During the advanced stages of cystic fibrosis, the anatomic alterations cause the patient to have

Q: Which of the following would you expect to find in a patient with cystic fibrosis?

Symptoms of CF Frequent lung infections including pneumonia or bronchitis. Wheezing or shortness of breath. Poor growth or weight gain in spite of a good appetite. Frequent greasy, bulky stools or difficulty with bowel movements.

Q: What is the most common complication of cystic fibrosis?

The most serious and common complications of cystic fibrosis are problems with the lungs, also known as pulmonary or respiratory problems, which may include serious lung infections.

Q: What causes respiratory alterations in cystic fibrosis?

The abnormal electrolyte transport system in CF causes the cells in the respiratory system, especially the lungs, to absorb too much sodium and water. This causes the normal thin secretions in the lungs to become very thick and hard to move. These thick secretions increase the risk for frequent respiratory infections.

Q: What complicating pulmonary problem is likely to happen to a patient with cystic fibrosis?

Respiratory failure. Over time, cystic fibrosis can damage lung tissue so badly that it no longer works. Lung function usually worsens gradually, and it eventually can become life-threatening. Respiratory failure is the most common cause of death.

Inhaltsverzeichnis Show

Which of the following would you expect to find in a patient with cystic fibrosis?
What is the most common complication of cystic fibrosis?
What causes respiratory alterations in cystic fibrosis?
What complicating pulmonary problem is likely to happen to a patient with cystic fibrosis?

