patient assessment Flashcards
flashcards
1
Q
the movement of air in and out of the lungs
A
ventilation
2
Q
moving oxygen into the blood
A
oxygenation
3
Q
moving blood throughout the body
A
circulation
4
Q
moving oxygen into the body tissue
A
perfusion
5
Q
ventilation is assessed by what vital signs?
A
1) RR
2) VT
3) chest movement
4) breath sounds
5) paco2
6) Etco2
6
Q
oxygenation is assessed by what vital signs?
A
1) HR
2) color
3) sensorium
4) pao2
5) spo2
7
Q
circulation is assessed by what vital signs?
A
1) HR
2) cardiac output
8
Q
perfusion is assessed by what vital signs?
A
1) BP
2) sensorium
3) temp
4) urine output
5) hemodynamics
9
Q
the most common problem you will see as an RT is what?
A
oxygenation
10
Q
includes the admitting diagnosis, history or present illness, chief complaint, past medical history, and current meds
A
admission notes
11
Q
objective information you can actually see
A
signs
12
Q
subjective information the patient must tell you
A
symptoms
13
Q
type of record that may include occupation, employment history, and hobbies
A
medical record
14
Q
examination that includes inspection, palpation, percussion, and auscultation.
A
physical examination
15
Q
how to calculate pack year
A
number of packs a day x the number of years smoked
16
Q
a set of instructions that documents the patients wishes regarding their treatments if they become unable to make medical decisions on their own
A
advanced directive
*must be dated, signed, and notarized to be authentic
17
Q
indicated that patients does not want to have CPR
A
DNR
18
Q
indicates the patients does not want to be intubated
A
DNI
19
Q
Even if the patients has a DNI you can still apply what therapy?
A
NIV or BIPAP
20
Q
may constraint the treatments the patients wishes to have if they come terminally ill and does not allow other parties to make medical decisions for them
A
living will
21
Q
a document that names someone other than the patient to be responsible for making health care decisions if the patient is unable to make the decisions for themselves
A
power of attorney
22
Q
Order that will include the type of treatment, frequency, and dosage
A
respiratory order
23
Q
order that includes notes from the doctor, nurses, and resp therapist
A
progress notes
24
Q
includes all of the ABG results, PFTs, imaging and X-ray reports and all other lab assessments
A
lab reports
25
normal urine output
40 ml/hr
*1 liter per day
26
If urine intake is more an output what will this result in?
weigh gain
electrolyte imbalance
increase hemodynamics
decreased lung compliance
27
sensible water loss includes what 2 things?
urine and vomiting
28
insensible water loss includes what 2 things?
lungs and skin
29
fluid imbalance is directly correlated with what?
CVP
30
normal CVP
2-6 mmhg
31
decreased CVP indicates what?
hypovolemia
32
increased CVP indicates what?
hypervolemia
33
If a pt is hypovolemic what should you recommend?
fluids
34
if a pt is hypervolemic what meds should you recommend?
diuretics
| ex) laxis
35
if a patients level of consciousness is lethargic or sleepy what should you consider?
sleep apnea or too much 02 given to a pt with COPD
36
if a patients level of consciousness is confused what should you consider?
drug overdose or intoxication
37
if a patients level of consciousness is semicomatose what should you consider?
the patient will only respond to painful stimuli
38
if a patients level of consciousness is obtunded what should you consider?
patients is drowsy and has a reduced cough and gag reflex
39
if a patients level of consciousness is in a coma what should you consider?
patient will not be responsive not even to painful stimuli
40
emotional state that is commonly correlated to added respiratory distress
anxiety
41
if a patient is angry or combative what should you consider?
an electrolyte imbalance
42
if a patient feels euphoric what does this indicate?
drugs overdose
*euphoric=high
43
If a patient feels like they are in a panic this indicates pt has what?
severe hypoxemia
44
Actives of daily life (ADLs) is evaluated using what system?
Katz system
45
ADLs include what tasks?
bathing, eating, dressing, bathroom use, movement
46
During interviewing a patients you should only stick to what kind of questions?
questions thats can be answered with yes and no responses
47
If you see the word orthopnea on the test you should always remember the answer will be what?
