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respiratory > patient assessment > Flashcards

patient assessment Flashcards

flashcards

1
Q

the movement of air in and out of the lungs

A

ventilation

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2
Q

moving oxygen into the blood

A

oxygenation

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3
Q

moving blood throughout the body

A

circulation

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4
Q

moving oxygen into the body tissue

A

perfusion

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5
Q

ventilation is assessed by what vital signs?

A

1) RR
2) VT
3) chest movement
4) breath sounds
5) paco2
6) Etco2

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6
Q

oxygenation is assessed by what vital signs?

A

1) HR
2) color
3) sensorium
4) pao2
5) spo2

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7
Q

circulation is assessed by what vital signs?

A

1) HR

2) cardiac output

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8
Q

perfusion is assessed by what vital signs?

A

1) BP
2) sensorium
3) temp
4) urine output
5) hemodynamics

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9
Q

the most common problem you will see as an RT is what?

A

oxygenation

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10
Q

includes the admitting diagnosis, history or present illness, chief complaint, past medical history, and current meds

A

admission notes

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11
Q

objective information you can actually see

A

signs

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12
Q

subjective information the patient must tell you

A

symptoms

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13
Q

type of record that may include occupation, employment history, and hobbies

A

medical record

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14
Q

examination that includes inspection, palpation, percussion, and auscultation.

A

physical examination

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15
Q

how to calculate pack year

A

number of packs a day x the number of years smoked

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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

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17
Q

indicated that patients does not want to have CPR

A

DNR

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18
Q

indicates the patients does not want to be intubated

A

DNI

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19
Q

Even if the patients has a DNI you can still apply what therapy?

A

NIV or BIPAP

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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

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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

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22
Q

Order that will include the type of treatment, frequency, and dosage

A

respiratory order

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23
Q

order that includes notes from the doctor, nurses, and resp therapist

A

progress notes

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24
Q

includes all of the ABG results, PFTs, imaging and X-ray reports and all other lab assessments

A

lab reports

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25
Q

normal urine output

A

40 ml/hr

*1 liter per day

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26
Q

If urine intake is more an output what will this result in?

A

weigh gain
electrolyte imbalance
increase hemodynamics
decreased lung compliance

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27
Q

sensible water loss includes what 2 things?

A

urine and vomiting

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28
Q

insensible water loss includes what 2 things?

A

lungs and skin

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29
Q

fluid imbalance is directly correlated with what?

A

CVP

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30
Q

normal CVP

A

2-6 mmhg

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31
Q

decreased CVP indicates what?

A

hypovolemia

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32
Q

increased CVP indicates what?

A

hypervolemia

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33
Q

If a pt is hypovolemic what should you recommend?

A

fluids

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34
Q

if a pt is hypervolemic what meds should you recommend?

A

diuretics

ex) laxis

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35
Q

if a patients level of consciousness is lethargic or sleepy what should you consider?

A

sleep apnea or too much 02 given to a pt with COPD

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36
Q

if a patients level of consciousness is confused what should you consider?

A

drug overdose or intoxication

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37
Q

if a patients level of consciousness is semicomatose what should you consider?

A

the patient will only respond to painful stimuli

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38
Q

if a patients level of consciousness is obtunded what should you consider?

A

patients is drowsy and has a reduced cough and gag reflex

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39
Q

if a patients level of consciousness is in a coma what should you consider?

A

patient will not be responsive not even to painful stimuli

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40
Q

emotional state that is commonly correlated to added respiratory distress

A

anxiety

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41
Q

if a patient is angry or combative what should you consider?

A

an electrolyte imbalance

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42
Q

if a patient feels euphoric what does this indicate?

A

drugs overdose

*euphoric=high

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43
Q

If a patient feels like they are in a panic this indicates pt has what?

A

severe hypoxemia

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44
Q

Actives of daily life (ADLs) is evaluated using what system?

A

Katz system

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45
Q

ADLs include what tasks?

A

bathing, eating, dressing, bathroom use, movement

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46
Q

During interviewing a patients you should only stick to what kind of questions?

A

questions thats can be answered with yes and no responses

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47
Q

If you see the word orthopnea on the test you should always remember the answer will be what?

A

CHF

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48
Q

A general feeling of discomfort, illness, or uneasiness usually indicates an electrolyte imbalance

A

malaise

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49
Q

shortness of breath is called what?

