Question Answer
angina spasmodic cramp like choking feeling
barrel chest abnormal increase in the a/p diameter of the chest caused by hyperinflation of the lungs
bradycardia abnormally decreased heart pain
bradypnea abnormal decrease in breathing rate
clubbing bulbous swelling of the terminal phalanges of the fingers and toes, often associated with certain chronic lung diseases
cough forceful expiratory effort designed to expel mucus and other foreign material from the upper airway
crackles discontinuous type of adventitious lung sound
cyanosis abnormal bluish discoloration of the skin or mucus membranes
diaphoresis secretion of sweat, especially profuse secretion associated with an elevated body temp, physical exertion, exposure to heat, and mental or emotional stress
diastolic pressure baseline blood pressure in the arteries during ventricular relaxation
dyspnea difficult of labored breathing
febrile to have a fever
fever abnormal elevation of body temp owning to disease
hemoptysis blood in sputum
hepatomegaly abnormal enlargement of the liver; usually a sign of disease
hypertension persistently high blood pressure
hypothermia abnormal and dangerous condition in which the temp of the body is less than 32 C, usually caused by long exposure to cold
jugular venous distension abnormal distension of the jugular veins, most often caused by heart failure
kussmaul breathing hyperpnea associated with diabetic ketoacidosis
mucoid resembling mucus
murmers abnormal heart sound created by turbulent blood flow through a narrowed or incompetent heart valve
orthopnea labored breathing in the reclining position
pedal edema swelling of the ankles usually secondary to heart failure
phlegm mucus from the tracheobronchial tree
platypnea opposite of orthopnea; an abnormal condition characterized by difficult breathing in the standing position, which is relieved in the lying or recumbent position
pulse pressure difference between systolic blood pressure and diastolic blood pressure
pulsus paradoxus abnormal decrease in pulse pressure with each inspiratory effort
purulent consisting of or pertaining to pus
retractions sinking inward of the skin around the chest cage with each inspiratory effort
sensorium general term referring to the relative state of a patients consciousness or alertness
sputum mucus from the respiratory tract that has passed through the mouth
stridor high-pitched, continuous type of adventitious lung sound heard from the upper airway
subcutaneous emphysema accumulation of air in the subcutaneous tissues owing to leakage from the lungs
syncope temporary unconsciousness; fainting
systolic pressure peak blood pressure occurring in the arteries during ventricular contraction
tachycardia abnormally elevated heart rate
tachypnea abnormal elevation in breathing rate
tripodding breathing technique most often used by patients with COPD in which they lean forward and place their elbows on a table or arms of a chair to support breathing with the accessory muscles
wheezes high pitched, continuous type of adventitious lung sound
what provides the basis for decisions regarding when to initiate, change, or discontinue therapy? an accurate clinical assessment
who is responsible for decisions regarding therapy? the physiscian
how do RT’s participate in the the clinical decision making process? by gathering and interpreting relevant bedside patient data
what is bedside assessment? the process of interviewing and examining a patient for signs and symptoms of disease as well as the effect of treatment
what does bedside assessment provide? initial evidence the something is wrong and its severity
does beside assessment cause risk to the patient? no
what are the two key sources of patient data? medical history and medical examination
what helps identify the need for diagnostic tests? interview and physical examination
why are assessment procedures repeated? to determine the effectiveness of treatment
why is the initial assessment performed and who does this? to identify the correct diagnosis; the physician
the three purposes of a an interview are? 1: establish rapport. 2: obtain essential diagnostic info. 3: monitor changes in the patients symptoms and response to therapy
interviewing is a crucial aspect of patient assessment. T or F true
interviewing is a way of ____ with the patient. connecting
meaningful human contact lessens the patients sense of _____. isolation
what are the factors that effect communication between the RT and the patient? sensory/emotional, environmental, verbal/non-verbal, cultural/values/beliefs/feelings/habits/preoccupations of both people
an interview in which the patient feels secure and free to talk is ____. ideal
how should an interview begin? with the RT introducing themselves, in the social space, and stating the purpose of the visit
what is social space? 4-12 ft from the patient
what is personal space? 2-4 ft from the patient?
where should the interview take place? personal space
how should you be positioned for a patient interview? in personal space, at eye level with the patient

 

Egan’s Chapter 15 Practice Questions:

 