CHF
48
A general feeling of discomfort, illness, or uneasiness usually indicates an electrolyte imbalance
malaise
49
shortness of breath is called what?
dyspnea
50
There are 5 grades of dyspnea, which grade is the worst?
Grade 5 is the most severe
51
Pain could easily increase what 2 things?
HR and BP
52
Difficulty swallowing
dysphagia
53
History of present illness in your chart indicates what information?
current medical problems
54
what family history is usually asked about for charting purposes?
asthma, heart disease, diabetes, cystic fibrosis
55
social history in the chart includes what info?
smoking and drug abuse history
56
medical term for swelling
edema
57
indicates excessive fluid
peripheral edema
58
peripheral edema is also called what?
pitting edema
59
pitting or peripheral edema is usually seen where?
arms and ankles
60
what do you treat edema with?
lasix
61
Peripheral edema is a clear indication of what disorder?
CHF
62
Excessive fluid in the abdomen
ascites
63
Ascites is usually causes by what?
liver failure
64
Finger clubbing is caused by what?
chronic hypoxemia with COPD pt
65
Venous distention is a sign of what disease?
CHF
66
Venous distention can be seen during exhalation with patients that have what type of disease?
obstructive lung disease
67
A test to check peripheral circulation
capillary refill
68
how long should it take the blood to return and make skin pink again?
3 seconds
69
Diaphoresis is seen with what?
CHF, fever or infection, anxiety, TB
70
What causes a pt is become pale or ashy colored?
anemia or blood loss
71
How do you treat CHF?
diuretics and positive inotropp
72
How do you treat a fever or infection?
antibiotics
73
how do you treat anxiety?
sedatives
74
How do you treat TB?
anti tuberculous drugs
75
Jaundice is a result of what increased lab value?
increased bilirubin
76
Erthyema, red skin is caused by what?
capillary congestion, inflammation, infection
77
cyanosis is caused by hypoxia and what reduced lab value?
reduces hemoglobin
78
Normal chest configuration should have a straight spine and what kind of diameter?
anterior posterier diameter
79
What is it called when the sternum protrudes anteriorly
pectus carinatum
80
what is it called when the sternum depresses inward?
pectus excavatum
81
an irregular forward leaning or convex curvature of the spine
kyphosis
82
a lateral or side to side curvature of the spine
scoliosis
83
a combo of kyphosis and sciolosis
kyphoscoliosis
84
kyphoscoliosis results in what type of pattern?
restrictive pattern
*lung volumes are decreased
85
Results in chronic air trapping
Barrel chest
| *COPD
86
pneumothorax will result in what kind of chest movement
asymmetrical
87
normal breathing pattern
eupnea
88
Tachypnea is caused by what ?
fever, pain, CNS issue
89
Bradypnea is caused by what?
sleep, drugs, alcoho, metabolic disorders
90
no breathing
apnea
91
a gradual increase and decrease of RR and depth in a cycle lasting from 30-180 seconds with periods of apnea
Cheyenne stokes
92
smilier the cheyenne stokes except that each breath has the SAME depth
Biots
93
an abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by brief insuffience release
Apneustic
94
the normal muscles of ventilation include?
```
diaphragm (80%)
external intercostals (20%)
```
95
Accessory muscles include
internal intercostals, scalene, sternocleiodmastoid, pectoralis major, abdominal muscles
96
an increase of muscle tone seen with COPD
hypertrophy
97
a loss of muscle tone that occurs with palsy's
atrophy/cachexia
98
Retractions indicate what two things?
respiratory distress and severe airway obstruction
99
a sign of respiratory distress in infants
nasal flarring
100
dry or unproductive cough indicates what?
tumor in the lungs
101
a productive cough with brown or green mucus indicates what?
infection
102
Things that make it hard to intubate a pt
short mandible, macroglassia, bull neck, limited neck motion
103
Causes of tachycardia
anxiety and stress
104
how do you treat tachycardia?
o2
105
When you hear tachycardia you should always think of what?
hypoxemia
106
Bradycardia indicates what?
heart failure and shock
107
what do you do when a pt has an adverse effect to therapy?
stop therapy, notify dr or nurse, and document in chart
108
pulse/blood pressure varies or changes during inspiration and exhalation
paradoxical pulse
109
paradoxical pulse can indicate what?
