# Respiratory

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1. What type of cell secretes surfactant?
Type 2
2. What are the 4 critical life functions?
Ventilation: air in and out

Oxygenation: o2 into blood

Circulation: moving blood through body

Perfusion: getting blood and o2 into tissue
3. What is water vapor pressure?
47 torr regardless of the inspired humidity.

Absolute humidity: 100% humidified is 44mg/L. When in the presence of gas, it behaves accoring to gas law
4. What is the Aa gradient?
P(A-a)O2: PAlveolar o2 (100)- Parterial o2 (80) = 20.

Normal AC membrane o2 < 20

if its high, that means decrease in diffusion rate due to poor AC membrane fxn due to enlargement
5. What is FRC?
Volume present in lung @ end of normal expiration b4 start of inspiration
6. What is in atmosphere aka barometric pressure?
78% N2, 21% O2, .95% Argon, .05% C02. At sea level its 760 mmHg or 1 atm.
7. What is the Alveolar air equation?
• Approximate Alveolar partial pressure of o2.
• PAo2=[(Pb-PH20)× fio2] - PaC02 × 1.25
8. What is normal CO and what is the formula?
• 3.5 - 8 Lpm.
• CO=SV × CR
9. What is the anatomical dead space?
1 mL/Lb or 2.2mL/kg
10. What is the formula for true alveolar VE?
[VT- Vd] × breathes per minute
11. Normal breathing at rest: what happens to the diaphragm and what is the intrapleural pressure?
Diaphragm drops 1.5 cm and intrapleural prrssure is 3-6 cwp or 2-4 mmHg
12. When there is no air movement @ end expiration, what does that tell us about pressures?
Pb=PA
13. CaO2 calculation. Short cut...
• Look @ SaO2, PaO2, Hb, if they are normal, pick normal and move on. Short cut to calculate:
• CaO2=Hb x 1.34
14. Shortcut to calculate alveolar air equation
(7 x fio2 as a whole#) - (PaC02 + 10)
15. How do u calculate pulse pressure?
Systolic - diastolic. Normal: 40 mmHg
16. How do u calculate map?
(2 x diastolic) + systolic ) ÷ 3. Normal is 120/80
17. What 3 factors control bp?
Heart, blood, vessel
18. Normal QT (cardiac output)
4-8 L/m
19. Normal CI (cardiac index)
2-4 L/min/m2
20. PAP
Lungs (25/8)
21. PAP norm?
25/8
22. PWP
Left heart (4-12mmHg)
23. PWP norm?
4-12 mmHg
24. CVP
Right heart (2-6 mmHg or 4-12 cwp)
25. CVP norm?
2-6 mmHg or 4-12 cwp
26. Normal CaO2?
17-20 vol% ml/dL
27. A-a gradient range for V/Q mismatch
66 -300 mmHg. Tx with o2
28. A-a gradient range for shunting
>300 mmHg. Tx with o2, peep or cpap
29. Normal A-a gradient
25-65 mmhg on 100% fio2
30. Cystic fibrosis
No chloride channel. Causes thick mucus accumulation.
31. Obtunded
Drowsy state, may have decreased cough or gag reflex
32. Assess ADL to determine 6 things
• -Nursing home admission
• -need for home health care providers
• -living arrangements
• -use of hospital services
• -insurance coverage
• -mortality
33. Living will
Describes tx pt would want if he became terminally ill (<6 months to live)
34. Eupnea
Normal RR, depth, and rhythm
35. Semi-comatose
Responds only 2 painful stimuli
36. What are the 6 criterias for ADL?
• -eating
• -dressing
• -walking/transferring
• -bathing
• -urine and bowel incontinence
• -toilet use
37. What do you want to review in a pt. chart?
• 1. Admission Notes
• 2. S/Sx
• 3. Occupational hx (maybe they were a cole miner?)
• 4. Allergies/Rxns?
• 5. Prior surgery,illness, or injury
• 6. V/S (pulse,rr,bp,temp)
• 7. Physical exam of chest (percussion,auscultation, inspection, palpation)
• 8. Smoking hx
38. How do you measure ventilation?
RR, VT, chest movement, BS, PaCO2
39. How do you monitor oxygenation?
Heart rate, color (if cyanotic, waited too long), sensorium, PaO2
40. How do you monitor Circulation?
• Pulse/heart rate and strength, cardiac output
• -Strong and bounding: hypoxic, need O2
• -Weak and thready: Heart failure=> circulation is at risk
41. How do you monitor Perfusion?
Blood pressure, sensorium, temperature (cold and clammy), urine output, hemodynamics
42. Respiratory care orders must include...
• 1. Type of tx
• 2. Frequency
• 3. Med dose and dilution
• 4. Physician signature
43. Normal urine output?
• 40 ml/hr (Minimum)
• => if <40, then we should be concerned with perfusion problems. Poor perfusion of kidneys=poor urine output
44. How do we know if intake exceeds output?
• 1. weight gain
• 2. electrolyte imbalance
• 3. increased hemodynamic pressures
• 4. decreased lung compliance
45. Changes in CVP pressures indicate what?
fluid balance
46. Decreased CVP <2 mmHg indicates...
Hypovolemia
47. Incresed CVP >6 mmHg indicates...
Hypervolemia
48. Somnolent, lethargic, sleepy
think COPD O2 overdose or sleep apnea
49. Stuperous, confused
responds inappropriately, think drug overdose, intoxication
50. 4 reasons why pt may be uncooperative
• 1. Language difficulties
• 2. Influence of medications
• 3. Hearing loss
• 4. Fear, apprehension, depression, etc
51. Emotional State...
1. Anxiety,nervousness: watching every movement, asthmatic, rt distress, hypoxemia

