Advanced Patient Care

Question 1

What does orthopnea mean? How is the severity determined?

Answer 1

difficulty lying flat. Severity determined by the number of pillows used.

Question 2

What is general malaise?

Answer 2

Run down feeling, nausea, weakness, and fatigue.

Question 3

What is dyshasia?

Answer 3

difficulty speaking

Question 4

What is dysphagia?

Answer 4

difficulty swallowing

Question 5

What is the difference between lethargy and obtunded?

Answer 5

Lethargy: drowsy, will not answer questions & follow commands but slowly.
Obtunded: difficult to arouse, needs constant stimuli to follow a simple command.

Question 6

What is diaphoresis and what causes it?

Answer 6

Profusely sweating, caused by increased metabolism(pregnancy, fever, infection, anxiety)

Question 7

_______ is a early sign of hypoglycemia.

Answer 7

Sweating

Question 8

What are some possible cardiac complications that can cause diaphoresis?

Answer 8

Heart failure or acute MI

Question 9

Night sweats may indicate ______.

Answer 9

TB

Question 10

What conditions can cause bilateral pitting edema?

Answer 10

Pulmonary HTN, heart failure, renal insufficiency, and septicemia.

Question 11

What conditions can cause unilateral pitting edema?

Answer 11

Venous extremity, obstruction(tight clothing, jewelry or possible DVT)

Question 12

What does clubbing of the digits indicate?

Answer 12

Chronic hypoxia, 10-15% CHD, CF, COPD

Question 13

What can cause JVD?

Answer 13

Fluid overload, Cor pulmonale, airway pressure (PEEP), and cardiac tamponade.

Question 14

What does nasal flaring mean with a neonate? What does it do?

Answer 14

It is a sign of respiratory distress, and it reduces Raw

Question 15

What is tachypnea and what causes it?

Answer 15

This is a rapid rate of breathing, caused by a loss of lung volume, hypoxemia, and metabolic acidosis.

Question 16

What is apnea, and what causes it?

Answer 16

A cessation of breathing, caused by cardiac arrest or OSA

Question 17

What is biots breathing? What causes it?
hint: think B for BRAIN

Answer 17

This is breathing with LONG periods of apnea, caused by increased intracranial pressure

Question 18

What is Cheyne-Stokes breathing?

Answer 18

Breaths that increase and decrease in RR with periods of apnea, caused by diseases of the CNS and CHF

Question 19

What causes kussmaul’s breathing? What is it?

Answer 19

It is deep and fast breathing, caused by metabolic acidosis

Question 20

What is paradoxical breathing and what causes it?

Answer 20

When a portion of the chest moves opposite, caused by chest trauma

Question 21

What does a streaked sputum indicate?

Answer 21

Infection

Question 22

What does pink/frothy sputum indicate?

Answer 22

pulmonary edema (R sided)

Question 23

What does bright red sputum indicate? What about yellow/green sputum?

Answer 23

Bright red: TB,PE, or cancer
Yellow/green(purulent): pnuemonia, bronciectasis, chronic bronchitis, CF

Question 24

What is bronchorrhea and what generally causes it?

Answer 24

> 100 ml of watery secretions, commonly caused by chronic bronchitis

Question 25

What is pulsus paradoxus?

Answer 25

This is when the pulse/BP varies with respirations (exaggerated)

Question 26

What is pulsus alterans? Where is it best visualized and what can cause it?

Answer 26

Alternating strong/weak pulse, best seen on monitor and may be caused by large pericardial effusion or L ventricular failure.

Question 27

If the trachea deviates toward the problem, what may that problem be? What about if it deviates away?

hint: if toward, the problem is most likely occurring in the lungs. If AWAY it is most likely occurring outside of the lungs.

Answer 27

Toward: atelectasis, pneumonia
Away: pneumothorax, pleural effusion, tumor/mass

Question 28

What is tactile fremitus? _____ areas will transmit sound better.

Answer 28

This is vibrations felt on the chest; solid

Question 29

What conditions will cause an increase in tactile fremitus?

hint: anything other than air will cause an increase in this!

Answer 29

Pneumonia(consolidation), lung tumor or mass, atelectasis

Question 30

What conditions will cause a decrease in tactile fremitus?

hint: anything that adds excessive air

Answer 30

Pneumothorax, mucus plug or foreign object, pleural effusion, COPD

Question 31

With egophany, you have the patient repeat the letter “E”, but if it sounds like the letter “A” is an indication of what?

Answer 31

Indicates area of consolidation

Question 32

Bilateral reduction in chest expansion is an indicator of what disease process?

Answer 32

NM disorders, COPD

Question 33

Unilateral reduction in chest expansion is an indicator of what disease process?

Answer 33

Pleural effusion or a pneumothorax

Question 34

What is resonance?

Answer 34

A hollow sound, this is the normal sound of the lungs

Question 35

What is hyporesonance(Flat/dull) and hyperresonance?

Answer 35

Hypo: indicates the presence of a solid or a liquid: muscle, organs, atelectasis, pleural effusion
Hyper: increase presence of air: pnuemothorax, emphysema, asthma

Question 36

What is the normal range for diaphragmatic excursion? In what type of patients is this decreased?

Answer 36

Normal range is 5-7cm; decreased in NM pts and emphysema

Question 37

What is the normal range for eCO?

Answer 37

1-3%

Question 38

A habitual’s smokers eCO range would be? What percentage indicates CO poisoning?

Answer 38

5-15%; >20%