Kettering Respiratory Flashcards

Questions and Answers

What are the four life functions?

Perfusion (correct)

Circulation (correct)

Ventilation (correct)

Oxygenation (correct)

What is objective information?

Sign

What is subjective information?

Symptom

The tobacco formula is calculated as: ___ pack/day x # of years smoked.

pack Signup and view all the answers

What are the four types of advance directives?

DNI Signup and view all the answers

What four things should a respiratory order include?

Dose + route Signup and view all the answers

What is the normal urine output?

40 mL/hour Signup and view all the answers

What is the normal CVP range?

2-6 mmHg Signup and view all the answers

What does low CVP indicate?

Hypovolemia Signup and view all the answers

What does increased CVP indicate?

Hypervolemia Signup and view all the answers

When is medication reconciliation carried out?

24 hrs within admission to hospital Signup and view all the answers

Obtunded is the same as what state?

Lethargic Signup and view all the answers

What does the Katz Scoring System evaluate?

Activities of daily living (ADL) Signup and view all the answers

The ability to breathe only in the upright position is called what?

Orthopnea Signup and view all the answers

What does run down feeling due to electrolyte imbalance indicate?

General malaise Signup and view all the answers

What does Grade I dyspnea indicate?

Unusual exertion Signup and view all the answers

What does Grade II dyspnea indicate?

Up hills or stairs Signup and view all the answers

What does Grade III dyspnea indicate?

Walking at normal speed Signup and view all the answers

What does Grade IV dyspnea indicate?

Walking short distance Signup and view all the answers

What does Grade V dyspnea indicate?

At rest Signup and view all the answers

Difficulty swallowing is called?

Dysphagia Signup and view all the answers

What method is used to communicate using simple language?

KISS Signup and view all the answers

What causes excessive fluid in tissue?

Peripheral edema Signup and view all the answers

What would you recommend for peripheral edema?

Diuretics Signup and view all the answers

Accumulation of fluid in the abdomen caused by liver failure is called?

Ascites Signup and view all the answers

What causes clubbing of fingers?

Chronic hypoxemia (COPD) Signup and view all the answers

What condition is associated with venous distention (JVD)?

CHF Signup and view all the answers

What is heavy sweating called?

Diaphoresis Signup and view all the answers

What does a decrease in color (ashen, pallor) indicate?

Anemia or acute blood loss Signup and view all the answers

What causes jaundice?

Increased bilirubin level Signup and view all the answers

What is redness of skin called?

Erythema Signup and view all the answers

What is protrusion of the sternum called?

Pectus Carinatum Signup and view all the answers

What is depression of the sternum called?

Pectus Excavatum Signup and view all the answers

What is convex curvature of the spine (leaning forward) called?

Kyphosis Signup and view all the answers

What is lateral curvature of the spine (side to side) called?

Scoliosis Signup and view all the answers

What lung volumes does kyphoscoliosis cause?

Reduced lung volumes Signup and view all the answers

What is barrel chest a result of?

Air trapping Signup and view all the answers

What does eupnea mean?

Normal breathing Signup and view all the answers

What occurs due to COPD related to muscle size?

Hypertrophy Signup and view all the answers

What is muscle wasting due to paralysis called?

Atrophy Signup and view all the answers

If an infant shows signs of nasal flaring, what does this indicate?

Respiratory distress Signup and view all the answers

What does Mallampati Class I show?

Uvula Signup and view all the answers

What does Mallampati Class II show?

Soft palate Signup and view all the answers

What does Mallampati Class III show?

Soft palate Signup and view all the answers

What does Mallampati Class IV show?

Hard palate only Signup and view all the answers

What 2 Mallampati classes may need a fiber optic bronchoscope?

Class 4 Signup and view all the answers

What is the normal heart rate?

60-100 bpm Signup and view all the answers

What would you recommend for tachycardia?

Oxygen Signup and view all the answers

What would you recommend for bradycardia?

Atropine Signup and view all the answers

Paradoxical pulse may indicate what?

Air trapping Signup and view all the answers

What are the causes of tracheal deviation pulled toward pathology?

Atelectasis Signup and view all the answers

What causes tracheal deviation pushed away from pathology?

Neck tumor Signup and view all the answers

What are bubbles under the skin called?

Crepitus Signup and view all the answers

What sound is emitted with normal air-filled lungs?

Resonant Signup and view all the answers

What sound is emitted over areas of atelectasis?

Flat Signup and view all the answers

What sound is emitted over a lung with pneumothorax or emphysema?

