resp theory final

What are the normal breath sounds and where are they heard?

Tracheal - over trachea, loud/high; Bronchial - over manubrium; Bronchovesicular - between scapula; Vesicular - over most lung fields.

What are adventitious (abnormal) breath sounds?

Crackles, wheezes, rhonchi, stridor, pleural rub.

What causes crackles?

CHF, atelectasis, pulmonary edema.

What causes rhonchi?

Pneumonia, bronchitis, cystic fibrosis.

What causes stridor?

Obstruction of upper airway.

What is wheezing?

High-pitched sound from narrowed airways (asthma).

What is normal blood pressure?

~120/80 mmHg.

What does high blood pressure cause?

Risk of stroke, heart disease.

What are abnormal spine curvatures?

Kyphosis - rounded upper back; Scoliosis - sideways curve; Lordosis - excessive inward curve.

What is radiolucent on X-ray?

Black (air) = lungs, trachea.

What is radiopaque on X-ray?

White (bone, fluid, consolidation).

What happens to the trachea in atelectasis?

Trachea pulled toward consolidation (white).

What happens to the trachea in pneumothorax?

Trachea pushed away.

What are signs of hypoxemia?

Cyanosis, confusion, agitation, ↑HR, ↑RR.

What is palpation?

Using hands to feel vibration, tenderness, symmetry.

What does IPPA stand for?

Inspect → Palpate → Percuss → Auscultate.

What is PEF?

Peak Expiratory Flow: monitors asthma severity.

What is the safety factor for oxygen tanks?

0.25 (leave 25% in tank).

What is the cylinder duration formula?

(PSI - 200) × cylinder factor ÷ flow.

What is the E cylinder factor?

0.28.

What is the H/K cylinder factor?

3.14.

What is the pin index system?

Prevents wrong gas connection.

What is the regulator pressure for oxygen tanks?

50 PSI.

What are the types of flowmeters?

Thorpe tube, Bourdon gauge.

What does a ball jumping in a flowmeter indicate?

Back pressure.

What color is the oxygen cylinder?

Green or white.

What are low flow devices for oxygen delivery?

Nasal cannula, simple mask, NRB, partial rebreather.

What is a high flow device for oxygen delivery?

Venturi mask.

What is the FiO2 range for nasal cannula?

24-44% @ 1-6 L/min.

What is the FiO2 for NRB?

Up to 90-100%.

What is the FiO2 range for Venturi masks?

24-60%.

What happens if you cover the venturi holes?

FiO2 increases (dangerous).

What is the 'Magic Box'?

Calculates total flow of venturi device.

What are the types of hypoxia?

Hypoxemic, Anemic, Stagnant, Histotoxic.

What causes anemic hypoxia?

Low hemoglobin.

What causes stagnant hypoxia?

Poor circulation.

What causes histotoxic hypoxia?

Cell cannot use O2 (cyanide).

What is the normal humidity level?

44 mg/L.

What are signs of poor humidification?

Thick secretions, nosebleeds, dry mucosa.

Where is the ISB located?

5 cm below carina.

What is the normal particle size for lungs?

1-5 microns.

Where do large particles deposit?

Upper airway.

What is the nebulizer flowrate?

6-8 L/min.

What is an advantage of a vibrating mesh nebulizer?

Silent, efficient.

What is a disadvantage of a vibrating mesh nebulizer?

Expensive.

What is cleaning?

Removes dirt.

What is disinfection?

Kills most germs.

What is sterilization?

Kills ALL microbes.

What does PPE stand for?

Personal Protective Equipment: gloves, gown, mask, eye shield.

What are the types of transmission?

Contact, droplet, airborne.

What is the suction duration?

10-15 seconds.

What is the suction pressure?

80-120 mmHg.

What are the hazards of ET tubes?

Infection, tracheal damage, aspiration.

How do you check tube placement?

Chest rise, CO2 detector, x-ray.

What is Trendelenburg position?

Head down, feet up.

What is Fowler's position?

Sitting up.

What is supine position?

Flat on back.

What is the purpose of CPT?

Loosen/move secretions.

What is an incentive spirometer used for?

Deep breathing to expand lungs.

How do you measure NP airway?

Nose to ear measurement.

When is oropharyngeal airway used?

Unconscious patient.

What are the signs of asthma?

Wheezing, ↑RR, nasal flaring, cyanosis.

What are the signs of COPD?

Barrel chest, pursed-lip breathing.

What does a chest X-ray show for COPD?

Flattened diaphragm.

What are Korotkoff sounds?

Sounds heard with a BP cuff when measuring blood pressure.

What causes high blood pressure (hypertension)?

Stress, obesity, smoking, kidney/heart disease.

What causes low blood pressure (hypotension)?

Dehydration, shock, blood loss, sepsis.

What is a common sign of hypotension?

Dizziness or fainting.

How do you know if an x-ray is overexposed?

Too dark, spine visible through heart.

How do you know if an x-ray is underexposed?

Too white, lungs not visible.

How can you tell if an x-ray is rotated?

Clavicles are not symmetrical.

What indicates proper inspiration on a chest x-ray?

See 10 posterior ribs.

What does the venturi mask do?

Delivers a precise, fixed FiO₂.

Why must air-entrainment ports NOT be blocked?

Increases FiO₂ → dangerous for COPD patients.

What are the 'Da Rules' for venturi device?

Smaller jet → higher FiO₂; Larger jet → lower FiO₂; More air entrained → lower FiO₂; Less air entrained → higher FiO₂.

What is the total flow formula using the Magic Box?

Flowmeter setting × total flow factor.

What is the partial pressure formula?

FiO₂ × 760 mmHg.

What is the room air partial pressure?

0.21 × 760 = 160 mmHg.

What is the partial pressure for 50% O₂?

0.50 × 760 = 380 mmHg.

What is a spacer?

Holds medication so patient can inhale better.

What is a holding chamber?

Spacer with one-way valve.

Why use a spacer?

Increases drug delivery to lungs.

Which is more cost-effective, MDI or nebulizer?

MDI.

Which delivers faster in ER, MDI or nebulizer?

Nebulizer.

What is the respirable dose of MDI?

10-25%.

What is the respirable dose of SVN?

5-15%.

What can attach to LVN?

Aerosol mask, T-piece, trach collar.

What is rainout?

Condensation in tubing.

What is the effect of water in heated T-piece?

↓ FiO₂, ↑ resistance, bacterial risk.

What lubrication should be used for NP airway?

Water-based lubricant.

What is the insert direction for NP airway?

Along floor of the nose.

What are the types of lung expansion therapy?

Incentive spirometry, CPAP, PEP, IPV.

What is the purpose of lung expansion therapy?

Prevent/treat atelectasis.

What are the dangers of bagging?

Overinflation, pneumothorax, ↓ cardiac output.

What is the best way to prevent dangers of bagging?

Use manometer & proper rate.

What is barrel chest?

Seen in COPD/emphysema.

What is pectus excavatum?

Sunken chest.

What is pectus carinatum?

Pigeon chest.

What is Cheyne-Stokes breathing?

Periods of apnea then deep breathing.

What is Biot's breathing?

Irregular breathing, brain injury.