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Problems of Oxygenation VentilationMedical Surgical Nursing

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Question Answer
Mucus is continually secreted at a rate of about _____ mL a day by goblet cells and submucosal glands.
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100 mL
What is in mucus that contributes to protection against bacteria and viruses?
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Secretory IgA
What areas of the respiratory system are covered with cilia?
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The trachea to the respiratory bronchioles
The further down into the tracheobronchial tree, the faster or slower the cilia beats?
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Slower
What impairs ciliary action?
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Dehydration, smoking, inhalation of high oxygen concentrations, infection, and ingestion of medications like atropine, anesthetics, alcohol and/or cocaine.
Why are patients with COPD and cystic fibrosis more prone to respiratory infections?
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Cilia are often destroyed by upper respiratory infections, which results in impaired secretion clearance, chronic productive coughing, and chronic colonization of bacteria.
________ is a back-up respiratory defense mechanism for the mucociliary clearance system, especially when it is overwhelmed or ineffective.
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The cough reflex
Coughing is only effective in removing secretions above the ________ level.
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Subsegmental (large or main airways)
_________ is an intervention that can be used to move secretions upward so they can be removed by coughing.
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Postural drainage
When does reflex bronchoconstriction occur?
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When a person inhales large amounts of irritating substances like dusts or aerosols
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What is the primary defense mechanism before the respiratory bronchioles?
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Alveolar macrophages
What happens to the debris captured by alveolar macrophages?
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It is moved to the bronchioles where the cilia move it upwards or the lymphatic system removes it
What recreational activity can inhibit alveolar macrophages?
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Smoking
What structural alterations of the respiratory system commonly occur from aging?
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-decrease in elastic recoil of the lungs -decrease in chest wall compliance -chest wall stiffens -costal cartilages calcify, interfering with chest expansion -outward curvature of the spine is marked -lumbar curve flattens -loss of subQ fat, leading
What changes occur within the lung due to aging?
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-decrease in number of functional alveoli -remaining alveoli are less elastic -Smaller airways close earlier in expiration resulting in poorer V/P matches, lowering PaO2
What changes occur in respiratory defense mechanisms due to aging?
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-Alveolar macrophages are less effective -cough isn't as forceful -Fewer and less functional cilia -Drier mucus membranes -IgA formation is decreased/decreased cell-mediated immunity -Decreased sensation in pharynx
What are the changes in respiratory control that occur due to aging?
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-A decreased response to hypoxemia (it takes a greater drop in PaO2 to trigger a change in respiration rate) -A decreased response to hypercapnea (it takes a greater rise in PaCO2 to trigger a change)
You have a patient in his 80's who has come in for a cold. You listen to his lung sounds and notice while auscultating the bases that his breath sounds are diminished. You know that this means...
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Nothing, it is a normal finding for an elderly adult to have diminished breath sounds, particularly in the bases of both lungs.
T/F Common changes in the respiratory related to aging result in a lower than normal blood pH and PaCO2.
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False. Those remain normal, however, they will have a lower than normal PaO2 and SaO2.
What is a key indicator of symptom control for patients with respiratory conditions like asthma?
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Overuse of short-term bronchodilators
You have a patient with a chronic cough that is on ACE inhibitor. He expresses he is concerned he has bronchitis because nothing seems to help his cough. You tell him...
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A common side effect of ACE inhibitors is a chronic cough
  
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