Hyperresonant (Boom sound) Signup and view all the answers

What sound is emitted over fluid-filled organs?

Dull Signup and view all the answers

What is it called when a patient is instructed to say 'E' but it sounds like 'A'?

Egophony Signup and view all the answers

What causes crackles?

Fluid in lungs Signup and view all the answers

What causes stridor?

Upper airway obstruction Signup and view all the answers

What causes wheezes?

Bronchospasm Signup and view all the answers

What are the normal heart sounds?

S2 Signup and view all the answers

What sound is made when the mitral and tricuspid valves close at the beginning of ventricular contraction?

S1 Signup and view all the answers

What sound is made when the pulmonic and aortic valves close?

S2 Signup and view all the answers

What are the abnormal heart sounds?

S4 Signup and view all the answers

What sound may suggest heart failure?

S3 Signup and view all the answers

What sound may suggest hypertension or stenosis?

S4 Signup and view all the answers

What do you recommend for abnormal heart sounds?

Echocardiogram Signup and view all the answers

What is the normal blood pressure?

120/80 Signup and view all the answers

What does hypertension indicate?

Cardiac stress (Hypoxemia) Signup and view all the answers

What does hypotension indicate?

Hypovolemia (CHF) Signup and view all the answers

What does narrowing of bronchi indicate?

Bronchogenic carcinoma Signup and view all the answers

The mediastinum may shift with which diseases?

Pneumothorax Signup and view all the answers

The costophrenic angles are blunted with what disease?

Pleural effusion Signup and view all the answers

What does an increase in the cardiac shadow indicate?

CHF Signup and view all the answers

What indicates crowding of ribs?

Atelectasis Signup and view all the answers

What are straight ribs associated with?

Air trapping Signup and view all the answers

The tip of the ETT should be how many centimeters above the carina?

2-6 cm Signup and view all the answers

Pacemakers are positioned in which ventricle?

Right ventricle Signup and view all the answers

Where is the pulmonary artery catheter positioned?

Right lower lung Signup and view all the answers

Where is the central venous catheter positioned?

Superior vena cava or right atrium Signup and view all the answers

Where should chest tubes be positioned?

Pleural space around lung Signup and view all the answers

What does croup show on an X-ray?

Steeple sign Signup and view all the answers

What does an enlarged epiglottis show on an X-ray?

Thumb sign Signup and view all the answers

What shows as a butterfly or batwing pattern?

Pulmonary edema Signup and view all the answers

What shows as patchy infiltrates or plate-like infiltrates?

Atelectasis Signup and view all the answers

What shows as a honeycomb pattern?

ARDS Signup and view all the answers

What shows as a wedge-shaped infiltrate?

Pulmonary embolism Signup and view all the answers

What does a normal ventilation scan with abnormal perfusion indicate?

Pulmonary embolism Signup and view all the answers

What is used to diagnose abnormalities in the hypopharynx, esophagus, or stomach?

Barium swallow Signup and view all the answers

A pulmonary angiography is used to diagnose what?

Pulmonary embolism Signup and view all the answers

What is the normal ICP?

5-10 mmHg Signup and view all the answers

When should treatment of ICP be initiated?

Above 20 mmHg Signup and view all the answers

What is the normal cerebral perfusion pressure (CPP)?

70-90 mmHg Signup and view all the answers

What would you use to monitor a patient's response to corticosteroid treatment?

Exhaled nitric oxide (FEno) Signup and view all the answers

What would you use to monitor abstinence in a cigarette smoker?

Exhaled carbon monoxide (FEco) Signup and view all the answers

What type of patients may have elevated FEco levels?

OSA (Obstructive Sleep Apnea) Signup and view all the answers

What are the normal RBC values?

4-6 mill/m3 Signup and view all the answers

What are the normal Hb values?

12-16 g/100 mL Signup and view all the answers

What are the normal Hct values?

40-50% Signup and view all the answers

Study Notes

Life Functions

Four essential life functions: Ventilation, Oxygenation, Circulation, Perfusion.

Objective vs Subjective Information

Objective information refers to signs.
Subjective information refers to symptoms.

Tobacco Use Assessment

Tobacco exposure calculated using the formula: pack/day x years smoked.

Advance Directives

Types include: Do Not Resuscitate (DNR), Do Not Intubate (DNI), Living Will, Durable Power of Attorney.

Respiratory Orders

Key components needed: type of treatment, frequency, dose + route, physician signature.