severe air trapping, pneumothorax, or cardiac tamponade
110
remember that paradoxical pulse= what?
status asthmatics
111
where do you place your finger to check for tracheal deviation
supra-sternal notch and compare the space between left clavicle
112
trachea deviates towards the affected side with what?
atelectasis
113
trachea deviates away from the affected side with what?
pneumothorax
114
A tracheal deviation will cause the trachea to be pulled towards the pathology with what things?
atelectasis, pulmonary fibrosis, pnuemoectomy, diaphragm paralysis
115
A tracheal deviation will cause the trachea to be pulled away from the pathology with what things?
pleural effusion, tension pneumothorax, tumors, large mediastinal mass
116
Vibrations felt on the chest wall during palpations
tactile femitus
117
vibrations on the chest wall from your voice
vocal fremitus
118
vibration on the chest wall from the pleural surfaces rubbing t together
pleaural rub fremitus
119
air bubbles on skin that can be palpated
crepitus/ subcutaneous emphysema
120
If a tension pneumothorax is presented, what needs to be inserted?
large-bore needle or chest tube
121
Normal lung percussion
resonant
122
percussion sound heard with atelectasis
flat percussion
123
percussion sound if a pneumonia and pleural effusions are presented
dull
124
percussion sound that is indicated when increased volumes are heard in the lung
tympanic
125
percussion sound heard over the lungs when a pneumothorax or emphysema is present
hypersonant
126
normal diaphragmatic excursion
3-5 cm
127
total movement of the diaphragm from inspiration to expiration
diaphragmatic excursion
128
normal breath sounds
vesicular
129
breath sound is normal when heard over the trachea and bronchi but if heard in the lungs this indicates a consolidation is present
bronchial breath sounds
ex) pneumonia
130
abnormal breath sounds are called?
adventitous
131
breath sounds that indicate secretions or fluid
crackles
132
breath sound that indicates large airway secretions
coarse crackles
133
coarse crackles would be described as what?
rhonchi with a clear cough
134
breath sound that indicates secretions in the middle airways
medium crackles
135
medium crackles are treated by what?
bronchial hygiene
136
breath sound that indicates fluid in the alveoli
fine crackles
137
type of crackles that are associated with CHF or pulmonary edema
fine crackles
138
what are wheezes caused by?
bronchospasm
139
how do you treat wheezes?
bronchodilator
140
a unilateral wheeze indicates a what?
foreign body obstruction
141
to release a foreign body obstruction what type of bronchoscopy is needed?
rigid bronchoscopy
142
breath sound with a high pitched or crowing inspiratory sound that is caused by upper airway obstruction
stridor
143
3 types of stridor
epiglottis, croup, foreign body aspiration
144
Supraglottic swelling
epiglottitis
145
subglottic swelling
croup
146
breath sound that is coarse, crunching sound when the pleura rub together
pleaural friction rub
147
breath sound caused by an inflamed surface of the visceral and parietal pleaura
pleaural friction rub
148
pleural friction rub is caused by?
pleurisy, TB, pneumonia, pulmonary infarction, cancer
149
created by the opening and closing of the heart valves
heart sounds
150
measures the systemic arterial pressure of the blood in your arteries
BP
151
norm adult BP
120/80
norm range...
systolic: 90-140mmhg
diastolic: 60-90mmhg
152
indication of cardiac stress
hypertension
153
indication of poor perfusion
hypotension
154
2 diseases related with poor perfusion
CHF and hypovolemia
155
type of equipment that measures BP
sphygmomanometer
156
a normal X-ray presents both hemisphiaphragms as what?
rounded
157
a normal X-ray presents what hemidiaphragm being slightly higher than the other?
rt is higher than left because of the liver
158
a normal X-ray presents the rt hemidiaphragm being presented and what rib?
