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What are the four vital life functions? List in the order of priority.
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What is the most common cause of Jugular Vein Distension in COPD patients?
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PT Assessment Final
| Question | Answer |
|---|---|
| What are the four vital life functions? List in the order of priority. | 1. Ventilation, 2. Oxygenation, 3. Circulation, 4. Perfusion |
| What is the most common cause of Jugular Vein Distension in COPD patients? | Right heart failure (cor pulmonale) |
| What is capillary refill used to assess? | Peripheral circulation |
| What causes barrel chest? | Chronic air trapping |
| What is the normal AP diameter ratio? | 1:2 |
| What is the AP ration for a barrel chest patient? | 1:1 |
| Increased depth of breathing | Hyperpnea |
| Normal breathing | Eupnea |
| RR>20 | Tachypnea |
| Fast deep respirations, with abrupt pauses | Biot's |
| Breathing gradually increases then decreases in rate and depth, followed by periods of apnea | Cheyne-Stokes |
| Cessation of breathing | Apnea |
| Increased rate and depth of breathing. Usually associated with diabetic ketoacidosis | Kussmaul's |
| Deep, gasping inspiration with brief, partial expiration | Apneustic |
| Decreased depth of breathing | Hypopnea |
| RR<12 | Bradypnea |
| An infant shows signs of nasal flaring, grunting, and has intercostal retractions. What does this indicate? | Respiratory distress |
| What are the primary muscles of ventilation? | Diaphragm, external intercostals |
| What are the accessory muscles of inspiration? | Scalenes, sternocleidomastoid, pectoralis major, trapezius |
| What are the accessory muscles of expiration? | Internal intercostals, rectus abdominals, transversus abdominals, obliques (internal and external) |
| What muscle(s) is/are used for passive expiration? | None |
| Thick sputum | Viscous |
| Hemoptysis | Bright red |
| Clear and translucent sputum | Normal |
| Pulmonary edema | Pink and frothy |
| Mucus with pus (clear with yellow) | Mucopurulent |
| Foul smelling sputum | Fetid |
| Pseudomonas aeruginosa | Green, foul smelling |
| Old blood in sputum | Dark/ brown |
| WBCs in sputum, bacterial infection | Yellow |
| Clear and thick sputum | Mucoid |
| Stagnant sputum or gram-negative bacteria | Green |
| Klebsiella pneumonia | Red, jelly-like |
| Sticky, adhesive sputum | Tenacious |
| Sputum that contains pus | Purulent |
| Creaking leather sound caused by pleuritis | Pleural friction rub |
| Vesicular sounds of low intensity in the lung periphery | Diminished |
| Associated with atelectasis or secretions in the peripheral airways | Crackles (rales) |
| Normally heard over mainstem bronchi | Bronchovesicular |
| Hollow, tubular sound heard mainly over the trachea | Bronchial |
| High pitched, continuous sounds with musical quality heard on inspiration and/or expiration; caused by bronchoconstriction | Wheezing |
| Loud, high pitched crowing sound heard during inspiration caused by upper airway edema | Stridor |
| Rustling sound heard throughout lung periphery | Vesicular |
| Gurgling, bubbling sound caused by thick secretions in the large airways; usually clears with a cough | Rhonchi |
| List the normal breath sounds | Bronchial, vesicular, bronchovesicular |
| List the adventitious breath sounds | Diminished, crackles (rales), rhonchi, wheezing, bronchial heard over lung periphery, pleural friction rub, stridor |
| What are two causes of tachycardia? | Hypoxemia, stress/ anxiety |
| What are two causes of bradycardia? | Heart failure, shock |
| At what point during the breath are fine crackles normally heard? | End of inspiration |
| What are the common pulse sites and their locations? | Radial (wrist, thumb side), brachial (bend of arm), carotid (neck), femoral (groin), apical (chest) |
| What is the normal value for Potassium? | 3.5-5.0 mEq/L |
| What is the normal value for Bicarbonate? | 22-26 mEq/L |
| What is the normal value for Chloride? | 80-100 mEq/L |
| What is the normal value for Sodium? | 135-145 mEq/L |
| What is the normal value for RBCs? | 4-6 million/mm3 |
| What is the normal value for WBCs? | 5k-10k/mm3 |
| What is the normal value for Hemoglobin (Hgb)? | 12-16g/dL |
| What is the normal value for Hematocrit (Hct)? | 40-50% |
| What is the normal value for Platelets? | 150k-400k/mm3 |
| What is the normal value for SpO2? | 93-97% |
| What is the normal HR? | 60-100 BPM |
| What is the normal RR? | 12-20 BPM |
| What is the normal blood pressure? | 120/80 mmHg |
| What is the normal body temp? | 37* C (98.6* F) |
| What type of chest pain is centrally located and constant? | Non-pleuritic |
| What type of chest pain is typically increased on inspiration? | Pleuritic |
| What type of chest pain is associated with Pleuritis? | Pleuritic |
| What type of chest pain is associated with Pneumothorax? | Pleuritic |
| What type of chest pain is associated with Pericardial inflammation? | Non-pleuritic |
