Kettering Respiratory Flashcards
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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.

    <p>pack</p> Signup and view all the answers

    What are the four types of advance directives?

    <p>DNI</p> Signup and view all the answers

    What four things should a respiratory order include?

    <p>Dose + route</p> Signup and view all the answers

    What is the normal urine output?

    <p>40 mL/hour</p> Signup and view all the answers

    What is the normal CVP range?

    <p>2-6 mmHg</p> Signup and view all the answers

    What does low CVP indicate?

    <p>Hypovolemia</p> Signup and view all the answers

    What does increased CVP indicate?

    <p>Hypervolemia</p> Signup and view all the answers

    When is medication reconciliation carried out?

    <p>24 hrs within admission to hospital</p> Signup and view all the answers

    Obtunded is the same as what state?

    <p>Lethargic</p> Signup and view all the answers

    What does the Katz Scoring System evaluate?

    <p>Activities of daily living (ADL)</p> Signup and view all the answers

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

    <p>Orthopnea</p> Signup and view all the answers

    What does run down feeling due to electrolyte imbalance indicate?

    <p>General malaise</p> Signup and view all the answers

    What does Grade I dyspnea indicate?

    <p>Unusual exertion</p> Signup and view all the answers

    What does Grade II dyspnea indicate?

    <p>Up hills or stairs</p> Signup and view all the answers

    What does Grade III dyspnea indicate?

    <p>Walking at normal speed</p> Signup and view all the answers

    What does Grade IV dyspnea indicate?

    <p>Walking short distance</p> Signup and view all the answers

    What does Grade V dyspnea indicate?

    <p>At rest</p> Signup and view all the answers

    Difficulty swallowing is called?

    <p>Dysphagia</p> Signup and view all the answers

    What method is used to communicate using simple language?

    <p>KISS</p> Signup and view all the answers

    What causes excessive fluid in tissue?

    <p>Peripheral edema</p> Signup and view all the answers

    What would you recommend for peripheral edema?

    <p>Diuretics</p> Signup and view all the answers

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

    <p>Ascites</p> Signup and view all the answers

    What causes clubbing of fingers?

    <p>Chronic hypoxemia (COPD)</p> Signup and view all the answers

    What condition is associated with venous distention (JVD)?

    <p>CHF</p> Signup and view all the answers

    What is heavy sweating called?

    <p>Diaphoresis</p> Signup and view all the answers

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

    <p>Anemia or acute blood loss</p> Signup and view all the answers

    What causes jaundice?

    <p>Increased bilirubin level</p> Signup and view all the answers

    What is redness of skin called?

    <p>Erythema</p> Signup and view all the answers

    What is protrusion of the sternum called?

    <p>Pectus Carinatum</p> Signup and view all the answers

    What is depression of the sternum called?

    <p>Pectus Excavatum</p> Signup and view all the answers

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

    <p>Kyphosis</p> Signup and view all the answers

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

    <p>Scoliosis</p> Signup and view all the answers

    What lung volumes does kyphoscoliosis cause?

    <p>Reduced lung volumes</p> Signup and view all the answers

    What is barrel chest a result of?

    <p>Air trapping</p> Signup and view all the answers

    What does eupnea mean?

    <p>Normal breathing</p> Signup and view all the answers

    What occurs due to COPD related to muscle size?

    <p>Hypertrophy</p> Signup and view all the answers

    What is muscle wasting due to paralysis called?

    <p>Atrophy</p> Signup and view all the answers

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

    <p>Respiratory distress</p> Signup and view all the answers

    What does Mallampati Class I show?

    <p>Uvula</p> Signup and view all the answers

    What does Mallampati Class II show?

    <p>Soft palate</p> Signup and view all the answers

    What does Mallampati Class III show?

    <p>Soft palate</p> Signup and view all the answers

    What does Mallampati Class IV show?

    <p>Hard palate only</p> Signup and view all the answers

    What 2 Mallampati classes may need a fiber optic bronchoscope?

    <p>Class 4</p> Signup and view all the answers

    What is the normal heart rate?

    <p>60-100 bpm</p> Signup and view all the answers

    What would you recommend for tachycardia?

    <p>Oxygen</p> Signup and view all the answers

    What would you recommend for bradycardia?

    <p>Atropine</p> Signup and view all the answers

    Paradoxical pulse may indicate what?

    <p>Air trapping</p> Signup and view all the answers

    What are the causes of tracheal deviation pulled toward pathology?