A

dyspnea

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50
Q

There are 5 grades of dyspnea, which grade is the worst?

A

Grade 5 is the most severe

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51
Q

Pain could easily increase what 2 things?

A

HR and BP

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52
Q

Difficulty swallowing

A

dysphagia

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53
Q

History of present illness in your chart indicates what information?

A

current medical problems

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54
Q

what family history is usually asked about for charting purposes?

A

asthma, heart disease, diabetes, cystic fibrosis

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55
Q

social history in the chart includes what info?

A

smoking and drug abuse history

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56
Q

medical term for swelling

A

edema

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57
Q

indicates excessive fluid

A

peripheral edema

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58
Q

peripheral edema is also called what?

A

pitting edema

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59
Q

pitting or peripheral edema is usually seen where?

A

arms and ankles

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60
Q

what do you treat edema with?

A

lasix

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61
Q

Peripheral edema is a clear indication of what disorder?

A

CHF

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62
Q

Excessive fluid in the abdomen

A

ascites

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63
Q

Ascites is usually causes by what?

A

liver failure

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64
Q

Finger clubbing is caused by what?

A

chronic hypoxemia with COPD pt

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65
Q

Venous distention is a sign of what disease?

A

CHF

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66
Q

Venous distention can be seen during exhalation with patients that have what type of disease?

A

obstructive lung disease

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67
Q

A test to check peripheral circulation

A

capillary refill

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68
Q

how long should it take the blood to return and make skin pink again?

A

3 seconds

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69
Q

Diaphoresis is seen with what?

A

CHF, fever or infection, anxiety, TB

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70
Q

What causes a pt is become pale or ashy colored?

A

anemia or blood loss

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71
Q

How do you treat CHF?

A

diuretics and positive inotropp

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72
Q

How do you treat a fever or infection?

A

antibiotics

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73
Q

how do you treat anxiety?

A

sedatives

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74
Q

How do you treat TB?

A

anti tuberculous drugs

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75
Q

Jaundice is a result of what increased lab value?

A

increased bilirubin

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76
Q

Erthyema, red skin is caused by what?

A

capillary congestion, inflammation, infection

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77
Q

cyanosis is caused by hypoxia and what reduced lab value?

A

reduces hemoglobin

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78
Q

Normal chest configuration should have a straight spine and what kind of diameter?

A

anterior posterier diameter

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79
Q

What is it called when the sternum protrudes anteriorly

A

pectus carinatum

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80
Q

what is it called when the sternum depresses inward?

A

pectus excavatum

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81
Q

an irregular forward leaning or convex curvature of the spine

A

kyphosis

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82
Q

a lateral or side to side curvature of the spine

A

scoliosis

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83
Q

a combo of kyphosis and sciolosis

A

kyphoscoliosis

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84
Q

kyphoscoliosis results in what type of pattern?

A

restrictive pattern

*lung volumes are decreased

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85
Q

Results in chronic air trapping

A

Barrel chest

*COPD

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86
Q

pneumothorax will result in what kind of chest movement

A

asymmetrical

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87
Q

normal breathing pattern

A

eupnea

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88
Q

Tachypnea is caused by what ?

A

fever, pain, CNS issue

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89
Q

Bradypnea is caused by what?

A

sleep, drugs, alcoho, metabolic disorders

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90
Q

no breathing

A

apnea

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91
Q

a gradual increase and decrease of RR and depth in a cycle lasting from 30-180 seconds with periods of apnea

A

Cheyenne stokes

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92
Q

smilier the cheyenne stokes except that each breath has the SAME depth

A

Biots

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93
Q

an abnormal pattern of breathing characterized by deep, gasping inspiration with a pause at full inspiration followed by brief insuffience release

A

Apneustic

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94
Q

the normal muscles of ventilation include?

A 
diaphragm (80%)
external intercostals (20%)
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95
Q

Accessory muscles include

A

internal intercostals, scalene, sternocleiodmastoid, pectoralis major, abdominal muscles

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96
Q

an increase of muscle tone seen with COPD

A

hypertrophy

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97
Q

a loss of muscle tone that occurs with palsy’s

A

atrophy/cachexia

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98
Q

Retractions indicate what two things?

A

respiratory distress and severe airway obstruction

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99
Q

a sign of respiratory distress in infants

A

nasal flarring

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100
Q

dry or unproductive cough indicates what?

