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Flashcards in Clinical Findings Deck (12):
1

Hypersensitivity reaction to something in the environment, causes narrowing/spasm in bronchi
Leading cause of chronic illness

Assessment:
Dyspnea, dry cough, wheezing, anxiety, diaphoresis, retractions, cyanosis

Asthma

2

binding of oxygen to hemoglobin

oxyhemoglobin

3

release of oxygen from hemoglobin

Deoxyhemoglobin

4

general term for inadequate O2 delivery to the tissues. When hemoglobin saturation is below 75%, the skin will become cyanotic, particularly under fingernails

Hypoxia

5

Leading cause of death from fires. Very competitive with O2 for binding to hemoglobin. Doesn't produce typical hypoxia symptoms - no cyanosis or respiratory distress. Instead it presents with confusion, throbbing HA, turns Hb cherry red. Treat by flushing CO out of the system with hyperbaric chambers, O2 therapy.

Carbon Monoxide poisoning

6

Normal respiration rate; 12-15 breaths/min

eupnea

7

too little CO2 in blood. Body's response is to constrict cerebro blood vessels, reducing perfusion (blood flow) to the brain, aka cerebral ischemia. Breathe into a bag to bring CO2 levels back up to restore cerebral perfusion. You could also breathe slowly, hold breath, and exhale

hypocapnia

8

Which of the following components comprise the history of present illness section of a patient's medical history?

I. Frequency and duration of symptoms
II. Symptoms exhibited by parents
III. Onset of symptoms
IV. Symptoms resulting in hospitalizations

A. I and III only
B. I, II, and III only
C. I, II, and IV only
D. II, III, and IV only

Correct response: A

The patient's current medical problems can be found under the headings chief complaint and history of present illness. This section of the medical history represents a detailed account of each of the patient's major complaints. It is written by the physician after interviewing the parents or patient on admission to the hospital.
The history of present illness represents a chronological description of each symptom expressed and identified. Components of the history of present illness include the following:
• Onset: time, type, source, setting
• Frequency and duration of symptoms
• Location and radiation of pain
• Severity (quantity)
• Quality (character)
• Aggravating and alleviating factors
• Associated manifestations

9

Which of the following components comprise the past medical history section of the patient's medical history?

I. Birth weight
II. Previous mechanical ventilation
III. Recurrence of symptoms based on season
IV. Emergency department visits

A. II only
B. II and IV only
C. I, II, and IV only
D. I, II, III, and IV

Correct response: C

Components of past medical history include the following:
• Neonatal/childhood diseases and developments
• Hospitalizations: surgeries, injuries, accidents, illnesses
• Allergies
• Medications
Other important components of the past medical history that may contribute to establishing a diagnosis include the following: history of prematurity, birth weight, previous oxygen therapy and/or assisted ventilation in the neonatal period, previous emergency room visits or hospitalizations for respiratory disturbances, and immunization history.

10

Which of the following components of a patient's medical history is intended to determine the presence of symptoms not identified in the history of present illness and that may be related or contribute to the child's underlying condition?

A. Chief complaint
B. Past medical history
C. Review of systems
D. History of present illness

Correct response: C

The review of systems attempts to identify symptoms that were not identified in the history of present illness. These symptoms may be related or contribute to the child's underlying respiratory condition. A systematic review of allergic, dermatologic, developmental, gastrointestinal, immunologic, otolaryngologic, musculoskeletal, neurologic, and neuromuscular symptoms may suggest contributions of atopic diseases, gastroesophageal reflux, immunodeficiency, as well as thoracic cage, neurological, and neuromuscular disorders to the presenting pulmonary complaint.

11

Which of the following pulmonary diseases are not chest wall deformities, but are characterized by an increased anteroposterior diameter?

I. Pectus excavatum
II. Severe asthma
III. Pneumonia
IV. Cystic fibrosis

A. I and III only
B. II and IV only
C. II, III, and IV only
D. I, II, III, and IV

Correct response: B

Inspection of the chest wall may reveal an increased anteroposterior diameter, abnormal shape, muscular weakness, or obesity. Chest wall inspection should include anterior, posterior, and lateral examinations. Chronic obstructive lung diseases such as severe asthma, advanced cystic fibrosis, and severe bronchopulmonary dysplasia may be associated with increased anteroposterior diameter of the chest caused by air-trapping. The chest wall may be abnormally shaped, as in pectus carinatum ("pigeon breast"), pectus excavatum ("sunken chest"), kyphosis ("hunchback"—posterior curvature of the thoracic spine), and scoliosis ("sideways"—lateral curvature of the thoracic spine).

12

After placing a stethoscope over the trachea, the therapist hears expiratory stridor. Which of the following conditions is consistent this finding?

A. Laryngotracheobronchitis
B. Adenotonsillar hypertrophy
C. Asthma episode
D. Tracheomalacia

Correct response: D

Stridor is an inspiratory or expiratory sound heard loudest over the trachea during inspiration or expiration. Stridor suggests an obstructed trachea or larynx, and therefore constitutes a medical emergency that requires immediate attention.
Inspiratory stridor suggests extrathoracic airway obstruction, as occurs in laryngomalacia, subglottic stenosis, and croup (laryngotracheobronchitis). Expiratory stridor suggests intrathoracic central airway obstruction, such as occurs in mass or vascular compression of the trachea, tracheomalacia, and bronchomalacia. Biphasic stridor typically indicates a more severe degree of laryngeal or central airway obstruction and may be associated with signs of respiratory distress.