2. Depressed: quiet or denial

3. Anger, combative, or irritable: electrolyte imbalance

4. Euphoria: drug overdose

5. Panic: hypoxia, tension pneumothorax, status asthmaticus

52. Katz ADL scoring
0: pt unable to perform or need assistance in performing ADL

1: pt needs NO direction or assistance in performing ADL
53. Interpretation of Katz scoring
6: pt is independent and has full functional capability

4: pt has moderate impairment and needs some assistance

<2: pt requires assistance when performing any activity
54. Orthopnea
difficulty breathing except when in upright position

CHF, heart problem
55. General Malaise
run down feeling, nausea, weakness, fatigue, headache

Electrolyte imbalance
56. Grades for dyspnea

• 1. dyspnea occuring after unusual exertion
• 2. breathless after going up hills or stairs
• 3. dyspnea while walking at normal speed
• 4. dyspnea slowly walking short distances
• 5. dyspnea at rest, shaving, dressing, etc
57. 8 characteristics to identify symptoms of pain (all are important)
• 1. location
• 2. quality (what kind is it)
• 3. severity ( on a scale of 1-10)
• 4. aggravating factors
• 5. relieving factors
• 6. hx (when did it start and how did it progress)
• 7. context (under what circumstances did it occur)
• 8. accompanying symptoms
58. symptoms of nose and throat
excessive nasal seretions from irritants, pollutants, allergies

itching, buring sensation of nose and thoat

dysphagia and hoarsness
59. Definition of assessing pt learning needs
influencing pt behaviou and producing changes in knowledge, attitudes, and skills necessary to maintain and improve health
60. learning topics
health status

disease management

use of medication and equipment

nutrition (eating more or less)

community resources

rehabilitation techniques
61. Pt/ Family history
History of present illness: current medical/physical problems

Past medical history: previous medical problems, accidents, injuries, etc

Family history: heart disease, diabetes, cystic fibrosis, etc

Social history: smoking, substance abuse, etc
62. General appearance
age, height, weight, sex, nourishment, etc
63. Peripheral Edema
excessive fluid in the tissue aka Pitting edema (may cause sob)

occurs mostly in arms and ankles, but ankles is usually best choice (think of gravity)

caused by CHF.