1. An abnormal increase in the anteroposterior diameter of the chest.: barrel chest

2. Abnormal protrusion of the sternum: pectus carinatum

3. An abrupt decrease in blood pressure upon standing, often seen in hypovolemic patients.: postural hypotension

4. Acute, severe elevation of blood pressure which can cause acute neurologic, cardiac, and renal failure.: acute hypertensive crisis

5. An alternating succession of strong and weal pulses.: pulsus alternans

6. An arterial blood pressure persistently greater than ____/___ mmHG is called hypertenstion: 140/90

7. The _______ artery is the most common site used to palpate a pulse.: radial

8. At what part of the lung should you auscultate when assessing for vocal fremitus?: at the base of the lung

9. The average body temperature for adults is about _______ C.: 37

10. Blood pressure is a __:__ ratio.: 3, 2

11. A bluish discoloration of the tissues.: cyanosis

12. A body temperature below normal.: hypothermia

13. Body temperature elevation caused by disease is called fever, and the patient is said to be ___________.: febrile

14. Bradypnea is a respiratory rate of less than _____ breaths/min.: 10

15. Breathlessness can be triggered by:
a. hypoxemia
b. hypercapnia
c. acidosis
d. all of the above: d

16. Bright, red blood (new blood) is said to be _______.: frank

17. Cardiac output is a function of _______ ________ and ________ _________.: heart rate, stroke volume

18. Combination of kyphosis and scoliosis, which may produce a sever restrictive lung defect as a result of poor lung expansion.: Kyphoscoliosis

19. A condition in which the pulse exceeds 100 bpm.: tachycardia

20. A condition in which the pulse is less than 60 bpm.: bradycardia

21. Conditions associated with JVD include:
a. left heart failure
b. tension pneumothorax
c. cardiac tamponade
d. mediastinal tumors
e. all of the above: e

22. A condition when the jugular vein is enlarged and can be seen more than 3 to 4 cm above the sternal angle.: Jugular Venous Distention

23. COPD patients cannot exhale all of their inspired air (they’re lungs never completely empty). Because of this, they will have high ______ levels.: carbon dioxide

24. COPD patients exhibit what type of resonance?: hyerresonance

25. COPD patients may use____________ (pursed-lip/deep) breathing during exhalation.: prused-lip

26. Coughing up blood or blood-streaked sputum from the lungs.: Hemoptysis

27. A _______, ____________cough is associated with diseases such as bronchitis and asthma.: loose, productive

28. A _____, ___________ cough is typical for restrictive lung diseases such as CHF or pulmonary fibrosis.: dry, nonproductive

29. A deep, rapid pattern of breathing.: Kussmaul breathing

30. Depression of part or entire sternum, which can produce a restrictive lung defect.: pectus excavatum

31. A desaturated ___________ must exist before cyanosis can be identified.: hemoglobin

32. Discontinuous lung sounds produced when airflow moves secretions or fluid in the airways: crackles

33. Diseases that increase lung tissue density such as pneumonia, tumor or atelectasis, or pleural spaces filled with fluid, results in a ___________ resonance when percussing the chest.: decreased

34. Dry or loose, productive or nonproductive, acute or chronic, occurring more frequently at certain times…these are characteristics of what symptom?: cough

35. During an interview, the RT should assume a position that is _____ level with the patient.: eye

36. During hypothermia, the hypothalamus initiates _________ and ______________ to conserve heat.: shivering, vasoconstriction

37. Dyspnea in the upright position.: platypnea

38. Dyspnea that is present only when one assumes the reclining position.: orthopnea

39. An elevated body temperature secondary to disease. often seen with infection.: fever

40. Enlarged lymph nodes: lymphadenopathy

41. A forceful expiratory maneuver that expels mucus & foreign materials from the airways.: Cough

42. The force in the major arteries remaining after relaxation of the ventricles.: diastolic pressure

43. Fremitus is __________ in patients who are obese or overly muscular.: reduced

44. The general term describing the sensation of breathing discomfort.: Dyspnea

45. _____ grade fever typically accompanies upper respiratory tract infections, whereas a _____ fever occurs with viral influenza infection.: Low, high

46. Green colored sputum is a result of the death of what types of cells?: white blood cells

47. The heart tries to maintain adequate oxygen delivery to the tissues by increasing __________ ________.: cardiac output

48. History of cigarette and alcohol consumption may be found in this section of the medical history.: past medical history

49. Hyperinflation causes the diaphragm to be in a low, flat position. Contraction of a flat diaphragm tends to draw in the lateral costal margins instead of expanding them. This is called what?: Hoover sign

