resp 2

Question 1

COPD lab values-blood-3

Answer 1

elevated:
RBC 4.2-6.1
Hgb 12-18
Hct 37%-52%

Question 2

COPD lab values- WBC differential-2

Answer 2

elevated:
neutrophils 2500-8000, 55-70%
eosinophils 50-500, 1-4%

Question 3

COPD lab values- ABG-2

Answer 3

Decreased: PaO2 80-100

elevated PaCO2 35-45

Question 4

sputum production

Answer 4

• assess color, consistency, odor, and amount

- normal 90mL a day

Question 5

smokers sputum

Answer 5

mocoid

Question 6

pulmonary edema sputum

Answer 6

excessive pink, frothy

Question 7

bacterial pneumonia sputum

Answer 7

rust colored

Question 8

lung abcess sputum

Answer 8

foul smelling

Question 9

hemoptysis

Answer 9

blood in sputum most seen in lung cancer and chronic bronchitis

Question 10

grossly bloody sputum

Answer 10

TB, pulmonary infarction, lung cancer, lung abcess

Question 11

palpation resp assessment

Answer 11

• identify areas of tenderness and check vocal or tactile fremitus (vibration)
• place hands at 9th rib inhale moves thumbs up and out, uneven expansion could be from pain, trauma, or air in pleural cav
• palpate abnormalities, crepitus

Question 12

crepitus

Answer 12

air trapped in and under skin, subcutaneous emphysema

• crackle beneath fingertips
• alert HCP if around wound, trach, or if pneumothorax suspected

Question 13

tactile (vocal) fremitus

Answer 13

• vibration felt on chest wall when speaking
• decreased with air (pneumothorax) or fluid (plearal effusion), or if bronchus obstructed
• increased with pneumonia and lung abcess

Question 14

percussion resp assessment- resonance

Answer 14

normal lung tissue

Question 15

percussion resp assessment- hyperresonance

Answer 15

presence of trapped air

Question 16

percussion resp assessment- flatness

Answer 16

may be pleaural effusion

Question 17

percussion resp assessment- dullness

Answer 17

atelectasis or consolidated lung

Question 18

percussion resp assessment- tympany

Answer 18

large pneumothorax

Question 19

breath sounds- fine crackles/rales

Answer 19

popping, discontinuous sounds caused by air moving into previously deflated airways; hair rolled between fingers
-asbestosis, atelectasis, interstitial fibrosis

Question 20

high-pitched rales

Answer 20

velcro sound, late in inspiration usually associated w restrictive disorders
-bronchitis, pneumonia, chronic pulm disease

Question 21

coarse/low pitched crackles

Answer 21

rattle produced by fluid/secretions in large airways, likely to change w cough/suction
-bronchitis, pneumonia, tumors, pulm edema

Question 22

wheeze

Answer 22

squeaky/musical/continuous ass. w air moving through narrowed small airways; heard w/o stethoscope, not cleared by coughing
-inflammation, bronchspasm, edema, secretions, pulm vessel engorgement

Question 23

rhonchus

Answer 23

low pitched, coarse, cont snoring, come from large airways

-thick tenacious secretions, sputum prod, foreign body obstruction, tumors

Question 24

pleural friction rub

Answer 24

loud/rough/grating/scratching due to inflamed surfaces of pleura rubbing together, pain on deep resp, heard in lateral lung fields
-pleurisy, TB, pulm infarction, pneumonia, lung cancer

Question 25

CT IV contrast contraindications

Answer 25

allergy to iodine or shellfish, kidney function, type 2 DM (nephrotoxic)
-metformin stop 24 prior and not restarted until adequate kidney funct reestablished

Question 26

benzocaine complications

Answer 26

may induce methemoglobinemia- altered iron state that does not carry oxygen results in tissue hypoxia

Question 27

pneumothorax signs

Answer 27

• can occur 24 hrs after thoracentesis
• pain on affected side worse at end of inhalation and exhalation, rapid heart rate, rapid shallow resp, feeling of air hunger
• prominence of affected side that does not move in and out w resp, trachea slanted to unaffected side, new nagging cough, cyanosis

Question 28

thoracentesis positioing

Answer 28

depends on vol and location of fluid, sitting leaning forward

Question 29

chronic hypercarbia oxygen requirements

Answer 29

Fio2 should be titrated to achieve oxygen saturation between 88-92%

Question 30

non-rebreather mask safety

Answer 30

ensure valve and flaps are intact and functional during ea breath, remove mucus and saliva, closely assess pt, intubation next step