rated +1, +2, +3, etc. the higher the #, the greater the swelling
64. Ascites
accumulation of fluid in the abdomen

ususally caused by Liver Failure

Tx: NG Tube
65. Clubbing of the fingers
caused by Chronic hypoxemia. Presence is suggestive of pulmonary disease or congenital heart defect
66. Venous distention
occurs with CHF, also seen in pts with Obstructive lung disease

JVD from chronic hypoxemia=>vasoconstriction=>heart failure
67. Capillary refill
indication of peripheral circulation.

Pinching their finger to see if it fills back up again, if it doesn't then we need to be concerned with perfusion
68. Define diaphoresis and list common causes.
A state of heavy/perfuse sweating.

• Heart failure
• Fever, Infection
• Anxiety, nervousness
• TB (night sweats)
69. Abnormal skin color (ashen, pallor) due to..
anemia or acute blood loss. (vasoconstriction will cause color to change by reduction of blood flow). Tx with O2
70. Increased bilirubin in blood and tissue causes
Jaundice. It appears mostly in the face and trunk
71. What is Erythema?
redness of the skin. may be from capillary congestion, inflammation, or infection or a reaction or CO poisoning
72. Cyanosis.
blue or blue-grey dusky discoloration.

Caused by hypoxia from increased amount of reduced hemoglobin (5g reduced hgb)
73. Scoliosis
Lateral curvature of the spine (side to side)
74. Kyphoscoliosis.
combination of both and causes severe restrictive impairment
75. Kyphosis
convex curvature of spine (lean forward, hunch back)
76. Pectus Excavatum
depression of part or all of the sternum
77. Pectus Carinatum
anterior protrusion of the sternum
78. Unequal (asymmetrical) movement may indicate what underlying pathologies?
• 1. Chronic lung disease
• 2. Atelectasis
• 3. Pneumothorax
• 4. Flail chest-Paradoxical
• 5. Intubated pt with ET in one lung (deflate cuff, pull out, reinsert)
79. Normal Adult RR
12-20 breaths/min
80. Tachypnea
Increased RR >20 breaths/min

Causes: hypoxia, fever, pain, CNS problem
decreased rr <12 per min variable depth and irregular rhythm.

Causes: sleep (normal), drugs, alcohol, metabolic disorders
82. Apnea
cessation of breathing
83. Hyperpnea
increased rr, increased depth, regular rhythm

Cause: Metabolic disorder/CNS disorders
84. Cheyne-Stokes breathing
gradually increasing then decreasing and depth in cycle lasting from 30- 180 seconds with periods of apnea lasting up to 60 seconds.

Cause: increased ICP, meningitis, drug overdose
85. Biots breathing
increased RR and depth with irregular periods of apnea. Each breath is same depth.

Cause: CNS problem
86. Kussmaul's Breathing
increased RR (usually over 20 breaths/min), increased depth, irregular rhythm, breathing sounds labored

Cause: Metabolic acidosis, renal failure, DKA

Tx of diabetes with insuline and HCO3 with documented blood gas only
87. Normal Muscles of ventilation
• 1. Diaphragm
• 2. External intercostals
• 3. Exhalation is normally passive
88. Accessory muscles of ventilation
• 1. Intercostal, scalene, sternocleidomastoid, pectoralis major
• 2. Abdominal muscles (oblique, rectus abdominus, etc)
• 3. Hypertrophy (increase in muscle size) of accessory muscle occurs with COPD
89. Muscle Hypertrophy
increase in muscle size
90. Muscle Atrophy
muscle wasting. loss ofmuscle tone, occurs with paralysis.