50. Hypotenstion is a systolic blood pressure less than ___ mm Hg or a mean arterial pressure less than ____ mm Hg.: 90, 65

51. The inadequate delivery of oxygen and nutrients to the vital organs relative to their metabolic demand.: shock

52. An intermittent sinking inward of the skin overlying the chest wall during inspiration; occur when the ventilatory muscles contract forcefully enough to cause a large decrease in the intrathoracic pressure.: retractions

53. Interviewing serves 3 purposes. What are they?: establish a rapport between the clinician and the patient, obtain essential diagnostic information, help monitor changes in the patient’s symptoms and response to therapy

54. The introduction for a patient interview is done in the ________ space, approximately _______ feet from the patient.: social, 4 to 12

55. ________ __________ is the difference between the systolic and diastolic pressures.: Pulse pressure

56. _________ _________ is the process for interviewing & examining a patient for signs & symptoms of disease and the effects of treatment.: Bedside assessment

57. A jugular venous pressure increase during inhalation.: Kussmaul sign

58. Jugular venous pressure reflects the volume & pressure of venous blood in the _____ side of the heart.: right

59. List the 4 steps of the physical examination.: inspection, palpation, percussion, auscultation

60. Lung sounds or vibrations produced by movement of air through abnormal airways are called ____________ lung sounds.: adventitious

61. Massive hemoptysis is when more than _____ mL of blood is expectorated within 24 hours.: 300

62. May occur with traumatic brain injury or hypothermia, as a side effect of medication (i.e. narcotics), with severe heart attack, and drug overdose.
a.tachypnea
b. bradypnea: b

63. The _______ medical history describes all past major illnesses, injuries, surgeries, hospitilizations, allergies & health-related habits.: past

64. Medical term for fainting.: syncope

65. The most accurate site for body temperature measurement, as it is closest to actual core body temperature.: rectum

66. The most common cause of JVD is:
a. left heart failure
b. right heart failure: b

67. Mucus from the tracheobronchial tree that has not been contaminated by oral secretions.: Phlegm

68. Mucus that comes from the lung but passes through the mouth as it is expectorated.: Sputum

69. The normal range for diastolic pressure is ___ to ___ mm Hg.: 60, 90

70. The normal range for systolic blood pressure is _____ to _____ mm Hg.: 90, 140

71. The normal resting adult rate of breathing is ____ to ____ breaths/min.: 12, 18

72. On average a normal, healthy individual produces ______ mL of mucus per day.: 100

73. Orthodeoxia may accompany this type of dyspnea.: platypnea

74. Orthopnea (dypsnea in the reclining position) is caused by the sudden increase in _________ _______ that occurs when reclining.: venous return

75. Oxygen desaturation when assuming the upright position.: Orthodeoxia

76. The _______ __ _________ part of the medical history reveals problem areas the patient forgot to mention or omitted.: review of systems

77. The patient’s current medical problems can be found in the _______ ___________ and _________ ___ _________ ___________ section of the medical chart.: chief complaint, history of present illness

78. The patient’s level of consciousness, orientation to time, place, person, and situation is called _________.: sensorium

79. A patient’s potential genetic or occupational links to disease & current life situation can be found in this section of the medical history.: family and social/environmental history

80. Patients who undergo ___________ surgery are prone to development of atelectasis in the postoperative period.: abdominal

81. Patients with ________ frequently complain of chest tightness.: asthma

82. Patients with ________ frequently feel suffocated.: coronary heart failure

83. The peak force exerted in the major arteries during contraction of the left ventricle.: systolic pressure

84. Pedal edema most often occurs with ______ __________.: heart failure

85. Percussion over normal lung fields produces a moderately low pitched sound that can be hard easily. This sound is described as normal resonance or _________.: tympanic

86. The _____________ plays an important role in regulating body temp.: hypothalamus

87. Postural hypotension is commonly caused by ___________.: hypovolemia

88. A pressure sensation with exertion or stress, resulting from coronary artery occlusion.: angina

89. The process of listening for bodily sounds.: auscultation

90. Psychogenic hyperventitlation syndrome is associated with _______ disorders.: panic

91. Pulsus alternans suggest _____ sided heart failure.: left

92. Pursed-lip breathing causes __________ to airflow and creates a slight ______ ___________ in the small airways during exhalation.: resistance, back pressure

