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Pharmacology · chapter 23 · Introduction to the Respiratory System

Introduction to the Lower Respiratory System

The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. Lobes of the lungs

    The lungs are air-filled organs on either side of the thorax. The right lung consists of three lobes, and the left lung consists of two lobes.

  2. Gas exchange in the alveoli

    Alveoli are microscopic air sacs where oxygen from the air is absorbed into the blood. Carbon dioxide travels from the blood to the alveoli so that it can be exhaled.

  3. Normal adult respiratory rate

    Assessing a client’s respiratory rate can provide an insight into proper function. A normal respiratory rate for an adult should be 12–20 breaths per minute.

  4. What pulmonary function tests measure

    They measure how much air goes into and out of the lungs, how much air goes from the lungs to the blood, and how well the lungs work during exercise.

  5. What happens in asthma

    The combination of these characteristics can make breathing difficult and cause coughing and wheezing (a whistling sound) when breathing out.

  6. Asthma triggers

    Symptoms can be worsened by respiratory viruses such as influenza. They also can be triggered by exercise, occupational exposure to chemicals or dust, and allergens such as pollen or mold.

  7. Asthma is controlled, not cured

    Asthma cannot be cured, but it can be treated and its symptoms controlled. Diagnosis of asthma is made utilizing PFTs as described previously, typically spirometry, after a client has exhibited symptoms.

  8. Treating acute asthma attacks

    Asthma is often treated with inhaled corticosteroid and inhaled bronchodilators. For treatment of acute asthma attacks, inhaled short-acting bronchodilators and anticholinergic agents such as ipratropium are often used (Mayo Clinic, n.d.-a).

  9. Main cause of COPD

    The main cause of COPD is tobacco smoke; other causes include air pollution, family history, and certain respiratory infections like pneumonia (Centers for Disease Control and Prevention, 2021).

  10. Air trapping in emphysema

    In clients with emphysema, the alveoli are damaged and do not work properly. Because of this damage, when the client exhales, old carbon dioxide–rich air becomes trapped and reduces room for fresh, oxygen-rich air.

  11. Emphysema can be silent for years

    Many clients do not have symptoms for years, but eventually they may notice difficulty breathing during normal everyday activities.

  12. Smoking cessation prevents emphysema

    Because smoking is the biggest risk factor for emphysema, smoking cessation is the most common preventative measure.

  13. Treating emphysema

    Bronchodilators, inhaled corticosteroids, and, if needed, antibiotics are utilized. Many clients may need supplemental oxygen to ensure proper blood oxygen levels (Mayo Clinic, n.d.-b).

  14. Nondrug care in chronic bronchitis

    Nonpharmacologic treatments include lifestyle changes such as quitting smoking, increasing physical activity, and having a healthy diet.

Terms to know

Asthma
Asthma is a condition in which airways swell and become narrow.
Chronic obstructive pulmonary disease
Chronic obstructive pulmonary disease (COPD) is a group of conditions that cause the blockage of air flow and result in breathing issues.
Chronic bronchitis
Chronic bronchitis is a type of COPD characterized by inflammation and irritation of the bronchial tubes.

Practice questions

Stuck on select-all-that-apply? How to take them one option at a time.

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Every question here, with the answer

  1. A nurse assesses an adult client's respiratory rate. Which rate falls within the normal range?

    1. 16 breaths per minute
    2. 8 breaths per minute
    3. 30 breaths per minute
    4. 24 breaths per minute

    Answer: 16 breaths per minute

    A normal adult respiratory rate is 12–20 breaths per minute, so 16 is normal. The other rates fall below or above that range.

  2. A nurse is teaching a client with asthma about possible triggers. Which triggers should the nurse include? Select all that apply.

    1. Pollen or mold
    2. Exercise
    3. Occupational exposure to chemicals or dust
    4. Drinking water
    5. Influenza

    Answer: Pollen or mold, Exercise, Occupational exposure to chemicals or dust, Influenza

    Asthma symptoms can be worsened by respiratory viruses such as influenza and triggered by exercise, occupational chemicals or dust, and allergens such as pollen or mold. Drinking water is not a listed trigger.

  3. A client is having an acute asthma attack. Which drugs should the nurse anticipate?

    1. An inhaled short-acting bronchodilator and ipratropium
    2. An oral antibiotic
    3. A decongestant nasal spray
    4. Supplemental oxygen only

    Answer: An inhaled short-acting bronchodilator and ipratropium

    Acute asthma attacks are often treated with inhaled short-acting bronchodilators and anticholinergic agents such as ipratropium. The other options are not the listed treatment for an acute attack.

  4. A client with emphysema asks why they get short of breath. Which explanation is accurate?

    1. Damaged alveoli trap carbon dioxide–rich air and leave less room for fresh air.
    2. The larynx is inflamed.
    3. Mucus from the sinuses blocks the bronchi.
    4. The trachea has collapsed.

    Answer: Damaged alveoli trap carbon dioxide–rich air and leave less room for fresh air.

    In emphysema the alveoli are damaged, so old carbon dioxide–rich air becomes trapped on exhalation and reduces room for oxygen-rich air. The other explanations are not how the section describes emphysema.

  5. A client with chronic bronchitis asks what they can do besides taking medicine. Which lifestyle changes should the nurse recommend? Select all that apply.

    1. Eat a healthy diet
    2. Avoid all physical activity
    3. Increase physical activity
    4. Stop all inhaled medicines once breathing improves
    5. Quit smoking

    Answer: Eat a healthy diet, Increase physical activity, Quit smoking

    Nonpharmacologic treatment for chronic bronchitis includes quitting smoking, increasing physical activity, and a healthy diet. Stopping prescribed medicines or avoiding activity is not recommended.

  6. A client who smokes asks what is most likely to prevent emphysema. What should the nurse say?

    1. Using a decongestant daily
    2. Taking antibiotics every winter
    3. Breathing through the mouth
    4. Stopping smoking

    Answer: Stopping smoking

    Smoking is the biggest risk factor for emphysema, so smoking cessation is the most common preventative measure. The other options are not preventative measures in the section.

Where every quote comes from

Section 23.2 Introduction to the Lower Respiratory System of Pharmacology for Nurses by Tina Barbour-Taylor, Leah Mueller (Sabato), Donna Paris, Dorie Weaver, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.