May be referred to cachectic
91. Retractions
intercostal and/or sternal retractions occur when the chest moves inward during inspiratory effors instead of outward

Causes: blocked (obstructed) airway

**Sign of RT distress in infants**
92. Nasal Flaring
Flaring of nostrils during inspiration.

**A sign of RT distress in infants**

Retraction, Nasal flaring, Grunting is them trying to produce cpap=> give cpap for support
93. Evidence of Difficult Airway
• 1. Look externally of evidence of face or neck pathology.
• -Enlarged tongue (macroglossia) (recommend anasthesiologist to intubate)
• -Bull Neck
• -Limited range of motion of neck
• -Short receding mandible
94. Pulse (2nd life function)

Tachycardia
>100 indicates hpoxemia, anxiety, stress

Tx with O2
<60 indicates heart failure, shock, code/emergency (inc. o2 consumption in muscle)

Atropine with O2
96. what do you do if there is increased heart rate > 20 beats/min
it's an ADVERSE REACTION, stop therapy, notify nurse and doctor
pulse/bp varies with respiration. May indicate severe air trapping (status asthmaticus or cardiac tamponade).
98. Emphysema: define and dx
alveoli distention resulting in rupture of elasticiy of the lung

Bedside assessment

• smoking hx
• sob
• Increased Hb/HCT
• Barrel Chest, Increased AP diameter
• Accessory muscle use
• Cyanotic
• Digital clubbing

Secondary assessment

• CXR: hyperlucency with diminished vascular markings and flattened diaphragm

ABG: compensated RT acidosis with moderate to severe hypoxemia

Pulmonary fxn: decreased DLco, decreased flows (FEF 25-75% and FEV1/FVC)
99. Chronic Bronchitis: define and dx
Productive cough for more than 3 months out of the year for 2 or more consecutive years

Bedside Assessment

• Smoking hx with chronic infxns
• sob
• Productive cough with Purulent Sputum

Secondary Assessment

• CXR: Essentially Normal or may exhibit and Emphysemic Pattern
• ABG: Hypoxemia with Normal to slightly increased PCO2 Levels
• Pulmonary fxn: Decreased flows (FEV1, FEF 25-75%), DLco Normal
100. How do you tx Emphysema?
• Low Flow (FiO2) O2 Therapy @ 1-2 L/min (.24-.28)
• Antibiotics as indicated from sputum culture
• Rehab and Home Care
• Bronchodilators, MDI, Aerosol Nebulizers
• Perhaps Trans-Tracheal oxygenation
• Nicotine replacement therapy may help to quit smoking
101. How do you tx Chronic bronchitis?
• good bronchial hygiene (CPT)
• Antibiotics for infxn
• Bronchodilator therapy
• O2 for hypoxemia
102. Bronchiectasis: define and dx
Abnormal dilation of bronchi secreting large amounts of purulent secretions

Bedside assessment

• Hx of recurrent gram negative infxn
• Digital clubbing
• Productive cough involving hemoptysis
• 3 Layer Sputum

Secondary Assessment

• CXR: Normal
• Bronchogram: BEST DIAGNOSTIC TEST Show "A Tree in Winter Pattern"
• Pulmonary Fxn: Decreased Flows (FEV1) (obstruction)
103. How do you TX Bronchiectasis?
• Good bronchial hygiene (CPT)
• Abs for infxn (senormyocin, tobermyocin)
• Aerosol Therapy with Bronchodilators
• Surgical resection of involved segments is an option
104. He/O2 mixtures using an o2 flowmeter 70/30 mixture
Actual flow is 1.6 times greater than the L/min on an o2 flowmeter with an 70/30 mixture
105. Patient's maximum heart rate
220 - age in years
106. Volume lost through chest tubes
Delivered Vt - exhaled Vt
107. He/O2 mixtures using an o2 flowmeter
Actual flow is 1.8 times greater than L/min on o2 flowmwter with an 80/20 mixture
108. Air - o2 ratio for various o2
(100-X) / X-20

(X=FiO2)
109. Total flow
Factor X Liter flow
110. Tank Factors: E cylinder, H cylinder
E cylinder = .28% L/psi (0.3)

