Assessment

Question 1

What is anatomic dead space?
How much of your tidal volume is anatomic dead space?

Answer 1

The amount of air that doesn’t reach the alveoli. It is in the trachea and bronchi and doesn’t take part in the gas exchange.

150 mL of 500 mL (average)

Question 2

What is tidal volume?

Answer 2

The amount of air exchanged in 1 breath (usually around 500 mL)

Question 3

What are the pores of Kohn?

Answer 3

Interconnections between alveoli that allow them to share air (and bacteria)

Question 4

What is atelectasis?

Answer 4

Collapsed, airless alveoli

Question 5

Why is deep breathing important?

Answer 5

Inflates alveoli and prevents atelectasis. Allows you to clear any mucus and promotes surfactant production.
–Tell patient to deep breath-hold it for 5 seconds-let it out. This holding breath allows alveoli to pop open and be functional. Have them progressively hold breath longer each time.–

Question 6

The lungs receive de-oxygenated blood from heart through the ___ventricle.

Answer 6

Right

Question 7

The lungs return oxygenated blood to the heart at the ___atrium.

Answer 7

Left

Question 8

What is too much fluid in intrapleural space called?
–Remember intrapleural space is space in between parietal and visceral pleura and allows layers to slide without friction–

Answer 8

Pleural effusion
–Can happen with HF or poor lymph drainage from that area–

Question 9

How many ribs do we have?

Answer 9

24 total
12 on each side

Question 10

What does PaO2 represent?

Answer 10

Amount of dissolved O2 in plasma.
It will be in mmHg.
This will be a blood gas reading.

Question 11

What is a normal range for PaO2?

What is it’s equivalent in SaO2 reading?

Answer 11

80—-100 mmHg

> 95%

Question 12

What is a severe hypoxemia range for PaO2?

What is it’s equivalent in SaO2 reading?

Answer 12

<40 mm Hg

<75%

Question 13

What is SaO2?

Answer 13

It is a ratio so value will be a %. Oxygen that is bound to hemoglobin in comparison to how much O2 the hemoglobin can carry.

Question 14

Which is passive-exhalation or inhalation?

Answer 14

Exhalation

Question 15

What is compliance?

Answer 15

The ability of the lungs to expand.
This is a result of the elasticity of the lungs and recoil of chest wall.
–Decreased when lungs have fluid–
–Increased when alveoli destroyed in COPD–

Question 16

What is the main factor that affects resistance of lungs?

Answer 16

Diameter of airway

Question 17

Where are chemoreceptors for pH and PaCO2 located?

Answer 17

Medulla
Carotid
Aortic arch

Question 18

What are some of the defense mechanisms to protect respiratory system?

Answer 18

Air filtration (mucus and nose hairs)
Mucociliary clearance system (mucus and cilia)
Cough reflex
Bronchoconstriction
Alveolar macrophages

Question 19

What are some geriatric changes in respiratory function?

Answer 19

Decreased amounts of: alveoli, immune function, cilia, muscle strength to cough.
Lungs become more stiff, barrel chest.
Respiratory control centers aren’t as sharp so body has decreased response to hypoxia.
–All of this means geri population higher risk of aspiration and pneumonia–

Question 20

What is med term for coughing up blood?

Answer 20

Hemoptysis

Question 21

What is med term for difficulty breathing while lying flat?

Answer 21

Orthopnea

Question 22

What is classic sign of TB?

Answer 22

Night sweats

Question 23

What are some EARLY CV signs of hypoxia?

What are some LATE CV signs?

Answer 23

Dysrhythmias
Mild HTN
Tachycardia

Cyanosis
Cool, clammy skin
Hypotension

Question 24

What are some early neuro signs of hypoxia?

Late neuro signs?

Answer 24

Apprehension
Confusion
Lethargy
Restlessness
Irritability

Combative
Coma

Question 25

What are some early respiratory signs of hypoxia? Late signs?

Answer 25

Activity intolerance Tachypnea Dyspnea at rest Can't finish sentences without stopping for breath Retractions Use of accessory muscles

Question 26

What is fremitus?

Answer 26

A normal finding. The vibration of the chest when a person speaks. Can auscultate for fremitus or do tactile fremitus. Have the person say "99"

Question 27

What is increased fremitus a sign of?

Answer 27

Lungs denser with fluid, secretions or tumor. Vibration will be louder than normal.

Question 28

What is decreased fremitus a sign of? What if absent?

Answer 28

Lungs further away like in a barrel chest. Absent fremitus means pneumothorax or atelectasis.

Question 29

When percussing over lungs, what is normal sound called?

Answer 29

Resonance (low pitched)

Question 30

When percussing over a hollow organ like the stomach, how is the sound described?

Answer 30

Tympany --also heard over a pneumothorax--

Question 31

When percussing over dense tissue, how is the sound described?

Answer 31

Flat (Soft, high pitched, short sound)

Question 32

What is egophony? EE-GOFF-UH-NEE

Answer 32

Auscultation over chest Have patient say "EE" If you heard an "AA" instead of "EE" this could mean pneumonia or pleural effusion.

Question 33

When is a sputum sample best obtained?

Answer 33

First thing in morning after patient cleans mouth.

Question 34

What are the 5 ABG tests and normal values?

Answer 34

pH: 7.35--7.45 PaCO2: 35--45 PaO2: 80---100 mmHg SaO2: >95% HCO3: 22----26

Question 35

What is the purpose of a thoracentesis?

Answer 35

Obtain specimen of lung fluid Remove fluid Instill medication

Question 36

What is the difference between a CPAP and a bi-PAP?

Answer 36

C-PAP is Continuous positive pressure at one setting (used on most sleep apnea patients) Bi-PAP delivers 2 levels of pressure, one for inhale and one for exhale. (better for people with COPD)

Question 37

Where is carina in children vs adults?

Answer 37

Children at T3 Adults at T6

Question 38

Which bronchi is most likely to become obstructed in children?

Answer 38

Right

Question 39

Which retraction site in children indicates mild distress? Moderate distress? Severe distress? The worst distress?

Answer 39

First: Nasal flaring then Intercostal Substernal and Subcostal Suprasternal Supraclavicular Sternocleidomastoid muscles (called wry neck, kid will flex head forward and muscles will pop out in neck)