Ch. 24: Assessment of Respiratory System

Question 1

Clinical hx of respiratory system is divided into 6 components:

Answer 1

Chief complaint
hx of present illness
Past health hx
Family hx
Personal and social hx
Review of systems

Question 2

Dyspnea

Answer 2

Paroxysmal nocturnal and orthopnea often signify HF.

Question 3

Sputum Production

Answer 3

Yellow, green, brown sputum signify bacterial infection.
Rust sputum may signify TB
Blood streaked may signify viral
Persistent blood streaked may signify carcinoma
Large amounts of clotted blood signifies pulmonary infarction

Question 4

What to look for during initial inspection:

Answer 4

Cyanosis
Labored breathing with intercostal retractions
A-P diameter
Chest deformities and scars
Posture
Position of trachea
RR
Respiratory effort
Expansion
Clubbing

Question 5

Physical findings found in Chronic Bronchitis

Answer 5

scattered coarse crackles in early inspiration and perhaps expiration; or wheezes or ronchi

Question 6

Physical finding found in early Left Sided HF

Answer 6

Late inspiratory crackles in the dependent portions of the lungs; possible wheezes

Question 7

Physical finding found in Consolidation

Answer 7

Dull percussion; bronchial breath sounds; late inspiratory crackles

Question 8

Physical finding found in Atelectasis

Answer 8

Dull percussion; breath sounds absent when bronchial plug persists. Exceptions include RUL atelectasis, where adjacent tracheal sounds may be trasmitted.

Question 9

Physical finding found in Pleural Effusion

Answer 9

Dull percussion; trachea shifted towards opposite side in a large effusion; decreased to absent breath sounds; possible pleural rub

Question 10

Physical finding found in Pneumothorax

Answer 10

Hyperresonant percussion; trachea shifted toward opposite side in large pneumo; decreased to absent breath sounds over affected area

Question 11

Physical finding found in COPD

Answer 11

Diffusely hyperresonant; crackles, wheezes, and rhonchi of associated chronic bronchitis

Question 12

Physical finding found in Asthma

Answer 12

Resonant to hyperresonant; wheezes and/or crackles breath sounds.

Question 13

Normal ABGs

Answer 13

PaO2: 80 - 100 mmHg
SaO2: 93 - 99%
pH: 7.35 - 7.45
PaCO2: 33 - 45 mmHg
HCO3: 22 - 26 mEq/L

Question 14

Mixed Acidosis

Answer 14

Where pH is acidic and PaCO2 is high and HCO3 is low

Question 15

Mixed Alkalosis

Answer 15

Where pH is alkaline and PaCO2 is low and HCO3 is high

Question 16

Partially compensated (X)

Answer 16

The pH is abnormal and PaCO2 and HCO3 are abnormal, but they are trending towards normal

Question 17

Fully compensated (X)

Answer 17

The pH is normal and PaCO2 and HCO3 are abnormal.