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What |action |should |be |recommended |if |the |APGAR |score |is | 3 |- |correct |answer
|✔Resuscitate
What |action |should |be |recommended |if |the |APGAR |score |is |8? |- |correct |answer
|✔Monitor |routine |care
Orthopnea |- |correct |answer |✔Difficult |breathing |except |in |the |upright |position |(CHF)
General |malise |- |correct |answer |✔Run |down |feeling, |nausea, |weakness. |fatigue. |headache |(check |electrolyte |imbalance)
Dyspnea |- |correct |answer |✔A |feeling |of |shortness |of |breath |or |difficulty |breathing
Dysphagia |- |correct |answer |✔Difficulty |swallowing |and |hoarseness |are |common |symptoms
Peripheral |Edema |- |correct |answer |✔Fluid |in |the |arms |and |legs |
Recommend |a |Diuretic |
Pathology: |Presence |of |excessive |fluid |in |the |tissue |as |pitting |edema |caused |by |CHF |and |renal |failure
Ascites |- |correct |answer |✔Accumulation |of |fluid |in |the |abdomen |generally |caused |by |liver |failure.
Pathology: |Abdominal |infection
Clubbing |of |fingers |- |correct |answer |✔Caused |by |chronic |hypoxemia |
Pathology: |Pulmonary |disease |COPD, |CHF
The |thumb |and |first |fingers |are |affected.
Venous |Distention |- |correct |answer |✔Increased |venous |distention, |jugular |distention |(JVD) |temporal |veins |popping |out |
Pathology: |occurs |with |CHF, |seen |during |exhalation |in |patients |with |COPD.
Capillary |refill |- |correct |answer |✔Indication |of |peripheral |circulation |
Pathology: |blanching |the |hand |and |watch |for |color |return |
Color |should |return |within | 3 |seconds
Diaphoresis |- |correct |answer |✔A |state |of |profuse/heavy |sweating, |heart |failure |recommend |diuretics. |positive |inotropic |agents.
Pathology: |fever |infection |(recommend |antibiotics), |anxiety |nervousness |(recommend |sedatives), |tuberculosis/night |sweats |(recommend |antitubular |gram |stain)
Ashen/pallor |- |correct |answer |✔Abnormal |
Condition: |normal |respiratory |rate |for |an |adult |12-20bpm
Tachypnea |- |correct |answer |✔Increased |respiratory |rate |>20bpm
Condition: |hypoxia, |fever, |pain, |CNS |problem
Bradypnea |- |correct |answer |✔Decreased |respiratory |rate |<12bpm
Condition: |sleep, |drugs, |alcohol, |metabolic |disorder
Cheyne-Stokes |- |correct |answer |✔Gradually |increasing |then |decreasing |rate |and |depth |in |a |cycle |lasting |from |30-180 |secs |with |periods |of |apnea |up |to | 60 |secs. |
Condition: |increased |intracranial |pressures, |brainstem |injury, |drug |overdose
Biot's |- |correct |answer |✔Increased |respiratory |rate |and |depth |with |irregular |periods |of |apnea |
Condition: |CNS |depression
Kussmaul's |- |correct |answer |✔Increased |respiratory |rate |(usually | 20 |breaths/min)
Condition: |increased |depth |rhythm, |breathing |sounds |labored |metabolic |acidosis, |renal |failure, |diabetic |ketoacidosis
What |causes |hypertrophy |of |the |accessory |muscles |and |what |type |of |patient
|might |this |be |present |in? |- |correct |answer |✔Increase |in |muscle |size |of |accessory |muscle |occurs |with |COPD
Describe |the |four |neck |pathologies |that |might |complicate |endotracheal
|intubation |- |correct |answer |✔Short |receding |mandible
Enlarged |tongue |
Bull |neck
Limited |range |of |motion
What |is |the |normal |range |for |a |patient's |heart |rate |- |correct |answer |✔60- 100/min
What |term |would |be |used |to |decribe |a |heart |rate |of |160/min? |would |this
|indicate |- |correct |answer |✔Tachycardia, |indicates |hypoxemia, |anxiety, |stress |recommended |oxygen |therapy
What |term |would |be |used |to |describe |a |pule |52/min? |what |would |this |indicate?
|- |correct |answer |✔Bradycardia, |indicates |heart |failure, |shock, |code/emergency |recommend |atropine.
