Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Unit 7 > acute care examination > Flashcards

acute care examination Flashcards

symptoms you might see in

1
Q

What are normal breath sounds?

A

vesicular, bronchial, bronchovesicular

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe vesicular breath sound.

A

normally heard in periphery.
soft, low pitch, gentle rustling
longer inhale than exhale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Describe bronchial breath sound.

A

normally heard over sternum.
low, high pitch, hollow tube
longer exhale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

bronchovesicular

A

normally heard at 1st and 2nd intercostal space, between scapulae, medium pitch
even inhale and exhale

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

List the adventitious breathe sounds.

A

crackles
wheezes
rhonci

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe the sound of crackles

A

Short, explosive, non-musical
Fine: high frequency, short duration=snapping open of previously closed airways
Coarse=lower pitch, longer duration=retain secretions, fluid accumulation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Describe the sound of wheezes

A

continuous, musical sounds w single or multiple notes

airway constriction due to occlusion, bronchoconstriction or collapse of airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Describe the sound of rhonci.

A

low pitched, gurgling, snoring, or moaning

retained secretions in larger airways

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the three categories of breath sound evaluation?

A

quality
volume
presence of adventitious sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is an egophony?

A

a sign of consolidation/increased density

patient says “e” sounds like “a”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is a branchophony?

A

a sign of consoidation/increased density

patient says “99” and “99” is heard clearly through stethoscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does the heart sound “lub” indicate and where is it heard?

A

S1, beginning of systole
closure of the tricuspid and mitral valves
best heard of the mitral area(bottom left corner of heart, about rib 5)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does the heart sound “dub” indicate and where is it heard?

A

S2, beginning of diastole
pulmonic and aortic valve closure
best heard over aortic area (top right corner of heart, by rib 2

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What part of the stethoscope do you use for S1 and S2?

A

diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What part of the stethoscope do you use for abnormal heart sounds?

A

Bell

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the type of abnormal heart sound described as vibrations caused by turbulent blood flow, often through incompetent valves?

A

Murmur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

How are heart murmurs graded?

A

I-VI, I being not a big deal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is an extra heart sound called?

A

Gallops

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is a ventricular gallop?

A

S3 is right after S2

Can suggest onset of volume overload/heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is an atrial gallop?

A

S4 right before S1
generated by atria ejecting blood into a stiff ventricle
Suggests diastolic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What can pitting edema indicate?

A

fluid overload due to organ failure, lymphedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are symptoms suggesting CVP impairment?

A 
chest pain (or neck, jaw, left arm)
dyspnea
dizziness or syncope
decreased activity tolerance
orthopnea or paroxysmal nocturnal dyspnea
palpitations, tachycardia
cough
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is dyspnea?

A

shortness of breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are causes of acute dyspnea? (minutes)

A

Pulmonary embolism, pneumothorax, asthma, pulmonary edema (CHF), upper airway obstruction, myocardial infarction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are causes of sub acute dyspnea? (hours-days)

A

Pulmonary edema, pneumonia, asthma, pleural effusions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are causes of chronic dyspnea? (weeks to years)

A

emphysema, restrictive lung dz, chronic heart failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the Borg Dyspnea Scale?

A

0-10 to evaluate dyspnea, 0=nothing at all

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the Visual Analog Scale used for?

A

Evaluate dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the Breathlessness Scale used for?

A

Evaluate dyspnea.

0-4, 0 being no dyspnea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are acute causes of coughing? (3 weeks or less)

A

Upper respiratory infections, acute bronchitis, pneumonia, asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What are chronic causes of coughing? (longer than 8 weeks)

A

asthma, chronic bronchitis, bronchiectasis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are sub-acute causes of coughing?

A

post-infectious, bacterial sinusitis, asthma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What colors can sputum be?

A

Color (from less sick to more sick)

clear, white, yellow, brown, green

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What consistency of sputum indicates illness?

A

thick

35
Q

What odor is present in sputum that would indicate a concern?

A

foul smell

36
Q

What factors do we evaluate in sputum?

A

color, consistency, odor, amount in a 24 hour period

37
Q

What is an indication of infection, inflammation, or cancer in sputum?

A

Hemoptysis, coughing up blood or blood colored mucus

38
Q

What are symptoms of angina?

A

squeezing, tightness, crushing
Sub-sternal, mid-chest, left arm and shoulder
worse with activity, relieved by nitroglycerin

39
Q

What are three complications of the pulmonary system after cardiothoracic surgery?

A

atelectasis
retained secretions
pneumonia

40
Q

What are two complications after cardiothoracic surgery on the cardiac system?

A

atrial fibrillation

heart block

41
Q

Is blood glucose typically elevated or decreased after cardiothoracic surgery?

