Part 2

Question 1

extra sounds produced by pathological processes in the airways, lungs and pleura

Answer 1

adventitious breath sounds

Question 2

T/F

adventitious breath sounds can sometimes be a normal response for a pt

Answer 2

false

if these sounds are heard they are ALWAYS ABNORMAL

superimposed on normal breath sounds

Question 3

3 main adventitious breath sounds

Answer 3

rales or crackles

ronchi or wheezes

pleural friction rub

Question 4

rales and crackles are

Answer 4

discontinuous

Question 5

when are rales and crackles heard

Answer 5

inspiration

Question 6

rales/crackles that occur early in inspiration is found in…

Answer 6

bronchitis

emphysema

asthma

Question 7

rales/crackles that occur late in inspiration is d/t

Answer 7

interstitial lung dz

pulmonary edema

pleural effusion

Question 8

rales/crackles are(longer answer)

Answer 8

disruption of air through small airways in the respiratory tree

Question 9

ronchi/wheezes are

Answer 9

continuous

Question 10

when are ronchi/wheezes most heard

Answer 10

expiration

Question 11

ronchi/wheezes during expiration is often associated w/

Answer 11

airway constriction found in bronchospasm

Question 12

T/F

monophonic wheeze (stridor) is considered a medical emergency

Answer 12

true

Question 13

normal spoken voice

Answer 13

vibrates

is transmitted thought the lung fields w/ relative ease

Question 14

3 sounds that are…

Answer 14

normally muffled and indistinct

Question 15

3 abnormal voice sounds

Answer 15

egophony

bronchophony

whispered pectoriloquy

Question 16

egophony test

Answer 16

“EEEEEEE” sounds like “AAAAA”

Question 17

bronchophony test

Answer 17

“99”

“AEIOU”

sounds clearer

Question 18

whispered pectoriloquy test

Answer 18

“99”

sounds like pt is actually whispering in your ear

Question 19

bronchophony is a sign for

Answer 19

pulmonary edema

tumor

pneumonia

Question 20

positive egophony test is a sign of

Answer 20

above pleural effusion

Question 21

how would we document a positive egophony test

Answer 21

positive E to A change

Question 22

when is whispered pectoriloquy considered pathological

Answer 22

when it sounds like the pt is whispering in your ear

Question 23

abnormal findings for bronchophony, egophony and whispered pectoriloquy are associated w/

Answer 23

consolidation

pleural effusion

atelectasis

Question 24

pulse Ox is used to asses

Answer 24

oxygen saturation

Question 25

normal pulse ox

Answer 25

98-100%

Question 26

a pt w/ acute respiratory problems will present w/ a pulse ox level of

Answer 26

90-94%

Question 27

cut off for PT is a pt w/ (pulmonary)--> pulse ox

Answer 27

88%

Question 28

a pt w/ acute cardiac problems will present with a pulse ox level of

Answer 28

95-97%

Question 29

cut off for a cardiac pt for therapy is --> pulse ox

Answer 29

90-92%

Question 30

3 zone model

Answer 30

zone 1 zone 2 zone 3

Question 31

zone 1

Answer 31

potentially no blood flow has no problem getting air

Question 32

zone 2

Answer 32

intermediate area receives varying blood flow/oxygen

Question 33

zone 3

Answer 33

received constant blood flow but not constant air flow

Question 34

to increase zone 1 perfusion, what position would you put the pt in

Answer 34

Trendelenburg

Question 35

increasing the ejection fraction will

Answer 35

increase zone 3 perfusion

Question 36

T/F in an upright position, more gas exchange takes place in zone 3 than zone 1

Answer 36

true

Question 37

in which zone are alveoli more efficient at gas exchange

Answer 37

zone 1

Question 38

in which zone are alveoli less efficient at gas exchange

Answer 38

zone 3

Question 39

increase carbon monoxide will

Answer 39

increase blood going to the pts lungs

Question 40

at rest, what position should we place the pt in so that zone 1 has constant blood flow

Answer 40

Trendelenburg

Question 41

what is the rationale for putting the pt in Trendelenburg so that zone 1 has constant blood flow

Answer 41

b/c the cells in zone 1 are much more efficient than those in zone 3

Question 42

primary drive for respiration

Answer 42

level of CO2

Question 43

what is the level of CO2 sensed by

Answer 43

central chemoreceptors

Question 44

pts who are CO2 retainers (COPD) the...

Answer 44

central receptors will turn off the peripheral receptors will take over

Question 45

for pts who are CO2 retainers (COPD) the main drive for respiration will

Answer 45

shift from the level of CO2 to the level of PO2

Question 46

for pts who are CO2 retainers (COPD) the main drive for respiration will shift from the level of CO2 to the level of PO2 b/c...

Answer 46

the decrease in O2 will become the primary drive for respiration hypoxic drive

Question 47

when treating a pt w/ COPD, what should you do if the pt becomes short of breath during exercise

Answer 47

next time decrease their exercise intensity instead of giving them more O2

Question 48

why cant we give a pt with COPD O2

Answer 48

remove their primary drive of respiration shut off their peripheral chemoreceptors

Question 49

evaluative percussion

Answer 49

percussion of lung segment to produce audible sounds which can be interpreted

Question 50

what does evaluative percussion give us

Answer 50

data about air, liquid, or solid content in the lung

Question 51

when going evaluative percussion, a normal sound will produce a

Answer 51

resonate note

Question 52

when doing evaluative percussion, a flat or dull sound is indicative of

Answer 52

consolidation atelectasis pneumonia effusion

Question 53

when doing evaluative percussion, a hyperresonate sound is indicative of

Answer 53

air trapped emphysema pneumothorax

Question 54

if you head a dull sound where a resonate sound is expected

Answer 54

indicative of fluid build a possible hemothorax

Question 55

if you hear a tympanic sounds where resonate sound is expected

Answer 55

this indicated an air build up possible pneumothorax

Question 56

for a pt with asthma, what secretion clearance technique should be avoided

Answer 56

percussions d/t possibility of stimulation bronchospasms

Question 57

what should be used w/ a pt w/ asthma for a secretion clearance

Answer 57

vibration

Question 58

percentage and duration of O2 that can lead to toxicity

Answer 58

>60% O2 for >48 hours

Question 59

administering too much O2 can lead to

Answer 59

toxicity airway inflammation increased alveolar permeability pulmonary edema death

Question 60

fraction of inspired O2 (FiO2) increases by ___ for every 1L/min increase in O2 flow rate

Answer 60

4%

Question 61

room air % of O2

Answer 61

21%

Question 62

the FiO2 and flow rate for nasal cannula

Answer 62

24-44% 1-6 L

Question 63

the FiO2 and flow rate for simple mask

Answer 63

flow rate = 5-10 L FiO2 = 35-55%

Question 64

the FiO2 and flow rate for aerosol mask

Answer 64

flow rate = 10-12 L FiO2 = 35-100%

Question 65

the FiO2 and flow rate for venturi mask

Answer 65

flow rate = 4-10 L FiO2 = 24-50%