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CMN 568 Exam Study Guide with Complete Solutions

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CMN 568 Exam Study Guide with Complete Solutions components of physical respiratory exam - Answer-IPPA: inspection, palpation, percussion, auscultation ratio of time spent in inspiration/expiration - Answer-ratio of 2:3 what should you palpate on a respiratory exam? - Answer-- trachea at supra...

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  • October 3, 2024
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CMN 568 Exam Study Guide with
Complete Solutions

components of physical respiratory exam - Answer✔✔-IPPA: inspection, palpation, percussion,

auscultation


ratio of time spent in inspiration/expiration - Answer✔✔-ratio of 2:3


what should you palpate on a respiratory exam? - Answer✔✔-- trachea at suprasternal notch


- posterior chest wall to gauge fremitus / transmission of spoken words through lungs


- anterior chest wall (assess cardiac impulse)


what do pulmonary function tests do? - Answer✔✔-measures:


- air flow rates


- lung volumes


- ability of lung to transfer gas across alveoli-capillary membrane


should you perform a PFT on a patient with asthma exacerbation? - Answer✔✔-no, PFTs are

contraindicated in acute severe asthma, respiratory distress, angina aggravated by testing,

pneumothorax, active TB, and hemoptysis


tachypnea - Answer✔✔-increased respiratory rate and decreased tidal volume




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kussmauls respirations - Answer✔✔-rapid LARGE VOLUME breathing due to intense stimulation of

respiratory center from metabolic acidosis


cheyne-stokes respirations - Answer✔✔-rhythmic waxing/waning of rate and TV; regular periods of

apnea; seen in end-stage LV failure, neurologic dx, and sleeping at high altitude


BLE edema indicates what? - Answer✔✔-indirectly measures pulmonary HTN; RV failure


what causes clubbing? - Answer✔✔-increased amounts of unsaturated Hgb in capillary blood; not a

reliable indicator of hypoxemia since cyanosis in polycythemia only means mild hypoxia


dull percussion indicates what? - Answer✔✔-lung consolidation or pleural effusion


hyper resonant percussion indicates what? - Answer✔✔-emphysema or pneumothorax


what does bronchial lung sounds heard over the periphery of the lung indicate? - Answer✔✔-

consolidation


what does globally diminished lung sounds imply? - Answer✔✔-significant airflow obstruction


Continuous adventitious lung sounds - Answer✔✔-- wheezes


- rhonchi


Discontinuous adventitious lung sounds - Answer✔✔-- fine crackles


- course crackles


wheezing - Answer✔✔-- high-pitched musical sounds


- bronchospasm, mucosal edema, excessive secretions DUE TO NARROWED AIRWAY


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- powerful indicator of obstructive lung disease


rhonchi - Answer✔✔-- lower pitched, snoring, gurgling quality sounds


- seen with excessive secretions and abnormal airway collapse


- clears after cough


fine crackles - Answer✔✔-- soft, high pitched crisp noise associated with interstitial diagnosis or early

pulmonary edema


- fine-late inspiratory crackles indicate pulmonary fibrosis


coarse crackles - Answer✔✔-- louder and lower pitched, slightly longer in duration


- associated with pneumonia or HF or late pulmonary edema


chest and abdominal wall should expand.... - Answer✔✔-simultaneously


normal lung sounds over periphery are described as... - Answer✔✔-vesicular, fades in expiration


normal lung sounds heard over suprasternal notch are described as.... - Answer✔✔-tracheal or bronchial

(louder, high pitched and hollow; louder on expiration)


FEV1 - Answer✔✔-amount of air exhaled during first forced breath


FVC - Answer✔✔-forced vital capacity; total amount of air exhaled during the entire FEV test


obstructive lung disease results in spirometry - Answer✔✔-- decreased FEV1/FVC ratio


- seen in asthma, copd, bronchiolitis, upper airway obstruction




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- if obstruction is evident, repeat test 10-20min after inhaled bronchodilator to help assess if dx is

reversible


- asthma would improve after bronchodilator, copd would not


examples of restrictive chest dysfuction - Answer✔✔-- ankylosing spondylitis


- scoliosis


- drugs like amiodarone or methotrexate


- interstitial lung disease such as asbestos, pneumonia, pulmonary fibrosis


- neurmuscular disease


is adult CAP caused from bacteria or virus? - Answer✔✔-most commonly bacteria S. pneumoniae


3 widely available point of care tests used to identify causative organism in adult CAP - Answer✔✔--

sputum gram stain


- urinary antigen tests


- rapid antigen tests


Why should you obtain a rapid flu test when diagnosing CAP? - Answer✔✔-Because positive flu test

reduce unnecessary antibiotic use


What imaging is required to establish a diagnosis of CAP? - Answer✔✔-A chest x-ray with pulmonary

opacity; clearing of opacities can take six weeks or longer


What do you do if a patient's chest x-ray shows significant pleural fluid collection's? - Answer✔✔-Refer

them; this may require a thoracentesis

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