16: Approach To Lower Respiratory Complaint

Question 1

Where does the neurovascular bundle run in relation to the ribs

Answer 1

Along inferior margin of each rib

Question 2

Where to place chest tube and needles into thorax

Answer 2

Along superior margin of the rib to avoid neurovascular bundle

Question 3

Getting a history: important things to ask about events leading up to the CC

Answer 3

1. Recent triggers
2. Noncompliance with meds or diet
3. Exposure to cold or allergens
4. Acute dyspnea immediately following a meal

Question 4

Pleural effusion causes

Answer 4

CHF, PNA, malignancies, PE

Question 5

Transudates vs exudates that can cause pleural effusion

Answer 5

Transudate: fluid leaking from blood vessels
Exudate: fluid leaking from inflammation of pleura and lung

Question 6

Empyema

Answer 6

Abscess in lung parenchyma that can collect in pleural space and cause pleural effusion

Question 7

Treatment of empyema

Answer 7

Drainage via chest tube

Question 8

Causes of a bad waveform in pulse oximetry

Answer 8

Improper oximeter placement, hypoperfusion, hypothermia, motion artifact

Question 9

What does pulse oximetry do?

Answer 9

Measures peripheral arterial oxygen saturation (pO2)

Question 10

End tidal CO2 + what it’s expressed as

Answer 10

Concentration of CO2 in exhaled air at the end of respiration to help measure ventilation; expressed as PETCO2

Question 11

Normal PETCO2

Answer 11

35-40 mmHg

Question 12

Atelectasis

Answer 12

Loss of lung volume due to collapse of lung tissue/alveoli

Question 13

Conditions associated with Cheyne-Stokes breathing vs Kussmaul

Answer 13

Cheyne-Stokes: heart failure

Kussmaul: DKA