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Question	Answer
The total volume of gas that can be exhaled as forcefully and rapidly as possible after and maximal inhalation is called?	Fvc forced vital capacity
What ratio compares the amount of air exhaled in one second to the total amount exhale during an FVC maneuver?	FEV1% forced expiratory volume
The maximum volume of gas that can be exhaled in one second is called?	FEV1
Which test provides a good assessment of the upper airways?	FEF 200-1200
Which test provides a good assessment of the medium to small sized airways?	FEF 25% to 75%
Which type of diseases would have increased TLC and decreased FEV 1%?	Obstructive
What type of diseases would have decreased TLC and normal or increased FEV1%?	Restrictive
The average peak flow rate for a male between 20 and 30 years old is?	600 L per minute
Airway resistance increases in obstructive disease is due to the weakening of the distal airways? (True false )	True
What is the test used to test the adequacy of gas transfer across the AC membrane?	DLco
Five obstructive lung disease is?	Cystic fibrosis, bronchiectasis, asthma, chronic bronchitis, emphysema
COPD is a combination of which two obstructive lung disease is?	Chronic bronchitis and emphysema
What is the most common cause of centrilobubar emphysema?	Smoking
What is the most common cause of panlobular emphysema?	AAT deficiency
What is the cause of jugular vein distention and peripheral Adema in COPD patients?	Core pulmonale
Emphysema patients are commonly referred to as___Due to their reddish complexion and pursed lip breathing in and chronic bronchitis patients are commonly referred to as___due to cyanosis and stockyiness?	Pink puffer type a, Blue bloater type b
Anatomic alterations found with emphysema?	Destruction of Alveolar walls, weakening and enlargement of air spaces distal to the terminal bronchioles, decreased surface area for gas exchange
Anatomic alterations found with chronic bronchitis?	Excessive mucus production, chronic bronchial wall inflammation, bronchospasm
What breath sounds are associated with emphysema?	Decreased diminished breath sounds, prolonged expiration
What breath sounds are associated with chronic bronchitis?	Rhonchi, wheezing, crackles
Your patient has been found to have tuberculosis in several organs of the body. What term is used to describe the situation?	Disseminated TB
Your patient has post primary tuberculosis. What are the major pathologic or structural changes is not associated with that?	Laryngeal edema
A patient who has an uncontrolled tuberculosis infection will show all of the following signs except?	High fever
A positive tuberculin test begins with a wheal of what size?	10 mm or greater
A patient is the suspected of having a mycobacterium tuberculosis infection. His sputum is being stain by the Ziehl-Nielsen method. How will these organisms be identified?	Bright red bacilli
What medication is used to treat a person who has converted to a positive tuberculosis skin test but does not have active disease?	Isoniazid
The most effective medication used to treat a tuberculosis infection is?	Isoniazid
A patient with an advanced case of tuberculosis may have the following radiological findings except?	Hyperlucent lung fields
Which of the following clinical manifestations are not associated with tuberculosis?	Decrease tactile and vocal fremitus
Because of the effects of the reaction to infection and the healing process, tuberculosis causes what type of lung pathology?	Restrictive
Your patient with pulmonary edema is cyanotic and complaining of difficulty breathing. What should be recommended by the respiratory therapist?	Provide 100% oxygen
The major pathologic or structural changes seen in the lungs with pulmonary edema include?	Atelectasis, high surface tension of alveolar fluids, alveolar flooding
Your patient with cardiogenic pulmonary Adema would be expected to have all of the following chest radiograph findings except?	Depressed diaphragm
If a patient has pulmonary Adema the sputum is?	Frothy white or pink
Pulmonary Adema involves?	Fluid moving from the pulmonary vascular system to the air spaces
The most common cause of pulmonary edema is?	Congestive heart failure
When a patient has left-sided heart failure, what is usually done to increase cardiac output?	Give digitalis
Your patient with pulmonary Adema is in respiratory failure. She does not want to be put onto mechanical ventilator. What should be tried first?	Mask CPAP
As pulmonary edema progressively worsens, The fluid moves in the following sequence?	Alveoli,bronchioles, bronchi
Pulmonary edema manifest itself clinically as?	Restrictive pulmonary disorder
The major pathologic for structural changes of the lungs associated with Ventilator failure accompanying guillain barre syndrome include?	Alveolar consolidation, atelectasis
Guillain barre syndrome is most likely to be found in which demographic group?	White male 45 years of age
When a person has guillain barre syndrome, what happens to the parade for your nerves?	The Myelin sheath is removed
The diagnosis of guillain barre syndrome is based on all the following except?	Urinalysis shows elevate blood urea nitrogen
Clinical indications that your patient has acute ventilatory failure include?	PH less than 7.35, PaCO2 greater than 45 mmHg, negative inspiratory force less than -25 cm H2O
In a myasthenia gravis patient, what happens after a rest period?	Muscle strength improves
Which of the following is/are signs and symptoms associated with myasthenia gravis?	Weakness of neck muscles, drooping of eyelids, difficulty speaking of
The physician is recommending a Thymectomy in a patient. The benefit of this procedure is to?	Remove the source of anti-ACH receptor in anti-bodies
A patient with myasthenia gravis Will have lung volume and capacity findings that show?	A restrictive pulmonary disorder
Typical test assessment findings in a patient with guillain barre syndrome include?	Diminished breath sounds, crackles and rhonchi
Chronic bronchitis is defined as?	Daily productive cough for three months, for two years in a row
Chronic obstructive pulmonary disease COPD includes which of the following conditions?	Emphysema, Chronic bronchitis
The alpha-1 antitrypsin phenotype associated with the lowest serum concentration is?	ZZ
What are the primary structures affected by chronic bronchitis?	Conducting airways
All of the following are anatomic alterations found with emphysema except?	Excessive mucus production