93. A quasimusical, adventitious lung sound.: wheeze

94. _________ (rapid/slow) respiratory rates are associated with exertions, fever, arterial hypoxemia, metabolic acidosis, anxiety, pulmonary edema, lung fibrosis, and pain.: Rapid

95. A respiratory rate greater than 20 breaths/min.: Tachypnea

96. A respiratory rate less than 10 breaths/min.: bradypnea

97. Retractions seen above the clavicles: Supraclavicular retractions

98. Retractions seen below the rib cage: Subcostal retractions

99. Retractions seen between the ribs.: intercostal retractions

100. ______ (right/left) heart failure commonly occurs in patients with advanced COPD because of chronic hypoxemia.: Right

101. Right sided heart failure: cor pulmonale

102. The second step of the interview is to move into the patient’s ________ space, which is _______ feet from the patient.: personal, 2 to 4

103. The sensation of tingling and numbness in the extremities that often accompanies respiratory alkalosis is called:: paresthesia

104. A significant decrease (>10 mmHg) in pulse strength during spontaneous inhalation.: pulsus paradoxus

105. A significant fever causes an increased __________ rate, an increased _________ consumption, and an __________ carbon dioxide production.: metabolic, oxygen, increased

106. Smoking history is recorded in ______ years, which is determined by multiplying the number of ______ smoked per ____ by the number of _______ smoked.: pack, packs, day, years

107. Sounds heard over the trachea that have a loud, tubular quality.: tracheal breath sounds

108. Sounds that can be heard around the upper half of the sternum on the anterior chest & between the scapulae; not as loud as tracheal breath sounds, slightly lower in pitch.: bronchovesicular breath sounds

109. The specific sensation of an unpleasant urge to breathe.: Breathlessness

110. Spinal deformity in which the spine has a lateral curvature: scoliosis

111. Spinal deformity in which the spine has an abnormal AP curvature.: kyphosis

112. Sputum containing pus cells is said to be ___________.: purulent

113. ________ sputum is clear and thick, and is commonly seen in patients with asthma.: Mucoid

114. _________ sputum suggests a bacterial infection, and appears thick, colored and sticky.: purulent

115. Sputum that is foul-smelling is said to be _______.: fetid

116. Swelling of the lower extremities.: pedal edema

117. Tachypnea is a respiratory rate of more than _____ breaths/min.: 20

118. The tapping on a surface to evaluate the underlying structure.: Percussion

119. T/F: Barrel chest is associated with COPD.: F

120. T/F: Barrel chest is associated with ephysema.: t

121. T/F: Bedside assessment is of little risk to the patient and provides the initial evidence that something is wrong.: T

122. T/F: Crepitus is a classic sign of barotrauma.: T

123. T/F: Dyspnea is a subjective experience.: T

124. T/F: Febrile patients often have increased heart and breathing rates.: T

125. T/F: Hemoptysis is commonly found in patients with bacterial pneumonia.: T

126. T/F: Hypotension is synonymous with shock.: F

127. T/F: Lymph nodes are tender when malignancy is the cause.: F

128. T/F: Respiratory alkalosis amplies the sensation of breathlessness and provokes further anxiety and increased intensity of hyperventilation.: T

129. T/F: The absence of cyanosis guarantees that oxygenation is adequate.: F

130. T/F: The RT should assume a position that is above eye level with the patient.: F

131. T/F: Vocal fremitus can be assessed on a comatose patient.: F

132. T/F: Vocal fremitus requires a conscious and cooperative patient.: T

133. T/F: When interviewing a patient, you should always ask leading questions.: F

134. There is a _________ in intensity of vocal/tactile fremitus when either fluid or air collects in the pleural space.: decrease

135. This condition occurs with total diaphragmatic fatigue; also occurs when the diaphragm is paralyzed.: abdominal paradox

136. This is caused by extreme negative pressure that pulls the trachea downward during inspiration.: tracheal tugging

137. This mechanism gradually moves mucus to the hypophyarnx (larynx).: mucociliary escalator

138. This pattern is noted by the upward motion of the diaphragm during inspiration on a series of breaths, followed by diaphragmatic contractions & inward movement of the abdominal wall on the following series of breaths.: respiratory alternans

139. This type of chest pain is located in the center of the anterior chest and may radiate to the shoulder or back; dull ache or pressure feeling.: nonpleuritic chest pain

140. This type of chest pain is usually located laterally or posteriorly, and worsens when the patient takes a deep breath; sharp, stabbing pain.: pleuritic chest pain