6th rib
159
a normal X-ray presents the trachea located where?
midline with sharp costophrenic angles
160
a normal X-ray presents the clavicles how?
head of clavicles should be level
161
the degree at which the xray passes through the body
penetration
162
with an X-ray with good penetration where should the vertebrae be presented?
visible behind the heart
163
if the vertebrae don't show on an X-ray this means that the image is over or under-penetrated?
under-penetrated
164
an over penetrated image will present lung parchyema without what?
blood vessels
165
on a normal cray the vertebrae should be what 3 things?
visible, equal, and distinct
166
on an X-ray the trachea should be roughly the same size as what?
vertebral columns
167
If their is a shift in the trachea on the X-ray this indicates what?
unilateral lung problem
168
The area where between the lungs where the heart, blood vessels, lymphatics, and major bronchi are found
mediastinum
169
mediastinum may shift in presence of what 2 things?
pneumothorax and pleural effusion
170
type of diameter that is increased with obstructive lung disease
anterior posterior diameter
171
the angles made by the outer curve of the diaphragm and chest wall
costophrenic angels
172
on X-ray the costophrenic angles are always obliterated if what is presented?
pleaural effusion
173
normall is a dome shape but is flattened with COPD
diaphragm
174
blood vessels and lymphathics that can be seen on x-ray
vascular markings
175
a heart shadow allows you to see what ventricle of the heart?
left ventricle
176
cardiomegaly is common with what disease?
CHF
177
tissue that surrounds the chest and neck area
soft tissue
178
represented as HYPERLUCENCY in the soft tissue area on an xray
subcutaneous emphysema
179
on xray ribs should have normal spacing and curves.
If they are closer together than normal this indicates what?
atelectasis
180
on xray ribs should have normal spacing and curves.
If they are straighter than normal this indicates what?
air trapping
181
xray projection that the image receptor is taking behind the back
AP projection
182
most common X-ray projection for bedridden patients
AP
183
xray projection that the image receptor is touching the chest
PA projection
184
a slanting or diagonal xray projection
oblique position
185
xray projection where the patient is laying on the infected side
lateral decubitus position
186
what X-ray projection is used to identify pleural effusion
lateral decubitus
187
X-ray projection that gives a view of the lung apices
apical lordotic
188
type of image taken at the end of exhalation to measure diaphragmatic excursion
end expiratory image
189
type of X-ray image used to detect a pneumothorax
end expiratory image
190
the tip of the ET tube should be positioned where
below the vocal cords
2-6cm above the carina
level of aortic arch
191
to determine proper positions before an X-ray is taken, you should do what?
inspect and auscultation
192
laryngotracheobronchitis is also called what?
croup
193
used to identify the upper airway obstructions in children such as croup and epiglottis
lateral next X-ray
194
presented on X-ray as steeple sign, picket fence, pencil point sign, hourglass
croup
195
how do you treat croup?
35-40% oxygen, aerosol, racemic epi
196
supraglottic narrowing with an enlarged and flattened epiglottis and swollen aryepiglottic folds
epiglottitis
197
epiglottitis is presented on cray as what?
thumb sign
198
dark pattern seen with air in the lungs which is normal
radiolucent
199
white pattern seen with fluid in the lungs which is not normal for lungs but normal over areas of bones and organs
radiodense
*same as radiopaque
200
seen with any ill defined radiodensity and common with atelectasis
infiltrate
201
a solid white areas, seen with pneumonia and pleural effusion
consolidation
202
extra pulmonary air
hyperlucency
203
diseases that would present on X-ray as hyper lucency
COPD asthma and pneumothorax
204
vascular markings will be increased with what and decreased with what?
decreased=pneumothorax
| increased= CHF
205
diffused infilate indicates what?
atelectasis and pneumonia
206
means fluid or solid
opaque
207
diffused whiteness of the cray that shows an infiltrate in the shape of a butterfly
pulmonary edema
208
fluffy infiltrates, butterfly pattern, batwing pattern
pulmonary edema
209
how do you treat pulmonary edema?
diuretics, digitalis, digoxin
210
X-ray shows scattered and thin layered densities
atelectasis
211
patch inflaters, plate like infiltrates, crowded vessels, crowded air bronchograms
atelectasis
212
how do you treat atelectasis?
lung expansion therapy
| IPPB, SMI, IS, CPAP, PEEP
213
shows a retrogranular pattern or honey cone pattern
ARDS
214
shows fluid on the affected side and possible mediastinal shift to unaffected side
pleaural effusion
215
how do you treat a pleural effusion
thoracentesis, chest tube, antibiotics, steroids
216
shows as a peripheral wedge shape infiltrate
pulmonary embolism
217
what do you treat a PE with?
