NUR 504 Exam 2 Review Questions and
Correct Answers
What is pulmonary edema? ✅Fluid buildup in the alveoli in the lungs and causes
edema
What is pleural effusion? ✅Accumulation of fluid in the pleural cavity
What is included in the upper respiratory system? ✅Nares, sinuses, turbinates,
pharynx and larynx
What is included in the lower respiratory system? ✅Trachea, bronchi/bronchioles, and
alveoli/alveolar ducts
Describe the air pathway in the body ✅Air enters upper airway->alveoli->alveolar
capillaries-> pulmonary vein-> L side of heart-> body tissues
Describe the oxygenation dissociation curve ✅Determines the amount of oxygen
released from Hgb
Left shift- Tissues need less O2
Right shift- Release of O2 quickly to tissues
Bronchial lung sounds ✅I<E
Bronchvesicular breath sounds ✅I=E
vesicular lung sounds ✅I>E
What are some s/s of pleural effusion? ✅Dyspnea, tachypnea, decreased O2, tachy,
pain, CP, cough, orthopnea
Also increased risk for infection
What is used to diagnose pleural effusion? ✅CXR, CT scan, US of chest
What is the treatment for pleural effusion? ✅Depends on underlying cause
-Thoracentesis, chest tubes
What are the 2 types of pleural effusions? ✅1. Transudative- fluid filters across intact
capillaries
2. Exudative- extravasation (pus)--usually includes an empyema
,What is an empyema? ✅Pus in the pleural space (pleural effusion)
-Caused by bacteria (pneumonia), tumor, drug use, surgery/trauma
True or False: Pulmonary edema is a life-threatening event. ✅True
What are some causes for pulm edema? ✅Heart failure, MI, mitral valve dz
What are some s/s of pulmonary edema? ✅Crackles, dyspnea at rest, confusion,
tachy, decreased U/O, Cough with frothy pink sputum, Dysrhythmias
What are some nursing considerations for pulm edema? ✅High Fowler's if not
hypotensive, provide O2
What is the treatment for pulm edema? ✅Diuretics, morphine, bronchodilators
-Nitro if BP is >100mmHg
-If severe, ultrafiltration
What is a pneumothorax? ✅Accumulation of air in the pleural space
Decribe the 2 types of pneumothorax ✅1. Spontaneous- Sudden onset of air in pleural
space (results in deflation of the affected lung)
2. Tension- Gradual buildup of air under pressure (results in decreased filling of both the
heart and lungs)
What are the S/S of a pneumothorax? ✅Moderate to sever dyspnea
Severe chest discomfort, CP
Diminished breath sounds on affected side
Asymmetric lung expansion
Tracheal deviation to unaffected side
Air hunger
Agitation, hypotension, cyanosis
How is a pneumothorax diagnosed? ✅CXR
What is the treatment for pneumothorax? ✅Needle aspiration (immediately for
tensions pneumo)
Chest tube placement
Pleurodesis/ thoracotomy
How is placement of a chest tube determined? ✅If from air-> placed high
If from fluid-> placed low
What should you do if a patient reports "burning" in chest with a chest tube?
✅Reposition them
, Describe the 3 types of BiPAP ✅1. CPAP (continuous positive airway pressure)-
delivers a set pressure through inspiration and expiration
2. Volume-limited/flow-limited- Delivers a set tidal volume with inspiration
3. Pressure-limited- Provides pressure support and different pressures at inspiration
and expiration
What is acute respiratory failure (ARF)? ✅Ventilatory failure, oxygenation failure, or
both
What is the most common sign for ARF? ✅Abnormal ABGs
PaO2<60
or PaCO2> 45 with pH<7.35
and SaO2<90% in both cases
A patient in ARF will always be __________ and have __________ ABGs.
✅Hypoxemic; decreased
What are s/s of ARF? ✅Hypoxia, acidosis, dyspnea/tachypnea, lung sounds,
confusion/lethargy, HA, brady/hypotension
What is acute respiratory distress syndrome (ARDS)? ✅ARF with the following:
Hypoxemia, Decreased pulmonary compliance, bilateral pulm edema
What is a key finding in the dx of ARDS? ✅Dense pulmonary infiltrates on CXR
(ground glass appearance)
What are s/s of ARDS? ✅Absent lung sounds
Tachypnea
Cyanosis, pallor
Intercostal retractions
Hypoxemia after 100% O2 given
In ARDS, you will most likely hear what type of lung sounds? ✅Absent lung sounds
What is a key symptom in ARDS? ✅Hypoxemia after 100% O2 given (refractory
hypoxemia)
What are the 5 P's of managing ARDS? ✅Perfusion, Positioning, Protective lung
ventilation, Protocol weaning, and Preventing complications
What are the 3 phases of ARDS? ✅1. Exudative- Dyspnea, tachypnea (support pt and
provide O2)
2. Fibroproliferative- Pulmonary HTN, fibrosis, reducaed gas exchange
3. Resolution- Usually occurs after 14 days of injury
