med surg resp

Question 1

what procedure should be performed for a patient with a pneumothorax secondary to blunt chest trauma?

Answer 1

chest tube insertion connected to a water seal drainage

Question 2

what procedure should be performed for a pt with pneumothorax secondary to cancer, pleurisy, or tuberculosis

Answer 2

thoracentesis

Question 3

how does a thoracentesis provide relief for a pt

Answer 3

removes air or fluid from lungs

Question 4

measure of air lungs can hold after maximum inhalation

Answer 4

total lung capacity

Question 5

measure of amount of air pt can exhale after maximum inhalation

Answer 5

vital lung capacity

Question 6

measure of amount of air in lungs after normal expiration

Answer 6

functional residual capacity

Question 7

measure of air in lungs after forced expiration

Answer 7

residual volume

Question 8

will tracheostomy with inflated cuff allow pt to speak

Answer 8

no

Question 9

how often should a nurse assess tracheostomy pt for suctioning

Answer 9

every 2 hrs

Question 10

after the pt coughs suctionin for a tracheostomy pt should only be performed if the nurse asses what

Answer 10

pt is unable to exporate secretions

Question 11

where will trachea be deviated in a pt with a tension pneumothorax?

Answer 11

unaffected side

Question 12

what breath sounds will u auscultate on afftected side of a tension pneumothorax

Answer 12

none they will be absent

Question 13

how will neck veins be in a pt with tension pneumothorax

Answer 13

distended

Question 14

breathing rhythm of pt with tension pneumothorax

Answer 14

tachypnea

Question 15

can a pt wear dentures, glasses or contacts during a bronchoscopy

Answer 15

no

Question 16

can a tissue sample be obtained during an endoscopy?

Answer 16

yes

Question 17

what does a friction rub during lung auscultation indicate?

Answer 17

pleurisy

Question 18

what do crackles/rales indicate during lung auscultation

Answer 18

pneumonia

Question 19

increased tactile fremitus is an indication of what

Answer 19

pneumonia

Question 20

how many meals should emphysema pt eat daily

Answer 20

4-6 small meals

Question 21

why should emphysema pts eat 4-6 small meals daily

Answer 21

to prevent exhaustion and SOB from big meals

Question 22

how long will a pt who undergoes a total laryngectomy need a tracheostomy?

Answer 22

forever

Question 23

will a pt who had a total laryngectomy be able to cough and breath deeply after surgery

Answer 23

yes and should to clear secretions

Question 24

can total laryngectomy pts eat immediately surgery

Answer 24

no will receive enteral feedings for 7-10 days after surgery

Question 25

will a pt s/p laryngectomy be able to speak with their normal voice?

Answer 25

no they will have no natural voice

Question 26

what should u do if pt s/p rhinoplasty has edema of nose, eyes and face

Answer 26

nothing its an expected finding

Question 27

how should pts s/p rhinoplasty breath

Answer 27

through their mouth

Question 28

what should u do if pt s/p rhinoplasty has frequent swallowing

Answer 28

notify surgeon

Question 29

why should u notify surgeon of frequent swallowing in pt s/p rhinoplasty

Answer 29

could be posterior nasal bleeding/hemorrhage

Question 30

what is transillumination used for

Answer 30

to diagnose occluded sinuses by seeing if light is able to be passed through tissues

Question 31

can symptoms be used to diagnose lung cancer in its early stages

Answer 31

no because cancer is metastasized by time pt shows sxs

Question 32

what does inspiratory stridor indicate?

Answer 32

airway obstruction

Question 33

what should be done if pt has inspiratory stridor

Answer 33

notify rapid response team give humidified oxygen

Question 34

how will pts neck be during bronchoscopy

Answer 34

hyperextended to align pharynx w trachea so no trauma occurs w scope insertion

Question 35

signs of inhalation injury

Answer 35

-singed hair on face, neck or torso -trouble talking -soot in nose/mouth -confusion/anxiety