heparin or streptokinase
218
TB is often seen in which lobes?
upper
219
the distal tip of the ETT should be seen in the middle of what?
trachea
220
If the ETT is inserted too deep it will be located where?
right mainstream bronchi
221
Signs of a pneumothorax
sudden chest pain and increased dyspnea and SOB
222
increase of peak and plateau pressures on a vent patient indicates what issue?
pneumothorax
223
an X-ray that goes though a specific place of the body part that you want to examine
CT scan
224
useful to detect presents of masses, nodules or lesions that can't be seen on X-ray
CT scan
225
test used to diagnose bronchiectasis
CT scan
226
diagnoses a pulmonary embolism
spiral CT scan with contrast
227
gives a 2-d view of the body without using radiation
MRI
228
test that can be done to determine presence of tumors
MRI
229
what type of cylinders need to be used while undergoing an MRI?
aluminum cylinders
230
a scan that uses radioactive material to examine airflow (ventilation)
V/Q scan
231
the purpose of a v/q scan is to determine if what is present?
pulmonary embolism
232
a normal v/q scan with an abnormal perfusion scan indicates what?
pulm. embolism
233
a test done to determine why painful swallowing, abdominal pain, vomit, or unexplained weightloss is occurring
barium swallow
234
a test that determine a disease quicker than MRI and CT
PET scan
235
on the exam if you see Pet scan always think of what?
cancer
236
metallic compound that shows up on X-ray and is used to help see abnormalities in the esophagus and stomach
barium sulfate
237
how many minutes does a pet scan take
15 mins to 2 hours
238
what is the main indication to do a bronchograpy?
bronchiectasis
239
you would perform an EEG when what is suspected?
brain tumors, brain injuries, loss of brain function, seizures, to evaluate sleep disorders
240
when you see pulmonary angiography on the exam you should automatically think what?
pulmonary embolism
241
a procedure to diagnose and treat cardiovascular conditions.
cardiac cauterization
242
norm ICP
5-10 mmhg
243
results in cerebral vasoconstriction and will temporally lower ICP
hyperventilation
244
osmotic agent that removes fluid from the brain
mannitol and hypertonic saline
245
formula for CPP
MAP-ICP
246
normal CPP
70-90mmhg
247
test done to see if steroids are being effective
FENO testing
248
a decrease in FENO levels indicates what?
steroids are working
249
used to measure the amount of co in patients echoed breath using a hand held device
FECO testing
250
FECO ranges for heavy smokers, moderate smokers, light smokers, and non-smokers
severe smother= over 20
moderate smoker= 11-20
light smoker= 7-10
non- smoker= less than 7
251
RBC consists of what?
HB
252
polycythemia is what?
too many RBC
253
normal RBC
5
254
transports oxygen in blood
Hb
255
normal hb level
15
256
the atop of the volume of abc to the total volume of blood
hematocrit
257
normal hematocrit
45%
258
used to fight infection
WBC
259
normal WBC
5,000-10,000
260
leukocytosis is what?
high WBC
261
leuokepenia indicates what type of infection?
viral
262
when you see eosinophils on the exam always think what?
asthma
263
WBC type associated with TB
monocytes
264
electrolyte that is the major intracellular cation. it is important for heart and muscle function
Potassium
265
norm potassium (K+)
3.5-4.5
266
hypokalemia which is low potassium and occurs with what?
metabolic alkalosis
267
hyperkalemia is high potassium and occurs with what?
kidney failure
268
major electrolyte that is associated with kidneys
sodium (Na)
269
hyponatremia is low sodium and occurs from what?
fluid loss
ex) CHF
270
hypernatremia is high sodium levels and occurs from what?
dehydration
271
electrolyte that is the major extracellular anion
chloride
272
normal chloride
80-100
273
hypochloremia is low chloride levels and occurs with what?
metabolic alkalosis
274
hyperchloremia is high chloride levels and occurs with what?
metabolic acidosis
275
electrolyte that is excreted by the kidneys
creatine
276
value needed to identify kidney failure
creatine
277
normal creatine
0.7-1.3mg/l
278
white/gret type of sputum that is a sign of chronic bronchitis
mucoid
279
sputum color that indicates that WBC presented and is most likely bacterial infection
yellow
280
foul smelling sputum color that is a sign of bronchiestsis
green
281
color of sputum that indicates old blood is in the sputum
brown
282
color of sputum that indicates new blood which is a sign of tumor or TB
bright red
283
pink frothy secretions indicates what?