A

tumor in the lungs

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101
Q

a productive cough with brown or green mucus indicates what?

A

infection

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102
Q

Things that make it hard to intubate a pt

A

short mandible, macroglassia, bull neck, limited neck motion

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103
Q

Causes of tachycardia

A

anxiety and stress

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104
Q

how do you treat tachycardia?

A

o2

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105
Q

When you hear tachycardia you should always think of what?

A

hypoxemia

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106
Q

Bradycardia indicates what?

A

heart failure and shock

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107
Q

what do you do when a pt has an adverse effect to therapy?

A

stop therapy, notify dr or nurse, and document in chart

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108
Q

pulse/blood pressure varies or changes during inspiration and exhalation

A

paradoxical pulse

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109
Q

paradoxical pulse can indicate what?

A

severe air trapping, pneumothorax, or cardiac tamponade

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110
Q

remember that paradoxical pulse= what?

A

status asthmatics

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111
Q

where do you place your finger to check for tracheal deviation

A

supra-sternal notch and compare the space between left clavicle

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112
Q

trachea deviates towards the affected side with what?

A

atelectasis

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113
Q

trachea deviates away from the affected side with what?

A

pneumothorax

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114
Q

A tracheal deviation will cause the trachea to be pulled towards the pathology with what things?

A

atelectasis, pulmonary fibrosis, pnuemoectomy, diaphragm paralysis

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115
Q

A tracheal deviation will cause the trachea to be pulled away from the pathology with what things?

A

pleural effusion, tension pneumothorax, tumors, large mediastinal mass

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116
Q

Vibrations felt on the chest wall during palpations

A

tactile femitus

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117
Q

vibrations on the chest wall from your voice

A

vocal fremitus

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118
Q

vibration on the chest wall from the pleural surfaces rubbing t together

A

pleaural rub fremitus

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119
Q

air bubbles on skin that can be palpated

A

crepitus/ subcutaneous emphysema

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120
Q

If a tension pneumothorax is presented, what needs to be inserted?

A

large-bore needle or chest tube

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121
Q

Normal lung percussion

A

resonant

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122
Q

percussion sound heard with atelectasis

A

flat percussion

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123
Q

percussion sound if a pneumonia and pleural effusions are presented

A

dull

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124
Q

percussion sound that is indicated when increased volumes are heard in the lung

A

tympanic

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125
Q

percussion sound heard over the lungs when a pneumothorax or emphysema is present

A

hypersonant

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126
Q

normal diaphragmatic excursion

A

3-5 cm

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127
Q

total movement of the diaphragm from inspiration to expiration

A

diaphragmatic excursion

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128
Q

normal breath sounds

A

vesicular

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129
Q

breath sound is normal when heard over the trachea and bronchi but if heard in the lungs this indicates a consolidation is present

A

bronchial breath sounds

ex) pneumonia

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130
Q

abnormal breath sounds are called?

A

adventitous

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131
Q

breath sounds that indicate secretions or fluid

A

crackles

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132
Q

breath sound that indicates large airway secretions

A

coarse crackles

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133
Q

coarse crackles would be described as what?

A

rhonchi with a clear cough

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134
Q

breath sound that indicates secretions in the middle airways

A

medium crackles

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135
Q

medium crackles are treated by what?

A

bronchial hygiene

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136
Q

breath sound that indicates fluid in the alveoli

A

fine crackles

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137
Q

type of crackles that are associated with CHF or pulmonary edema

A

fine crackles

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138
Q

what are wheezes caused by?

A

bronchospasm

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139
Q

how do you treat wheezes?

A

bronchodilator

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140
Q

a unilateral wheeze indicates a what?

A

foreign body obstruction

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141
Q

to release a foreign body obstruction what type of bronchoscopy is needed?

A

rigid bronchoscopy

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142
Q

breath sound with a high pitched or crowing inspiratory sound that is caused by upper airway obstruction

A

stridor

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143
Q

3 types of stridor

A

epiglottis, croup, foreign body aspiration

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144
Q

Supraglottic swelling

A

epiglottitis

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145
Q

subglottic swelling

A

croup

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146
Q

breath sound that is coarse, crunching sound when the pleura rub together

A

pleaural friction rub

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147
Q

breath sound caused by an inflamed surface of the visceral and parietal pleaura

A

pleaural friction rub

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148
Q

pleural friction rub is caused by?

