Test 2 Lung And Cardiac

Question 1

This is the ridge where the manubrium attaches to sternum. Also where 2nd rib is

Answer 1

Sternal angle

Question 2

The angle between the ribs and costal margins

Answer 2

Costal angle-90 degrees

Question 3

During cpr, where are the hands placed to avoid breaking xiphoid process off and causing complications?

Answer 3

Above xiphoid process

Question 4

When you flex your neck forward, which spinous process protrudes mostly? This is used as a landmark to inspect and auscultate lungs

Answer 4

C7

Question 5

How many lobes does the right vs left lung have?

Answer 5

Left has 2 and right has 3 lobs but they’re both same size

Question 6

In which direction do we auscultate lungs?

Answer 6

From apex to base (top to bottom) and each side. One full breath in and out per section

Question 7

What can sometimes happen when a central venous catheter is placed in the chest wall?

Answer 7

Needle may accidentally nick the lung causing a pneumothorax or collapsed lung

Question 8

Why are lung sounds always auscultate after a patient is intubated?

Answer 8

The right mainstream bronchus is more likely to aspirate and unsuccessful endotracheal intubation. If sounds are only hear on left side after tube placement, right side is blocked so we slowly pull out until we can hear on right side

Question 9

What happens when the nurse hears crackles on auscultation?

Answer 9

Crackles usually signify fluid filling alveoli. Can be coarse or fine. Have patient breath in and cough 3 times, then listen again. They sounds like hair rubbing or Velcro opening. Mostly heard on inspiration

Question 10

Sound heard in lung that’s a continuous high pitched musical sound. Caused by air squeezing through narrowed airways. Occurs in asthma.

Answer 10

Wheezing

Question 11

Lung sound that’s a continuous, low pitched snoring sound from secretions moving around in airways. May clear with coughing. Heard mostly in patients with chronic bronchitis

Answer 11

Ronchi

Question 12

What are the 3 voice sounds that are abnormal and found with consolidation or compression with pneumonia and pulmonary edema?

Answer 12

Egophony bronchophony, whispered pectoriloquoy

Question 13

What are the accessory muscles patients use if having difficulty breathing?

Answer 13

Sternocleidomastoid, scalene, abdominal, internal intercostal, trapezius muscle

Question 14

Normal respiratory rate for adults

Answer 14

12-20 breaths/minute

Question 15

A high pitched crowing sound from upper airway. Results from tracheal or laryngeal spasm or constriction. lIFE THREATENING emergency requiring immediate attention

Answer 15

Stridor

Question 16

Term for free air that creates a crackling sensation similar to bubble wrap or rice crispy cereal under the skin (felt)

Answer 16

Crepitus

Question 17

Assessment is made to evaluate density of lung tissue. Place palmar base or lunar surface of hand on patient’s chest above scapula. Ask patient to say “99”. Vibrations of air in the bronchial tree are transmitted to chest wall when patient speaks. Note intensity and symmetry on each side. Normal = vibrations felt ok both sides

Answer 17

Tactile Fremitus

Question 18

The 3 normal breath sounds?

Answer 18

Vesicular (lung periphery), bronchovesicular (heard more central) bronchial (heard over trachea and larynx)

Question 19

What happens when you hear crackles on auscultation?

Answer 19

Fluid fills alveoli (crackles cause CRAZY fluid)

Question 20

What are 2 membranous sacs in the thorax?

Answer 20

Visceral and parietal

Question 21

How is breathing different for older adults?

Answer 21

Lungs lose elasticity, decrease in cartilage, thorax gets barrel shaped and rounded, risk for atelectasis, hypoxia, hypercapnia, acidosis, decreased gag reflex and cough

Question 22

This is an adventitious breath sound that involves air moving through wet secretions can be fine (high pitched) or coarse (low pitched) long

Answer 22

Crackles

Question 23

This is a continuous high pitched sound caused by small airways by severe toons, swelling, tumors -adventitious breath sound

Answer 23

Wheezing

Question 24

This is an adventitious breath sound involving grating or creaking caused by pleural rubbing against chest wall, loud, coarse, low pitched

Answer 24

Pleural friction rub

Question 25

Low pitched snoring or gurgling sound. May clear with coughing. Sometimes moves in inspiration and expiration

Answer 25

Ronchi

Question 26

An adventitious breath sound that is loud, high pitched crowing or honking sound. Louder in upper airway and is an emergency

Answer 26

Stridor

Question 27

When listening for voice sounds, ask patient to say 99 and it’s easily understood

Answer 27

Broncophony

Question 28

When listening to voice sounds, ask patient to say “ee” and I sounds like a long A

Answer 28

Egophony

Question 29

When listening for voice sounds, whisper one, 2, 3 and if it sounds louder or clear mer then whispered sound

Answer 29

Pectgriloqux

Question 30

Where does the nurse start when auscultation the lungs? What landmarks?

Answer 30

1. Above clavicle(apex of lungs)
2. 2nd intercostal space (right and left lobes)
3. 4th intercostal space (right and left middle lobes)
4. Midaxillary line at 6th intercostal space (right and left lower lobes)

Posterior
1. Right above scapulae (apex of lungs)
2. Find c7 then go to t3 (listen to right and left upper lobes)
3. T3 to t10 (listen to right and left lower lobes
Have patient lean forward to get better access posteriorly

Question 31

What are the 3 normal lung sounds called?

Answer 31

Vesicular ( anterior and posterior and heard over peripheral lungs)

Bronchial (heard over tracheal area) high pitch, loud on inspiration slightly shorter than expiration

Question 32

What arteries transport blood from heart to the head?

Answer 32

Carotid

Question 33

Functions as the pacemaker of heart

Answer 33

SA node

Question 34

Most common type of heart failure

Answer 34

Left sided

Question 35

Spread of depolarization of atria/contraction

Answer 35

P wave

Question 36

Time from firing of sa node to ventricular depolarization

Answer 36

PR interval

Question 37

This is seen on an ECG where ventricles contract

Answer 37

QRS complex

Question 38

What is a common symptom of A-fib?

Answer 38

Fatigue, palipitations, heart failure with decreased atrial kick

Question 39

It’s important to find info about symptoms, follow orders the perform focused cardiac or lung assessment, call provider to order chest X-ray or ecg if needed

Question 40

These heart sounds are best heart at the apex of the heart with the bell of stethoscope while patient is on their left side

Answer 40

S3. S4, heart murmurs—-note it’s normal to not have these sounds

Question 41

What are the grades of heart murmurs?

Answer 41

Grade 1- hard to hear, grade 2-faint but heard, grade 3-easy to hear, grade 4-loud with a chest thrill, grade 5 very loud: can hear with corner chest piece tilted off chest
Grade 6-loudest can hear with whole chest piece lifted off chest

Question 42

Caused by ventricle resistance from Atrial kick during presystole. Sounds like “TA-LUB-DUB”

Answer 42

S4

Question 43

Heart after s2 and sounds like LUB-DUB-TA caused by vibrations of ventricle filling from a resistant ventricle due to fluid volume or heart failure

Answer 43

S3

Question 44

This is a blowing or swishing noise from blood turbulence in the chambers of the heart (wall defect) or valve problem (stenosis or regurgitation)

Answer 44

Heart murmur