    <p>Atelectasis</p> Signup and view all the answers

    What causes tracheal deviation pushed away from pathology?

    <p>Neck tumor</p> Signup and view all the answers

    What are bubbles under the skin called?

    <p>Crepitus</p> Signup and view all the answers

    What sound is emitted with normal air-filled lungs?

    <p>Resonant</p> Signup and view all the answers

    What sound is emitted over areas of atelectasis?

    <p>Flat</p> Signup and view all the answers

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

    <p>Hyperresonant (Boom sound)</p> Signup and view all the answers

    What sound is emitted over fluid-filled organs?

    <p>Dull</p> Signup and view all the answers

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

    <p>Egophony</p> Signup and view all the answers

    What causes crackles?

    <p>Fluid in lungs</p> Signup and view all the answers

    What causes stridor?

    <p>Upper airway obstruction</p> Signup and view all the answers

    What causes wheezes?

    <p>Bronchospasm</p> Signup and view all the answers

    What are the normal heart sounds?

    <p>S2</p> Signup and view all the answers

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

    <p>S1</p> Signup and view all the answers

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

    <p>S2</p> Signup and view all the answers

    What are the abnormal heart sounds?

    <p>S4</p> Signup and view all the answers

    What sound may suggest heart failure?

    <p>S3</p> Signup and view all the answers

    What sound may suggest hypertension or stenosis?

    <p>S4</p> Signup and view all the answers

    What do you recommend for abnormal heart sounds?

    <p>Echocardiogram</p> Signup and view all the answers

    What is the normal blood pressure?

    <p>120/80</p> Signup and view all the answers

    What does hypertension indicate?

    <p>Cardiac stress (Hypoxemia)</p> Signup and view all the answers

    What does hypotension indicate?

    <p>Hypovolemia (CHF)</p> Signup and view all the answers

    What does narrowing of bronchi indicate?

    <p>Bronchogenic carcinoma</p> Signup and view all the answers

    The mediastinum may shift with which diseases?

    <p>Pneumothorax</p> Signup and view all the answers

    The costophrenic angles are blunted with what disease?

    <p>Pleural effusion</p> Signup and view all the answers

    What does an increase in the cardiac shadow indicate?

    <p>CHF</p> Signup and view all the answers

    What indicates crowding of ribs?

    <p>Atelectasis</p> Signup and view all the answers

    What are straight ribs associated with?

    <p>Air trapping</p> Signup and view all the answers

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

    <p>2-6 cm</p> Signup and view all the answers

    Pacemakers are positioned in which ventricle?

    <p>Right ventricle</p> Signup and view all the answers

    Where is the pulmonary artery catheter positioned?

    <p>Right lower lung</p> Signup and view all the answers

    Where is the central venous catheter positioned?

    <p>Superior vena cava or right atrium</p> Signup and view all the answers

    Where should chest tubes be positioned?

    <p>Pleural space around lung</p> Signup and view all the answers

    What does croup show on an X-ray?

    <p>Steeple sign</p> Signup and view all the answers

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

    <p>Thumb sign</p> Signup and view all the answers

    What shows as a butterfly or batwing pattern?

    <p>Pulmonary edema</p> Signup and view all the answers

    What shows as patchy infiltrates or plate-like infiltrates?

    <p>Atelectasis</p> Signup and view all the answers

    What shows as a honeycomb pattern?

    <p>ARDS</p> Signup and view all the answers

    What shows as a wedge-shaped infiltrate?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What does a normal ventilation scan with abnormal perfusion indicate?

    <p>Pulmonary embolism</p> Signup and view all the answers

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

    <p>Barium swallow</p> Signup and view all the answers

    A pulmonary angiography is used to diagnose what?

    <p>Pulmonary embolism</p> Signup and view all the answers

    What is the normal ICP?

    <p>5-10 mmHg</p> Signup and view all the answers

    When should treatment of ICP be initiated?

    <p>Above 20 mmHg</p> Signup and view all the answers

    What is the normal cerebral perfusion pressure (CPP)?

    <p>70-90 mmHg</p> Signup and view all the answers

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

    <p>Exhaled nitric oxide (FEno)</p> Signup and view all the answers

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

    <p>Exhaled carbon monoxide (FEco)</p> Signup and view all the answers

    What type of patients may have elevated FEco levels?

    <p>OSA (Obstructive Sleep Apnea)</p> Signup and view all the answers

    What are the normal RBC values?

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

    What are the normal Hb values?

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

    What are the normal Hct values?

    <p>40-50%</p> 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!

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