A

elevated

42
Q

What are reasons for a CABG?

A

coronary artery disease leads to angina leads to ischemia =need for CABG

43
Q

Why would someone have a valve repair/replacement?

A

stenotic or incompetent valves

44
Q

What are two types of surgery used for end stage heart failure?

A

Transplant or ventricular assistive device

45
Q

What is claudication?

A

burning feeling in leg that limits LE movement

46
Q

Why would someone need a LE bypass?

A

stenotic or clogged LE arteries that have caused claudication

47
Q

What does CABG stand for?

A

coronary artery bypass graft

48
Q

What is the term for where new artery is attached during a CABG?

A

anastamosis

49
Q

On-pump during CABG, what happens?

A

heart is stopped chemically during procedure, pump takes blood in and puts back as surgery progresses

50
Q

What is a side-effect of an on-pump CABG?

A

longer surgery time=short/long-term neurocognitive deficits

51
Q

Off-pump during CABG, what happens?

A

heart still beating during procedure

52
Q

What is a benefit of an off-pump CABG?

A

less early neurocognitive deficits

53
Q

What are the two benefits of using arteries for a CABG?

A

longer lasting

durable under high pressure

54
Q

What is the benefit of using veins for a CABG?

A

risk of plaque build-up is less

55
Q

What is the major contraindication to using biological tissue in a valve replacement?

A

patient’s use of blood thinners, concerns over previous stroke or brain bleed

56
Q

What kind of medication will a patient have to take with a mechanical valve replacement?

A

anti-coagulants

57
Q

What are two major questions a PT needs to ask in relationship to mobilization/fall risk post CABG?

A

Low blood pressure

neurocognitive deficits caused by on-pump CABG

58
Q

What is a ballooning/weakening of the vessel wall in the aorta called?

A

Aortic aneurysm

59
Q

What is a tear in the intimal layer of the aorta called?

A

aortic dissection

60
Q

What is mechanism by which an aortic aneurysm is dangerous?

A

rupture of the vessel

61
Q

What is the mechanism by which an aortic dissection is dangerous?

A

Each time there is a pulse

62
Q

Acute, intimal tear in the aorta that originates in the ascending aorta and can extend into the descending aorta?

A

Type A

63
Q

Acute or chronic intimal tear in the aorta that originates in the descending aorta and can extend into the iliac arteries? What can this cause due to perfusion?

A

Type B

paralysis due to the path of the descending arteries

64
Q

What is the difference between control of blood pressure non- and post- operatively when thinking about CABG or aneurysm related issues?

A

Blood pressure should be kept low initially when aortic root is replaced due to coronary artery anastamosis but there is a risk of ischemia and LE infarct=paraplegia during surgery.

65
Q

What is a major concern as a sternotomy heals?

A

malunion of sternum

66
Q

What four surgeries warrant sternal precautions?

A

CABG
valve
thoracic aorta
transplant

67
Q

What are 7 examples of sternal precautions?

A

protect incision
prevent sternal bone malunion
1-3 months of limitations
no weight lifting over 5-20 lbs
avoid pushing and pulling during bed mobility
no driving due to twisting and/or use of narcotics

68
Q

What are two procedures that would warrant a thoractomy?

A

approach to lung or aorta

69
Q

What is the name of a classic procedure used for a double lung transplant?

A

clamshell thoractomy

70
Q

What is the goal of a LE bypass?

A

Correct pain from lack of perfusion from peripheral artery disease

71
Q

LVRS? Why?

A

lung volume reduction surgery
small section of lung removed
cancer or emphysema in isolated area

72
Q

What is the term for the removal of an entire lobe of lung?

A

lobectomy

73
Q

If the entire lung is removed, what is that called?

A

pneumonectomy

74
Q

What are some procedures potentially associated with a thoracotomy?

A

lobectomy
lung transplant
aortic aneurysm repairs

75
Q

What are post-operative precautions associated with a thoractomy?

A

2-4 weeks or as directed by physician
no “heavy lifting”
ROM encouraged
avoid boney involvement (the ribs were spread!)

76
Q

What is the equation to determine FEV1% post lobectomy?

A

ppoFEV%=preopFEV1%* (1-%Functional lung tissue removed/100)

77
Q

How many total lung subsegments are in the body?

A

42

78
Q

How many subsegments are in the right superior lobe?

A

6

79
Q

How many subsegments are in the right middle lobe?

A

4

80
Q

How many subsegments are in the right inferior lobe?

A

12

81
Q

How many subsegments are in the left superior lobe?

A

10

82
Q

How many subsegments are in the left inferior lobe?

A

10

83
Q

LVAD? Is this a permanent solution?

A

Left ventricular assistive device

Can be thought of a “bridge to a decision”

Unit 7 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions