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BSN 366 Week 3 Gas Exchange Questions With Complete Solutions
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BSN 366 Week 3 Gas Exchange Questions With CompleteSolutions
:Airway and Alveolar Abnormalities
The underlying pathophysiology of the following conditions
results in airflow obstruction and air trapping:
-Asthma
-COPD
-Cystic fibrosis
Ultimately, respiratory muscle fatigue and ventilatory failure
occur because of the additional work needed to breathe Correct
Answer CNS Abnormalities:
A variety of CNS issues may suppress the drive to breathe.
Overdose of a respiratory depressant drug (eg, an opioid or a
benzodiazepine)
-High-level spinal cord injuries
-Traumatic brain injuries
-Limited nerve supply to the respiratory muscles of the chest
wall and diaphragm
Acute Respiratory Distress Syndrome:
Question 1 of 3
The nurse knows that patients with which diagnoses are at risk
of developing acute respiratory distress syndrome (ARDS)?
Select all that apply.
Septic shock
Severe head injury
Acute heart failure
Amniotic fluid embolus
Chronic kidney disease (CKD) Correct Answer Septic shock
,Patients with sepsis or septic shock are at the highest risk for
developing ARDS. This is especially true when the sepsis is due
to a gram-negative infection. The nurse should monitor
respiratory status of these patients closely.
Severe head injury
Patients with severe head injuries can have a secondary injury to
the lungs resulting from central nervous system damage. This
can result in the development of ARDS, and the nurse should
monitor these patients accordingly.
Amniotic fluid embolus
Patients with any type of embolism—fat, air, amniotic fluid, or
thrombus—are at higher risk for developing ARDS. The nurse
should monitor the respiratory status of these patients
accordingly
Acute Respiratory Failure:
Acute respiratory failure (ARF) is a syndrome in which the
respiratory system fails in one or both of its gas exchange
functions: oxygenation and carbon dioxide elimination. As a
result, the patient will experience hypoxemia (low blood oxygen
levels) or hypercapnia (high blood carbon dioxide levels)
Correct Answer
Acute Respiratory Failure: Drug Therapy
Goals of drug therapy for patients with ARF include relief of
bronchospasm, reduction of airway inflammation and
pulmonary congestion, treatment of pulmonary infection, and
reduction of severe anxiety and restlessness. Correct Answer
Acute Respiratory Failure: Nutritional Therapy
Maintenance of protein and energy stores is especially important
because nutritional depletion causes a loss of respiratory muscle
,mass, which may prolong recovery. During ARF, the risk of
aspiration typically prevents oral intake. Enteral nutrition should
generally be started within 24 to 48 hours.
Chemotherapy
Primary treatment for small cell lung cancer.
Specific chemotherapy agents are used to destroy the cancer
cells.
Chemotherapy agents also affect healthy cells in the body.
Agents such as etoposide, carboplatin, cisplatin, paclitaxel, and
vinorelbine are used in combination Correct Answer Targeted
Therapy
Specific drugs that interfere with the growth of the cancer cells
or inhibit blood vessel growth to the cancerous tumor.
Includes immunotherapy, which works with the immune system
to fight cancer cells.
Differ from chemotherapy by affecting tumor growth rather than
killing cells directly, resulting in decreased toxicity.
Examples:
Erlotinib: blocks signals for growth in cancer cells.
Bevacizumab: inhibits new blood vessel growth (angiogenesis).
Chest Trauma:
A pneumothorax is a complete or partial collapse of a lung as a
result of an accumulation of air in the pleural space.
Pneumothorax can be classified as:
Open:
-Air entering through an opening in the chest wall
-May occur from a penetrating trauma that allows air to enter the
pleural space
Closed:
, -No external wound
-Suspect after any blunt trauma to chest wall Correct Answer
Pathophysiology
Normally, negative pressure exists between the visceral pleura
(surrounding the lung) and the parietal pleura (lining the
thoracic cavity), allowing the lungs to fill by chest wall
expansion. The pleural space contains only a few milliliters of
lubricating fluid to reduce friction when the tissues move. When
air enters the pleural space, the change in from negative pressure
to positive pressure causes a partial or complete lung collapse.
As the volume of air in the pleural space increases, the lung
volume decreases.
Chest Wall Abnormalities:
The following conditions limit lung expansion or diaphragmatic
movement, and consequently, gas exchange:
Flail chest: Fractures prevent the rib cage from expanding
normally because of pain, mechanical restriction, and muscle
spasms.
Kyphoscoliosis: The abnormal spinal configuration compresses
the lungs and prevents normal expansion of the chest wall.
Severe obesity: The weight of the chest and abdominal contents
may limit lung expansion.
These abnormalities often result in painful work of breathing,
further limiting lung expansion. Correct Answer
Neuromuscular Conditions:
The following neuromuscular diseases may result in respiratory
muscle weakness or paralysis:
-Guillain-Barré syndrome
-Muscular dystrophy
-Myasthenia gravis (acute exacerbation)
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