LARACAS, LEZEL M.

BSN3-B

ASSESSMENT OF 7. Gas exchange between the

RESPIRATORY FUNCTION lungs and blood and between
the blood and tissues is called
Activity A. Fill in the blanks. internal respiration.

1. The two centers in the brain 8. The maximum volume of air

that are responsible for the that can be inhaled after a
neurologic control of ventilation normal inhalation is known as
are Apneustic center in the inspiratory reserve volume.
lower pons and pneumotaxis
center in the upper pons. 9. Tidal volume, which may not
significantly change with
2. The alveoli begin to lose disease, has a normal value of
elasticity at about age 50 years, approximately 1000 mL.
resulting in decreased gas
diffusion. 10. The exchange of oxygen
and carbon dioxide from the
3. The lungs are enclosed in a alveoli into the blood occurs by
serous membrane called the External respiration.
pleura.
11. The pulmonary circulation is
4. The left lung, in contrast to considered a low pressure, low
the right lung, has two lobes. resistance system.

5. The divisions of the lung 12. The symbol used to identify

proceed in the following order, the partial pressure of oxygen is
beginning at the main- stem PAO2.
bronchi: lobar bronchi,
segmented bronchi, sub Activity B Briefly answer the
segmented bronchi, and following.
bronchioles. are the alveolar
cells that secrete surfactant. 1. Distinguish between the
terms ventilation and
6. Alveolar type II cells are the respiration.
alveolar cells that secrete Ventilation and respiration
surfactant. are two distinct processes. Air is
moved during the mechanical
LARACAS, LEZEL M.
BSN3-B

process of ventilation. The  sputum production,

physiological process of hemoptysis (coughing up
respiration includes the blood)
exchange of gases in the cells  wheezing
(internal respiration) and the  chest pain
alveoli (external respiration).  and nasal or sinus
drainage.
2. Describe the function of the
epiglottis. 6. Wheeze is a high-pitched,
Epiglottis protects your musical sound that is
ability to breathe by protecting continuous, meaning it is heard
your larynx (voice box). on either expiration (asthma) or
inspiration (bronchitis).
3. List four conditions that cause
low compliance or distensibility 7. Explain the breathing pattern
of the lungs: characterized as Cheyne-
 Morbid obesity Stokes respirations.
 Atelectasis A period of fast, shallow
 Pneumothorax breathing followed by slow,
 Hemothorax heavier breathing and moments
without any breath at all, called
4. Define the term partial apneas.
pressure.
Partial Pressure is defined 8. What is the purpose of cilia?
as if a container filled with more The function of cilia is to
than one gas, each gas exerts move water relative to the cell in
pressure. a regular movement of the cilia.

5. List six major signs and 9. What are four common

symptoms of respiratory phenomena that can alter
disease. bronchial diameter?
 dyspnea which may be call  contraction of bronchial
shortness of breath smooth muscle (asthma)
 breathlessness, or  thickening of bronchial
“winded”, cough mucosa (chronic
bronchitis)
LARACAS, LEZEL M.
BSN3-B

 obstruction of the airway

(mucus, tumor, foreign 3. Antihistamine remain the
body) most common treatment for
 loss of lung elasticity rhinitis and are administered for
(emphysema) sneezing, pruritus, and
rhinorrhea.
10. Compare and contrast the
concepts of diffusion and 4. Rhinosinusitis is classified by
pulmonary perfusion. duration of symptoms as Acute
Perfusion is the flow of rhinosinusitis, Subacute
blood through a specific mass of rhinosinusitis, and Recurrent
tissue in a unit of time, whereas acute rhinosinusitis
diffusion is the passive
movement of particles along a 5. Tonsillopharyngeal cellulitis is
concentration gradient (gas the most common major
exchange in alveoli). suppurative complication of sore
throat.
MANAGEMENT OF PATIENTS
WITH UPPER RESPIRATORY 6. The most serious
TRACT DISORDER complication of a tonsillectomy
is delayed hemorrhage.
Activity A
Fill in the blanks. Activity B.
Briefly answer the following.
1. The most common cause of
laryngitis is low hoarse voice 1. Explain how rhinitis can lead
with symptoms including to rhinosinusitis.
difficulty speaking, sore throat, Allergic rhinitis and sinusitis
mild fever and an irritating are linked to each other,
cough. because allergic rhinitis causes
your nose to become blocked,
2. Medication therapy for and in turn blocks the sinuses.
allergic and nonallergic rhinitis
focuses on desensitization and 2. Name four bacterial
use of decongestants, organisms that account for more
antihistamines, and mast-cell than 60% of all cases of acute
mediators. rhinosinusitis:
LARACAS, LEZEL M.
BSN3-B