H cylinder= 3.14 L/psi (3.0)
111. Duration of flow (cylinder duration in minutes)
Guage pressure (psi) x Tank factor / liter flow
112. To approximate fiO2 with a nasal cannula
20 + (4 x Liter flow) = approximate FiO2
113. RSBI
RR / VT (L)
114. Calculating minimum flow rate
Flowrate= (tidal volume x rate) x (I+E)
115. Work of breathing
Change in pressure x change in volume
116. IBW formula for females
105 lb + 5 lb/in over 5 ft
117. Ibw formula males
106 lb + 6 lb/in over 5 feet
118. Airway resistance (raw) - (estimate)
Raw = peak pressure - plateau pressure
119. Static compliance
Exhaled volume/ plateau - peep
120. Dynamic compliance
Exhaled vol / pip - peep
121. Normal icp
5-10 mmHg
122. Diagnostic chest percussion, norm
Resonant
123. Norm bs
Vesicular
124. Norm heart sounds
S1 and s2
125. Norm cerebral perfusion pressure
70-90 mmHg
126. Norm rbc
4-6 mill/mm3
127. Norm hemoglobin
12-16 gm/100 ml blood
128. Normal hct
40-50%
129. Norm wbc
5000-10,000 per mm3
130. Norm potassium (k+)
4.0 mEq/L, range 3.5 -4.5 mEq/L
131. Norm sodium (Na+)
140 mEq/L, range 135-145 mEq/L
132. Normal Chloride (Cl-)
90 mEq/L, range 80-100 mEq/L
133. Normal bicarbonate (HCO3-)
24 mEq/L, range 22-26 mEq/L
134. Norm Creatinine
0.7 - 1.3 mg/dL
135. Norm Blood Urea Nitrogen (BUN)
8-25 mg/dL
136. Norm Clotting time
Up to 6 minutes
137. Norm platelet count
150,000-400,000/mm3
138. Activated partial thromboplastin time (APTT)
24-32 seconds
139. Norm Prothrombin (PT)
12-15 seconds
140. Norm Thrombin time
7-12 seconds
141. Norm term infant (gestational age)
38-42 weeks
142. Norm APGAR Score
7-10
143. Normal infant temp
36.5 degrees
144. Norm heart rate (infant)
110 - 160/min
145. Norm RR (infant)
30-60 breaths min
146. Normal BP (infant)
60/40 mmHg
147. Normal birth weight (term infant)
3000g
148. Norm Dubowitz score
40
149. Normal axis
Down and to the left

Electrical impulse begins in upper right corner (sa, rt atria) and moves down and across the heart to the left
150. Resonant percussion
Normal air filled lung, gives hollow sound
151. Flat percussing sound
heard over the sternum, muscle, or areas of atelectasis

**LOSS of Air**
152. Dull percussing sound
heard over fluid fille dorgans such as the heart or the liver.

Pleural Effusion (tracheal deviation away) or PNA (tracheal deviation toward) will give this a thudding sounds.

**loss of air**
153. Tympanic percussion sound..
heard over air filled stomach. This is a drum like sound and when heard over the lungs, indicates increased volume.

**loss of Air**
154. Hyperresonant percussion sound...
found in areas of the lung where pneumothorax (absent bs with tracheal shift) or emphysema is present. this is a booming sound.

**Extra Air**
155. Bronchial breath sounds
normal sounds over the trachea or bronchi.

These sounds over the lung periphery would indicate lung consolidation.
156. Egophony
When the pt says "E" and it sounds like "A". This indicates Consolidation of the lung wiht PNA-like condition
157. Adventitious breath sounds
Abnormal breath sounds
158. Rales (crackles) indicate..
secretion/fluid
159. Coarse rales (rhonchi) indicates...
Large airway secretions. Pt needs suctioning
160. Medium rales indicate
MIddle airway secretions, Pt needs CPT
161. Fine rales (moist crepitant rales) indicate...
fluid in the alveoli, can't suction in the alveoli. Pt needs IPPB, heart durgs, diuretics, and o2.