141. This type of dyspnea is common in patients with CHF (coronary heart failure).: orthopnea

142. Touching the chest wall to evaluate underlying structure & function.: Palpating

143. The treatment for a fever is this type of drug.: antipyretic

144. Two key sources of patient data are the ______ _______ and the ________ ____________.: medical history, physical examination

145. The type of precaution needed when you need to protect the patient from yourself because they have NO immunity.: reverse isolation

146. The vibration created by percussion penetrates the lung to a depth of ___ to ___ cm below the chest wall.: 5, 7

147. Vibrations created by the vocal cords during speech.: vocal fremitus

148. Vocal and tactile fremitus _____ in intensity when the lung becomes consolidated such as in pneumonia.: increases

149. Vomiting blood from the GI tract.: hematemesis

150. Weakness and emaciation (extreme weight loss and thinness).: cachexia

151. What are the four sites to measure body temperature?: mouth, axilla, ear, rectum.

152. What does the effectiveness of a cough depend on?
a. ability of the person to take a deep breath
b. elastic recoil of the lungs
c. expiratory muscle strength
d. being awake or asleep
e. level of airway resistance: a, b, c, e

153. What factors affect a person’s perception of breathing?: the neural drive to breath, the tension developed in the respiratory muscles, the corresponding displacement of the lungs and chest wall

154. What is a sphygmomanometer?: blood pressure cuff

155. What is the first sign of acute diaphragmatic fatigue?: tachypnea

156. What is the medical term for sweating?: diaphoresis

157. What questions should the RT ask patients with chronic cardiopulmonary disease?: What activities of daily living trigger the dyspnea, how much exertion is required for the patient to stop and catch their breath, whether the quality of sensation of breathing discomfort varies with different activities, when did the dyspnea first began

158. What stimulates a cough?: inflammation, mucus, foreign materials, noxious gases

159. What words should you ask the patient to repeat to assess for tactile fremitus?: ninety nine

160. What would be the treatment option for a patient with angina?
a. Nitric oxide
b. Oxygen
c. Magnesium: b

161. When air leaks from the lung into the subcutaneous tissues, fine air bubbles product a crackling sound & sensation when palpated. This condition is known as__________. The sensation produced on palpation is called _______.: subcutaneous emphysema, crepitus

162. When a patient sits or stands while bracing his elbows on a table, allowing for the accessory muscles to gain a mechanical advantage for breathing.: tripodding

163. When a patient with normal cardiopulmonary function complains of intense dyspnea or suffocation, it is known as __________ _________ __________.: psychogenic hyperventilation syndrome

164. When a small fluid leak occurs at the point where pressure is applied.: weeping edema

165. When auscultating over the lung parenchyma of a healthy person, soft, muffled sounds are heard. These normal sounds are called:: vesicular breath sounds.

166. When examining a patient’s face for indications of respiratory problems, the most common facial signs are:
a. pursed-lip breathing
b. cyanosis
c. nasal flaring
d. red eyes: a, b, c

167. When percussing, a decreased resonance is called ___________ or ____.: dampened, dull

168. When pressure is applied with a finger on a swollen extremity, an indentation mark left on the skin is called ________ ________.: pitting edema

169. When the expiratory component of harsh breath sound equals the inspiratory component, they are described as:: bronchial breath sounds

170. When the lungs are hyperinflated or if there is a pneumothorax, there will be an _____________ resonance when percussing the chest.: increased

171. When the muscles alternately power breathing in an attempt to give each muscle group some rest.: respiratory alternans

172. When the percussion note is louder & lower than normal, the sound is said to be increased resonance or _____________.: hypertympanic

173. When vocal fremitus vibrations are felt on the chest wall.: tactile fremitus

174. Which of the following are the purposes of interviewing:
a. obtain essential diagnostic information
b. monitor changes in the patient’s symptoms and response to therapy
c. chit chat with the patient
d. establish a rapport between the clinician and the patient: a, b, d

175.With a heart attack, __________ happens first, followed by _________ ___________.: ischemia, myocardial infarction

 

Egan’s Chapter 15 Test Bank:

 

1. Abdominal Paradox: diaphragm becomes fatiqued, accessory muscles of breathing attempt to maintain ventilation by becoming more active, effort to cause gas to flow into the lung, negative intrathoracic pressure causes diaphragm to be pulled up and the abs to sink during inspiration

2. Adventitious Lung Sounds: additional breath sounds superimposed on normal sounds that indicate pathologic changes in the lung (ie crackles, wheezes, rhonchus, and pleural friction rub.)

