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CMN 568 Exam 2- Physical Exam #1 Latest Update
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CMN 568 Exam 2- Physical Exam #1 Latest Update 2024-2025Physical examination Answer Inspection
- Palpation
- Percussion
- Auscultation
Observe pattern of breathing Answer RR (12-14rr/min)
- Rhythm (regular with a sigh every 90 breaths or so)
- Depth of breathing / tidal volume (5ml/kg)
- Relative time spent inspiration and expiration (ratio 2:3)
Inspect for extrapulmonary signs of pulmonary disease Answer Use what you find to
perform more detailed exam
Palpate - Trachea at suprasternal notch
- Percussion of posterior chest wall - gage fremitus / transmission through lungs of
vibrations of spoken words
- Percussion of anterior chest wall - assess cardiac impulse
Auscultation - Lung sounds
Pulmonary Function Tests - Measures airflow rates, lung volumes, ability of lung to
transfer gas across alveoli-capillary membrane
What would prompt FNP to order PFT to indicate patient needs PFT? - Answer - Assess
type/extent of lung dysfunction
, - Dx of causes of dyspnea and cough
- Detect early evidence of lung dysfunction
- Follow-up response to therapy
- Pre- op assessment
- Disability eval
Patient has acute asthma exacerbation w/mild resp. distress. You want to do a PFT to
see how well gas exchange is occurring. Is this correct management for the patient? -
Answer - No
- PFTs are contraindicated in acute severe asthma, resp. distress, angina aggravated by
testing, pneumothorax, ongoing hemoptysis, active TB
How would you measure your patients PFTs to establish whether they are normal or
not? Answer They are measured against predicted values derived from large studies of
healthy subject
- Vary with age, gender, height, weight, ethnicity
Tachypnea Answer Increased resp rate and decreased TV
Irregular rhythm Answer - Rapid, shallow breathing
- Restrictive lung disease (precursor to resp failure)
Kussmaul resp - Answer - Rapid large volume breathing leads to intense stimulation of
resp center
- R/T metabolic acidosis
Cheyne-Stokes resp - Answer - Rhythmic
- Waxing/waning of rate and TV
- Regular periods of apnea
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