Interviewing the patient

Question 1

It is the process of interviewing and examining a patient for signs and symptoms of disease and the effects of treatment

Answer 1

Bedside assessment

Question 2

Two key sources of patient data are the

Answer 2

medical history and the physical examination

Question 3

What are the 3 purposes of interview

Answer 3

1. To establish a rapport between the clinician and patient
2. To obtain essential diagnostic information
3. To help monitor changes in the patient’s symptoms and
   response to therapy

Question 4

The ideal interview is one in which the patient feels_______ about important personal matters.

Answer 4

Secure and free to talk

Question 5

Each interview should begin with the RT______

Answer 5

introducing himself or herself to the patient and stating the purpose of the visit.

Question 6

The introduction is done in the______ , approximately_______

from the patient.

Answer 6

social space, 4 to 12 feet

Question 7

How long does personal space to begin the interview?

Answer 7

2 to 4 feet from the patient

Question 8

encourage patients to describe events and priorities as they see them, helping to
bring out concerns and attitudes and to promote understanding.

Answer 8

Open-ended questions

Question 9

Type of question that focuses on specific information and provides clarification.

Answer 9

closed questions

Question 10

can be open-ended or closed and always end in a question mark. Although they are used to obtain specific information, a series of direct questions or frequent use of the question “Why?” can be intimidating and cause the patient to minimize his or her responses to questions.

Answer 10

Direct question

Question 11

are less threatening than direct questions because they sound like statements (e.g., “I gather your doctor told you to take the treatments
every 4 hours”)

Answer 11

Indirect question

Question 12

Type of questions that are preferred for all interactions with the patient.

Answer 12

Neutral question

Question 13

is a series of focused questions that pursue specific information related to a tentative diagnosis.

Answer 13

Interview

Question 14

a general term describing the sensation of breathing discomfort. It is the most important symptom that the RT is called on to assess and treat

Answer 14

Dyspnea

Question 15

Is dyspnea subjective or objective

Answer 15

subjective

Question 16

what is the primordial sensation of life

Answer 16

breathing

Question 17

specifically to describe difficulty in the mechanical act of breathing.

Answer 17

Dyspnea

Question 18

Dyspnea is characterized by The_______is proportionally greater than______

Answer 18

Effort to breath, tidal volume achieved

Question 19

When the neuronal signals governing these sensations become unbalanced, breathing is perceived to be abnormal and unpleasant. The technical name for this imbalance is

Answer 19

neuromechanical dissociation

Question 20

Is the specific sensation of an unpleasant urge to breathe.

Answer 20

Breathlessness

Question 21

It is believed to be the conscious perception of intense neural discharge to the
respiratory muscles.

Answer 21

Breathlessness

Question 22

Breathlessness can be triggered by what 3 conditions

Answer 22

acute hypercapnia and acidosis and by hypoxemia

Question 23

What type of dyspnea assumes the reclining position. It is common in patient with what diseases

Answer 23

Orthopnea, CHF

Question 24

Orthopnea is also a symptom of bdp or?

Answer 24

bilateral diaphragmatic paralysis.

Question 25

Dyspnea in the upright position is known as

Answer 25

platypnea

Question 26

Orthopnea is apparently is caused by the sudden

Answer 26

increased venous return

Question 27

Platypnea may be accompanied by ______, which is oxygen desaturation on assuming an upright position.

Answer 27

orthodeoxia

Question 28

Patients with asthma frequently complain of

Answer 28

chest tightness

Question 29

patients with interstitial lung disease tend to focus on the sensations of

Answer 29

increased work of breathing, shallow breathing, and gasping.

Question 30

Patients with CHF are seemingly unique in frequently feeling

Answer 30

suffocated.

Question 31

It may be very difficult for patients with ______ from any cause to speak more than a few words at a time.