Streptococcus pneumoniae, 6. List the clinical manifestations

Haemophilus influenzae, that are used to diagnose
Moraxella catarrhalis, and obstructive sleep apnea.
Streptococcus pyogenes.  Excessive daytime
sleepiness.
3. If untreated, chronic  Loud snoring.
rhinosinusitis can lead to severe  Observed episodes of
complications. List four: stopped breathing
 eye infections during sleep.
 ear infections  Waking during the night
 skin infections and gasping or choking.
 issues within the brain.  Awakening in the
morning with a dry
4. List four possible nursing mouth or sore throat.
diagnoses for a patient with an
upper airway infection: 7. List three types of laryngeal
 inability to clear secretions communication: esophageal,
or obstructions from the buccal, and pharyngeal speech
respiratory tract to
maintain a clear airway. Activity C.
 Ineffective breathing Match the term listed in
pattern. Column II with its associated
 Ineffective airway definition for surgical options
clearance. for laryngeal cancer listed in
 Risk for aspiration. Column I.

5. List five potential Column I

complications of an upper
airway infection: E 1. Removal of the mucosa on
 Pneumonia the edge of the vocal cord
 Meningitis
 Sepsis B 2. Excision of the vocal cord
 Bronchitis for lesions in the middle third of
 Paranasal sinusitis the vocal cord
LARACAS, LEZEL M.
BSN3-B

C 3. Complete removal of the

larynx 2. In current tuberculosis (TB)
treatment, four first-line
A 4. Portion of the larynx is medications are used: Rifampin,
removed, along with one vocal isoniazid, pyrazinamide, and
cord, and the tumor ethambutol

D 5. Microelectrodes are used 3. A(n) empyema is an

for surgical resection of smaller accumulation of thick, purulent
laryngeal tumors fluid within the pleural space,
often with fibrin development
Column II
and a loculated area where
infection is located.
a. Partial laryngectomy

b. Vocal cord stripping 4. Tachypnea, dyspnea, and

mild to moderate hypoxemia are
c. Total laryngectomy hallmarks of the severity of
atelectasis.
d. Laser surgery
5. When a nonfunctioning
e. Cordectomy nasogastric tube allows the
gastric contents to accumulate
in the stomach, a condition
MANAGEMENT OF PATIENTS known as silent aspiration may
WITH CHEST AND LOWER result.
RESPIRATORY TRACT
DISORDERS 6. Three common pathogens
that cause aspiration
Activity A. pneumonia are Streptococcus
Fill in the blanks. pneumoniae, Haemophilus
influenzae, and staphylococcus
1. Hospital-acquired pneumonia aureus
develops 48 hours or more after
admission and does not appear
to be incubating at the time of
admission.
LARACAS, LEZEL M.
BSN3-B

