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NUR 634- Exam #2/371 Q’s and A’s
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NUR 634- Exam #2/371 Q’s and A’s
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NUR 634- Exam #2/371 Q’s andA’s
Which lobes of the lung will be heard anteriorly? - --Right Upper Lung
-Right Middle Lung
-Right Lower Lung
-Left Upper Lung
-Left Lower Lung
-Which lobes of the lung will be heard posteriorly? - --Right Upper Lung
-Right Lower Lung
-Left Upper Lung
-Left Lower Lung
-Which lobes of the lung will be heard laterally - right? - --Right Upper Lung
-Right Middle Lung
-Right Lower Lung
-Which lobes of the lung will be heard laterally - left? - --Left Upper Lung
-Left Lower Lung
-Possible causes of chest pain? - --Anxiety/panic disorders
-Costochondritis
Cardiovascular:
-Heart attack
-Pericarditis or myocarditis
Respiratory:
-Bronchitis
-Pneumonia
Abdominal:
-GERD
-Chest S/S that indicate a cardiovascular problem - --Exertional chest pain
-Orthopnea (SOB when supine) / paroxysmal nocturnal dyspnea (relieved by
sitting up)
-Palpitations
-Edema
, -How to assess for dyspnea? - -Ask the patient "Have you had difficulty
breathing?"
-How to assess for degree of severity of dyspnea? - -Determine its effect on
patient's ADLs
-Possible causes of shortness of breath? - --Anxiety
-Activity
-Possible causes of cough? - --Irritating stimuli (ex. mucus, allergens, dust,
foreign bodies)
-Inflammation
-Compression of bronchioles from tumor, enlarged lymph nodes, or
pulmonary edema
-Left-sided heart failure
-Specific possible causes of chronic cough - --GERD
-Postnasal drip
-Bronchiectasis
-Bronchiectasis (define) - -Reversible dilatation of the bronchi where the
elastic and muscular tissue is destroyed by inflammation and infection. This
damage impairs the natural drainage of bronchial secretions which can
become chronically infected
-Possible causes of hemoptysis - --Bronchitis
-Cystic fibrosis
-Bronchiectasis
-Malignancy
-How to differentiate if coughed up blood is coming from the stomach or the
respiratory tract? - -Blood from the stomach is usually darker than blood
from the respiratory tract
-Most common cause of acute cough - -**Viral upper respiratory infection**
~Acute = < 3 weeks~
-Acute coronary syndromes (S/S) - --Chest pain
-Dyspnea / orthopnea
-Pneumonia (S/S) - --Fever
-Productive cough
, -How to differentiate between bacterial and viral infections in pneumonia? -
-**Bacterial pneumonia = purulent sputum (yellow or green)
**Viral infections = mucoid sputum (translucent, white)
^this type of sputum also present in cystic fibrosis
-Five As framework - --Ask about tobacco use
-Advise to quit
-Assess willingness to make a quit attempt
-Assist in quit attempt
-Arrange follow-up
-What type of prevention is screening? - -Secondary prevention
^interventions to detect disease early
-Primary prevention (define) - -Preventative measures that come before the
onset of disease (ex. immunization)q
-Timing for flu vaccine - -Late fall & winter (peaking in February)
-Nasal spray flu vaccine is/was recommended for what age group? - -
**Healthy people 2-49 years old**
-Timing for pneumonia vaccine - -**Prevnar**
*Under 2 years old:
-2 mnths, 4 mnths, 6 mnths, & 15 mnths
*Greater than 65 years old:
-First, PCV13
-Then PPSV23 6-12 months later
*If already received PPSV23, give PCV13 one year after most recent PPSV23
vaccination
-Special groups who should be immunized with PCV13 & PPSV23 - -*Pts >2
years old who are immunocompromised & those with chronic illnesses
associated with increased risk for pneumococcal infection (sickle cell
disease, diabetes, alcoholism, etc.)
*Pts >19 years old who smoke or have asthma
*Residents of nursing homes or long-term care facilities
, -Order for respiratory assessment - -1) Inspect
2) Palpate
3) Percuss
4) Auscultate
-Where are you most likely to hear abnormal wheezes or crackles? - -The
dependent side
^ventilation is greater in dependent lung
-Signs of respiratory distress - --Tachypnea (>25 breaths/min)
-Cyanosis or pallor
-Clubbing of fingers
-Audible signs of breathing
-Contraction of accessory muscles
-Stridor (define) - -Audible high-pitched inspiratory whistling; sign of upper
airway obstruction
-Stridor (causes) - --Epiglottitis
-Foreign body
-Anaphylaxis
-Tracheal stenosis from intubation
-Airway edema after device removal
-AP (anteroposterior) diameter - -A measure of the shape and symmetry of
the chest; Normally, the ratio of AP diameter to lateral chest diameter = 0.7-
0.9
~A barrel-shaped chest (anteroposterior diameter = transverse diameter)
characterized aging and chronic lung disease
-Asymmetric expansion/unilateral delay in chest expansion occurs in what
conditions? - --Pleural effusions
-Pleural disease (from asbestosis or silicosis)
-Lobar pneumonia
-Unilateral bronchial obstruction
-Crepitus (define) - -Crackling or grinding sound over bones, joints, or skin
(with or without pain) due to air in subcutaneous tissue
-Possible causes:
~Arthritis joints
~Overt fractures
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