What |does |paradoxical |pulse/pulsus |paradoxus |indicate |- |correct |answer
|✔Pulse/blood |pressure |varies |with |respiration. |May |indicate |severe |air |trapping |(status |asthmaticus, |tension |pneumothorax, |cardiac |tamponade.
Causes |of |tracheal |deviation |Pulled |to |abnormal |side |(toward |pathology) |AIR |-
|correct |answer |✔Pulmonary |atelectasis |
Pulmonary |fibrosis |
Pneumoectomy |
Diaphrgamatic |paralysis
Hyperresonant |- |correct |answer |✔Booming |sound |that |can |be |heard |in |an |area |of |the |lung |where |either |a |pneumothorax |or |emphysema |may |be |present.
EX: |COPD
What |is |egophony |and |what |would |it |indicate |- |correct |answer |✔The |patient |is |instructed |to |say |"E" |and |it |sounds |like |"A"
This |would |indicate |consolidation |of |the |lung |tissue |as |with |pneumonia |like |condition.
What |breath |sounds |would |be |expected |in |a |patient |with |pulmonary |edema |-
|correct |answer |✔Fine |crackles |(moist |crepitant |rales) |alveoli |fluid
Coarse |rales/rhonchi |- |correct |answer |✔Clears |with |a |cough, |large |airway |
Treatment: |suction |patient |or |instruct |to |cough
Medium |rales |- |correct |answer |✔Middle |airway |secretions |
Treatment: |recommend |bronchial |hygiene
Fine |rales/crackles |- |correct |answer |✔Moist |crepitant |rales, |alveoli |fluid |
Treatment: |oxygen, |positive |pressure, |postive |inotropic, |diuretic/
Wheeze |- |correct |answer |✔Most |caused |by |bronchospasm |
Treatment: |recommend |bronchodilator
Stridor |- |correct |answer |✔High |pitched |or |crowing |inspiratory |sound |
Treatment: |caused |by |upper |airway |obstruction
Pleural |Friction |Rub |- |correct |answer |✔A |coarse |granting |raspy |crunching |sound |
Treatment: |recommend |steroids |and |antibiotics
What |effect |would |cardiac |stress |have |on |blood |pressure? |- |correct |answer
|✔Increased |blood |pressure |(hypertension) |indicates |cardiac |stress |hypoxemia
What |effect |would |hypoperfusion |have |on |blood |pressure |- |correct |answer
|✔Decreased |blood |pressure |(hypotension) |indicates |poor |perfusion |hypovolemia, |CHF
Describe |the |normal |appearance |on |a |chest |x-ray |- |correct |answer
|✔Hemidiaphragms- |are |rounded |(dome-shaped)
Trachea- |midline, |bilateral |radioluency, |with |sharp |costophrenic |angles
Clavicles- |head |of |clavicles |should |be |level
Quality |of |radiologic |images |- |correct |answer |✔Exposure/Penetration- |proper |exposure |will |show |the |intervertbal |disc |spaces |through |the |shadow |of |the |mediastinum |
Under/Penetration- |Image |does |not |allow |visualization |of |the |intervertebral |discs |through |the |heart |shadow |
Describe |where |each |of |the |following |should |be |located |when |positioned
|properly |- |correct |answer |✔Chest |tube- |in |the |plerual |space |surrounding |the |lung
Nasogastric |and |feeding |tube- |in |the |stomach |2-5 |cm |below |the |diaphragm.