7. Pneumonia tends to occur in possible causes of atelectasis in

patients with one or more of the postoperative patient?
these five underlying disorders:  Age
 Alcoholism  Smoking
 Chronic obstructive  Use of general anesthesia
pulmonary disease  Duration of surgery
(COPD)  Pre-existing lung or
 Acquired immune neuromuscular disease
deficiency syndrome  Prolonged bed rest
(AIDS) (especially with limited
 Diabetes position changes)
 Heart failure  Poor post-operative pain
control (resulting in
8. Three severe complications shallow breathing)
of pneumonia are hypotension,
shock, and respiratory failure.
2. Name seven possible clinical
9. Four respiratory system manifestations of atelectasis.
mechanisms that can lead to
 shallow breathing
acute respiratory failure (ARF)
 rapid breathing
are
 fever
 chest pain
10. The most serious
 wheezing or crackling
complication and most frequent
 sounds
cause of death among patients
 coughing
with COVID-19 is acute
respiratory failure.  sputum (phlegm, or thick
mucus) production
Activity B.
Briefly answer the following. 3. Identify eight nursing
interventions that are used to
1. Atelectasis, which refers to prevent atelectasis.
closure or collapse of alveoli,  deep breathing
may be chronic or acute in  early ambulation
nature. What are some of the
LARACAS, LEZEL M.
BSN3-B

 proper use of an incentive

spirometer or acapella
device
 chest physiotherapy
 tracheal suctioning if Activity A.
intubated Fill in the blanks.
 use of positive pressure
ventilation. 1. Cor pulmonale is one of the
complications of emphysema, is
4. Explain the meaning of the right-sided heart failure brought
on by long-term high blood
term superinfection.
pressure in the pulmonary
A superinfection is a second
arteries
infection superimposed on an
2. Smoking depresses the
earlier one, especially by a activity of scavenger cells and
different microbial agent of affects the respiratory tract's
exogenous or endogenous ciliary cleansing mechanism,
origin, that is resistant to the which keeps breathing
treatment being used against passages free of inhaled
the first infection. irritants, bacteria, and other
foreign matter.
5. Describe the characteristic 3. The most important
and diagnostic feature of ARDS. environmental risk factor for
ARDS may develop over a COPD worldwide is air pollution.
few days, or it can get worse 4.Spirometry is used to evaluate
very quickly. The first symptom airflow obstruction, which is
of ARDS is usually shortness of determined by the ratio of FEV,
breath. Other symptoms of to forced vital capacity (FVC).
ARDS are low blood oxygen, 5. A bullectomy is a surgical
rapid breathing, and clicking, option for select patients with
bubbling, or rattling sounds in bullous emphysema.
the lungs when breathing. 6. The single most cost-effective
ARDS can develop at any age. intervention to reduce the risk of
developing COPD or slow its
MANAGEMENT OF PATIENTS progression is cessation of
WITH CHRONIC PULMONARY smoking.
DISEASE
LARACAS, LEZEL M.
BSN3-B

7. Primary causes for an acute 2. Describe the two main types

exacerbation of COPD are of emphysema.
Tracheobronchial infection and Panlobular emphysema
air pollution. (PLE) – PLE affects the lungs
8. To help prevent infections in as a whole but can affect the
patients with COPD, the nurse lower section of the lungs more
should recommend vaccination severely. Paraseptal
against two bacterial organisms: emphysema (PSE) – PSE
Streptococcus pneumoniae and damages the air sacs in the
haemophilus influenzae. outermost part of the lungs, but
9. The strongest predisposing with more severe forms of PSE,
factor for asthma is allergies ; damage can occur in other parts
the three most common of the lungs too.
symptoms are cough,
wheezing, and dyspnea. 3. What are the three primary
10. Complications of asthma goals of pulmonary
may include status asthmaticus, rehabilitation?
respiratory failure, pneumonia, Improve symptoms,
and atelectasis. restore functional capabilities,
11. Chest physical therapy and enhance overall quality of
(CPT) includes postural life.
drainage, chest percussion and
vibration, and breathing 4. List the three primary
retraining. symptoms associated with the
progressive stage of COPD.
Activity B Chronic cough, sputum
Briefly answer the following. production, dyspnea on
1. Describe the results of exertion.
chronic airway inflammation in
COPD. 5. List five of the nine major
Increased goblet cells and factors that determine the
enlarged submucosal glands, clinical course and survival of
inflammation and airway patients with COPD.
narrowing, and narrowing of the age, rate of decline of FEV,
airway lumen. hypoxemia, weight loss, history
of smoking.
LARACAS, LEZEL M.
BSN3-B