A

pleurisy, TB, pneumonia, pulmonary infarction, cancer

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149
Q

created by the opening and closing of the heart valves

A

heart sounds

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150
Q

measures the systemic arterial pressure of the blood in your arteries

A

BP

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151
Q

norm adult BP

A

120/80

norm range…

systolic: 90-140mmhg
diastolic: 60-90mmhg

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152
Q

indication of cardiac stress

A

hypertension

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153
Q

indication of poor perfusion

A

hypotension

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154
Q

2 diseases related with poor perfusion

A

CHF and hypovolemia

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155
Q

type of equipment that measures BP

A

sphygmomanometer

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156
Q

a normal X-ray presents both hemisphiaphragms as what?

A

rounded

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157
Q

a normal X-ray presents what hemidiaphragm being slightly higher than the other?

A

rt is higher than left because of the liver

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158
Q

a normal X-ray presents the rt hemidiaphragm being presented and what rib?

A

6th rib

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159
Q

a normal X-ray presents the trachea located where?

A

midline with sharp costophrenic angles

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160
Q

a normal X-ray presents the clavicles how?

A

head of clavicles should be level

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161
Q

the degree at which the xray passes through the body

A

penetration

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162
Q

with an X-ray with good penetration where should the vertebrae be presented?

A

visible behind the heart

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163
Q

if the vertebrae don’t show on an X-ray this means that the image is over or under-penetrated?

A

under-penetrated

164
Q

an over penetrated image will present lung parchyema without what?

A

blood vessels

165
Q

on a normal cray the vertebrae should be what 3 things?

A

visible, equal, and distinct

166
Q

on an X-ray the trachea should be roughly the same size as what?

A

vertebral columns

167
Q

If their is a shift in the trachea on the X-ray this indicates what?

A

unilateral lung problem

168
Q

The area where between the lungs where the heart, blood vessels, lymphatics, and major bronchi are found

A

mediastinum

169
Q

mediastinum may shift in presence of what 2 things?

A

pneumothorax and pleural effusion

170
Q

type of diameter that is increased with obstructive lung disease

A

anterior posterior diameter

171
Q

the angles made by the outer curve of the diaphragm and chest wall

A

costophrenic angels

172
Q

on X-ray the costophrenic angles are always obliterated if what is presented?

A

pleaural effusion

173
Q

normall is a dome shape but is flattened with COPD

A

diaphragm

174
Q

blood vessels and lymphathics that can be seen on x-ray

A

vascular markings

175
Q

a heart shadow allows you to see what ventricle of the heart?

A

left ventricle

176
Q

cardiomegaly is common with what disease?

A

CHF

177
Q

tissue that surrounds the chest and neck area

A

soft tissue

178
Q

represented as HYPERLUCENCY in the soft tissue area on an xray

A

subcutaneous emphysema

179
Q

on xray ribs should have normal spacing and curves.

If they are closer together than normal this indicates what?

A

atelectasis

180
Q

on xray ribs should have normal spacing and curves.

If they are straighter than normal this indicates what?

A

air trapping

181
Q

xray projection that the image receptor is taking behind the back

A

AP projection

182
Q

most common X-ray projection for bedridden patients

A

AP

183
Q

xray projection that the image receptor is touching the chest

A

PA projection

184
Q

a slanting or diagonal xray projection

A

oblique position

185
Q

xray projection where the patient is laying on the infected side

A

lateral decubitus position

186
Q

what X-ray projection is used to identify pleural effusion

A

lateral decubitus

187
Q

X-ray projection that gives a view of the lung apices

A

apical lordotic

188
Q

type of image taken at the end of exhalation to measure diaphragmatic excursion

A

end expiratory image

189
Q

type of X-ray image used to detect a pneumothorax

A

end expiratory image

190
Q

the tip of the ET tube should be positioned where

A

below the vocal cords
2-6cm above the carina
level of aortic arch

191
Q

to determine proper positions before an X-ray is taken, you should do what?

A

inspect and auscultation

192
Q

laryngotracheobronchitis is also called what?

A

croup

193
Q

used to identify the upper airway obstructions in children such as croup and epiglottis

A

lateral next X-ray

194
Q

presented on X-ray as steeple sign, picket fence, pencil point sign, hourglass

A

croup

195
Q

how do you treat croup?