Pt probably has CHF/Pulmonary Edema
162. Wheezing indicates...
airway narrowing due to bronchospasm. Pt needs bronchodilator
163. Unilateral wheeze indicates ...
foreign body obstruction, need bronchoscope to go down and find it to get it ous. Can't have asthma on just one side.
164. Stridor indicates...
• due to upper airway obstruction
• a. supraglottic swelling (epiglottitis)
• b. subglottic swelling (croup, post extubation)
• c. Froeign body aspiration (solids or fluids)

• Tx:
• a. racemic epi for swelling and edema
• b. suctioning and /or bronchoscopy for secretions and foreign body aspiration
• c. intubation for severe swelling.
165. Pleural friction rub...
A coarse grating or crunching sound caused by inflamed surface of the visceral and parietal pleura rubbing 2gether.

Associated with pleurisy, TB, PNA, pulm infarct, CA

TX with abs (infxn) or steriods (inflammation)
166. normal adult b/p
120/80
167. Roentgenogram
168. 5 things to note on a normal cxr
1. both hemidiaphragms dome shaped

2. Right hemidiaphragm slightly higher due to liver

3. Right hemidiaphragm @ the level of 6th anterior rib (if @ 7,8,9 Emphysemic)

4. Trachea midline, bilateral radiolucency, sharp costrophrenic angles

5. head of clavicles should be level, if not (scoliosis)
169. CXR Landmarks:

Trachea
Midline
170. CXR Landmarks:

Mediastinum
Midline, will shift with pleural effusion or pneumothorax
171. CXR Landmarks:

AP diameter
increased with COPD, barrle chest, hyperinflation
172. CXR Landmarks:

Costrophrenic angles
obliterated with Pleural effusion (also dull percussion)
173. CXR Landmarks:

Diaphragm
dome shaped normally, flattened with COPD. Left or Rt Pneumothorax may shift downward, appearing flattened on one side
174. CXR Landmarks:

Vascular markings
engorged with CHF, absent with Pneumo or a collapsed lung
175. CXR Landmarks:

left ventricle normally seen, cardiomegaly seen with CHF
176. CXR Landmarks:

Soft tissue
Tissue surrouding the echest and avove the neck area.

Sub Q emphysema is when hyperlucency is seen in the surrounding tissue.
177. CXR:

Lateral position
projection from either the right or left side
178. CXR:

Oblique view
Slanting/diagonal view.

Aid in localizing lesions behind bones or unusal places
179. CXR:

Lateral decubitis
Pt lying on affected side

Good for detecting small pleural effusions
180. CXR:

apical Lordotic
projection from lung apices
181. CXR:

End expiratory film
Taken when the pt is at end exhalation.

Good for detecting small pneumothorax or if their is an obstruction
182. CXR:

ETT position
2cm or 1 inch above the carina, level with aortic knob or aortic arch
183. CXR:

position of Ng tube
2-5 cm below the diaphragm
air, Normal
Solid, normal for bones and organs, heart shadow
186. Infiltrate
atelectasis
187. Consolidation
solid, PNA/Pleural effusion
188. Hyperlucency
EXTRA air, COPD, asthma attack

Unilateral:: pneumothorax
189. Opaque
fluid, consolidation
190. Fluffy infiltrates, Butterfly/Batwing pattern
Pulmonary Edema
191. Patchy infiltrates, Platelike infiltrates
atelectasis
192. Gound glass, homeycomb pattern, diffuse bilateral rediopacity
ARDS/RDS
193. Air Bronchogram
PNA