3. Angina: a heart condition marked by paroxysms of chest pain due to reduced oxygen to the heart

4. Barrel Chest: a condition characterized by increased anterior-posterior chest diameter caused by increased functional residual capacity due to air trapping from small airway collapse. A barrel chest is frequently seen in patients with chronic obstructive diseases, such as chronic bronchitis and emphysema.

5. Bradycardia: abnormally slow heartbeat

6. Bradypnea: slow respiratory rate, usually below 10 respirations per minute

7. Bronchophony: Abnormal transmission of sounds from the lungs or bronchii. Pathology that increases lung density will enhance transmission of voice sounds ex// you hear a clear “nighty-nine”

8. Clubbing: a condition in which the ends of toes and fingers become wide and thick

9. Cough: sudden expulsion of air from the lungs that clears the air passages

10. Crackles: fine crackling or bubbling sound heard on inspiration, fluid in alveoli or opening of closed alveoli

11. Cyanosis: bluish color of the skin, nail beds, and/or lips due to an insufficient amount of oxygen in the blood

12. Diaphoresis: Excessive sweating

13. Diastolic Pressure: the blood pressure during that part of the heartbeat when the heart’s ventricles are relaxing

14. Dyspnea: difficult or labored breathing, , shortness of breath

15. Febrile: feverish; pertaining to or marked by fever; frenetic

16. Fetid: having a foul odor

17. Fever: a rise in the temperature of the body

18. Gallop Rhythm: the addition of a 3rd or 4th heart sound makes the rhythm sound like the cadence of a galloping horse

19. Heave: breathe noisily, as when one is exhausted

20. Hematemesis: Vomiting of blood.

21. Hemoptysis: coughing up blood from the respiratory tract

22. Hepatomegaly: abnormal enlargement of the liver

23. Hoover’s Sign: contraction of the flattened diaphragm pulls the lateral margins of the chest wall inward during each inspiratory effort

24. Hypertension: a common disorder in which blood pressure remains abnormally high (a reading of 140/90 mm Hg or greater)

25. Hypotension: abnormally low blood pressure

26. Hypothermia: Below normal body temperature

27. Jugular Venous Distention: visible thickening of the jugular veins, sign of congetive heart failure or overhydration

28. Kussmaul Breathing: a very deep gasping type of respiration associated with diabetic ketoacidosis.

29. Kussmaul’s Sign: increased jugular venous distention during inspiration, secondary to negative pressure during inspiration being transferred to the venous outflow tract,

30. Loud P2: abnormally loud closure of the pulmonic valve as part of the second heart sound; usually due to pulmonary hypertension

31. Lymphadenopathy: Any disease process affecting a lymph node or nodes

32. Mucoid: Resembling mucus.

33. Murmers: caused by abnormal flow of blood thru valves

34. Orthodeoxia: oxygen desaturation on assuming an upright position

35. Orthopnea: form of dyspnea in which the person can breathe comfortably only when standing or sitting erect

36. Pedal Edema: swelling of the feet and ankles caused by collection of fluid in the tissues; a possible sign of congestive heart failure (CHF)

37. Phlegm: thick mucus secreted by the membranes that line the respiratory tract.

38. Platypnea: shortness of breath in the upright position

39. Pneumothorax: abnormal presence of air in the pleural cavity resulting in the collapse of the lung

40. Postural Hypotension: low blood pressure occurring in some people when they stand up

41. Pulse Deficit: the difference between the apical and radial pulse rates

42. Pulse Pressure: the difference between systolic and diastolic blood pressure

43. Pulsus Alternans: regular rhythm, but force of pulse varies w/ alternating beats of large & small amplitude

44. Pulsus Paradoxus: decrease in systolic BP of more than 10mmHg with normal inspiration; palpated as weakened pulse with inspiration along with more heart contractions to pulse beats

45. Purulent: containing, consisting of, or forming pus

46. Respiratory Alternans: periods of breathing using only the chest wall muscles alternation with periods of breathing entirely by the diaphragm.