The management of chronic obstructive pulmonary disease COPD includes?	Supplemental oxygen, Postural drainage and percussion to drain mucus, anabiotic's to find any pulmonary infection, bronchodilator medications
A patient with moderate to severe emphysema will have all of the following pulmonary function values?	Normal or increased tidal volume
The professional heard on a patient with emphysema is?	Hyperresonance
Auscultation of the chest of a patient with emphysema will reveal?	Decreased breath soundstage
Inspection of the fingers of a patient with chronic bronchitis will often reveal?	Cyanosis, digital clubbing
Emphysema?	Is most closely associated with chronic bronchitis, leads to the destruction of Avalor walls
According to the gold report, which of the following is the greatest worldwide risk factor for COPD?	Tobacco smoke
A genetically linked cause of panlobular emphysema is?	A-1 antitrypsin deficiency, AAT deficiency
Emphysema is probably caused by all the following except?	Inhaling asbestos fibers
The genetic reference for a person with a normal level of a-1 antitrypsin is?	MM
Which of the following or anatomic alterations found with chronic bronchitis?	Increased size of sub mucosal bronchiole glands, chronic bronchial wall information, bronchospasm
Which of the following or anatomic alterations fan with emphysema?	Hyperinflation, weakened distal airways, Decreased surface area for gas exchange
The management of chronic obstructive pulmonary disease COPD includes?	Annual influenza immunization, bronchopulmonary hygiene procedures, lung volume reduction surgery, smoking cessation
Which of the following terms is/are commonly applied to a patient with emphysema?	Pink puffer type a COPD
At which stage of COPD does the patient usually for seek medical attention because of worsening symptoms?	Stage two
A patient with chronic bronchitis will have all the following clinical manifestations?	Rhonchi, Stocky, overweight build, cor pulmonale
A patient with emphysema will often have the following clinical manifestations?	Barrel chest, pursed lip breathing
Which of the following is true of the diffusing capacity test DLCO findings in a patient with COPD?	Decreased in emphysema
Which of the following are associated with chronic bronchitis?	Cyanosis, right heart failure, elevated CO2 level, purulent sputum
Which of the following would indicate a diagnosis of advanced COPD?	Arterial blood gases show low O2 and high CO2. Pulmonary function test show low flow of air on expiration
A patient with a severe asthma attack has many mucous plugs. What structural changes can be expected because of this?	Atelectasis
Which of the following are associated with so-called extrinsic asthma?	Dog dander, mold
A medical term is used to describe when An asthmatic patient has an early response followed by a late response to an allergen	Biphasic response
Which of the following are associated with so called intrinsic asthma?	Emotional stress, obesity, GERD
Mechanical ventilation may be required during which of the following situations?	Status asthmaticus
If and asthmatic patient is given a sympathomimetic & parasympatholytic meditation, what can be expected to happen?	Bronchial smooth muscle relaxation will occur
After a patient in heels a bronchodilator medication, what percentage change in peak expiratory flow PEF indicates a diagnosis of asthma?	Greater than 20%
Pulsus paradoxus would be manifested as?	Inspiratory systolic blood pressure greater than 10 mmHg less than during expiration
As a respiratory therapist, you are performing a chest assessment. What findings would be calm and in a patient during an asthma attack?	Decreased vocal fremitus, increased vesicular breath sounds
In asthmatic patient has been complaining of increased difficulty in breathing. The physician has ordered pulmonary function testing to be performed. Which of the following findings would confirm how the patient feels?	Increased RV, decrease VC
A patient is having a severe asthma attack. What blood gas results would indicate to the respiratory therapist and physician that the patient is having great difficulty?	Increased carbon dioxide level, decreased oxygen level
A sputum sample from a suspected asthmatic patient has been sent to the laboratory for analysis. Which of the following findings would confirm the diagnosis?	Increased IGE level
A patient has been admitted to the hospital with a suspected asthma tag. What radiographic findings would confirm the diagnosis?	Depressed diaphragm, increased anterior posterior diameter, translucent lung fields
Which of the following anatomical alterations are found in the patient during an asthma attack?	Increased mucus production, constriction of bronchial smooth muscle's
Which of the following changes will be found in a patient during an asthma attack?	Air trapping
Chest x-ray findings commonly seen in a patient during an asthma attack include?	Flatten diaphragm, so called barrel chest, dark lung fields
An asthma attack that fails to respond to the usual types of amounts of medications is called?	Status asthmaticus
Which of the following medication types are usually given by respiratory therapist to treat an asthma attack?	Sympathomimetic, parasympatholytic,corticosteroid
What pulmonary function test is performed to monitor a patient as for medication management?	Peak expiratory flow PEF
As a respiratory therapist, you enter an asthmatic patients room. What observable signs would indicate to you that the patient is having difficulty breathing?	Use of inspiratory accessory muscles
What chest assessment findings would be typically found on a patient having an asthma attack?	Pro long expiration, diminished breath sounds
Patients with bronchiectasis can have the following anatomic alterations?	Hyper inflation, consolidation
Rigid and dilated bronchi are the key anatomic alterations found in which type of bronchiectasis?	Cylindrical
Irregularly dilated and constricted bronchi are the key anatomic alterations found in which type of bronchiectasis?	Varicose
Which form of bronchiectasis causes the greatest amount of damage to the Tracheobronchial tree?	Cystic
Congenital causes of bronchiectasis include?	Cystic fibrosis, Kartageners syndrome
Your patient has rhinosinusitis, right-sided heart placement, and bronchiectasis. She is likely to have which of the following conditions?	Kartageners syndrome