A

35-40% oxygen, aerosol, racemic epi

196
Q

supraglottic narrowing with an enlarged and flattened epiglottis and swollen aryepiglottic folds

A

epiglottitis

197
Q

epiglottitis is presented on cray as what?

A

thumb sign

198
Q

dark pattern seen with air in the lungs which is normal

A

radiolucent

199
Q

white pattern seen with fluid in the lungs which is not normal for lungs but normal over areas of bones and organs

A

radiodense

*same as radiopaque

200
Q

seen with any ill defined radiodensity and common with atelectasis

A

infiltrate

201
Q

a solid white areas, seen with pneumonia and pleural effusion

A

consolidation

202
Q

extra pulmonary air

A

hyperlucency

203
Q

diseases that would present on X-ray as hyper lucency

A

COPD asthma and pneumothorax

204
Q

vascular markings will be increased with what and decreased with what?

A

decreased=pneumothorax

increased= CHF

205
Q

diffused infilate indicates what?

A

atelectasis and pneumonia

206
Q

means fluid or solid

A

opaque

207
Q

diffused whiteness of the cray that shows an infiltrate in the shape of a butterfly

A

pulmonary edema

208
Q

fluffy infiltrates, butterfly pattern, batwing pattern

A

pulmonary edema

209
Q

how do you treat pulmonary edema?

A

diuretics, digitalis, digoxin

210
Q

X-ray shows scattered and thin layered densities

A

atelectasis

211
Q

patch inflaters, plate like infiltrates, crowded vessels, crowded air bronchograms

A

atelectasis

212
Q

how do you treat atelectasis?

A

lung expansion therapy

IPPB, SMI, IS, CPAP, PEEP

213
Q

shows a retrogranular pattern or honey cone pattern

A

ARDS

214
Q

shows fluid on the affected side and possible mediastinal shift to unaffected side

A

pleaural effusion

215
Q

how do you treat a pleural effusion

A

thoracentesis, chest tube, antibiotics, steroids

216
Q

shows as a peripheral wedge shape infiltrate

A

pulmonary embolism

217
Q

what do you treat a PE with?

A

heparin or streptokinase

218
Q

TB is often seen in which lobes?

A

upper

219
Q

the distal tip of the ETT should be seen in the middle of what?

A

trachea

220
Q

If the ETT is inserted too deep it will be located where?

A

right mainstream bronchi

221
Q

Signs of a pneumothorax

A

sudden chest pain and increased dyspnea and SOB

222
Q

increase of peak and plateau pressures on a vent patient indicates what issue?

A

pneumothorax

223
Q

an X-ray that goes though a specific place of the body part that you want to examine

A

CT scan

224
Q

useful to detect presents of masses, nodules or lesions that can’t be seen on X-ray

A

CT scan

225
Q

test used to diagnose bronchiectasis

A

CT scan

226
Q

diagnoses a pulmonary embolism

A

spiral CT scan with contrast

227
Q

gives a 2-d view of the body without using radiation

A

MRI

228
Q

test that can be done to determine presence of tumors

A

MRI

229
Q

what type of cylinders need to be used while undergoing an MRI?

A

aluminum cylinders

230
Q

a scan that uses radioactive material to examine airflow (ventilation)

A

V/Q scan

231
Q

the purpose of a v/q scan is to determine if what is present?

A

pulmonary embolism

232
Q

a normal v/q scan with an abnormal perfusion scan indicates what?

A

pulm. embolism

233
Q

a test done to determine why painful swallowing, abdominal pain, vomit, or unexplained weightloss is occurring

A

barium swallow

234
Q

a test that determine a disease quicker than MRI and CT

A

PET scan

235
Q

on the exam if you see Pet scan always think of what?

A

cancer

236
Q

metallic compound that shows up on X-ray and is used to help see abnormalities in the esophagus and stomach

A

barium sulfate

237
Q

how many minutes does a pet scan take

A

15 mins to 2 hours

238
Q

what is the main indication to do a bronchograpy?

A

bronchiectasis

239
Q

you would perform an EEG when what is suspected?

A

brain tumors, brain injuries, loss of brain function, seizures, to evaluate sleep disorders

240
Q

when you see pulmonary angiography on the exam you should automatically think what?

