Final RCA

Three Zones: Social space 4'12

Introduce yourself to patient; gain overview of whole patient and their environment.

Three Zones: Personal Space 4'-18’

For interviews; pulling curtains may be advantageous; your personal appearance/hygiene are important

Three Zones: Intimate Space 18” to 0

This requires a “go ahead” before beginning

What the K mean in SPEAK UP

what medicine you take and why you take them

Normal Values

pH: 7.35 – 7.45

PaO2: 80-100 mmHg

PaCO2: 35-45 mmHg

HCO3: 22-25 mmol/L

B.E. + or – 2 mmol/L

Uncompensated Respiratory Acidosis

pH: 7.25

PaCO2 65

HCO3 26

Partially compensated respiratory acidosis

pH: 7.33

PaCO2 65

HCO3 28

Compensated respiratory acidosis

pH: 7.36

PaCO2 65

HCO3 30

Uncompensated Respiratory Alkalosis

pH: 7.57

PaCO2 24

HCO3 23

Partially compensated respiratory alkalosis

pH: 7.49

PaCO2 24

HCO3 20

Compensated respiratory alkalosis

pH: 7.44

PaCO2 24

HCO3 18

Uncompensated Metabolic Acidosis

pH: 7.29

PaCO2 40

HCO3 16

Partially compensated metabolic acidosis

pH: 7.31

PaCO2 34

HCO3 16

Compensated metabolic acidosis

pH: 7.35

PaCO2 30

HCO3 16

Uncompensated Metabolic Alkalosis

pH: 7.52

PaCO2 39

HCO3 29

Partially compensated metabolic alkalosis

pH: 7.49

PaCO2 46

HCO3 29

Compensated metabolic alkalosis

pH: 7.45

PaCO2 49

HCO3 29

Assessing the patient's level of consciousness is important because it….

Evaluates the adequacy of cerebral perfusion and oxygenation

The presence of early morning headache may be caused by which of the following conditions

Hypercapnia

Eupnea is normal rate and depth of breathing…True or False

True

Daytime somnolence is seen in patients with….

OSA or Obstructive Sleep Apnea

A 20-year old respiratory care student enters the room of a 65 year old female patient, saying “Hi Linda I am Joe from Respiratory Care” He immediately approaches her, looks her in her eye, and places her stethoscope on her chest

Joe has inappropriately entered the patient's inmates space

A “+4” pitting edema is characterized as very mild…..True and False

False

Which of the following definitions is consistent with massive hemoptysis

400 mL in 3 hours

Who writes progress notes each day

The physician, nurse, and the physical therapist

Which of the following activities is part of the role of respiratory therapists in patient assessment

Document the patient diagnosis in the patient's chart

Normal Sputum is

100 mL /day

Calculate the pack year of a 50 year old male who has smoked 3 packs of cigarettes every day for the past 24 years

72 pack years

Hemoptysis is commonly associated with lung cancers and bronchiectasis. True or False

True

One effective teaching tool is the teach-back method. This is….

A technique where the teacher explains the procedure to the learner repeat the information in his or her own words

A legal document in which a person specifies what actions should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity is called:

Advance Directive

A brief notation explaining why the patient sought health care is referred to as the patient's “chief complaint”…..True or false

True

Chest pain associated with inspiration is termed pleuritic….True or False

True

A pitting edema value of “+1” would be indicative of severe peripheral fluid retention

False

Which term is used to describe dyspnea while lying flat but not in the upright position

Orthopnea

What describe a patient who is neither awake or aware and postures to painful stimuli

Coma

For which of the following patients would the use of a pulse oximeter be LEAST appropriate for monitoring the patient's oxygenation status

A smoke-inhalation victim

The best denfition of sputum

Secretions from the nose, mouth, and tracheobronchial tree

A temporary loss of consciousness resulting from low cerebral blood flow and oxygen is known as

Syncope

Hemoptysis would be least associated with which of the following disorders

Asthma

Which of following is NOT a complication of forceful coughing

Pleural effusion

Which of the following would be the most appropriate way for respiratory care student Amy Long to initially approach a 58 year old female patient, Mrs. Nora Jones

“Hello, Mrs. Jones. I am Amy from respiratory care, and with your permission I would like to assess you for your treatment.” (Amy stans 5 feet away from the patient and makes direct eye contact)

Black sputum is most closely associated with:

Smoke or coal dust inhalation

What is the most common manifestation of infection in a patient with pulmonary disease

Fever

A chronic cough is defined as a persistent cough lasting more than

3 weeks

You are riding in an elevator at the hospital where you are employed as an RT. The elevator is full, but standing next to you is Joe, the RT who is scheduled to relieve you. He turns to you and asks, “How is Mr. Copper doing?” Earlier in the day, Mr. Copper had a cardiac arrest, and he is now being mechanically ventilated. How should you respond to Joe?