Pna fills small airways with fluid, big airways are full of air so they stand out
194. Peripheral wedge shaped infiltrate
Pulmonary embolus
195. Concave superior interface/border, basilar ifiltrates with meniscus
pleural effusion
196. A sprial CT with contrast dye is used to dx..
Pulmonary embolus
197. Resusitation Equipment for MRI should be...
Non-Ferrous (non-metallic)
198. In V/Q scan, if ventilation is normal but perfusion is abnormal, this indicates...
Pulmonary emboli
199. If pt has dysphagia, what kind of therapy would be inappropriate and may cause the pt to aspirate?
BIPAP
200. Bronchography (bronchogram) is an injection of radio-opaque contrast medium into that tracheobronchial tree that is helpful for what disease process?
Bronchiectasis, helps id location of involved areas that will allow better administration of postural drainage
201. Indications for EEG
Traumatic brain injuries

epilepsy/seizures

Evaluation of sleep disorders
202. Indications for Echocardiograpy
Cardiac anomaliles in the infant (ASD, VSD, PDA, etc)

Abnormal heart sounds
203. Normal ICP
5-10 mmHg
204. treatment of ICP > 20mmHG
hyperventilation until PaCO2 is 25-30 torr
205. Shortcut for remembering RBC, Hgb, Hct
Magic # is 3

5 (norm rbc) x 3 = 15 (norm hgb) x 3 =45% (norm hct)
206. Increased vs Decreased WBC
Norm: 5000-10,000 per mm3

Increased (leukocytosis):::bacterial infection

Decreased (leukopenia)::: viral infection
207. Hypokalemia occurs with
Metabolic alkalosis, excessive excretion, renal lowss, flattened T wave on EKG
208. Hyperkalemia indicates
Metabolic Acidosis, Spiked T wave, Kidney Failure
209. Hypernatremia
Dehydration
210. Hyponatremia
fluid loss from diuretics, vomiting, diarrhea
211. Hypchloremia
low chloride: metabolic alkalosis (it follows K+ so K+ is low too)
212. Hyperchloremia
high chloride (metabolic acidosis) (K+ is high)
213. Bicarbonate (HCO3-) ::: total Co2 content
co2 is carried in blood as HCO3, so total co2 contetn relfects changes in blood base

• high co2=high HCo3=Metabolic alkalosis=low K+
• low CO2=low HCo3=Metabolic acidosis=high K+
214. Clear sputum
normal
215. Mucoid white/grey sputum
chronic bronchitis
216. Yellow sputum
presence of WBC, bacterial infxn
217. Green sputum
gram neg. bacteria, bronchiectasis, pseudamonas
218. Brown/dark sputum
old blood
219. bright red sputum
hemoptysis (bleeding , tumor)
220. pink, frothy sputum
pumonary edema
221. Which is considered a "Quick" assessment for sputum tests?

a) Gram Stain

b) Sputum culture & sensitivity
a) Gram stain: it's quick and will tell you if its a gram neg or gram pos.

If it doesn't as for "Quick Assessment" then you could pick Sputum culture and sensitivity to tell yuou the type of bacteria and what kind of abs will work. Sputum C&S takes time
222. what is the difference between Neurtrophil bands and segs?
Bands: immatures cells, 4% of wbc, INCREASED BACTERIAL INFXN

Segs: mature cells, 60% of wbc, DECREASED BACTERIAL INFXN
223. What pathology is associated with increased eosinophils?
Athma, 2% of wbc, Increased with ALLERGIC rxn produce yellow sputum
224. Pulmonary angiogram is used to dx what pathology?
Pulmonary embolism
225. Tx is recommended when ICP increases above what level?
> 20 mmHg
226. Define cerebral perfusion pressure (CPP)
pressure gradient that measures cerebral perfusion
227. What is the formula to calculate cerebral perfusion pressure (CPP)
CPP=MAP - ICP
228. What is the normal value for CPP?
70-90mmHg
229. What is exhaled nitric oxide (NIOX) testing used for?
monitor asthma pt's response to antiinflammatory (corticosteroid) through monitoring pt level of nitric oxide in pt exhaled breath
230. Decrease in FEno level suggests...
decrease in airway inflammation
231. What are the indications for a barium swallow test?
Dysphagia