Urine Output and Measurements

Normal urine output is 40 mL/hour.
Normal Central Venous Pressure (CVP) range is 2-6 mmHg.
Low CVP indicates hypovolemia; increased CVP suggests hypervolemia.

Medication Reconciliation

Conducted within 24 hours of hospital admission.

Terms and States

Obtunded is synonymous with lethargic.
General malaise refers to feelings of exhaustion due to electrolyte imbalance.

Dyspnea Classification

Grade I: Unusual exertion.
Grade II: Difficulty with uphill or stair activities.
Grade III: Trouble walking at a normal pace.
Grade IV: Difficulty walking short distances.
Grade V: Dyspnea occurs at rest.

Swallowing and Communication

Dysphagia indicates difficulty swallowing.
KISS (Keep It Simple, Stupid) refers to using simple language for communication.

Fluid Accumulation Conditions

Peripheral edema is caused by conditions like CHF and renal failure.
Diuretics are recommended for managing peripheral edema.
Ascites results from fluid accumulation in the abdomen, commonly due to liver failure.

Physical Signs of Conditions

Clubbing of fingers indicates chronic hypoxemia, typically from COPD.
Jugular venous distention (JVD) occurs in congestive heart failure (CHF).
Diaphoresis describes excessive sweating.
Ashen skin or pallor indicates anemia or blood loss.
Jaundice indicates elevated bilirubin levels.
Erythema refers to redness of the skin, usually from infection.

Chest and Spine Deformities

Pectus Carinatum refers to protrusion of the sternum.
Pectus Excavatum refers to depression of the sternum.
Kyphosis is a convex curvature of the spine; Scoliosis is lateral curvature.
Kyphoscoliosis leads to reduced lung volumes.
Barrel chest results from air trapping.

Breathing and Pulmonary Terms

Eupnea means normal breathing; hypertrophy refers to increased muscle size from COPD; atrophy is muscle wasting due to paralysis.
Nasal flaring in infants indicates respiratory distress.

Mallampati Classification

Class I shows soft palate, uvula, fauces, and pillars.
Classes II to IV progressively reduce visibility; classes III and IV may require fiber optic bronchoscopy.

Heart Rate and Cardiac Recommendations

Normal heart rate ranges from 60-100 bpm.
Oxygen is recommended for tachycardia; Atropine is suggested for bradycardia.

Respiratory and Cardiac Sounds

Normal heart sounds are S1 and S2.
Abnormal sounds include S3 (suggesting heart failure) and S4 (indicating hypertension or stenosis).
Echocardiogram is recommended for abnormal heart sounds.

Blood Pressure and Its Implications

Normal blood pressure is 120/80 mmHg.
Hypertension indicates cardiac stress, while hypotension suggests hypovolemia.

Tracheal Deviation Causes

Deviations toward pathology: pneumonectomy, atelectasis, diaphragmatic paralysis.
Deviations away from pathology: pleural effusion, tension pneumothorax, neck tumors, large mediastinal masses.

Breath Sounds and Their Meanings

Resonant sound in normal lungs; flat in cases of atelectasis; hyperresonant in pneumothorax/emphysema; dull over fluid-filled organs.
Egophony occurs when a patient saying "E" sounds like "A".
Crackles indicate fluid presence in lungs; stridor suggests upper airway obstruction; wheezes result from bronchospasm.

Imaging and Diagnostic Techniques

Croup shows a steeple sign on X-ray; enlarged epiglottis shows a thumb sign.
Pulmonary edema presents as a butterfly pattern; atelectasis shows patchy infiltrates.
Honeycomb patterns indicate ARDS; wedge-shaped infiltrates suggest pulmonary embolism.
A normal ventilation scan with abnormal perfusion indicates a pulmonary embolism.

Invasive Procedures and Monitoring

Normal Intracranial Pressure (ICP) is 5-10 mmHg; treatment initiated above 20 mmHg.
Normal Cerebral Perfusion Pressure (CPP) is 70-90 mmHg.
Exhaled nitric oxide (FEno) monitors corticosteroid treatment; exhaled carbon monoxide (FEco) assesses smoking status.

Blood Component Values

Normal red blood cell (RBC) count is 4-6 mill/m3.
Normal hemoglobin (Hb) levels range from 12-16 g/100 mL.
Normal hematocrit (Hct) values are 40-50%.

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Description

This quiz covers essential concepts in respiratory care, including vital life functions, types of information, and tobacco use assessments. It provides a clear understanding of signs, symptoms, and advance directives relevant to respiratory health. Prepare to test your knowledge and enhance your expertise in respiratory therapy!