A

pulmonary embolism

241
Q

a procedure to diagnose and treat cardiovascular conditions.

A

cardiac cauterization

242
Q

norm ICP

A

5-10 mmhg

243
Q

results in cerebral vasoconstriction and will temporally lower ICP

A

hyperventilation

244
Q

osmotic agent that removes fluid from the brain

A

mannitol and hypertonic saline

245
Q

formula for CPP

A

MAP-ICP

246
Q

normal CPP

A

70-90mmhg

247
Q

test done to see if steroids are being effective

A

FENO testing

248
Q

a decrease in FENO levels indicates what?

A

steroids are working

249
Q

used to measure the amount of co in patients echoed breath using a hand held device

A

FECO testing

250
Q

FECO ranges for heavy smokers, moderate smokers, light smokers, and non-smokers

A

severe smother= over 20
moderate smoker= 11-20
light smoker= 7-10
non- smoker= less than 7

251
Q

RBC consists of what?

A

HB

252
Q

polycythemia is what?

A

too many RBC

253
Q

normal RBC

A

5

254
Q

transports oxygen in blood

A

Hb

255
Q

normal hb level

A

15

256
Q

the atop of the volume of abc to the total volume of blood

A

hematocrit

257
Q

normal hematocrit

A

45%

258
Q

used to fight infection

A

WBC

259
Q

normal WBC

A

5,000-10,000

260
Q

leukocytosis is what?

A

high WBC

261
Q

leuokepenia indicates what type of infection?

A

viral

262
Q

when you see eosinophils on the exam always think what?

A

asthma

263
Q

WBC type associated with TB

A

monocytes

264
Q

electrolyte that is the major intracellular cation. it is important for heart and muscle function

A

Potassium

265
Q

norm potassium (K+)

A

3.5-4.5

266
Q

hypokalemia which is low potassium and occurs with what?

A

metabolic alkalosis

267
Q

hyperkalemia is high potassium and occurs with what?

A

kidney failure

268
Q

major electrolyte that is associated with kidneys

A

sodium (Na)

269
Q

hyponatremia is low sodium and occurs from what?

A

fluid loss

ex) CHF

270
Q

hypernatremia is high sodium levels and occurs from what?

A

dehydration

271
Q

electrolyte that is the major extracellular anion

A

chloride

272
Q

normal chloride

A

80-100

273
Q

hypochloremia is low chloride levels and occurs with what?

A

metabolic alkalosis

274
Q

hyperchloremia is high chloride levels and occurs with what?

A

metabolic acidosis

275
Q

electrolyte that is excreted by the kidneys

A

creatine

276
Q

value needed to identify kidney failure

A

creatine

277
Q

normal creatine

A

0.7-1.3mg/l

278
Q

white/gret type of sputum that is a sign of chronic bronchitis

A

mucoid

279
Q

sputum color that indicates that WBC presented and is most likely bacterial infection

A

yellow

280
Q

foul smelling sputum color that is a sign of bronchiestsis

A

green

281
Q

color of sputum that indicates old blood is in the sputum

A

brown

282
Q

color of sputum that indicates new blood which is a sign of tumor or TB

A

bright red

283
Q

pink frothy secretions indicates what?

A

pulmonary edema

284
Q

if sputum color changes in color from white to yellow to green this indicates what?

A

pneumonia

285
Q

identifies what bacteria is present in 48-72 hours

A

sputum culture

286
Q

identifies what antibiotic to use to kill the specific bacteria

A

sputum sensitivity

287
Q

tells you id the bacteria is positive or negative

A

gram stain

288
Q

used to identify TB

A

acid fast stain

289
Q

used to check preoperative patients to see if they are at risk for assesive bleeding

A

coagulation study

290
Q

normal clotting factor time is how many minutes?

A

6

291
Q

a decrease in platelets is a sign of decreased what?

A

blood marrow function

292
Q

normal platelet count

A

150,000-400,000

293
Q

measures the length of time required for plasma to form a fibrin clot

A

activated partial thromboplastin time (APTT)

294
Q

normal APTT time

A

24-32 seconds

295
Q

used to monitor warfarin therapy

A

prothrombin time

*12-15 seconds

296
Q

used to detect and manage the range of disorders such as UTI, kidney disease and diabetes

A

urinalysis

297
Q

a protein found in myocardial cells and indicates damage to the heart muscle

A

troponin

298
Q

If troponin is over 0.1 always think what?

