Lab quiz 1 Flashcards
What is the recommended patient positioning for auscultation?
Patient should be sitting upright if possible. In critically ill patients, side-lying or supine positions may be necessary.
Ear pieces of the stethoscope should be facing away from you.
What is a pleural rub?
Raspy, grating sound heard near the end of inspiration, caused by inflamed pleural surfaces rubbing across one another. Not affected by coughing.
It is a significant indicator of pleural pathology.
What should be noted when charting breath sounds?
Note the type of breath sound, specify location, document anything abnormal during inhalation or exhalation.
Patient effort providing inhale and exhale is necessary for accurate auscultation.
Where are bronchial breath sounds located?
Loud, high pitch, located over the trachea, upper part of sternum, and both main stem bronchi.
Hearing these sounds in other locations indicates an abnormality.
What is the starting point for lung auscultation?
Begins at the base of the lung, starting at the left base, moving right and working your way up.
This helps identify any abnormalities that may clear with deep inhalation.
What is the proper stethoscope positioning?
Ear pieces of stethoscope facing away from you, patient in an upright and relaxed position.
Ask the patient to breathe a little more deeply than normal through the mouth, NOT the nose.
What are the uses of the bell and diaphragm of a stethoscope?
Bell: Lower-pitched sounds for pulse, heart tones, and bowel sounds; Diaphragm: Higher-pitched sounds for breath sounds.
Understanding these uses is crucial for effective auscultation.
Define vesicular breath sounds.
Soft, low-pitched breath sounds located in the peripheral lung areas.
All normal breath sounds are produced primarily by turbulent flow in the airways.
What are the indications for PEP/PAP therapy?
- To reduce air trapping in asthma and COPD
- To aid in mobilization of retained secretions in cystic fibrosis and chronic bronchitis
- To prevent or reverse atelectasis
- To optimize delivery of bronchodilators in patients receiving bronchial hygiene therapy.
PEP stands for Positive Expiratory Pressure, and PAP stands for Positive Airway Pressure.
What are the desired outcomes of PEP/PAP therapy?
- Change in sputum production, mobilize secretions
- Change in breath sounds
- Patient subjective response to therapy
- Change in vital signs
- Change in chest radiograph
- Change in arterial blood gas values or oxygen saturation.
Monitoring these outcomes helps assess the effectiveness of therapy.
Which disease processes might benefit from PEP/PAP therapy?
- COPD
- Asthma
- Cystic fibrosis
- Chronic bronchitis
- Atelectasis
- Neuromuscular diseases leading to weak cough effort
- Acute respiratory failure.
Identifying these conditions is key for appropriate therapy.
What is the difference between a series resistor and a threshold resistor?
- Series resistor: Resistance is created by a fixed orifice; flow is dependent on the patient’s effort.
- Threshold resistor: Uses a set, adjustable valve to maintain consistent pressure regardless of flow.
Understanding this difference is essential for selecting the correct type of resistor for therapy.
What is the appropriate pressure range for PEP therapy?
10–20 cmH₂O for exhalation against a fixed orifice series resistor.
This range is critical for effective PEP therapy.
What is the desired I:E ratio for PEP/PAP therapy?
1:3 to 1:4.
This ratio is important for optimizing breathing patterns during therapy.
What is the Coanda effect in relation to Ez-PAP?
The Coanda effect allows for entrainment of additional airflow, increasing positive pressure in the lungs and assisting in lung expansion.
This principle is used to enhance respiratory therapy effectiveness.
What troubleshooting steps should be taken if a patient is not achieving the desired expiratory pressure with Ez-PAP?
- Ensure a proper seal around the mouthpiece or mask
- Check for leaks in the system
- Adjust flow rate (increase if necessary)
- Encourage slow, deep inspiration and controlled exhalation
- Assess for fatigue and provide breaks if needed.
These steps help ensure the effectiveness of the Ez-PAP therapy.
