patient evaluation / section A

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imatissa
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176268
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patient evaluation / section A
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2012-10-08 15:09:19
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patient evaluation / section A
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  1. presence of excessive fluid in the tissue known as pitting edema
    peripheral edema
  2. pathology of peripheral edema
    ankles and arms
  3. peripheral edema is caused by
    • chf (left side)
    • renal failure
  4. fluid in the abdomen
    ascites
  5. ascites is caused by
    liver failure
  6. clubbing of fingers is caused by 
    chronic hypoxemia
  7. presence of clubbing of fingers is generally found in which type of patients
    CF
  8. increase in venous distention occurs with
    CHF
  9. an indication of peripheral circulation
    capillary refill
  10. capillary refill is commonly done for which test?
    modified allens test
  11. a state of profuse/heavy sweating
    diaphoresis
  12. abnormal decrease in color due to anemia or acute blood loss
    ashen, pallor
  13. increase in bilirubin in blood and tissue. appears mostly in the face and trunk
    jaundice
  14. redness fo the skin, may be due to cap congestion, inflammation, infection
    erythmia
  15. blue or blue gray dusky discoloration
    cyanosis
  16. convex curfacture of the spine (lean fwd)
    kyphosis
  17. lateral curvature of the spine
    scoliosis
  18. result of air trapping in the lungs for a long period of time
    barrel chest
  19. barrel chest is due to 
    COPD
  20. barrel chest is an increase in
    a-p diameter
  21. describe symmetrical chest movement
    both side of chest moves the same
  22. 5 pathologies that can contribute to a pt displaying asymmetrical movement
    • chronic lung disease
    • atelectasis
    • pneumothorax
    • flail chest
    • intube pt w/ ett in one lung
  23. normal resp rate, depth and rythm
    eupnea
  24. normal rr for adult is
    12-20 bpm
  25. increased in rr over 20 bpm
    tachypnea
  26. causes of tachypnea is
    • hypoxia
    • fever
    • pain
    • cns problem
  27. decreased rr less than 12 bpm
    bradycardia
  28. causes of bradycardia is
    • normal sleep
    • drugs
    • alcohol
    • metabolic disorders
  29. cessation of breathing
    apnea
  30. increased rr, increased depth, regular rhtym
    hyperpnea
  31. hyperpnea is caused by
    metabolic disorder/cns disorders
  32. gradualy increased then decreasing rate and depth in a sysle lasting from 30/180 seconds, with periods of apnea lasting up to 60 seconds
    cheyne stokes
  33. cheyne stokes is caused by
    • increased icp
    • meningitis
    • drug overdose
  34. increased in resp rate and depth w/ irregular periods of apnea
    biots
  35. biots is caused by what problem
    cns
  36. increased in resp rate usually over 20 bpm, increased in depth, irregular rhythm, breathing sound labored
    kussmauls
  37. kussmauls is caused by
    • metabolic acidosis
    • renal failure
    • diabetic ketoasidosis
  38. what are the normal muscles of ventilation
    • diaphragm
    • external intercostals
    • exhalation is normall passive
  39. what causes hypertrophy of the the accessory muscles
    COPD
  40. muscle wasting is
    atrophy
  41. atrophy is loss of muscle tone and occurs in 
    paralysis
  42. atrophy may be referred to as
    cachetic
  43. signs of resp distress in infants
    • retractions
    • nasal flaring
  44. normal range for a pt's hr
    60-100
  45. tachycardia indicates
    • hypoxemia
    • anxiety
    • stress
  46. bradycardia indicates
    • heart failure
    • shock
    • code/emergency
  47. what does paradoxical pulse/pulsus paradocus indicate
    severe air trapping
  48. what should be used to determine tracheal position
    palpation
  49. to determine tracheal position, place the index finger into the 
    supra-sternal notch
  50. if tracheal deviations is pulled TOWARD the affected side
    • pulm atelectasis
    • pulm fibrosis
    • pneumonectomy
    • diaphragmatic paralysis
  51. if trachel deciations is pulled AWAY from the affected side
    • massive pleural effusion
    • tention pneumothorax
    • neck or thyriod tumors
    • large mediastinal mass
  52. what is tactile fremitus
    vibrations that are felt by the hand on the chest wall
  53. what is meant by tenderness
    pt's skin ,ay be tender around sutures, chest tube, bruises, fractured bones
  54. bubbles of air under the skin that can be palpated 
    crepitus
  55. crepitus indicates the presense of