A

myocardial infaction

299
Q

enzyme that is secreted by the heart when heart failure develops and is the best indicator of CHF

A

BNP

300
Q

If BNP is elevated always think what?

A

CHF

301
Q

Normal BNP is less than what?

A

100 pg/ml

302
Q

greater than 300 BNP indicates?

A

mild heart failure

303
Q

greater than 600 BNP indicates?

A

moderate heart failure

304
Q

greater than 900 BNP indicates?

A

severe heart failure

305
Q

skin test to diagnose TB

A

mantaux test

306
Q

ECG axis measures the direction of electrical activity, the implies moves in what direction?

A

starts in rt heart then moves down and then to the lt

*starts in SA node and ends in lt ventricle

307
Q

an ecg monitor that proves continuous visual image of the heart activity

A

oscilloscope

308
Q

a portable version of the electrocardiograph that is used to detect cardiac arrhythmias i

A

holter monitor

309
Q

node that generates electrical impulse

A

sa node

310
Q

the wave of deporliaztion goes through where which causes contraction creating the p wave

A

atria

311
Q

the impulse from the atria is received by what node and then there isa short delay creating pr interval

A

av node

312
Q

the stimulus moves from the AV node to the bundle of his then to the bundle branches then to where?

A

pirkenje fibers

313
Q

QRS complex is created where?

A

pirkinje fibers

314
Q

after the QRS complex is created there is a short delay called what?

A

st segmanet

315
Q

after the delay of the st segment the heart is then depolarized and what wave is created?

A

t wave

316
Q

a myocardial infarction will most likely occur in what ventricle?

A

left

317
Q

t wave is that wave where the heart is what?

A

repolarized

318
Q

displays the movement of electricity from one electrode to another

A

lead

319
Q

V1 is located on what rib on what side of the sternum?

A

rt side of sternum on 4th rib

320
Q

v2 is located on what rib on what side of the sternum?

A

lt side of sternum on 4th rib

321
Q

v3 is located on what rib on what side of the sternum?

A

between 2 and 4 on the lt side of sternum on 4th rib

322
Q

v4 is located on what rib on what line?

A

5th rib on the lt midclavicular line

323
Q

v5 is located on what rib on what side of sternum

A

between v4 and v6 on 5th rib on left side of sternum

324
Q

v6 is located on what rib on what line?

A

5th rib on midaxillary line

325
Q

normal HR

A

60-100

326
Q

bradycardia

A

below 60

327
Q

tachycardia

A

over 100

328
Q

flutter

A

over 200

329
Q

fibrillation

A

too many bpm to count

330
Q

HR equation

A

300 / # of boxes between R waves

ex) 300/ 3= 100
* normal HR

331
Q

treat sinus tachy with what?

A

o2

332
Q

treat sinus brady with?

A

o2 and atropine

333
Q

what does a PVC on ekg indicate?

A

electrolyte imbalance

334
Q

if a pt is presented with v-tach and still has a pulse what do you do?

A

cardiovert

335
Q

if pt is present with v-tach and does not have a pulse what do you do?

A

defibrillate, CPR, give amiodarone

336
Q

if a pt presents with v-fib what do you do?

A

defrillate, cpr, epi, amiodarone

337
Q

if asystole is shown what do you confirm first then proceed to do what?

A

2 ECG leads are in the correct place then do CPR and give epi

338
Q

myocardial infarction presents with what elevated on ECG?

A

st elevation

339
Q

inverted t wave on ECG

A

ischemia

340
Q

often occurs after ischemia and presents as elevated ST on strip

A

injury

341
Q

term when MI is actually occurring and is diagnosed by significant q waves on strip

A

infarction

342
Q

cardiac rhythm disturbances and muscle weakness are signs of what?

A

hypokalemia

343
Q

how do you treat hypokalemia?

A

potassium

344
Q

a way to evaluate infants health immediately after birth measures at first minute after birth and again at 5 mins

A

APGAR score

345
Q

for an agar score of 0-3 what do you do?

A

resuscitate the newborn

346
Q

for an agar score of 4-6 what do you do?

A

support give 02 and stimulate newborn

347
Q

for an agar score of 7-10 what do you do?

A

baby is healthy just continue to monitor

348
Q

recommend a transillumination when what is suspected?

