Lower Respiratory Tutor Questions Flashcards
At what intercostal space would you insert a needle to treat a tension pneumothorax?
What space would you insert a chest tube?
Pneumothorax - 2nd intercostal space
Chest tube - 4th
If your pt’s chest was caved in structurally, what would you document in their medical record
Caved in - pectus excavatum
Pushed out - pectus carinatum
What is the cause of a flail chest
Multiple rib fractures resulting in paradoxical movements of the thorax
What 4 things are you assessing with palpation of the chest?
Tender areas
Observed abnormalities
Chest expansion
Tactile fremitus
At which rib level do you place your hands to evaluate thoracic expansion?
10th ribs
What do you have your pt say when palpating for tactile fremitus?
What would increased or decreased fremitus results from?
99 or 111
Increased - pneumonia
Decreased - COPD, pleural effusion, fibrosis, pneumothorax
What are the different sounds heard during percussion of the chest and what do those sounds indicate?
Resonant - normal
Flat - (like thigh sounds like) pleural effusion
Dull - lobar pneumonia
Tympanic - more air than normal
Hyper resonant - never normal - too much air and indicates COPD or pneumothorax
What is a normal distance when performing diaphragmatic excursion?
3-5 cm
What are the three areas you can listen for lung sounds?
Vesicular - peripheral lung sounds (low)
Bronchovesicular - main bronchus (medium)
Bronchial/Tracheal - (high)
What are the ABC’s of chest X-rays?
Adequate - done correctly Bones and soft tissues Cardiac size and valve appearance Diaphragm Effusions
Wheezing
High pitched hissing when air flows rapidly over narrowed/constricted airway
-COPD, asthma, bronchitis
Crackles
Discontinuous, intermittent during inspiration
-pneumonia, fibrosis or early CHF
Rhonchi
Prolonged, low pitched snoring sounds
-secretions in the airways due to chronic bronchitis
Pleural friction rub
Creaking like sound when inflamed pleural surfaces rub during both phases
-pleural effusion