6. Describe three ways that 1. About 66 % of total body fluid

bronchodilators relieve is in the intracellular space; the
bronchospasm. major positively charged ion in
Alter smooth muscle tone, intracellular fluid is potassium.
reduce airway obstruction, and The extracellular space is
improve alveolar ventilation. divided into three
compartments: Intravascular,
Activity C interstitial, and transcellular; the
Match the drug category major positively charged ion in
listed in Column II with an extracellular fluid is sodium.
associated medication in About 50% of the 6L of total
Column I blood volume is plasma.
2. The primary concentration of
Column I phosphorus (85%) is located in
____F_____1. Albuterol the bones with about 15%
____c_____2. Ipratropium located in soft tissue.
bromide 3. The normal blood pH is 7.35-
____E_____3. Combivent 7.45.
____D____4. Theophylline 4. The upper and lower blood
___B____5. Montelukast pH levels that are incompatible
A 6. Cromolyn sodium with life are 6.7 and 7.8
5. The average daily urinary
Column II output in an adult is_1.5L.
a. Mast cell stabilizer 6. Cardiac effects of
b. Leukotriene modifier hyperkalemia are usually
c. Anticholinergic agent present when the serum
d. Methylxanthine potassium level reaches 8
e. Combination short acting mEq/L.
beta-2 adrenergic agonist agent 7. A normal oxygen saturation
f. Beta-2 adrenergic agonist value for arterial blood is 95%.
agent 8. Sodium, the most abundant
electrolyte in extracellular fluid,
is primarily responsible for
FLUID AND ELECTROLYTES maintaining fluid is osmolality
Activity A ,which affects the movement of
Fill in the blanks. water between fluid
compartments.
LARACAS, LEZEL M.
BSN3-B

9. Sodium is regulated by thirst, your urine. The blood urea

antidiuretic hormone and the nitrogen (BUN) test measures
renin-angiotensin aldosterone how much urea nitrogen is in
system. your blood. It helps a
10. Sodium establishes the healthcare provider determine
electrochemical state- if your kidneys are working as
necessary for muscle they should. Creatinine is a
contractions and the chemical waste product of
transmission of nerve impulses, creatine. Creatine is a
11. The most common buffer chemical made by the body
system in the body is the and is used to supply energy
bicarbonate-carbonic acid buffer mainly to muscles.
system.
12. The most characteristic 3. Distinguish between the
manifestation of hypocalcemia term’s baroreceptors and
and hypomagnesemia is tetany. osmoreceptors.
There are two main
Activity B types of receptors involved
Briefly answer the following. in the control of the body
PART I water balance-
1. Define the term osmotic osmoreceptors and
pressure. baroreceptors. Osmorecep
The pressure that must be tors reside in
applied to the solution side to hypothalamus and
stop fluid movement when a respond to changes of
semipermeable membrane extracellular fluid (ECF)
separates a solution from osmolality. Baroreceptors
pure water. are mechanoreceptors that
sense blood pressure in
2. Distinguish between the the vessel wall.
term’s urine specific
gravity, blood urea 4. How are calcium levels
nitrogen, and creatinine. regulated?
Urine specific Blood calcium levels
gravity measures the are regulated
electrolytes and osmolality of by parathyroid hormone
LARACAS, LEZEL M.
BSN3-B