pulmonary edema
284
if sputum color changes in color from white to yellow to green this indicates what?
pneumonia
285
identifies what bacteria is present in 48-72 hours
sputum culture
286
identifies what antibiotic to use to kill the specific bacteria
sputum sensitivity
287
tells you id the bacteria is positive or negative
gram stain
288
used to identify TB
acid fast stain
289
used to check preoperative patients to see if they are at risk for assesive bleeding
coagulation study
290
normal clotting factor time is how many minutes?
6
291
a decrease in platelets is a sign of decreased what?
blood marrow function
292
normal platelet count
150,000-400,000
293
measures the length of time required for plasma to form a fibrin clot
activated partial thromboplastin time (APTT)
294
normal APTT time
24-32 seconds
295
used to monitor warfarin therapy
prothrombin time
*12-15 seconds
296
used to detect and manage the range of disorders such as UTI, kidney disease and diabetes
urinalysis
297
a protein found in myocardial cells and indicates damage to the heart muscle
troponin
298
If troponin is over 0.1 always think what?
myocardial infaction
299
enzyme that is secreted by the heart when heart failure develops and is the best indicator of CHF
BNP
300
If BNP is elevated always think what?
CHF
301
Normal BNP is less than what?
100 pg/ml
302
greater than 300 BNP indicates?
mild heart failure
303
greater than 600 BNP indicates?
moderate heart failure
304
greater than 900 BNP indicates?
severe heart failure
305
skin test to diagnose TB
mantaux test
306
ECG axis measures the direction of electrical activity, the implies moves in what direction?
starts in rt heart then moves down and then to the lt
*starts in SA node and ends in lt ventricle
307
an ecg monitor that proves continuous visual image of the heart activity
oscilloscope
308
a portable version of the electrocardiograph that is used to detect cardiac arrhythmias i
holter monitor
309
node that generates electrical impulse
sa node
310
the wave of deporliaztion goes through where which causes contraction creating the p wave
atria
311
the impulse from the atria is received by what node and then there isa short delay creating pr interval
av node
312
the stimulus moves from the AV node to the bundle of his then to the bundle branches then to where?
pirkenje fibers
313
QRS complex is created where?
pirkinje fibers
314
after the QRS complex is created there is a short delay called what?
st segmanet
315
after the delay of the st segment the heart is then depolarized and what wave is created?
t wave
316
a myocardial infarction will most likely occur in what ventricle?
left
317
t wave is that wave where the heart is what?
repolarized
318
displays the movement of electricity from one electrode to another
lead
319
V1 is located on what rib on what side of the sternum?
rt side of sternum on 4th rib
320
v2 is located on what rib on what side of the sternum?
lt side of sternum on 4th rib
321
v3 is located on what rib on what side of the sternum?
between 2 and 4 on the lt side of sternum on 4th rib
322
v4 is located on what rib on what line?
5th rib on the lt midclavicular line
323
v5 is located on what rib on what side of sternum
between v4 and v6 on 5th rib on left side of sternum
324
v6 is located on what rib on what line?
5th rib on midaxillary line
325
normal HR
60-100
326
bradycardia
below 60
327
tachycardia
over 100
328
flutter
over 200
329
fibrillation
too many bpm to count
330
HR equation
300 / # of boxes between R waves
ex) 300/ 3= 100
* normal HR
331
treat sinus tachy with what?
o2
332
treat sinus brady with?
o2 and atropine
333
what does a PVC on ekg indicate?
electrolyte imbalance
334
if a pt is presented with v-tach and still has a pulse what do you do?
cardiovert
335
if pt is present with v-tach and does not have a pulse what do you do?
defibrillate, CPR, give amiodarone
336
if a pt presents with v-fib what do you do?
defrillate, cpr, epi, amiodarone
337
if asystole is shown what do you confirm first then proceed to do what?
