Resp 304 Exam 2

What would you do with someone who has a 60- cycle rhythm?

- move them away from electricity

- have them take their hand off the handrail

- move them away from lights

What happens in a paced rhythm

- bradycardia

- low BP

- fix with transdermal pacing

What is transdermal pacing?

little shocks 60x a min across the chest

What is the diaphragm normally used for?

high frequency sounds like breath sounds

What is the bell normally used for?

low frequency sounds like heart sounds

What are bronchial breath sounds?

harsh and tubular normally heard over the middle chest (sternum) and lower part of trachea

What are vesicular breath sounds?

low-pitched, soft sound during inspiration heard over most of the lungs (parenchyma)

What are bronchovesicular breath sounds?

medium pitch sound heard during all of inspiration and expiration

If you hear bronchial sounds when you should hear vesicular sounds what disease should come to mind?

pneumonia or consolidation

What are crackles?

spontaneous opening of small airways (coarse and fine)

What is wheezing?

continuous high frequency sounds

What is a pleural friction rub?

visceral and parietal pleura rubbing against one another

What is stridor?

a harsh vibrating noise when breathing, caused by obstruction of the windpipe or larynx

What does ronchi sound like?

low frequency snoring

What is bradycardia?

slow heart rate

What is a PVC?

premature ventricular beat

What is a First Degree AV block?

prolonged PR interval

What is Second Degree AV block?

some atrial depolarization some are blocked leading to a lone P wave

What is Third Degree AV block?

total block of conduction to the ventricles

What is atrial flutter?

rapid succession of identical back to back atrial depolarization

What is atrial fibrillation?

- continuous chaotic atrial spikes

- irregular ventricular rhythm

- continuous rapid firing of multiple automaticity foci

Stroke equals

left heart

Emboli equals

right atrium

What is tachycardia?

rapid heart rate and the first sign of hypoxia

Describe dependent lung

- blood is in lower posterior and vent is in lower anterior

- causes atelectasis

What is the treatment for dependent lung?

shake up regimen (move them around deep breathing exercises)

What is the most important step in IPPA

inspection

What are some characteristics of ARDS

- ground glass appearance

-refractory hypoxia

What is refractory hypoxia?

increasing FiO2 with no change in saturation

What is the only true measure for proper tube placement?

x-ray

If a pt has a low RR (say 4) what should we do for them?

breathe for them

advantages and disadvantages of a PA film

clearer film heart shadow isn't as magnified can't be done bedside

advantages and disadvantages of AP film

can be done at bedside not as clear larger heart shadow

Breath sounds you can hear superimposed exp wheeze in acute distress is an...

EMERGENCY

Fluffy infiltrates

pulmonary edema

butterfly sign/infiltrates

pulmonary edema

patchy infiltrates

atelectasis

platelike infiltrates

atelectasis

ground glass appearance

ARDS or COVID

peripheral wedge

pulmonary embolism

concave superior interface

pleural effusion

What causes the PIP Pplat graph to change?

a change in compliance