“Let's talk later in the report room”

Chest pain is the cardinal symptom of which of the following diseases

Heart disease

In which section of the patient record should the following entry appear? “Day 4 of hospitalization. Patient febrile (39o C). Rates in both lung bases; sputum moderate, thick, green, tinged with blood. Plan: Continue ordered antibiotic therapy. Bronchoscopy tomorrow in AM”

Progress notes

What term is used to describe secretions strictly from the lungs and lower airways

Phlegm

Which of the following techniques is NOT a behavior associated with active listening during interview process

Taking notes while a patient is talking

A prolonged expiratory phase is commonly associated with disorders like emphysema….True or False

True

The patient's family history would be most beneficial in aiding in the diagnosis of

Cystic fibrosis

Brownish sputum is most closely associated with

Cigarette smoker

Social and environmental history would be most beneficial in aiding in the diagnosis of

Asbestosis

What is the most common cause of fever above 102 F

Infection

The cardiopulmonary symptom that is the most important factor limiting the ability to function is

Shortness breath

Stridor is an indication of potentially life-threatening upper airway obstruction….True or False

True

Cheyne-Stokes breathing is commonly associated with which condition

Congestive heart failure

What is thoracic configurations can potentially cause a restrictive defect for a patient

Pectus excavatum

A trauma patient enters the ER and on initial examination the respiratory therapist observes paradoxical respiration. Which of the following should the therapist suspect

Chest trauma

Which of the following is Coagulation screening test

PT/INR

What is associated with rapid airflow through obstructed upper airway caused by inflammation or fixed obstruction

Stridor

Which of the following terms is used for blood platelets

Thrombocytes

Elevation of troponin is associated with what disorder

Acute myocardial infarction

Which problem is associated with an abnormally high international normalized ratio (INR) value

Bleeding

Which of the following terms means “pinpoint pupils”

Miosis

During palpation of the patient the RT asks the patient to repeatedly say the number “99” as she uses her hands to palpate over the chest wall. The RT finds that vibration is increased over the LLL. Which of the following abnormalities would be associated with this increase in vocal resonance

Pneumonia

You are most likely to see barrel chest in which disorder

COPD

Reduced downward diaphragmic movement would likely to expected in which patient

Someone with serve hyperinflation

A pulse rate above normal range is called

Tachycardia

A bilateral reduction in chest expansion is usually not seen with which disorder

Pleural effusion

A respiratory therapist examining a patient notes that on assessment of chest expansion with palpation, the right lower chest is found to lag behind the left Lower chest. With which of the following problems is this finding consistent

Right lower lobe pneumonia

Which of the following types of white blood cells are useful against allergic reactions such as asthma

Eosinophil

What is associated with airflow through mucus

Rhonchi (coarse crackles)

Which of the following clinical disorders will cause hyperresonance

Pneumothorax

Which of the following patterns of breathing is associated with a loss in lung volume

Rapid and shallow

Which of the following is not true concerning the Angle of Louis

It is located at the approximate level of T6

An elevated BNP level is suggestive of

Congestive heart

The normal pulse rate range for adults is

60-100

The purpose of performing the sensitivity test on sputum samples is to

Prescribe antibiotic

A therapist examining a patient encounters in area of skin along the right midaxillary line, which, when palpitated, produces a crackling sound and sensation, This is an indication of ...... within a patient

Subcutaneous emphysema

Elevation of blood urea nitrogen (BUN) and creatinine levels in blood suggests what type of problem

Renal failure

What is not a component of a physical examination

Manipulation

The right hemidiaphragm sits lower than left hemidiaphragm because of the position of the liver. True or False

False

Evaluation of the skin turgor provides information on

Hydration status

Inspiratory to expiratory ratios of 1:5 or 1:6 are commonly associated with obstructive lung disorders such as asthma and COPD. True or False

True

Which electrode is the most associated with heart arrhythmia

Potassium

An elevated D-dimer may indicate

Patient has had a myocardial infarction

A WBC of 21,000 in a patient indicates

Patient may have an infection

Obstructive atelectasis can be caused by

Pneumothorax and Mucus

Unilateral reduction in chest movement is usually not seen with which disorder

Asthma

Which of the following terms is used for red blood cells

Erythrocytes

Normal fasting blood sugar level ranges from 70-90 mg/dl. True or False

True

In which of the following disorders does a skin test use purified protein derivative PPD

Tuberculosis

Which of the following breathing patterns describes Kussmaul's breathing

Fast and deep

You are assisting with CPR. The physician asks you to check for a pulse. The most appropriate location for checking a pulse during CPR is

Carotid

What is associated with rapid air flow through obstructed airways caused by bronchospasm and mucousal epidemia

Wheezing

Heavy smokers are prone to what changes in the red blood cell count

Secondary polycythemia

The most common cause of jugular vein distention is

Right-sided heart failure

Normal Potassium values are

6.3-7.9