Pulmonary Rehab

Question 1

Explain the V/ Q mismatch using the terms “shunt and dead

Answer 1

V/Q mismatch: either the lung gets blood flow with not enough O2 or O2 with not enough blood
dead space: excess oxygen ( V)
shunt: excess blood flow ( P)

Question 2

Which volume is the amount of air that we inhale and exhale during one respiratory cycle

Answer 2

Tidal volume

Question 3

Which is the amount of air remaining in the lungs at the end of normal exhalation

Answer 3

functional residual capacity

Question 4

This breathing aid helps prevent infection and reduce atelectasis

Answer 4

Incentive spirometer
measures volume of air inhaled after inspiration

Question 5

Which capacity is the total amount of air exhaled after maximal inhalation?

Answer 5

vital capacity
Indicator of ability to breathe deeply and cough
Reflects Inspiratory and expiratory muscle strength

Question 6

This lung volume is directly affected in emphysema and pneumothorax infection since there is air trapping and increased intra thoracic pressure

Answer 6

residual volume

Question 7

apnea ( breathing pattern definitions)

Answer 7

Lack of airflow to the lungs for >15 seconds

Question 8

Biot’s respirations

Answer 8

CONSTANT increased rate and depth of respiration followed by periods of apnea of varying lengths

Question 9

Cheyne-Stokes respirations

Answer 9

Increasing DEPTH of ventilation followed by a period of apnea

Question 10

Kussmaul respirations

Answer 10

Increased regular RATE and DEPTH of ventilation

Question 11

Paradoxic ventilation

Answer 11

Inward abdominal or chest wall movement with inspiration and outward movement with expiration
MISMATCH OF HOW THE CHEST WALL MOVES AND BREATHS GOING IN AND OUT

Question 12

Bradypnea

Answer 12

Ventilation rate <12 breaths per minute

Question 13

Hyperpnea

Answer 13

Increased depth of ventilation

Question 14

Hyperventilation

Answer 14

Increased rate and depth of ventilation resulting in decreased PCO2

Question 15

Hypoventilation

Answer 15

Decreased rate and depth of ventilation resulting in increased PCO2

Question 16

Hoover’s sign

Answer 16

The inward motion of the lower rib cage during inhalation

Question 17

Sighing respirations

Answer 17

The presence of a sigh >2-3 times per minute

Question 18

Orthopnea

Answer 18

Dyspnea that occurs in a flat supine position. Relief occurs with more upright sitting or standing

Question 19

What does arterial blood gas measure

Answer 19

pH
ventilation ( CO2)
oxygenation ( O2)

Question 20

What happens the oxyhemoglobin dissociation curve shifts to the right

Answer 20

pH increases
alkalosis or hypocapnia

Question 21

What happens the oxyhemoglobin dissociation curve shifts to the right

Answer 21

pH decreases
acidosis or hypercapnia

Question 22

arterial blood gases purpose

Answer 22

streamlines medical or therapeutic interventions
examples- mechanical ventilation and breathing assist techniques

Question 23

PaO2(PO2) vs. SaO2(O2saturation)

Answer 23

PaO2 =Partial pressure of dissolved O2in plasma
SaO2 = % of hemoglobin paired with O2 molecules

Question 24

Air trapping

Answer 24

gas stuck in the lungs –> obstructive lung disease
little miss emphysema

Question 25

Consolidation

Answer 25

some type of thing replacing alveolar air

Question 26

bronchospasm

Answer 26

smooth muscle in the bronchi constrict asthma

Question 27

air trapping leads to

Answer 27

hyperinflation

Question 28

Hypoxemia

Answer 28

low O2 levels in BLOOD ( below 60 mmHg) 60 to 80 mmHg = normal

Question 29

Hypoxia

Answer 29

low level of oxygen in TISSUES

Question 30

Respiratory distress

Answer 30

comes before respiratory failure dyspnea, respiratory muscle fatigue, abnormal respiratory pattern and rate, anxiety, and cyanosis related to INADEQUATE GAS EXCHANGE

Question 31

Non-rebreather mask (10-15 lpm)

Answer 31

60 to 80% face mask that is connected to a reservoir bag that is filled with a high concentration of oxygen

Question 32

Partial Rebreather ( 6-10)pm)

Answer 32

60 to 80% a two-way valve present between the reservoir bag and mask

Question 33

High flow nasal cannula

Answer 33

up to 100% FiO2 highest FiO2

Question 34

Salt nasal cannula

Answer 34

25%-44% FiO2

Question 35

FIO2

Answer 35

Concentration of O2 that is being breathed

Question 36

What are the 3 continous lung sounds

Answer 36

1. wheeze 2. stridor 3. rhonchi

Question 37

wheeze- cause and more common with what type of respiration

Answer 37

airway obstruction, more common on expiration

Question 38

Stridor- cause and when does it show up special consideration

Answer 38

high-pitched wheeze both inhale and exhale A MEDICAL EMERGENCY

Question 39

Rhonchi- cause and what it sounds like

Answer 39

low-pitched from airway obstruction, snoring sound

Question 40

discontinous adventitous breath that is like bubbling, popping sounds from fluid/secretions or sudden opening of closed airway

Answer 40

crackles

Question 41

origin of extrapulmonary ( EP) sound

Answer 41

dysfunction outside of the lung tissue.

Question 42

what are the 3 ADVENTITIOUS BS voice sounds

Answer 42

1. Whispered pectoriloquy 2. Bronchophony 3. Egophony

Question 43

what is the most common EP sound

Answer 43

pleural friction rub = loud grating sound and present in inspiration and expiration

Question 44

Whispered pectoriloquy

Answer 44

pt. whispers 1 2 3 and + for either consolidation or hyperinflation + for consolidation = CLEARLY AUDIBLE in distal lung fields + for hyperinflation = LESS AUDIBLE in distal lung

Question 45

Bronchophony

Answer 45

Patient repeats the phrase “ninety-nine.” results = similar to whispered pectoriloquy.

Question 46

Egophony

Answer 46

Patient repeats the letter e. If the auscultation in the distal lung fields sound like a, then there's probably fluid in the air spaces or lung parenchyma

Question 47

adult respiratory distress syndrome PT considerations

Answer 47

associated with a lot of issues and a high mortality rate HAVE PT. IN PRONE ( improves V/Q matching)

Question 48

Flail chest - what it is and prognosis

Answer 48

= 2+  rib fractures with two or more breaks per rib  = high morbidity and mortality rate

Question 49

Bronchial LUNG AUSCULTATION ETIOLOGY

Answer 49

Fluid or secretion consolidation (airlessness) may occur w/ pneumonia

Question 50

Decreased or diminished (less audible) LUNG AUSCULTATION ETIOLOGY

Answer 50

Hypoventilation, severe congestion, or emphysema

Question 51

Absent LUNG AUSCULTATION ETIOLOGY

Answer 51

Pneumothorax or lung collapse

Question 52

General pulmonary treatment ideas for PT

Answer 52

1. Breathing retraining exercises 2. Secretion clearance techniques 3. Positioning 4. Functional activities Exercise 5. Patient education Monitoring VS