47. Retractions: Sinking inward of the skin around the chest cage with each inspiratory effort.

48. Sensorium: General state to a patients consciousness and alertness

49. Sputum: mucous secretion from the lungs, bronchi, and trachea expelled through the mouth

50. Stridor: high-pitched sound heard on inspiration; upper-airway sound indicating partial obstruction of the trachea or larynx

51. Subcutaneous Emphysema: The presence of air in soft tissues, causing a characteristic crackling sensation on palpation.

52. Syncope: a sudden, and generally temporary, loss of consciousness and postural tone, due to inadequate flow of oxygenated blood to the brain (fainting)

53. Systolic Pressure: the blood pressure during that part of the heartbeat when the heart’s ventricles are contracted and the blood is being pushed out into the arteries

54. Tachycardia: abnormally rapid heartbeat (over 100 beats per minute)

55. Tachypnea: an abnormally rapid rate of respiration, usually >20 breaths per minute

56. Thrills: fine “vibration” felt during palpation of a pulse

57. Tripodding: patient with severe pulmonary hyperinflation tends to sit upright while bracing his or her elbow on a table

58. Wheezes: sounds produced by movement of air through narrowed passages in the traceobronchial tubes

 

Egan’s Chapter 15 Study Guide:

 

1. adventitious lung sounds: added sounds or vibrations produced by the movement of air through abnormal airways

2. apnea: no breathing

3. apneustic breathing: prolonged inhalation

4. asthmatic breathing: prolonged exhalation

5. average body temperature for adults is approximately: 98.6 F or 37 C

6. axillary site for temp is acceptable for infants or small children. How much is the value off for that temp: 1 or 2 degrees C

7. barrel chest: adnornal increase in AP diameter and is associated with emphysema

8. biots respiration: irregular breathing with long periods of apnea

9. bodies response to hypothermia is: shivering and vasoconstriction

10. bradycardia: pulse rate is less than 60 beats per minute

11. cap refill time should be less than…………………..: 3 secs

12. characteristics of coarse crackles: coarse, inspiratory and expiratory

13. characteristics of fine crackles: fine, late inspiratory

14. characteristics of stridor: high pitched, monophonic

15. characteristics of wheezes: high pitched, usually expiratory

16. cheyne-stokes repiration: irregular type of breathing; breaths increase and decrease in depth and rate with periods apnea

17. clubbing: is a painless enlargement of the terminal phalanges fo the fingers and toes. the nail base increases and the base of the nail becomes spongy

18. comatose: unconscious, does not repond to stimuli, does not move voluntarily, exhibits possible signs of upper motor neuron dysfunction, such as babinski’s reflex or hyperreflexia, loses reflexes with deep or prolonged coma

19. A common cause of nonpleuitic chest pain is: angina

20. Confused: exhibits slight decrease of consciousness, has slow mental responses, has deceased or dulled perception, has incoherent thoughts

21. continuous ALS: duration longer than 25 milliseconds

22. cor pulmonale: right side heart failure

23. cough: is a forceful expiratory maneuver that expels mucus and foreign material from the airways

24. cough is associated with the use of what types of medication: medication for hyptertension (angiotensin-converting enyzme inhibitors)

25. cyanosis: bluish discoloration of the tissues

26. delirious: easily agitated

27. diaphoresis: sweating

28. discontinuous ALS: are intermittent, crackling, or bubbling sounds of short duration

29. diseases associated with a loose productive cough: inflammatory obstructive diseases such as bronchitis and asthma

30. diseases associated with a nonproductive cough: restrictive lung diseases such as CHF or pulmonary fibrosis

31. during systolic murmurs what noises can be hear when listening over the heart: whooshing noise

32. dyspnea: shortness of breath

33. Febrile: temperature elevation caused by disease

34. fetid: sputum that is foul smelling

35. The fist heart sound (S1) is produced by closure of what valves: mitral and tricuspid (the AV valves) during the contractions of the ventricles

36. gallop rhythm: a patient with heart desease who has an S3 and S4

37. heave: a systolic thrust produced by right ventricular hypertrophy

38. hematemesis: vomiting blood

39. hemoptysis: coughing up blood or blood streaked sputum from lungs

40. hepatomegaly: enlarged liver

41. how big is a normal size liver: 10cm. any bigger and is considered enlarged

42. How do you measure JVP?: distance the veins are distended above the sternal angle

43. how fast to do release pressure in the BP cuff: 2 -3 mmHg per sec

44. how is pleuritic chest pain usually described: sharp or stabbing type of pain