2 ECG leads are in the correct place then do CPR and give epi
338
myocardial infarction presents with what elevated on ECG?
st elevation
339
inverted t wave on ECG
ischemia
340
often occurs after ischemia and presents as elevated ST on strip
injury
341
term when MI is actually occurring and is diagnosed by significant q waves on strip
infarction
342
cardiac rhythm disturbances and muscle weakness are signs of what?
hypokalemia
343
how do you treat hypokalemia?
potassium
344
a way to evaluate infants health immediately after birth measures at first minute after birth and again at 5 mins
APGAR score
345
for an agar score of 0-3 what do you do?
resuscitate the newborn
346
for an agar score of 4-6 what do you do?
support give 02 and stimulate newborn
347
for an agar score of 7-10 what do you do?
baby is healthy just continue to monitor
348
recommend a transillumination when what is suspected?
pneumothorax
349
normal infant temp
36.5 degrees
350
normal infant HR
110-160
351
normal infant RR
30-60
352
normal infant BP
60/40
353
premature infants BP
50-30
354
to determine a cause of a shunt you should do what kind of study?
echocardiogram
355
norm infant glucose
30
356
L/s ratio is done to determine fetal lung immaturity. a good ratio is what?
2:1 or greater
357
less than 2:1 L/s ratio indicates the infant is at risk for what?
HMD and IRDS
358
a L/s ratio less than 2:1 is in need of what replacement therapy?
surfactant
359
used to monitor exhaled co2 using infrared absorption
capnography
360
an increase in end tidal co2 indicates what ventilation?
decreased ventilation
361
a decrease in end tidal co2 indicates a what in ventilation?
increase in ventilation
362
low end tidal co2 right after intubation means that the tube is where?
in the esophagus
363
acceptable pulse ox range
93-97%
364
pulse oximeters will read falsely higher in presence of what?
carbon monoxide
365
used to confirm tracheal intubation
color metric co2 detector
366
if you suspect having a sleep disorder like obstructive sleep paean you may recommend the patient to undergo what test?
overnight pulse ox
367
during an overnight pulse ox reading if an episode of spo2 below 89% recommend what?
polysomnography
368
best way to evaluate a pt with carbon monoxide poisoning
co-oximeter/hemoximeter
369
a method of choice to contusing monist oxygenation and ventilation
transcutaneous monitoring
370
way to monitor circulation and perfusion
hemodynamic monitoring
371
factors that control BP
heart, blood, vessels
372
increase in HR will _____ BP
| decrease in HR will ____ BP
increase, decrease
373
increase in contractibility will ___ BP
decrease in contractibility will ____BP
increase, decrease
374
excessive fluids will ____ BP
increase
375
constriction of vessels will ___ BP
dilation of vessels will ___ BP
increase, decrease
376
transducer used to continuously monitor BP
strain-gauge transducer
377
If transducer is ABOVE the catheter, readings will be ___ than the actual
lower
378
if transducer is BELOW the catheter, readings will be ___ th an the actual
higher
379
Blood flow starts at what ventricle?
left
380
blood leaves the heart through the what valve into the systemic arterial system
aortic valve
381
blood then travels into the capillaries then tissues then into what veins?
systemic veins
382
After blood reaches systemic veins the blood traces back into the heart to the ____
rt atrium
383
the difference between systolic and diastolic pressures
pulse pressure
384
normal pulse pressure
40
385
MAP equation
MAP= 2x diastolic + systolic / 3
386
normal cardiac output (QT)
4-8
387
normal cardiac index (CI)
2-4
388
SVR equation
SVR=MAP-CVP/Cardiac Output
389
PVR equation
PVR= MAP- PCWP/ cardiac output
390
urine output
40
391
normal chest percussion
resonant
392
norm breath sounds
vesicular
393
norm heart sounds
s1 and s2
394
ICP
5-10
395
Cerebral perfusion pressure
70-90
396
BUN
8-25
397
MAP
120/80
| *mean of 93
398
CVP
2-6
399
PAP
25/8
| *mean of 13
400
pulmonary cap pressure
8-10
401
PCWP
4-12
402
lt ventricular pressure
120/0
403
SVR
20mmhg or 1600 dynes
404
PVR
less than 2.5 mmhm or 200 dynes
405
decreased PCWP is usually associated with
dehydration or vasodilation
406
AN increased PCWP is associated with what?
fluid overload, heart failure, mitral valve insufficieny, cardiac tamponade
