Exam 3

Question 1

Arterial Blood Gases (ABG)

Answer 1

Determine the O2 status and the acid/base balance

Question 2

Mixed Venous Blood Gases

Answer 2

uses a pulm artery catheter to get venous sample

Question 3

Pursed-lip breathing

Answer 3

exhalation through mouth with lips pursed together to slow exhalation. Holds O2 longer allowing more time for gas exchange

Question 4

Orthopnea

Answer 4

sleep sitting up; indicates mod to severe distress; seen with COPD/asthma; main cause is mucous

Question 5

Splinting

Answer 5

pain d/t chest expansion, voluntary decrease in tidal volume d/t thoracic or abd incision

Question 6

Kussmaul Respirations

Answer 6

reg, rapid, deep resp due to metabolic acidosis, increase in CO2 excretion

Question 7

Abdominal paradox

Answer 7

inward movement of abdomen during inspiration

Question 8

Vesicular breath sounds

Answer 8

normal; soft, low pitched, gentle rustling sounds hear over all portions of the lungs

Question 9

Bronchovesicular breath sounds

Answer 9

medium pitched over mainstem bronchi

Question 10

Bronchial breath sounds

Answer 10

loud, higher pitched along trachea

Question 11

**Rhonchi

Answer 11

rumbling, snoring or rattling heard on expiration

Question 12

Hemoptysis

Answer 12

blood tinged, streaked, or frank red blood

Question 13

Pack year

Answer 13

multiply number of packs of cigarettes smoked every day by the number of years smoked
2 packs a day X 30 years = 60 pack year

Question 14

Tidal volume (TV)

Answer 14

air volume of each breath (total)

Question 15

Inspiratory Reserve Volume (IRV)

Answer 15

maximum volume that can be inhaled after a normal inhalation

Question 16

Expiratory Reserve Volume (ERV)

Answer 16

maximum volume exhaled after a normal exhalation

Question 17

Vital capacity (VC)

Answer 17

the maximum volume of air exhaled from a maximal inspiration

VC=TV+IRV+ERV

Question 18

Forced expiratory volume (FEV)

Answer 18

volume exhaled forcefully over time in seconds.

FEV1 - how much can be exhaled in 1 second

Question 19

Position the patient for Thoracentesis

Answer 19

• sitting upright with the arms supported on an over bed table
• Assist physician with sterile procedure
• Monitor and document post procedure vital signs and breath sounds

Question 20

How to draw ABGs

Answer 20

1. Arterial blood draw with a heparinized syringe (from artery)
2. Hold pressure for 5 minutes
3. Put on ice immediately
4. Avoid changing oxygen therapy for 20 minutes prior to draw and until results come back

Question 21

trismus

Answer 21

inability to open mouth normally

Question 22

crackles

Answer 22

short low or high pitched heard at end of inspiration (in bases) fluid on lungs

Question 23

wheezes

Answer 23

high pitched musical sound caused by obstruction of airway & heard during expiration (give bronchodilator first)

Question 24

friction rubs

Answer 24

creaking or grating from inflamed pleural surfaces rubbing accompanied by discomfort (give anti-inflammatory)

Question 25

Chest x-ray

Answer 25

Posterior, anterior, or lateral. Can detect fluids, tumors, or foreign bodies w/ or w/o symptoms

Question 26

Computerized Tomography (CT)

Answer 26

can note fine tissue density not visible on CXR, may be with or without contrast * *W/ Contrast: * assess for allergies * lots of fluids after * liver function - BUN/creatinine

Question 27

Magnetic Resonance Imaging (MRI)

Answer 27

can detect pulmonary nodules, cancer, PE, pulmonary HTN, evaluate inflammatory activity

Question 28

Ventilation Perfusion (V/Q Scans)

Answer 28

IV radioisotope given to assess perfusion. Great for assessing for PE. Ventilation without perfusion suggests PE

Question 29

Pulmonary angiogram

Answer 29

inject dye and x-ray the vessels of the lungs; can be used to to diagnose PE

Question 30

Positron Emission Tomography (PET)

Answer 30

assess lung nodules for malignancy

Question 31

Pulmonary edema manifestations

Answer 31

severe respiratory distress, cyanosis, falling O2 sats, blood tinged sputum

Question 32

Pulmonary edema medical management

Answer 32

oxygen, diuretics, morphine, vasodilators, possible intubation

Question 33

Stroke volume (SV)

Answer 33

amount of blood ejected with each heartbeat

Question 34

cardiac output (CO)

Answer 34

amount of blood pumped by ventricle in liters per minute

Question 35

preload

Answer 35

degree of stretch of cardiac muscle fibers at end of diastole

Question 36

contractility

Answer 36

ability of cardiac muscle to shorten in response to electrical impulse

Question 37

afterload

Answer 37

resistance to ejection of blood from ventricle

Question 38

ejection fraction

Answer 38

percent of end diastolic volume ejected with each heart beat | Norm - 50-70%

Question 39

depolarization

Answer 39

electrical activation of cell-caused by influx of Na into cell while K exits cell

Question 40

repolarization

Answer 40

return of cell to resting state-caused by re-entry of K into cell while Na exits

Question 41

Mean Arterial Pressure (MAP)

Answer 41

1 systolic BP + 2 diastolic BP/3 | Need MAP at least 60 to perfuse organs