Thorax & Lungs

Question 1

Where exchange of oxygen and carbon dioxide takes place

Answer 1

alveolar sac

Question 2

Assessing the Lungs

Answer 2

General inspection(visualize pt’s respiratory status)
Chest expansion(if both sides expand equally)
Tactile Fermitus
Chest percussion
Lung auscultations

Question 3

Abnormal findings

Answer 3

Barrel chest (common in people w/COPD)
Pectus excavatum
Pectus carnatum
Scoliosis
Kyphosis

Question 4

wider in diameter than normal chest

Answer 4

Barrel chest

Question 5

sternum caved in

Answer 5

pectus excavatum

Question 6

sternum sticks out

Answer 6

pectus carinatum

Question 7

“hunch back” (associated with old age & osteoporosis)

Answer 7

kyphosis

Question 8

lateral curvature of the spine (left to right curvature is abnormal)

Answer 8

scoliosis

Question 9

Abnormal Respiratory Patterns

Answer 9

Hyperventilation (Kussmaul)
Cheyne-Stokes respirations
Biot respirations

Question 10

this respiration pattern is typically associated with extremely high blood sugar (DKA); increased in both rate and depth

Answer 10

hyperventilation (kussmaul)

Question 11

the respiration pattern where the client will breathe light, then deeper and deeper, then back to light, then eventually stop breathing.

Answer 11

Cheyne-Stokes

Question 12

this respiration pattern is irregular; no pattern at all. usually caused from brain/head injury; also seen in alot of icu patients when they are dying

Answer 12

Biot respirations

Question 13

rapid, shallow breathing

Answer 13

Tachypnea

Question 14

slow breathing

Answer 14

Bradypnea

Question 15

an irregular shallow pattern caused by an overdose of narcotics or anesthetics

Answer 15

hypovetilation

Question 16

Signs of Respiratory Distress

Answer 16

1. Assessory muscles (using extra muscles you don’t normally use to breathe; the whole torso moves)
2. Grunting
3. Head bobbing (head wiggling with each breath-typically in kids)
4. Nasal flaring
5. Retractions
6. Tachypnea
7. Tripod position

Question 17

position used in those who are trying to breath (lean forward w/hands on knees propping themselves up)

Answer 17

Tripod position

Question 18

Chest Expansion assessment

Answer 18

checking for symmetrical chest expansion with the patient’s breaths

Question 19

Tactile Fermitus assessment

Answer 19

using the heel of your hand, have patient say “99” as you move from side to side checking for equal vibrations

Question 20

During tactile fermitus assessment, if the vibrations on each side from patient’s voice is unequal or different this could be a sign of what?

Answer 20

a mass or fluid

Question 21

Lung Auscultation

Answer 21

listening to each breath with a stethoscope

Question 22

What are some conditions which might cause unequal chest expansion?

Answer 22

marked atelectasis, lobar penumonia, pleural effusion, thoracic trauma such as fractured ribs or pneumothroax

Question 23

what does the word fremitis mean?

Answer 23

palpable vibration

Question 24

why should you avoid assessing for tactile fremitis over a patient’s scapula?

Answer 24

bone damps out sound transmission

Question 25

If someone has lobar pneumonia, would you expect increased or decreased fremitus over that area?

Answer 25

increased

Question 26

If someone has a pneumothroax, would you expect increased or decreased fremitus over that area?

Answer 26

decreased

Question 27

what is the predominate percussion sound you should expect to hear over the lungs fields?

Answer 27

normal resonant

Question 28

what might an area of hyperresonance indicate?

Answer 28

too much air is present such as emphysema or pneumothorax

Question 29

what might an area of dullness indicate?

Answer 29

pneumonia, pleural effusion, atelectasis, or tumor

Question 30

should you use the bell or diaphragm of your stethoscope when auscultating lungs sounds?

Answer 30

diaphragm

Question 31

what should you do if your client has a particularly hairy chest?

Answer 31

press harder with the stethescope or wet the hair with a damp cloth

Question 32

Are you supposed to auscultate on top of clothing?

Answer 32

no

Question 33

ask your client to breathe through his or her ____.

Answer 33

mouth

Question 34

How hard should your client breathe?

Answer 34

client should breathe normally

Question 35

What is the name of the sound you should hear when auscultating peripheral lung fields?

Answer 35

vesicular

Question 36

when you are auscultating the posterior chest, which lobes are you primarily listening to?

Answer 36

lower lobes