Question 36

why does CO (carbon monoxide) poisoning cause hypoxia

Answer 36

CO binds to Hgb faster than Oxygen

Question 37

cherry red skin is a sign of what kind of inhalation injury

Answer 37

carbon monoxide poisoning

Question 38

how to treat CO (carbon monoxide) poisoning

Answer 38

100% oxygen

Question 39

which side of the chest can u hear the upper lung lobes

Answer 39

anterior

Question 40

which side of the chest will u hear lower lung lobes the best

Answer 40

posterior

Question 41

what position should pt sit when auscultating lungs

Answer 41

semi fowlers

Question 42

what are the 3 normal lung sounds

Answer 42

-bronchial -vesicular -bronchovesicular

Question 43

how will brochial lung sounds sound

Answer 43

-high -loud -hollow

Question 44

where can u hear brochial lung sounds

Answer 44

over the trachea/larynx

Question 45

can u hear bronchial lung sounds posteriorly

Answer 45

no only anteriorly over trachea/larynx

Question 46

what part of breathing will bronchial sounds be longer

Answer 46

expiration

Question 47

what of breathing will vesicular sounds be longer

Answer 47

on inspiration

Question 48

when will brochovesicular sounds be longer

Answer 48

they will be equal on inspiration and expiration

Question 49

how will vesicular breath sounds sound

Answer 49

-soft -low-pitched -rushing sound

Question 50

where can vesicular sounds be heard

Answer 50

anteriorly and posteriorly

Question 51

how will bronchovesicular breath sounds sound

Answer 51

medium pitched hollow

Question 52

adventitious lung sounds are

Answer 52

abnormal lung sounds

Question 53

what are the 2 categories of adeventitious lung sounds

Answer 53

-discontinuous lung sounds -continuous lung sounds

Question 54

discrete crackling sounds in the lungs are what category of adventitious lung sounds

Answer 54

discontinuous

Question 55

what are the 3 types of discontinuous adventitious lung sounds

Answer 55

-fine crackles -coarse crackles -pleural friction rub

Question 56

high pitched crackling sounds are what type of discontinuous adventitious lung sounds

Answer 56

fine crackles

Question 57

low pitched wet bubbling sounds are what discontinuous adventitious lung sounds

Answer 57

coarse crackles

Question 58

low pitched harsh grating sounds are what discontinuous adventitious lung sounds

Answer 58

pleural friction rub

Question 59

connected musical sounds are what kind of adventitious lung sounds

Answer 59

continuous sounds

Question 60

what are the 2 types of continuous adventitious lung sounds

Answer 60

wheezes stridor

Question 61

high pitched musical with polyphonic sound quality is what continous adventitious breath sound

Answer 61

wheezing

Question 62

high pitched whistling/gasping with harsh sound quality is what continuous adventitious lung sound

Answer 62

stridor

Question 63

what causes fine crackles

Answer 63

deflated airways popping back open (i.e pulmonary edema, asthma, COPD)

Question 64

what causes coarse crackles

Answer 64

inhaled air colliding with secretions [anything where fluid in lungs] (i.e pulmonary edema, pneumonia, depressed cough reflex)

Question 65

what causes pleural friction rub

Answer 65

surfaces rubbing together during respirations because of pleural inflamation (I.e pleuritis)

Question 66

what causes wheezing

Answer 66

air moving through narrow airway (I.e asthma, bronchitis, chronic emphysema)

Question 67

what causes stridor

Answer 67

disturbed air flow in larnx or trachea (I.e croup, epiglottitis, airway obstruction)

Question 68

how to diagnose COPD

Answer 68

-ABGs -CXR -pulmonary function test (spirometry)

Question 69

pt with COPD would have what ratio of FEV1/FVC

Answer 69

less than 70%

Question 70

what is FEV1

Answer 70

forced expiratory volume

Question 71

what is FVC

Answer 71

forced vital capacity

Question 72

what are the 2 types of COPD

Answer 72

emphysema chronic bronchitis

Question 73

s/s of emphysema

Answer 73

-barrel chest (hyperinflation of the lungs) -weight loss -SOB -dyspnea

Question 74

what causes barrel chest

Answer 74

hyperinflation of the lungs (puffed up lungs)

Question 75

s/s of chronic bronchitis

Answer 75

-overweight -cyanotic -peripheral edema -rhonchi -wheezing -chronic cough

Question 76

diet education for COPD pt

Answer 76

-increase calories -small frequent meals -stay hydrated

Question 77

why should COPD increase calories

Answer 77

to replace burned calories from breathing

Question 78

why should COPD pts stay hydrated

Answer 78

to thin secretions

Question 79

how should COPD pts breath

Answer 79

pursed lips using diaphragm

Question 80

why should COPD pts breath through pursed lips

Answer 80

to eliminate CO2 while keeping air passages open

Question 81

what vaccines should be suggested to COPD pts

Answer 81

-influenza -pnemococcal vaccine

Question 82

meds for COPD

Answer 82

bronchodilators corticosteroids

Question 83

how should u give meds for COPD

Answer 83

bronchodilator and then corticosteroids

Question 84

corticosteroid suffixes

Answer 84

-asone -inide -olone

Question 85

what kind of med ends in -asone

Answer 85

corticosteroid

Question 86

what kind of med ends in inide

Answer 86

corticosteroid

Question 87

what kind of med ends in olone

Answer 87

corticosteroid

Question 88

how to diagnose pneumonia

Answer 88

-cxr -wbc -sputum culture