X RAY

Question 1

What is R.I.P in X-Ray Reading

Answer 1

R= Make sure your patient is not rotated and is flat. Make sure the spine is strait and the clavicles meet at the sternum equal
I= Make sure the patient takes and inspiration and holds breath for the Xray. Anterior ribs 5-7 should be seen at the mid clavicular line.
P= Penetration of the x-ray. Should see the spine clearly through the heart.

Question 2

Which is the preferred position for a chest X-Ray?

Answer 2

Posterior Anterior

Question 3

Dark areas of the X-Ray are _________ white areas of the Xray are __________

Answer 3

Dark areas of the X-ray are air and white areas are bone and solid organs.

Question 4

What is the treatment for COPD?

Answer 4

Bronchodilators, Anticholinergics, Atropine, Ipratropium, corticosteroids, Phosphodiesterase.

Question 5

In COPD patients you will have a flat diaphragm and an anterior-posterior increase on the R-ray T/F

Answer 5

True there is hyper inflation n the chest causing the diaphragm to flatten. There is also a long narrow heart

Question 6

What are the differences between COPD and Asthma signs and treatment.

Answer 6

Asthma has pulses paradoxus and treatment includes heliox and Ketamine.

Question 7

What are your findings? and how do you know?

Answer 7

Right tension pneumothorax there is no visible vasculature on the right Hilor area. the trachea is shifted and the right heart has shifted.

Question 8

What is happening in ARDS?

Answer 8

The alveoli are damaged and leaking fluid ( white)

Question 9

What are the three groups in the Berlin definition of ARDS and what are the ranges?

Answer 9

Mild Pao2/Fio2 < 300 with > 5 PEEP
Moderate P/F <200 with > 5 PEEP
Severe P/F <100 with > 5 PEEP

Question 10

What are your findings and why?

Answer 10

ARDS Ground glass on X-Ray is hazy and diffused patchy areas.

Question 11

What is the clue in an ARDS chest x-ray?

Answer 11

It affects bi-lateral lung fields
The word hazy and patchy.
The word ground glass.

Question 12

Treatment for ARDS?

Answer 12

Conserve fluids
Antibiotics
Lower TV Lung protection

Question 13

What is your finding and why,
What is the treatment?

Answer 13

Pneumonia because pneumonia is consolidated only in the affected area.
Treatment is antibiotics, bronchodilators C-PAP, or vent

Question 14

How do you confirm an NG tube placement?

Answer 14

Greater than 10cm past the gastroesophageal junction just under the left lung.

Question 15

On a chest X-ray, what is the correct ET tube placement?

Answer 15

ET-Tube placement 5cm +/- 2 above the Corina. At the same level of the ends of the clavicles.

Question 16

Where should chest tube placement be preformed and in which position?

Answer 16

5th intercostal space midaxillary line, facing down to drain blood facing in upward position for air.

Question 17

What is your findings and why?

Answer 17

Plural effusion costophrenic angles on the right is not visible meaning there is a fluid build-up. Effusion

Effusion definition An excessive collection of fluid in the pleural cavity, the fluid-filled space that surrounds the lungs

Question 18

Shortness of breath. This symptom typically appears suddenly and always gets worse with exertion.
Chest pain. You may feel like you’re having a heart attack. The pain is often sharp and felt when you breathe in deeply, often stopping you from being able to take a deep breath. It can also be felt when you cough, bend or stoop.
Cough. The cough may produce bloody or blood-streaked sputum.
Other signs and symptoms include:

Rapid or irregular heartbeat
Lightheadedness or dizziness
Excessive sweating
Fever
Leg pain or swelling, or both, usually in the calf caused by a deep vein thrombosis
Clammy or discolored skin (cyanosis)

Answer 18

Pulmonary Embolism: Clues= sudden SOB, Chest pain, cough leg pain, and swelling Hx of DVT, EKG inversion in leads V1-V4

Question 19

What is a D dimer test?
When is a D-dimer test used?

Answer 19

A D-dimer test looks for D-dimer in blood. D-dimer is a protein fragment (small piece) that’s made when a blood clot dissolves in your body
Help rule out a pulmonary embolism along with a CTA ( which is the gold standard)

Question 20

What are the hemodynamic changes in a PE?
Treatment for PE?

Answer 20

High RV, PAP, and CVP low to normal PCWP normal CO
Vasopressors
Anticoagulation
Thrombolytic Therapy
Filter placement

Question 21

What is a V/Q mismatch?
What is the right-to-left shunt in a case of PE?
will the patient be in acidosis or alkalosis?

Answer 21

V/Q mismatch happens when part of your lung receives oxygen without blood flow or blood flow without oxygen
Oxygen in the lungs but no blood flow to the lungs. as in PE

Blood flow from the right heart is blocked in the lungs by a PE and shunt to the left side of the heart

Alkalosis

Question 22

Go over chest x-ray