CP EXAM

Question 1

For a CF pt what do you want to rule out?

Answer 1

RA, osteoporosis, lover DM related CF

Question 2

Exam HR- tell me everything

Answer 2

Apical with steth
Always done with someone with a fib
NORM- 60-90 bpm
Sinus tach >100 normal in athletes, beta blockers

Most accurate is auscultation at cardiac apex (apical pulse)

Question 3

HR & pulse rate should be

Answer 3

equal

Unless you have a fib or dysrhythmias

Question 4

Measurement of apical HR?

Answer 4

Pulse deficit is Diff between HR and pulse rate

Indicates some heart beats have not caused sufficient blood flow to reach periphery
Common in a fib and other dysrhythmias

Question 5

What’s the HR range for newborn?

Answer 5

120-170

Question 6

1 yr HR

Answer 6

80-160

Question 7

3 yr HR

Answer 7

80-120

Question 8

Pulse

Answer 8

Dorsalis pedis- check both feet

Radial

Question 9

Rating scale of pulse

Answer 9

4+ bounding (just finished ex)
3+ increased
2+ brisk, normal
1+ diminished weaker, SV not as efficient, more threads
0 absent

Question 10

cuffs that are too short or narrow …

Answer 10

Gives falsely high readings

Question 11

BP should be taken in each arm during IE

Answer 11

TRUE

Question 12

How manymmHg will show arterial compression/obstruction? Which side?

Answer 12

10-15, on side with lower BP

Question 13

What indicates orthostatic hypotension?

Answer 13

Fall of SBP or DBP of 10+mmHg accompanied with increasing HR by 10-20bpm (5 min)

Question 14

What level should the arm be?

Answer 14

Just above waist level if seated

Standing- arm is supported mid chest

Question 15

What is a medical emergency BP?

Answer 15

At resting 200/110

No BP or extremely low with lack of mentation or unconsciousness

Question 16

When is activity contraindicated for BP?

Answer 16

SBP >200 or <80
DBP >100

TERMINATE is > 250/110

Question 17

What’s the range forpulse pressure

Answer 17

30-50

Question 18

Does PP increase or decrease with age

Answer 18

Increase

Question 19

What is abn PP and can be predictive of what

Answer 19

> 60 in adults, CHF

Low is a marker of low Q with heart failure

Question 20

Increased PP indicates what

Answer 20

Vascular wall stiffness and predicts CV events (HF in HTN disease)

Aortic valve disorders, severe anemia and overactive thyroid

Question 21

What are better predictors of mortality than PP

Answer 21

SBP and DBP

Question 22

What lung sound would you hear for a pt with CHF

Answer 22

Adventitious crackles- fluid in alveoli

Heard during insp

Question 23

What’s a wheeze

Answer 23

Airway obstruction/constriction

Heard during exhalation

Question 24

What is the normal vent rate

Answer 24

12-16 bpm

Question 25

Tachypnea is

Answer 25

Rate higher than 20 bpm

Question 26

Bradypnea is

Answer 26

Rate lower than 10 bpm

Question 27

Dyspnea is

Answer 27

Pts subjective report of discomfort SOB is actual sx.

Question 28

Orthopnea is

Answer 28

Difficulty breathing while pt is SUPINE with easing of breathing with a more vertical position

Question 29

What does ACSM recommend?

Answer 29

Not performing endurance test if vent is more than 45 bpm

Question 30

What does a fine tremor often associated with

Answer 30

High dose bronchodilators

Question 31

Warm and sweaty hands with irregular flapping tremor

Answer 31

Acute CO2 retention

Question 32

Hands- weakness and wasting is sx of

Answer 32

Upper love tumor -brachial plexus (pancoasts tumor)

Question 33

Palmar erythema

Answer 33

Liver disease

Question 34

Clubbing

Answer 34

Chronic tissue hypoxia Cause by lung disease (infective, fibrotic, malignant) Cardiac (congenital bacterial Other (familial, cirrhosis, GI) Idiopathic

Question 35

SPUTUM COLORS

Answer 35

``` Red-blood (tumor) Rust- pneumonia Purple-neoplasm Yellow/green-infection Pink-pulmonary edema ```

Question 36

What are the two types of cough

Answer 36

Effective | Productive

Question 37

What should you look for in a cough

Answer 37

Smell consistency amount Freq Only clears 6/7th generation up* Splint++

Question 38

T/F you can open dressing to inspect wound

Answer 38

F

Question 39

Graphs can be taken from

Answer 39

Radial (female) Saphenous (men) L int mammary artery (Female)

Question 40

Cheyne-Stokes

Answer 40

Cyclic waxing and waning of depth of breathing with periods of apnea- seen in severe CNS lesions -goes into shallow breathing and then stops breathing

Question 41

Kussmaul

Answer 41

``` Continuous hyperventilation, increased rate and depth of breathing to eliminate CO2 Diabetic ketoacidosis (med emergency) ```

Question 42

When looking for breathing efficiency, what are you looking for

Answer 42

Diaphragm movement - 2-3in with deep inspiration

Question 43

When palpating the trachea, when do deviations occur toward side of lesion?

Answer 43

Loss of lung volume on one side Atelectasis, fibrosis, surgical excision of lung tissue

Question 44

Palp- when do deviations occur away from side of abn?

Answer 44

Increase in lung vol | -pneumothorax, pleural effusion, herniation of ab viscera

Question 45

Pectus excavatum

Answer 45

Funnel chest- (SHANE)

Question 46

What is BADCAT?

Answer 46

``` Breathing audible Active accessory muscles Dyspnea Cyanosis or clubbing A-P diameter >= 1.0 Tracheal deviation ``` These are alarming resp signs