Exam 4

Question 1

Congestive Heart Failure

Answer 1

Condition in which the heart is unable to pump sufficient blood to meet metabolic needs of the body. Common symptoms include fatigue, shortness of breath, and edema in ankles or feet, in sacral area, or throughout body. Ascites may cause Pt to feel bloated and may compromise respiratory effort.
Onset of symptoms may be rapid or gradual, depending on underlying etiology.

Question 2

Left-sided Heart Failure (Pulmonary)

Answer 2

Orthopnea, pulmonary edema, crackles or wheezes, dysrhythmias, tachycardia, tachypnea, dyspnea, anxiety, cyanosis, HTN (early CHF), low BP (late CHF), and decreased CO.

Question 3

Right-sided Heart Failure (Systemic Circulation)

Answer 3

Dependent edema, JVD, bounding pulses, oliguria, dysrhythmias, Heptomegaly, Splenomegaly, increased CVP, and altered liver function tests.

Question 4

Bruit

Answer 4

A low-pitched blowing or swooshing sound manifested from turbulent blood flow movement in a peripheral vessel

Question 5

Sinus Arrhythmia

Answer 5

A mild cycle of decelerations and accelerations of the heart rate that coincide with respirations; a normal assessment finding in children

Question 6

Pitch

Answer 6

Frequency-The number of vibrations per second of a note.

Question 7

Amplitude

Answer 7

Intensity-How loud/soft a sound is.

Question 8

Timbre

Answer 8

Quality-Asubjective difference due to a sounds overtones.

Question 9

Resonance

Answer 9

Hollow, low-pitched (Air-filled organs, Lungs)

Question 10

Hyperresonance

Answer 10

An increased resonance produced when an area is percussed. (Gaseous, distended abdomen)

Question 11

Tympany

Answer 11

Drum (Hollow organs, Bowels)

Question 12

What is the size of Lymph nodes?

Answer 12

<1 cm round & smooth (Filter Pathogens)

Question 13

Bronchovesicular

Answer 13

Moderate pitched, inspiration=expiration

Question 14

Pleural Friction Rub

Answer 14

Coarse, low-pitch during inspiration & expiration, patient complains of pain with breathing. Fluid in pleural cavity

Question 15

What happens to breathing with ^intracranial pressure?

Answer 15

The pattern changes without our awareness.

Question 16

Where is the respiratory center located?

Answer 16

The brain stem

Question 17

At what week, in utero, is surfactant present in adequate amounts needed for sustained inflation of the lungs?

Answer 17

32 Weeks

Question 18

Foramen Ovale

Answer 18

Hole in septum of newborn which closes after birth.

Question 19

Homan’s Sign

Answer 19

Calf pain that occurs when the foot is dorsiflexed (flexed up toward knee); may occur with deep vein thrombosis, phlebitis, achilles tendonitis, or muscle injury.

Question 20

Allen Test

Answer 20

Compress both the radial and ulnar arteries and ask the patient to open and close the fist several times until the palm blanches, release pressure on the ulnar artery only. Color should return to the palm within 5 sec if the ulnar artery is functioning and it will be safe to draw an ABG.

Question 21

Claudication

Answer 21

Cramping pain during exercise that limits movement of arms and legs.

Question 22

Pitting Edema

Answer 22

\+1 = 2mm, disappears rapidly; No swelling
\+2 = 4mm, 10-15 sec; No swelling
\+3 = 6mm, >1 min; Extreme swelling
\+4 = 8mm, 2-3 min; Gross swelling

Question 23

Infarction

Answer 23

Death of tissue due to lack of blood flow.

Question 24

How do you calculate a pulse?

Answer 24

Systolic-Diastolic=Pulse

Question 25

Scaphoid

Answer 25

Abnormally sunken abdominal wall, as in malnutrition.

Question 26

Blumberg’s Sign

Answer 26

(Rebound tenderness) Elicit or intensify pain in the abdomen during palpation when the pressure is suddenly released.

Question 27

Murphy’s Sign

Answer 27

Palpate right mid-clavicular line, if painful on deep inspiration = inflamed gallbladder.

Question 28

pneumonia

Answer 28

Cough, SOB, and fever although these symptoms are not universal. Bacterial pneumonias are marked by abrupt onset, high fevers, shaking chills, pleuritic chest pain, and prostration.

Question 29

Vesicular

Answer 29

Low, soft, & rustling (Like the wind)

Question 30

Bronchial

Answer 30

High, loud, harsh, & hollow tubular

Question 31

Bronchophony

Answer 31

“99”

Question 32

Pathological conditions that increase lung density will enhance the transmission of voice sounds.

Answer 32

Bronchophony & Egophony

Question 33

Pedi respiratory distress?

Answer 33

Flaring nostrils, sternal retractions, trouble eating.

Question 34

Venous Disease

Answer 34

Causes signs and symptoms of metabolic waste build-up.

Chronic: calf; aching, tiredness, feeling of fullness; Chronic pain increases at end of day; Aggravating: Prolonged standing; Symptoms: Edema, Varicosities, Weeping ulcers at ankles.

Acute: Calf; Intense, sharp, deep muscle tender to touch; Sudden onset, within 1hr; pos. Homan’s sign; Red, warm, swollen leg.

Question 35

Arterial Disease

Answer 35

Signs & symptoms of oxygen deficit.

Chronic: Deep muscle pain calf & foot dorsal; Intermittent claudication; Chronic pain, onset gradual after exertion, pain at rest indicates severe involvement.

Acute: Distal to occlusion, may involve entire leg; 6 P’s (Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Coldness