| What type of chest pain is associated with Myocardial infarction? | Non-pleuritic |
| What type of chest pain is associated with pleural effusion? | Pleuritic |
| What conditions increase the intensity and clarity of vocal fremitus, as with bronchophony and whispered pectoriloquy? | Pneumonia, consolidation |
| In normal lungs, the phrase "ninety nine" or "blue moon" would sound | Muffled |
| In normal lungs, the phrase "1,2,3", when whispered would sound | Muffled |
| With egophany, what condition would change an "ee" sound to an "ay" sound similar to a bleating goat? | Consolidation, pneumonia |
| What conditions would decrease vocal fremitus? | Obstructed bronchi, pneumothorax, emphysema |
| What conditions decrease tactile fremitus? | Large pleural effusion, large pneumothorax, hyperinflation (air trapping), atelectasis |
| What conditions increase tactile fremitus? | Pneumonia |
| Difficult breathing while lying down | Orthopnea |
| General term used for difficult breathing | Dyspnea |
| Profuse sweating | Diaphoresis |
| Excess fluid in the tissues | Peripheral edema |
| Above normal body temp | Hyperthermia |
| Below normal body temp | Hypothermia |
| General run down feeling | Malaise |
| Enlargement of terminal phalanges of fingers and toes due to chronic hypoxemia | Digital clubbing |
| Unequal expansion of the chest | Asymmetrical |
| Both side of the chest moving evenly | Symmetrical |
| What percussion note would you hear over trapped gas in the lungs or in the pleural space? | Resonance |
| What percussion note would you hear over atelectasis or consolidation? | Dullness |
| What percussion note would you heard over fluid in the pleural space? | Dullness |
| What type of cyanosis is seen in the nailbeds of the fingers and toes? | Peripheral |
| What type of cyanosis is seen in the oral mucosa and is urgent? | Central |
| Name three things that may cause an irregular pulse | Inadequate blood flow, inadequate O2 supply to the heart, electrolyte imbalance |
| Breathing air in and out of the lungs | Ventilation |
| How would you measure ventilation? | RR, tidal volume, chest movement, breath sounds |
| Getting oxygen into the blood | Oxygenation |
| How would you measure oxygenation? | HR, color, sensorium (consciousness) |
| Moving blood through the body | Circulation |
| How would you measure circulation? | HR, pulse strength |
| Getting blood into the tissues (into the capillary beds) | Perfusion |
| How would you measure perfusion? | BP, sensorium, temp |
| Your patient smoked 2 packs/day for 30 years. What is their pack year history? | 60 |
| What causes an increase in WBCs? | Bacterial infection |
| What type of WBC is elevated with asthma and allergic reactions? | Eosinophils |
| Describe the pulse strength for normal HR and blood volume | Strong, throbbing |
| Describe the pulse strength for weak contraction and low blood volume | Weak, thready |
| Describe the pulse strength for an increased HR and large volume | Full, bounding |
| The rhythm of the pulse can be described as ______________ or ______________. | Regular or Irregular |
| A pulse rate greater than 100 BPM | Tachycardia |
| A pulse rate less than 60 BPM | Bradycardia |
| Where can Bronchial (tracheal) breath sounds be heard? | Ausculated of the trachea |
| Where can vesicular breath sounds be heard? | Over most of the lung surface |
| Where can bronchovesicular breath sounds be heard? | Anterior: Heard over mainstem bronchi between first and second ribs / Posterior: Heard between the scapulae near the spinal column between the first and sixth ribs; especially on the right side |
| What causes adventitious bronchial breath sounds? | Consolidation or atelectasis |
| What causes diminished breath sounds? | Patients who move a lower air volume, obese patients, or muscular patients |
| What causes crackles (rales) breath sounds? | Atelectasis, fibrosis, pulmonary edema, pneumonia |
| What causes rhonchi breath sounds? | Severe pneumonia or bronchitis |
| What causes wheezing breath sounds? | Bronchoconstriction (bronchospasm), asthma |
| What causes pleural friction rub breath sounds? | Pleurisy (pleuritis), pneumonia |
| What causes stridor breath sounds? | Upper airway narrowing or obstruction |
| What color would air appear on an x-ray? | Black |
| What color would bone appear on an x-ray? | White |
| Regarding x-ray, what does translucent mean? | Darker areas of the x-ray |
| Regarding x-ray, what does opaque mean? | White |
| What would you ask to determine a patient's sensorium or LOC? | Date, location, name, situation |
| What is pectus excavatum? | AKA funnel chest; sternum caves in |
| What is pectus carinatum? | AKA pigeon chest; protrusion of the sternum |
| What is pedal edema? | Swelling of the lower extremities |
| What is subcutaneous emphysema? | Crepitus; coarse, crackling sensation that may be palpable over the skin surface |
| What is the max time for capillary refill to be considered normal? | 2 seconds |
Created by:
ashconrad417
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