Answer 31

severe dyspnea

Question 32

The intensity of dyspnea can be documented using a

Answer 32

numeric intensity or visual analog scale

Question 33

There are perplexing situations in which patients with normal cardiopulmonary function complain of intense dyspnea or suffocation. This condition is known as

Answer 33

psychogenic hyperventilation syndrome and is associated | with panic disorders

Question 34

This syndrome may be either______ and | often is self-perpetuating

Answer 34

sporadic or chronic

Question 35

T/F......The RT always must approach any situation involving hyperventilation or dyspnea as if it had a pathophysiologic basis.

Answer 35

T

Question 36

The first priority is to measure _____, _____, _______, ________

Answer 36

Vitals signs, O2 sat, 12-lead electrocardiogram, ABG

Question 37

is the most common, yet nonspecific symptom seen in patients with pulmonary disease.

Answer 37

Cough

Question 38

forceful expiratory maneuver that expels mucus and foreign material from the airways.

Answer 38

Coughing

Question 39

Location of cough receptors

Answer 39

larynx, trachea and larger bronchi

Question 40

Cough receptors are stimulated by

Answer 40

inflammation, mucus, foreign materials, or noxious gases

Question 41

The effectiveness of a cough depends on the ability of | the individual to

Answer 41

take a deep breath, lung elastic recoil, expiratory muscle strength, and level of airway resistance.

Question 42

The ability to take a deep breath or exhale forcefully is | often impaired in patients with

Answer 42

neuromuscular disease

Question 43

The most common cause of an acute, self-limited cough is | a

Answer 43

viral infection of the upper airway

Question 44

mucus from the tracheobronchial tree that has not been contaminated by oral secretions is called

Answer 44

phlegm

Question 45

Mucus that comes from the lung but passes through the mouth as it is expectorated is called

Answer 45

sputum

Question 46

Sputum that contains pus cells is said to be______ , suggesting a______

Answer 46

purulent, bacterial infection

Question 47

Purulent sputum appears

Answer 47

thick, colored and sticky

Question 48

Sputum that is foul-smelling is said to be

Answer 48

fetid

Question 49

Sputum that is clear and thick is______ and is commonly seen in patients with airways disease (i.e., asthma).

Answer 49

mucoid

Question 50

Nonproductive cough is caused by

Answer 50

1) Irritation of the airway (2) Acute inflammation of the respiratory mucosal membrane (3) Presence of a growth (4) Irritation of the pleura (5) Irritation of the tympanic membrane

Question 51

contains normal mucus

Answer 51

White and translucent

Question 52

Yellow sputum indicates

Answer 52

indicates infection and contains | WBCs; called purulent sputum

Question 53

Green sputum contains

Answer 53

contains old, retained secretions

Question 54

Green and foul smelling: indicates

Answer 54

Pseudomonas infection

Question 55

Sputum that contains old blood

Answer 55

Brown

Question 56

Sputum that contains fresh blood

Answer 56

Red

Question 57

When a cough is productive, it is important to record the_______ because changes in these qualities over 24 hours are important in the diagnosis of pulmonary disease

Answer 57

amount, consistency, odor, and color of sputum

Question 58

may help facilitate coughing and secretion | removal.

Answer 58

Aerosolized hypertonic saline

Question 59

Characteristics of cough that usually indicates croup

Answer 59

Barklike

Question 60

Cough that indicates upper airway problems.

Answer 60

Harsh, dry cough with inspiratory stridor

Question 61

Cough that usually indicates lower airway pathology

Answer 61

Wheezing-type coughs

Question 62

A cough that is indicative of chronic bronchitis.

Answer 62

Chronic productive coughs

Question 63

may be the result of smoking or sinus or viral infection

Answer 63

Frequent hacking cough and throat clearing

Question 64

Coughing up blood or blood-streaked sputum from the | lungs is referred to as .

Answer 64

hemoptysis

Question 65

is the presence primarily of blood in the expectorant

Answer 65

Frank hemoptysis

Question 66

Hemoptysis is characterized as massive when ________ is expectorated over 24 hours, and this represents a medical emergency

Answer 66

more than 300 ml of blood

Question 67

It is vomiting blood from the gastrointestinal tract

Answer 67

hematemesis

Question 68

Nonmassive hemoptysis is caused most often by

Answer 68

airway infection, lung cancer, tuberculosis

Question 69

Common causes of massive hemoptysis include

Answer 69

bronchiectasis, lung abscess, and acute or old tuberculosis

Question 70

pleuritic chest pain usually is located______. It worsens when the patient takes a_______, and it is described as a________ type of pain.