(PTH), which is produced Weak pulse,

by the parathyroid glands. hypotension,
unresponsiveness, and
5. Name the primary pain in the chest
complication of hyper-
phosphoremia which PART II
occurs when the calcium-
magnesium product 1. Indicate which of the
exceeds 70 mg/dL. following factors con
Metastatic calcification tribute to hyponatremia
of soft tissue, joints and by writing "Low" in the
arteries. space provided, and
indicate which
6. Write the mathematical contribute to
formula that a nurse would hypernatremia by
use to approximate the writing "High in the
value of serum osmolality. space provided.
Na X 2 = glucose divided
by 18 + BUN divided by LOW a. vomiting
3. LOW b. diarrhea
HIGH C. watery diarrhea
7. Explain why the HIGH D. ability to quench
administration of a 3% to thirst
5% sodium chloride burns over a large surface
solution requires intense area
monitoring. LOW f. diuretics
Only small volumes HIGH g. heatstroke
are needed to elevate the HIGH h. adrenal
serum sodium from insufficiency
dangerously low levels. LOW i. syndrome of
inappropriate antidiuretic
8. List four of six symptoms hormone
HIGH j. status post
associated with air
therapeutic abortion
embolism, a complication
HIGH k. diabetes insipidus
of intravenous therapy. with water restriction
LARACAS, LEZEL M.
BSN3-B

LOW I. excessive tribute to hypocalcemia

parenteral administration by writing "Low" in the
of dextrose and water space provided, and
solution indicate which
contribute to
2. Indicate which of the hypercalcemia by
following factors con- writing "High" in the
tribute to hypokalemia space provided.
by writing "Low" in the
space provided, and HIGH a.
indicate which hyperparathyroidism
contribute to LOW b. massive
hyperkalemia by writing administration of citrated
"High" in the space blood
provided. HIGH C. malignant tumors.
HIGH __d. immobilization
LOW a. alkalosis because of multiple
HIGH b. tourniquet too fractures
tight when collecting a _ LOW e. pancreatitis
blood sample HIGH f. thiazide diuretics
LOW C. vomiting LOW g. kidney failure
LOW d. gastric suction LOW _h. aminoglycoside
HIGH e. leukocytosis administration
LOW f. anorexia nervosa
LOW g. 4. Indicate which of the
hyperaldosteronism
following factors con-
LOW h. furosemide
tribute to
administration
LOW i. steroid hypomagnesemia by
administration writing "Low" in the
HIGH _J. kidney failure space provided, and
HIGH k. penicillin indicate which con-
administration adrenal tribute to
steroid deficiency hypermagnesemia by
3. Indicate which of the writing "High" in the
following factors con- space provided.
LARACAS, LEZEL M.
BSN3-B

LOW a. alcohol abuse metabolic alkalosis, "R-

HIGH b. kidney failure ACID" for respiratory
HIGH C. diarrhea acidosis, or "R-ALKA"
_ LOW d. gentamicin for respiratory alkalosis.
administration
LOW e. untreated R-ACID a. sedative
ketoacidosis overdose
M-ACID b. lactic acidosis
5. Indicate which of the M-ACID C. ketoacidosis
following factors con- R-ACID D.severe
tribute to pneumonia
hypophosphatemia by R-ALKA e. hypoxemia
writing "Low" in the R-ACID f. acute pulmonary
space provided, and edema
indicate which M-ACID g. diarrhea
contribute to M-ALKA h. vomiting
hyperphosphatemia by M-ALKA i. hypokalemia
writing "High" in the R-ALKA j. gram-negative
bacterial infection
space provided.
Activity C
LOW a.
Correlate the
hyperparathyroidism
associations between
HIGH b. kidney failure
body fluid
LOW C major thermal
compartments. Match
burns
the fluid space in
LOW d. alcohol withdrawal
Column II with an
HIGH e. neoplastic
associated factor in
disease chemotherapy
Column I.
Column I
6. For each of the
F 1. Third-space fluid shift
following factors, C 2. The smallest
indicate the probable compartment of the
cause by writing "M- extracellular fluid space
ACID" for metabolic D 3. Space where plasma
acidosis, "M-ALKA" for is contained
LARACAS, LEZEL M.
BSN3-B

B 4. Comprises the intra-

vascular, interstitial, and
transcellular fluid
A 5. Comprises about 60%
of body fluid
E 6. Comprises fluid
surrounding cell

Column II
a. Intracellular space
b. Extracellular fluid
compartment
c. Intravascular space
d. Transcellular space
e. Interstitial space
f. Intravascular fluid
volume deficit