Pulmonary |artery |catheter- |should |appear |in |the |right |lower |lobes
Pacemaker- |normally |positioned |in |the |right |vertical. |
Central |venous |catheter- |inserted |through |the |subclavian |or |jugular |vein |and |should |rest |in |the |superior |vena |cava |or |right |atrium
Lateral |Neck |X-ray |- |correct |answer |✔Croup- |the |x-ray |of |the |neck |will |reveal |tracheal |narrowing |with |subglottic |swelling |in |a |pattern, |steeple |sign, |picket |fence, |hourglass |sign. |
Epiglottis- |shows |supraglottic |narrowing |with |an |enlarged |and |flattened |epiglottis |and |swollen |epiglottis
What |type |of |radiograph |are |helpful |in |locating |areas |of |air-trapping |- |correct
|answer |✔Inspiratory/Expiratory |radiographs
Radiolucent |- |correct |answer |✔Dark |pattern, |air
Normal |for |lungs
Radiodense.opacity |- |correct |answer |✔White |pattern, |solid, |fluid
- |Normal |for |bones, |organs
Infilitrate |- |correct |answer |✔Any |ill-defined |radiodensity |
Consolidation |- |correct |answer |✔Solid |white |area
Pneumonia/pleural |effusion
Hyperluency |- |correct |answer |✔Extra |pulmonary |air |
COPD, |asthma |attack. |pneumothorax
Vascular |markings |- |correct |answer |✔Lymphatics, |vessels, |lung |tissue
Increased |with |CHF, |absent |with |pneumothorax
Diffuse |- |correct |answer |✔Spread |throughout |
atelectasis/pneumonia
Opaque |- |correct |answer |✔Fluid |solid
consolidation
Pulmonary |Edema |(white) |- |correct |answer |✔Fluffy |infiltrates, |Butterfly |pattern, |batwing |pattern, |kerley |lines
Diffuse |whitness, |infiltrates |in |shape |of |a |butterfly
Tuberculosis |- |correct |answer |✔Cavity |formation, |often |in |upper |lobes |
Treatment: |antitubular |agents
For |what |patholgies |would |a |CT |be |indicated |- |correct |answer |✔Pulmonary |embolus
What |special |type |of |CT |scan |is |indicated |to |diagnose |a |pulmonary |embolus |-
|correct |answer |✔A |spiral |CT |scan, |with |contrast |dye
What |is |indicated |by |normal |ventilation |with |abnormal |perfusion |- |correct
|answer |✔Pulmonary |embolism
What |are |three |indications |for |a |barium |swallow |test? |- |correct |answer
|✔Suspected |esophageal |malignancy
Dysphagia |(difficulty |swallowing) |
Indication |for |aspiration
What |is |the |main |indication |for |bronchography |- |correct |answer |✔By |outlining |the |airways |it |will |identify |obstructing |leisons |(tumors) |and |bronchietasis
List |two |hazards |of |bronchography |- |correct |answer |✔Allergic |reaction |
Impairement |of |ventilation
An |EEG |is |indicated |to |assess |activity |of |use |- |correct |answer |✔Brain |tumors
Traumatic |brain |injury |
Loss |of |brain |function |
Evaluation |of |sleep |disorders
A |pulmonary |angiogram |is |indicated |to |diagnose |- |correct |answer |✔Pulmonary |embolism
List |two |indications |for |a |pulmoanry |angiogram |- |correct |answer |✔High |clinical |suspicion |for |pulmonary |embolism |
Inconclusive |V/Q |scan |and/or |CT |scan
An |echocardiogram |is |a |- |correct |answer |✔Noninvasive |method |for |monitoring |cardiac |performance
An |echocardiogram |is |used |to |assess |- |correct |answer |✔Cardiac |function |left |ventricular |and |ejection |fraction. |volume
List |three |indications |for |an |echocardiogram |- |correct |answer |✔Cardiac |anomalies |in |the |infant |
Abnormal |heart |sounds |
Myocardial |disease
What |is |the |normal |range |for |ICP |- |correct |answer |✔70-90 |mmhg
State |the |formula |for |CPP |- |correct |answer |✔Map-ICP
Hct |- |correct |answer |✔Spin |the |whole |blood |and |measure |the |% |of |RBC
Normal |value: |40-50%
Low |values: |anemia |
High |values: |polycythemia
WBC |- |correct |answer |✔Used |by |the |body |to |fight |infections |
Normal |value: |5,000-10,
Low |value: |leukopenia |viral |infection |
High |values: |leukocutyosis, |bacterial/infection
What |are |neutrophils: |- |correct |answer |✔Major |WBC, |help |fight |infection |by |ingesting |micoorganisms |and |releasing |enzymes |that |kill |microorganisms.