    subcutaneous emphysema
  56. normal air filled lungs. gives hollow sound
    resonant
  57. heard over sternum, muscles or areas of atelectasis
    flat
  58. heard over fluid filled organs such as the heart or liver. pleural effusion or pneumonia will give this thudding sound
    dull
  59. heard over air filled stomach 
    tympanic
  60. pneymothorax or emphysema is present
    hyperresonant
  61. normal bs
    vesicular
  62. abnormal bs
    adventitious
  63. pt is instructed to say E and it sounds like A
    egophony
  64. egophony indicates
    consilidation of the lung tissue as with a pneumonia like condition
  65. large airway secretions
    coarse rales (rhonchi)
  66. tx for coarse rales (rhonchi)
    pt needs suctioning
  67. middle airway secretions
    medium rales
  68. tx for medium rales
    cpt
  69. alveoli, fluid b/s
    fine rales / moist crepitant rale
  70. pt with fine rales has 
    • chf
    • pulm edema
  71. pt with fine rales pt needs
    • ippb
    • heart drugs
    • diuretics
    • o2
  72. wheeze is due to 
    bronchospasms
  73. when a pt wheezes, pt needs what type of bronchodilator
    albuterol
  74. if pt has a unilateral wheeze and has an indication of a foreign body obstructions, what should you give
    a bronchoscope
  75. stridor is due to a 
    upper airway obs
  76. tx for stridor
    racemic epi
  77. a course of grating or crunching sound
    pleural friction rub
  78. pleural friction rub is caused by
    inflamed surface of the visceral and parietal pleura rubbing together
  79. tx for pleural friction rub
    • steroids
    • antibiotics
  80. is created by the normal closure of the mitral and tricuspid valves at the beginning of ventricular contraction
    S1
  81. is normal and occurs when systole ends, the ventriles relax and the pulmonic and aortic valves close
    S2
  82. the presence of S3 is abnormal and may suggest what type of disease
    CHF
  83. S4 is an indicative of a cardiav abonrmality such as 
    • myocardial infarction
    • cardiomegaly
  84. what should u use to measure cuff pressures
    sphygmomanometer
  85. adult normal bp
    120/80
  86. the right hemidiaphragms is slightly highter than the 
    left hemi
  87. the right hemidiaphragm is at the level of the
    sixth anterior rib
  88. trachea should be 
    midline, bilateral radioluceny, with sharp costophrenic angles
  89. head of clavicles should be
    leveled
  90. list 3 possible causes for loss of airway patency
    • foreign objects
    • trachial spasms
    • air leak
  91. what condition causes obliteration of the costophrenic angles
    pl. effusion
  92. in what pathology is the diaphragm flattened
    COPD
  93. what type of position will confirm a presence of a small pl effusion? 
    lateral decubitus position
  94. what type of position will confirm a small pneumothorax
    end expiratory film
  95. lateral decubitis is laying on which side?
    affected side
  96. where should the tip of the endotracheal tube be positioned when viewed on a chest roentgenogram
    2cm or 1 inch above carina
  97. what is the quickest way to determine adequate ventilation following enndotracheal intubation
    auscultation
  98. description for radiolucent
    dark patter, air
  99. diagnosis of radiolucent
    normal for lungs
  100. description for radiodense
    • white
    • solid
    • fluid
  101. diagnosis of radiodense
    normal for bones, organs
  102. description for infiltrate
    ill define radiodesity
  103. diagnosis of infiltrate
    atelectasis
  104. description for consolidation
    solid white
  105. diagnosis of consolidation
    pneumonia
  106. description of hyperlucency
    extra pulm air
  107. diagnosis of hyperlucency
    • copd
    • asthma
  108. description of vascular markings
    • lymphatic
    • vessels
    • lung tissue
  109. description of vascular markings
    • increased chf
    • absent w/ pneumothorax
  110. description of diffuse
    spread throughout
  111. diagnosis of diffuse
    • atelectasis
    • pneumonia
  112. opaque
    • fluid
    • solid
  113. opaque diagnosis
    consolidation
  114. bilateral
    both sides
  115. unilateral
    one side
  116. fluffy infiltrates =
    diffuse whiteness
  117. diagnosis fluffy infiltrates
    pulm edema
  118. butterfly/batwing pattern =
    infitrate in shape of butterfly
  119. diagnosis of butterfly/batwing
    pulm edema
  120. patchy infiltrates=
    scattered densities
  121. diagnosis of patchy infiltrates
    atelectasis
  122. platelike infiltrates=
    thin layered densisties
  123. diagnosis of platelike infiltrates
    atelectasis
  124. ground

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