NUR 681- Test 2 (Respiratory) Review Questions and Correct Answers
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Course
NUR 681
Institution
NUR 681
Cough can be a side effect of which meds? Hypertensives: ~ACE inhibitors ~ARBs ~beta blockers
-Nitrofurantoin -Aminoglycosides (ex. Gentamicin)
Chronic cough (define) A cough that lasts > 8 weeks
Most common cause of chronic cough? **Cigarette smoking** ^triggers the cough reflex by direct br...
NUR 681- Test 2 (Respiratory) Review
Questions and Correct Answers
Cough can be a side effect of which meds? ✅Hypertensives:
~ACE inhibitors
~ARBs
~beta blockers
-Nitrofurantoin
-Aminoglycosides (ex. Gentamicin)
Chronic cough (define) ✅A cough that lasts > 8 weeks
Most common cause of chronic cough? ✅**Cigarette smoking**
^triggers the cough reflex by direct bronchial irritation
Arnold reflex (define) ✅Mechanical stimulation of external auditory meatus can cause
cough
^check ears for cerumen or hairs impinging on the TM
Crackles vs. rhonchi ✅Crackles- typically related to fluid accumulation in the lungs;
generally do not clear with cough
Rhonchi- typically due to mucus accumulation; clear after the patient coughs and clears
the airways
Tuberculosis (diagnostics) ✅**Mantoux purified protein derivative (PPD) tuberculin
skin test (TST)**
A positive result on TB screening test warrants what? ✅**Chest x-ray**
What diagnostic is helpful in determining the presence of obstructive or restrictive lung
disease? ✅**Spirometry**
Indications for antitussives ✅Severe, acute coughing that disrupts sleep and causes
pain or extreme fatigue & weakness
~should only be used on short-term basis & only at night~
When should antihistamines be avoided? ✅In asthmatic individuals because
antihistamines may thicken secretions and inhiit expectoration
Expectorants are warranted when? ✅They are intended to decrease sputum viscosity
and are used when the patient has a productive cough and needs help in clearing the
airways
-Ex. Guaifenesin (Mucinex)
Alternative to expectorants? ✅Increase water intake to 3-4 L/day
Herbal remedies for cough suppression ✅-Horehound
-Licorice
Dyspnea in the elderly ✅Dyspnea is the major atypical presentation for ischemic heart
disease and MI and is considered a frequent anginal equivalent
Anxiety-related dyspnea - common presentation ✅Onset of dyspnea at rest;
accompanied by:
~Sense of chest tightness
~Feeling of suffocation
~Inability to "get air in"
When should ABGs be done? ✅When O2 sats are less than 90%
Peak expiratory flow rate (define) ✅Determines the degree of expiratory airflow
obstruction in patients with asthma or COPD
Hemoptysis (define) ✅Expectoration of blood
Hemoptysis in patients < 45 years old - likely causes ✅-Mitral stenosis
-TB
-Bronchiectasis
-Lung abscess
Hemoptysis in patients > 45 years old - likely causes ✅-Bronchogenic carcinoma
-Bronchitis
, -TB
-Pulmonary embolus with infarction
Hemoptysis - labs in nonemergent cases ✅-Sputum culture
^for acid-fast bacilli if TB is suspected
Sleep apnea (define) ✅A temporary pause in breathing during sleep that lasts at least
10 seconds; should occur a minimum of 5 times an hour for a confirmed diagnosis
Central apnea (define) ✅Occurs when both airflow and respiratory efforts are absent; a
result of an absence of neural output from the brainstem
Central apnea is more common in which groups of people? ✅Individuals who live at
high altitudes
Obstructive sleep apnea (OSA) [define] ✅Respiratory efforts persist although airflow is
absent at nose and mouth; airflow obstruction occurs as a result of tongue and soft
palate falling backward and partially or completely obstructing pharynx
Mixed apnea (define) ✅Both central and obstructive patterns occur
Apnea-hypopnea index (AHI) [define] ✅May be used to define and quantify severity of
OSA; obtained by dividing total # of apnea and hypopnea episodes throughout the
entire night by total sleep time
Respiratory disturbance index (RDI) [define] ✅Another commonly used diagnostic for
sleep apnea; defined as the AHI (total # of apnea and hypopnea episodes per hour) +
the average number of snoring-related arousals per hour
A diagnosis of OSA is confirmed with AHI and RDI scores of what? ✅-AHI or RDI > or
equal to 5 and less than 14 if comorbid factors such as excessive daytime sleepiness,
hypertension, stroke, or heart failure are present
~OR~
-AHI or RDI > or equal to 15 in the absence of comorbid factors
What are significant complications of OSA? ✅**Dysrhythmias**
^esp. A-fib!!
-Pulmonary & systemic hypertension
-Insulin resistance
Increased risk of:
-stroke
-MI
OSA is most prevalent in which groups of people? ✅-Men > 50 years old
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