Answer 70

laterally or posteriorly, deep breath, sharp, stabbing

Question 71

Cause of pleuritic chest pain

Answer 71

pneumonia or pulmonary embolism

Question 72

Nonpleuritic chest pain is located typically in the ________ and may radiate to the_________ . It is not affected by breathing, and it is described as a _______type of pain

Answer 72

center of the anterior chest, shoulder or back, dull ache or pressure

Question 73

A common cause of nonpleuritic chest pain which classically is a pressure sensation with exertion or stress and results from coronary artery occlusion.

Answer 73

Angina

Question 74

Other common causes of nonpleuritic chest pain includes

Answer 74

gastroesophageal reflux, esophageal spasm, chest wall pain (e.g., costochondritis), and gallbladder disease

Question 75

an elevated body temperature secondary to disease) is a common complaint of patients with an infection of the airways or lungs.

Answer 75

Fever

Question 76

_______typically accompanies common upper respiratory tract infections, whereas a_______ occurs with viral influenza infection

Answer 76

Low-grade fever, high fever

Question 77

a persistent fever of_________ is suggestive of pneumonia.

Answer 77

at least 38.9° C (102° F) for 2 days accompanied by chills

Question 78

Patients with a significant fever have an___________ The increased need for O2 intake and CO2 removal may cause__________

Answer 78

increased metabolic rate and an increased oxygen (O2) consumption and carbon dioxide (CO2) production, tachypnea

Question 79

Swelling of the lower extremities is known as

Answer 79

pedal edema

Question 80

It most often occurs with heart failure, which causes an increase in the________ of the blood vessels in the lower extremities. This increase in hydrostatic pressure causes fluid to leak into the_______ and leads to pedal edema, the degree of which depends on the level of heart failure

Answer 80

hydrostatic pressure, interstitial spaces

Question 81

What are the two subtypes of pedal edema?

Answer 81

Pitting and weeping edema

Question 82

When pressure is applied with a finger on a swollen extremity, an indentation mark left on the skin is called_________, is when a small fluid leak occurs at the point where pressure is applied.

Answer 82

pitting edema, Weeping edema

Question 83

Patients with chronic hypoxemic lung disease are especially prone to ________because of the heavy demands placed on the right ventricle when hypoxemia causes severe _________. Eventually, the right side of the heart begins to fail and results in a backup of pressure into the venous blood vessels, especially in the dependent regions such as the lower extremities. This situation promotes________

Answer 83

right-sided heart failure (cor pulmonale), pulmonary vasoconstriction, high intravascular venous hydrostatic pressures and pedal edema

Question 84

This section of the medical history represents a detailed account of each of the patient’s major complaints. It is written by the physician after his or her interview with the patient at admission to the hospital

Answer 84

chief complaint and history of present illness

Question 85

which describes all past major illnesses, injuries, surgeries, hospitalizations, allergies, and health-related habits. This information provides a basic understanding of the patient’s previous experiences with illness and health care and may have an impact on decisions made during the current hospitalization.

Answer 85

past medical history

Question 86

The smoking history is often recorded in_______ , which is determined by multiplying the number of packs smoked per day by the number of years smoked.

Answer 86

pack-years

Question 87

It is designed to uncover problem areas the patient forgot to mention or omitted. This information is usually obtained in a head-to-toe review of all body systems.

Answer 87

Review of Systems

Question 88

the medical record should be examined for information indicating any limits on the extent of care to be provided in the event of cardiac or respiratory arrest. This information is known as an_________, whereby the patient (or a legally authorized representative) has formalized his or her wishes for resuscitative efforts

Answer 88

advance directive

Question 89

This information may be found either in the_______ or within the body of the

Answer 89

admission note, physician's progress notes