Descirbe |the |difference |between |bands |and |segs |- |correct |answer |✔Bands- |Immature |cells |normally |4% |of |WBC, |increased |with |bacterial |infection. |
Segs- |mature |cells, |normally |60% |of |WBC |decreased |with |bacterial |infection
What |pathology |would |show |an |increase |in |eosinophils |- |correct |answer
|✔Allergic |Reaction/Asthma
What |are |the |electrolytes |and |what |is |their |function? |- |correct |answer
|✔Elements |required |by |the |body |for |metabolism |
Closely |associated |with |fluid |levels, |muscle |function |(cardiac) |and |kidney |function.
Describe |the |signs |and |symptoms |of |an |electrolyte |imbalance |- |correct |answer
|✔Muscle |weakness, |soreness, |nausea, |and |mental |changes |such |as |lethargy, |dizziness |and |drowsiness |are |associated |with |the |electrolyte |imbalance
Na+ |- |correct |answer |✔More |extracellular |cation |controlled |by |kidneys |
Normal |value: |135-
Low |value: |hypoatremia |fluid |loss |from |diuretics, |vomiting, |diarrhea.
High |value: |hyperatemia, |dehydration
K+ |- |correct |answer |✔Major |intracellular |cation, |acid |base |muscle |function |
Normal |value: |4.0mEq/L |(range |3.5-4.5)
Low |values: |hypokalemia |metabolic |alkalosis |excessive |excretion |
High |values: |hyperkalemia |spiked |T |wave, |metabolic |acidosis
CI- |- |correct |answer |✔Major |extracellular |anion |
90 |mEq/L |(80-100)
Low |values: |hypochloremia |metabolic |alkalosis |
High |values: |hyperchloremia |metabolic |acidosis
HCO3- |- |correct |answer |✔Total |CO2 |content |most |of |CO2 |in |the |blood |is |carried |as |HCO3 |so |that |changes |in |total |CO2 |content |reflect |changes |in |blood |base |
Normal |vale: |24mEq/L |(22-26)
What |information |is |obtained |from |a |gram |stain? |- |correct |answer |✔Weather |bacteria |are |gram |positive |or |gram |negative, |takes | 1 |hr
Coagulation |studies |are |a |series |of |tests |that |evaluates |the |- |correct |answer
|✔Clotting |mechanism |of |the |body
Platelet |Count |- |correct |answer |✔An |analysis |of |the |number |size |and |shape |of |the |platelets |
Normal |value: |150,000-400,
Decreased |values |are |associated |with |decreased |bone |marrow |and |sepsis
Activated |partial |thromboplastin |time |(aPTT) |- |correct |answer |✔Measures |the |length |of |time |required |for |plasma |to |form |a |fibrin |clot |
Normal |value: |24-32 |secs
Used |for |monitoring |heparin |therapy
Prothombin |time |- |correct |answer |✔Used |for |monitoring |warfarin |coumadian |\
Normal |value: |12-15secs
Urinalysis |- |correct |answer |✔Reflects |metabolic |status |of |pt |and |screening |test |for |kidney |disease |
- |Blood |in |the |urine |hematria |is |associated |with |kidney |trauma
Troponin |- |correct |answer |✔A |protein |found |in |myocardial |cells |
1). |specific |indicator |of |damage |heart |muscle |
Normal |value: |>0.1 |ng/mL |place |the |patient |at |high |risk |for |death |for |Recommend |O2, |morphine, |aspirin, |nitroglycerin
Brain |Natriuretic |Peptide |(BNP) |- |correct |answer |✔Secreted |by |cardiac |muscle |when |heart |failure |develops |or |worsens |
Normal |value: |< |<100ng/mL
Recommend |diuretic |positive |inotropic |agent
Elevated |levels |of |BNP |indicates? |- |correct |answer |✔CHF
BNP |levels |- |correct |answer |✔>300 |pg/mL- |Mild |
600 |pg/mL- |Moderate |
900 |pg/mL- |Severe
A |mantoux |test |is |the |most |reliable |test |for |detecting |- |correct |answer
|✔Tuberculin |skin |test
Allergy |testing |may |be |indicated |in |patients |with |- |correct |answer |✔Asthma |to |help |identify |allergen |triggers |such |as |dust,pollen |mold |and |food
List |the |two |types |of |allergy |test |procedures |- |correct |answer |✔a. |Skin |prick |or |scratch |test |
b. |Intracutaneous |Test
