobronchial wall; these receptors are extremely sensitive to irritating substances and to the presence of excess secretions. Blood gas changes and ventilation–perfusion mismatch do not directly initiate the cough reflex.

513072

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The sensation of chest tightness due to an impending asthmatic attack appears to be related to which of the following physiological causes?

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Explanation

The sensation of chest tightness due to an impending asthmatic attack appears to be related to input from lung receptors that monitor bronchial constriction. Transmission of excessive chemoreceptor stimulation of the medullary respiratory center to sensory centers in the forebrain relates to air hunger. Labored breathing, an uncomfortable work of breathing sensation, is thought to be mediated by excessive input from stretch receptors in the chest muscles. A perceived shortness of breath, known as dyspnea, is a multidimensional sensation involving both the sensory intensity and unpleasantness.

513352

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A client has presented to an ambulatory clinic complaining of a persistent headache. What assessments should the clinician conduct to differentiate between rhinosinusitis and alternative health problems?

Select the correct answer(s).

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Explanation

Transillumination is performed to confirm or rule out sinusitis, and sinusitis headache usually is exaggerated by bending forward, coughing, or sneezing. The other cited assessments do not differentiate between rhinosinusitis and other health problems.

513353

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A distinguishing feature of viral influenza is:

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Explanation

One distinguishing feature of influenza is the rapid onset, sometimes within minutes, of profound malaise. As with many viral respiratory tract infections, transmission is by aerosol or direct contact. In the early stages, the symptoms of influenza often are indistinguishable from other viral infections—fever, chills, malaise, muscle aching, headache, profuse watery nasal discharge, nonproductive cough, and sore throat. Persons with chronic rhinosinusitis complain of a constant pounding headache.

513354

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Which of the following individuals should be prioritized for receiving a seasonal influenza vaccination?

Select the correct answer(s).

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Explanation

An older adult who lives in a nursing facility is a high-priority candidate for influenza vaccination. Infants younger than 6 months and persons who are acutely ill should not receive immunizations. Younger hospital clients may be vaccinated but are usually of lower priority than the elderly.

513355

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Which of the following clients would be considered at high risk for developing pneumonia (both community and hospital setting)? Select all that apply.

Select the correct answer(s).

(0/0)

Explanation

Persons requiring intubation and mechanical ventilation are particularly at risk, as are those with compromised immune function, chronic lung disease (like asthma), and airway instrumentation, such as endotracheal intubation or tracheotomy. Ventilator-associated pneumonia is pneumonia that develops in mechanically ventilated clients more than 48 hours after intubation. Neutropenia and impaired granulocyte function predispose to infections caused by S. aureus, Aspergillus, gram-negative bacilli, and Candida. Pneumonia in immunocompromised persons remains a major source of morbidity and mortality. The epithelial cells of critically and chronically ill persons are more receptive to binding microorganisms that cause pneumonia.

Pathophysiology: Pulmonary I & II

Question 1 of 1

Time Left

Clients with chronic obstructive lung disease (COPD) may experience airway closure at the end of normal instead of low lung volumes, which result in:

Select the correct answer(s).

(0/0)

Explanation

Respiratory movement of air that does not participate in alveolar gas exchange is known as alveolar dead space. Dead space increases when alveolar/alveoli:

Select the correct answer(s).

(0/0)

Explanation

Generalized acute hypoxia in lung tissue, when alveolar oxygen levels drop below 60 mm Hg, causes pulmonary:

Select the correct answer(s).

(0/0)

Explanation

Following surgery, a client had a chest x-ray that reported some opacities in the lung bases likely due to atelectasis. Which of the following pathophysiologic processes will result from this condition?

Select the correct answer(s).

(0/0)

Explanation

Diffusion of gases in the lung is decreased, as in pulmonary edema or pneumonia, by causing an increase in alveolar:

Select the correct answer(s).

(0/0)

Explanation

Which of the following clients are likely experiencing a shift to the right in the dissociation curve? Select all that apply.

Select the correct answer(s).

(0/0)

Explanation

While discussing carbon dioxide transport within the body, the instructor asks, “What enzyme helps carbon dioxide with water to form bicarbonate?” Which student response is correct?

Select the correct answer(s).

(0/0)

Explanation

Select the correct answer(s).

(0/0)

Explanation

COPD clients live with persistently elevated PCO2 levels. Therefore, which assessment finding would likely initiate a stimulus for ventilation in this client population?

Select the correct answer(s).

(0/0)

Explanation

A client has experienced a bout of coughing after aspirating some of his secretions. The client's coughing was triggered by which of the following?

Select the correct answer(s).

(0/0)

Explanation

The sensation of chest tightness due to an impending asthmatic attack appears to be related to which of the following physiological causes?

Select the correct answer(s).

(0/0)

Explanation

A client has presented to an ambulatory clinic complaining of a persistent headache. What assessments should the clinician conduct to differentiate between rhinosinusitis and alternative health problems?

Select the correct answer(s).

(0/0)

Explanation

A distinguishing feature of viral influenza is:

Select the correct answer(s).

(0/0)

Explanation

Which of the following individuals should be prioritized for receiving a seasonal influenza vaccination?

Select the correct answer(s).

(0/0)

Explanation

Which of the following clients would be considered at high risk for developing pneumonia (both community and hospital setting)? Select all that apply.

Select the correct answer(s).

(0/0)

Explanation

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