Esophageal varices

Suspected esophageal malignancy
232. A ballon tipped, flow directed catheter positioned in the pulmonary artery with the balloon inflated measures which pressure?
A)PAP
B)PWP
C)CVP
D)MAP
B)PWP
(this multiple choice question has been scrambled)
233. A balloon tipped, flow directed catheter is positioned in the pulmoary arter with the balloon deflated, which pressure is being measured by the proximal lumen?
A)PWP
B)MAP
C)PAP
D)CVP
D)CVP
(this multiple choice question has been scrambled)
234. Symptoms of Pleural Effusion
Dullness to Percussion

Decreased Tactile Fremitus

Dry, Non productive cough

Diminished Breath Sounds

Dyspnea
235. What is a Galvanic Cell used for?
to monitor o2 concentration
236. which is the best aerosolized bronchodilator fo ra pt with acute asthma exacerbation?

A) Ipratrpium Bromide (Atrovent)
B) Albuterol (proventil)
C) Tiotropium (spiriva)
D) Salmeterol (Serevent)
B) Albuterol. A fast acting beta 2 agonist is the appropriate tx for acute bronchospasm
(this multiple choice question has been scrambled)
237. In VCV, which controls can be changed to adjust the I:E ratio?
• Volume (affects i time)
• Mandatory Rate(affects e time)
• Inspiratory Flow (affects i time)
238. Drug: Dornase alfa (Pumozyme)

ususally used with what kind of pts? and what does it do?
Cystic fibrosis

It decreases the viscosity of sputum in CF pts to decreased exacerbations that req. hospitalization
239. If pt has increased PaCo2 during weaning trial, this indicates...
respiratory muscle fatigue with resulting hypercapnia
240. MIP, VT, VC measures what exactly in weaning from mechanical ventilation?
Muscle Strength
241. Suction pressures for Infant, Child, Adult??
Infant: -60 to 80mmHg

Child: -80 to -100 mmHg

Adult: -100 to -120 mmHg
242. Drug: Pentamidine Isethionate (NebuPent)

What is it and what side effect may be caused by it?
Anti-Viral for tx of Viral PNA. Side effect: Bronchospasm
243. Bilateral fluffy infiltrates in cxr indicative of...
Pulmonary Edema from increased interstitial and alveolar fluid
244. when calibrating a thermal conductivity helium analyzer, what should the analyzer read when calibrated in air?

A) 0%
B) 100%
C) 21%
D) 79%
A) 0%. Air contains no helium; therefore, it should read 0
(this multiple choice question has been scrambled)
245. When in proper position, the tip of the CVP catheter should be where?
in the lower portion of the superior vena cava
246. the is the correction factor for heliox mixture 80/20 and 70/30?
1.8 for 80/20 mix, 1.6 for 70/30 mix
247. If a pt is on a beta blocker medication and requires bronchodilator therapy, which medication should the RT recommend in leu of Albuterol?
Atrovent. Albuterol is a beta receptor stimulator and may show reduced efficacy int eh presence of beta blocking agents. Atroven uses a different mechanism for bronchodilation.
248. Cuff pressures > 30 ktorr on the tracheal wall will cause obstruction of...
Capillary Flow

Venous Flow

Lymphatic Flow
249. What device is used to deliver Pentamidine (NebuPent)?
A filtered exhalation nebulizer to prevent environmental contamination
250. what is the appropriate location of a chest tube for a pt with a hemothorax?
5th ics in mid axillary line is appropriate to drain fluids from the chest. Any higher and thorax may not adequately drain the fluid
251. MIP measures?
inspiratory muscle strength
 Author: svtep01 ID: 16039 Card Set: Respiratory Updated: 2010-05-31 08:26:34 Tags: NBRC CRT RRT Folders: Description: Board study questions Show Answers: