Normals

Question 1

Potassium (K+) Sodium (Na+) Chloride (Cl-) Think ABG

Answer 1

• Potassium (K+) 3.5-4.5 mEq/L
• Sodium (Na+) 135-145mEq/L
• Chloride (Cl-) 90-100 mEq/L

Question 2

Urine Output

Answer 2

minimum 40 mL/hr

Question 3

Fluid balance- think CVP

Answer 3

Normal CVP 2-6mmHg
decreased CVP = hypovolemia
increased CVP = hypervolemia

Question 4

Orthopnea

Answer 4

difficulty breathing except in the upright position - think CHF

Question 5

General malaise

Answer 5

run down feeling, nausea, weakness, fatigue, headache - think electrolyte imbalance

Question 6

Edema

Answer 6

• Peripheral edema- excess fluid in the arms and legs
  
  • caused by CHF and renal failure recommend diuretic therapy
• Ascites - accumulation of fluid in the abdomen caused by liver failure

Question 7

Venous distension

Answer 7

• Occurs with CHF
• Seen during exhalation in patients with obstructive lung disease and air trapping

Question 8

Diaphoresis

Answer 8

• Profuse/heavy sweating
• Heart failure (Recommend diuretics, positive inotropic agents
• Fever, infection (Recommend antibiotics)
• Anxiety (sedatives)

Question 9

Jaundice

Answer 9

• increased bilirubin level in blood and tissue, mostly in face and trunk

Question 10

Erythema

Answer 10

• redness of the skin

Question 11

Unequal/asymmetrical chest movement

Answer 11

• Post lung resection
• Atelectasis
• pneumothorax
• flail chest - paradoxical chest movement

Question 12

Tachypnea

Answer 12

• respiratory rate greater than 20
• causes: hypoxia, fever, pain, CNS problem

Question 13

Bradypnea

Answer 13

• respiratory rate less than 12
• Cause: drugs, alcohol, metabolic disorder

Question 14

Hyperopnea

Answer 14

• Increased respiratory rate, increased depth, regular rhythm
• Cause: Metabolic disorder, CNS disorder

Question 15

Cheyne-Stokes

Answer 15

• gradually increasing and decreasing rate and depth with periods of apnea
• causes: increased intracranial pressure, brainstem injury, drug overdose

Question 16

Kussmaul’s

Answer 16

• increased respiratory rate(greater than 20), increased depth, irregular rhythm, breathing sounds labored
• hypoxemia, metabolic acidosis, renal failure, diabetic ketoacidosis

Question 17

Apneustic

Answer 17

• prolonged gasping inspiration followed by extremely short insufficient exhalation
• causes: problem with respiratory center, trauma, tumor

Question 18

Tracheal deviation

Pulled toward pathology- pulled is pad

Answer 18

• Pulled to abnormal side (Toward pathology)
  
  • Atelectasis
  • pneumonectomy
  • diaphragmatic paralysis
• Pushed to normal side (Away from pathology)
  
  • pleural effusion
  • tension pneumothorax
  • neck or thyroid tumors
  • mediastinal mass

Question 19

Scoliosis

Answer 19

Lateral curve of the spine (Side to side)

Question 20

Kyphosis

Answer 20

Convex curve of the spine (hump back of notre dame)

Question 21

Hypertrophy

Answer 21

Increase in muscle size

Question 22

Atrophy

Answer 22

Loss of muscle

Question 23

What is considered an adverse reaction?

Answer 23

change of more than 20 BPM

stop treatment consult with RN or Dr

Question 24

Tachycardia

What is it?

Causes

Treatments

Answer 24

HR >100 BPM

Hypoxemia, Anxiety, stress

Recommend O2

Question 25

Bradycardia What is it? Causes Treatments

Answer 25

HR \<60 Heart failure, shock. code Atropine

Question 26

Paradoxical pulse/ Pulsus paradoxus What is it? Causes

Answer 26

Pulse/BP varies with respiration may indicate air trapping (Status asthmatics, tension pneumothorax)

Question 27

Resonant

Answer 27

Normal air-filled lung

Question 28

Flat Dull

Answer 28

* * Interchangeable * Less air than there should be * atelectasis, Pleural effusion, pneumonia

Question 29

Tympanic Hyperresonant

Answer 29

Interchangeable Extra air Indicated extra volume when over the lungs Pneumothorax or emphysema

Question 30

Crackles

Answer 30

* Coarse crackles - large airway secretions * Medium crackles- middle airway secretions * Fine crackles- alveoli opening, fluid in alveoli * CHF/Pulmonary edema * Recommend * O2 * PPV * Positive inotropic agents (stregtens heart) * Diurtetics

Question 31

Heart sounds

Answer 31

Normal is S1 and S2 If anything else order an EKG

Question 32

Apical Lordotic Xray

Answer 32

Projection of lung apices TB

Question 33

Lateral decubitus position

Answer 33

Patient lying on affected side Small pleural effusion

Question 34

PCWP

Answer 34

* wedge think left * 2-6 (4) *

Question 35

PAP

Answer 35

* P think pulmonary * 25/8 mean 14

Question 36

MAP

Answer 36

* monitors perfussion * 120/80

Question 37

CVP

Answer 37

* Monitors fluids (or right heart) * 2-6

Question 38

Creatine

Answer 38

* Excreted by kidneys * 0.7-1.3 * Increased means kidney failure

Question 39

Blood urea nitrogen

Answer 39

* kidney function * 8-25 * less specific than Creatine

Question 40

Biots

Answer 40

* Increased RR, increased depth, irregular rhythm * CNS problem

Question 41

Radiolucent

Answer 41

* Dark pattern, air * normal for lungs

Question 42

Radioopacity

Answer 42

* White pattern, solid, fluid * normal for bones

Question 43

Consolidation

Answer 43

* Solid white area * Pneumonia/Pleural effusion

Question 44

Hyperlucency

Answer 44

* COPD, Asthma attach, pneumothorax

Question 45

Vascular markings

Answer 45

* lymphatics, vessels, lung tissue * Increased with CHF * absent with pneumothorax

Question 46

Pulmonary Edema

Answer 46

* Fluffy, butterfly, batwing * Diuretics, Digitalis, digoxin

Question 47

Atelectasis

Answer 47

* Patchy, platelike, crowded *

Question 48

ARDS or IRDS

Answer 48

* Ground glass, Honeycomb, diffuse bilateral radiopacity