new test

Question 1

aging adults don’t have what? (the capacity stays the same)

Answer 1

decreased lung capacity

Question 2

older adults - a decline in elasticity of the (thorax)

Answer 2

bony thorax

Question 3

older - alveoli gas exchange and surface area?

Answer 3

decrease in alveolar gas exchange surface

Question 4

older adult - compliance and elasticity?

Answer 4

an increase in parenchymal compliance decreasing elastic recoil of the lungs and ultimately a change in structure and function of the chest wall due to a loss of intervertebral spaces

Question 5

older adult? do you feel stiff?

Answer 5

stiffening of the chest wall from changes in ribs, sternum and articular cartilages making the chest less expansible

Question 6

bronchetitis caused by

Answer 6

Airway obstruction, pulmonary infections
Diffuse airway injury
Genetic disorders
Abnormal host defenses
Idiopathic causes

Question 7

speaking trach - cuff deflated or not?

Answer 7

deflate cuff

Question 8

cuffless tracheostomy

Answer 8

tube does not have a cuff (balloon like feature) at the end of the tube. If the patient does not require that the air from the ventilator is monitored and measured and is able to tolerate cuff deflation without respiratory distress, then a cuffless tracheostomy tube may be place

Question 9

fenestrated tracheostomy tube

Answer 9

fenestrated tracheostomy tube is a type that has an opening in the tube above the cuff, which allows air to enter so that the patient is able to speak with the tube in place.

Question 10

cuff is inflated if

Answer 10

It is used if the patient is at risk of aspiration or needs mechanical ventilation.

Question 11

use cuffless

Answer 11

When the patient can protect the airway from aspiration and does not require mechanical ventilation.

Question 12

Diaphragmatic excursion

Answer 12

5-7 cm

Question 13

Dullness - purcussion

Answer 13

Dullness → pneumonia

Question 14

Flatness → percussion (effusion is lying flat)

Answer 14

Flatness → pleural effusion

Question 15

Hyperresonance → (hollow, nothing there)

Answer 15

emphysema, pneumothorax

Question 16

crackles (HF and edema crack me up)

Answer 16

Associated w/ heart failure and pulmonary edema

Question 17

course crackles (of course Rhonda is obstructing the door)

Answer 17

Obstructive pulmonary disease

Question 18

Fine crackles (I was fine with pneumonia, but restricted)

Answer 18

Fine crackles: soft high pitched, interstitial pneumonia, restrictive pulmonary disease

Question 19

wheezing (wheezy has bronchitis)

Answer 19

partially obstructed airway + chronic bronchitis or bronchiectasis

Question 20

Bronchophony (bronchophony on blast)

Answer 20

Bronchophony → vocal resonance that is more intense and clearer than norma breath sounds, pneuomia or atelectisis

Question 21

egophony →

Answer 21

egophony → voice sounds that are distorted

Question 22

left sided heart failure

Answer 22

Increased pressure in the pulmonary veins causes congestion and interstitial edema (around the alveoli); bronchial mucosa may become edematous.

Question 23

left sided heart failure lung sounds (left-sided HF cracks me up)

Answer 23

crackles

Question 24

COPD

Answer 24

Slowly progressive disorder in which the distal airspaces enlarge and lungs become hyperinflated.

Question 25

during asthma attack what do the lungs do?

Answer 25

air flow decreases lungs hyperinflate.

Question 26

broncoscopy - when to withhold food?

Answer 26

Food and fluids witheld 4-8 hrs prior to reduce aspiration risk

Question 27

broncoscopy post procedure - and in older pts?

Answer 27

VS, O2 sat, breath sounds, observe LOC, airway, sputum, gag/cough reflex prior to any oral intake → ice chips → fluids. In older pts assess for lethargy and confusion

Question 28

early symptoms of hypoxemia

Answer 28

Early: mental status changes, altered LOC, increased RR, HR, BP
Tripod position can help expand lungs

Question 29

late symptoms of hypoxemia

Answer 29

Late signs of hypoxemia:
Rapid RR and HR progresses to cardiopulmonary arrest
Cyanosis
Loss of mm control

Question 30

atalectisis symptoms (addy spits with a fever)

Answer 30

slow and gradual: increasing dyspnea, cough, sputum production, low grade fever, tachycardia, tachypnea, pleural pain, central cyanosis

Question 31

atalectisis sounds

Answer 31

Decreased breath sounds and crackles

Question 32

asthma patho (I’ME MEB)

Answer 32

Allergen sensitizes IGE antibody
Mast cells are activated: eosinophils follow
Mediators are released
Edema and bronchospasm are result

Question 33

what causes empyemas?

Answer 33

Most empyemas occur as complications of bacterial pneumonia or lung abscess.

Question 34

empyemas lung sounds

Answer 34

Chest auscultation demonstrates decreased or absent breath sounds over the affected area, and there is dullness on chest percussion as well as decreased fremitus.

Question 35

empyema diagnosis

Answer 35

The diagnosis is established by chest CT. Usually, a diagnostic thoracentesis is performed, often under ultrasound guidance.