45. How is S3 produced: by rapid ventricular filling immediately after systole

46. How is smoking history recorded: pack a day x years of smoking

47. how long should your stethocope tubing be: 25 to 35 cms

48. how to evaluate the posterior thoracic expansion: place your hands over the posterolateral chest with the thumbs meeting at the T8 vertebra

49. how to evalulate anterior chest wall expansion: place your hands over the anterolateral chest, with the thumbs extended along the costal margin toward the xiphoid process

50. hwo high do you pump the BP cuff: 30mmHg above the point where the pulse can not be felt any longer

51. hypertension: BP that is higher than 140/90mmHg

52. hypotension: below95/60mmHg

53. Hypothermia: body temperature below normal

54. If a patient ingests hot or cold liquid or has been smoking, oral temperature measurement should be delayed for how long: 10 to 15 minutes

55. in general the trachea shift___________ the area of a collapsed lung: toward

56. JVD: (Jugular vein distention) jugular vein is enlarged and it can be seen more than 3 to 4 cm above the sternal angle

57. JVD is a sign of: right side heart failure

58. The key sources of patient sources of patient data are: medical history and the physical examination

59. korotkoff sounds: sound heard with stethoscope over brachial artery during blood pressure

60. kussmaul’s respiration: deep and fast repirations

61. kussmauls respiration (what causes): metabolic acidosis

62. kussmaul’s sign: JVP rise during inhalation

63. kyphoscoliosis: combination of kyphosis and scolisis, which may produce a severe restrictive lung defect as a result of poor lung expansion

64. kyphosis: spinal deformity in which the spine has an abnormal AP curvature

65. lethargic: sleepy
arouses easily
responds appropriatly when aroused

66. lyphadenopathy: enlarged lymph nodes

67. most chest pain can be categorized as either: pleurtic or nonpleurtic

68. mucoid: sputum that is clear and thick

69. murmurs: are identified whenever the heart valves are incompetent or stenotic

70. Noninfectious cause of fever: head trauma, cancer, immunologic disorders, adverse reaction to certain meds, thromboembolic disorders

71. Nonmassive hemoptysis is caused most often by infection of the airways by also seen in: lungs

72. normal adult pulse: 60 to 100 beats per minutes

73. normally there is a slight ______ in pulse pressure during every inspiratory effort.: drop

74. normal resting rate: 12-18

75. obtunded: awakens only with diffculty
responds appropriately when aroused

76. orthodeoxia: oxygen desaturation in the upright position

77. orthopnea: patient who becomes short of breath when reclining

78. orthopnea is common in what type of patients: CHF, bilateral diaphragmatic paralysis

79. paradoxical respiration: part or all of the chest wall moves in with inhalation and out with exhalation

80. pectus carinatum: abnormal pretrusin of the sternum

81. pectus excavatum: depression of part or the entire sternum, which can produce a restrictive lung defect

82. pedal edema: swelling of the lower extremities

83. personal space: 2-4 feet from patient

84. phlegm: mucus from the tracheobronchial tree that has not been contaminated by oral secretions

85. Platypnea: shortness of breath when sitting in the upright position

86. PMI: point of maximal impulse

87. postural hypotension: abrupt change in blood pressure supine and sitting positions

88. pulmonary hyptertension produces an increased intensity of ______: S2

89. pulse deficit: apical rate is higher than the peripheral pulse. common in a fib

90. Pulsus alternans: is an alternating succession of strong and weak pulses

91. pulsus paradoxus: drop in systolic pressure of more than 6 to 8 mmHg during a resting inhalation

92. purulent: sputum that contains pus cells

93. respiratory alternans: a few minutes of accessory muscles use then a few minutes of diaphragm takes over

94. retractions: are an intermittent sinking inward of the skin overlying the chest wall during inspiration

95. scoliosis: spinal deformity in which the spine has a lateral curvature

96. the second heart sound is produced by the closure of what valves: aortic and pulmonary semilunar valves
(during the contraction of the atriums

97. sensorium: level of consciousness

98. a significatn decrease in pulse strength during spontaneous ingalation is called: pulsus paradoxus

99. social space: 4-12 feet from the patient

100. sputum: mucus that comes form the lung but passes through the mouth as it is expectorated

101. Stridor if most often heard during ________: inspiration

102. subcutaneous emphysema: fine air bubbles produced a cracking sound and sensation when palpated.

103. sustained hypertension can cause: headaches, blurred vision, and confusion, uremia, CHF, and cerebral hemorrhage stroke

104. syncope: fainting