A

pneumothorax

349
Q

normal infant temp

A

36.5 degrees

350
Q

normal infant HR

A

110-160

351
Q

normal infant RR

A

30-60

352
Q

normal infant BP

A

60/40

353
Q

premature infants BP

A

50-30

354
Q

to determine a cause of a shunt you should do what kind of study?

A

echocardiogram

355
Q

norm infant glucose

A

30

356
Q

L/s ratio is done to determine fetal lung immaturity. a good ratio is what?

A

2:1 or greater

357
Q

less than 2:1 L/s ratio indicates the infant is at risk for what?

A

HMD and IRDS

358
Q

a L/s ratio less than 2:1 is in need of what replacement therapy?

A

surfactant

359
Q

used to monitor exhaled co2 using infrared absorption

A

capnography

360
Q

an increase in end tidal co2 indicates what ventilation?

A

decreased ventilation

361
Q

a decrease in end tidal co2 indicates a what in ventilation?

A

increase in ventilation

362
Q

low end tidal co2 right after intubation means that the tube is where?

A

in the esophagus

363
Q

acceptable pulse ox range

A

93-97%

364
Q

pulse oximeters will read falsely higher in presence of what?

A

carbon monoxide

365
Q

used to confirm tracheal intubation

A

color metric co2 detector

366
Q

if you suspect having a sleep disorder like obstructive sleep paean you may recommend the patient to undergo what test?

A

overnight pulse ox

367
Q

during an overnight pulse ox reading if an episode of spo2 below 89% recommend what?

A

polysomnography

368
Q

best way to evaluate a pt with carbon monoxide poisoning

A

co-oximeter/hemoximeter

369
Q

a method of choice to contusing monist oxygenation and ventilation

A

transcutaneous monitoring

370
Q

way to monitor circulation and perfusion

A

hemodynamic monitoring

371
Q

factors that control BP

A

heart, blood, vessels

372
Q

increase in HR will _____ BP

decrease in HR will ____ BP

A

increase, decrease

373
Q

increase in contractibility will ___ BP

decrease in contractibility will ____BP

A

increase, decrease

374
Q

excessive fluids will ____ BP

A

increase

375
Q

constriction of vessels will ___ BP

dilation of vessels will ___ BP

A

increase, decrease

376
Q

transducer used to continuously monitor BP

A

strain-gauge transducer

377
Q

If transducer is ABOVE the catheter, readings will be ___ than the actual

A

lower

378
Q

if transducer is BELOW the catheter, readings will be ___ th an the actual

A

higher

379
Q

Blood flow starts at what ventricle?

A

left

380
Q

blood leaves the heart through the what valve into the systemic arterial system

A

aortic valve

381
Q

blood then travels into the capillaries then tissues then into what veins?

A

systemic veins

382
Q

After blood reaches systemic veins the blood traces back into the heart to the ____

A

rt atrium

383
Q

the difference between systolic and diastolic pressures

A

pulse pressure

384
Q

normal pulse pressure

A

40

385
Q

MAP equation

A

MAP= 2x diastolic + systolic / 3

386
Q

normal cardiac output (QT)

A

4-8

387
Q

normal cardiac index (CI)

A

2-4

388
Q

SVR equation

A

SVR=MAP-CVP/Cardiac Output

389
Q

PVR equation

A

PVR= MAP- PCWP/ cardiac output

390
Q

urine output

A

40

391
Q

normal chest percussion

A

resonant

392
Q

norm breath sounds

A

vesicular

393
Q

norm heart sounds

A

s1 and s2

394
Q

ICP

A

5-10

395
Q

Cerebral perfusion pressure

A

70-90

396
Q

BUN

A

8-25

397
Q

MAP

A

120/80

*mean of 93

398
Q

CVP

A

2-6

399
Q

PAP

A

25/8

*mean of 13

400
Q

pulmonary cap pressure

A

8-10

401
Q

PCWP

A

4-12

402
Q

lt ventricular pressure

A

120/0

403
Q

SVR

A

20mmhg or 1600 dynes

404
Q

PVR

A

less than 2.5 mmhm or 200 dynes

405
Q

decreased PCWP is usually associated with

A

dehydration or vasodilation

406
Q

AN increased PCWP is associated with what?

A

fluid overload, heart failure, mitral valve insufficieny, cardiac tamponade

respiratory (4 decks)

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