A mother brought her two-year-old son to the physician. He has been coughing up secretions and having Weezy breathing ever since choking on food six months ago. The physician diagnosed a boy with bronchiectasis. What could be the cause?	Aspiration
Not getting childhood immunizations could cause what?	Bronchiectasis
Management of the patient with bronchiectasis may include?	Expectorants, early childhood immunizations, lung resection
For a patient with bronchiectasis to reduce the risk of his or her condition worsening, which of the following should be done?	Avoid air pollution, get an influenza vaccination, avoid smoking
Severe bronchiectasis is associated with all of the following except?	Vesicular breath sounds
What pulmonary function testing values would be found in a patient with severe, Obstructive bronchiectasis?	Decreased FEF 25% to 75%
A patient with long-standing bronchiectasis also has pneumonia. What hematology test results would be expected?	Elevated white blood cell count, increased hemoglobin and hematocrit
The preferred radiographic method to evaluate a patient bronchiectasis is?	Computed tomography CT
A patient with bronchiectasis will?	Frequently cough out large amounts of foul smelling sputum
Anatomic alterations found in patients with bronchiectasis can include?	Fibrosis, atelectasis
The most common underlying cause of bronchiectasis is?	Cystic fibrosis
Your patient has had genetic testing performed and has been found to have Kartageners syndrome. Why is the patient at risk for developing bronchiectasis?	The cilia are defective
Bronchiectasis can be acquired through what?	Inhalation of toxic fumes, repeated lower respiratory tract infections
Management of a patient with bronchiectasis can include?	Antibiotics, supplemental oxygen, Postural drainage and percussion therapy
A patient with bronchiectasis has a repeated problem with keeping his or her distal long units inflated. What can be done to help prevent this problem?	Incentive Spirometry
A patient with bronchiectasis has been coughing all of his sputum into a container over the last 24 hours. The respiratory therapist can expect to see what occurrence with the patient sputum?	Sputum will form in layers
A patient with primary obstructive disease related to her bronchiectasis now has an acute lung infection. You're performing bedside spirometry. What can be expected when she performs the PEFR test?	It will be decreased
During the event stages of cystic fibrosis, the anatomic alterations cause the patient to have?	A primarily obstructive lung disease
What is commonly cultured from the mucus in the tracheobronchial tree of a patient with cystic fibrosis?	Pseudomonas aeruginosa, haemophilus influenzae, staphylococcus aureus
The major pathologic or structural changes associated with cystic fibrosis include?	Partial airway obstruction leading to hyperinflation, thick tenacious mucus, total airway obstruction leading to atelectasis
Cystic fibrosis patients can have all of the following?	Malnutrition, meconium ileus (bowel obstruction), excessive, viscous pulmonary secretions
Men with cystic fibrosis have difficulty reproducing because?	The vas deferens is missing or underdeveloped
If both the mother and the father are carriers for the cystic fibrosis gene, what are the chances that their child will be a cystic fibrosis carrier?	50%
What ethnic group has the greatest number of people with cystic fibrosis?	Whites
What can be used to diagnose a patient with cystic fibrosis?	And elevated chloride level in the sweat, genetic testing of the patient and or parents, chronic lung infections from an early age
What are commonly used in the treatment of cystic fibrosis patients?	Pancreatic enzymes and vitamins, antibiotics, expectorant, postural drainage
Your patient has a long infection with pseudomonas aeruginosa. What anabiotic's should be used against it?	Tobramycin TOBI
If a cystic fibrosis patient is in general good condition, what might be done to permanently fix the lung problem?	Lung transplant
Common chest assessment findings in a patient with cystic fibrosis include?	Breath sounds reveal crackles and rhonchi, hyperresonant percussion note
What complicating pulmonary problem is likely to happen to a patient with cystic fibrosis?	Spontaneous pneumothorax
What pulmonary function findings would be expected in a patient with moderate to severe cystic fibrosis?	Increased RV, decreased PEFR, decreased FEF 50%
What are the initial anatomic changes that happen in the lungs of a new born with cystic fibrosis?	Bronchial gland hypertrophy, metaplasia of goblet cells
The type of genetic disorder found with cystic fibrosis is caused by?	Autosomal recessive gene disorder
What organ systems are affected by cystic fibrosis?	Reproductive, pulmonary, cardiovascular
Some infants with cystic fibrosis develop intestinal problem soon after birth. What is this called?	Meconium ileus
When the CFTR gene becomes dysfunctional, there is abnormal transportation of what electrolytes?	Chloride, sodium
In order for a child to have cystic fibrosis it must inherit the?	Cystic fibrosis gene from each parent
The diagnostic test used with the vast majority of the suspected cystic fibrosis cases is?	Sweat test
In order to assist the respiratory therapist and the parents in the clearance of secretions from the child with cystic fibrosis, which protocol is usually implemented?	Bronchopulmonary hygiene therapy
What aerosolized medication has been approved to help break down the thick bronchial mucous of a patient with cystic fibrosis?	Dornase alpha, pulmozyme
Physical examination of a patient with moderate to severe cystic fibrosis would reveal?	Pursed lip breathing in, inspiratory accessory muscle use, barrel chest, digital clubbing
When a patient has an ammonia, what would be found in the alveolar effusion fluids?	Serum fluid, red blood cells
Your patient has a bacterial pneumonia, what kills the invading bacteria?	Polymorphonuclear leukocytes
What can cause pneumonia?	Bacteria, viruses, fungi
If a patient has pneumonia, what can increase the risk of life-threatening illnesses or death?	COPD, heart disease
Approximately half of all pneumonia caused by?	Viruses
What pulmonary infection is most likely seen in patients with aids?	Pneumocystis carinii
Ventilator acquired pneumonia is defined as pneumonia that develops?	More than 48 to 72 hours after endotracheal intubation
A patient has a pleural effusion related to her pneumonia. What can be used to help treat it?	Thoracentesis
The most commonly prescribed class of anabiotic used against gram-positive bacteria organisms is?	Penicillin/amoxicillin
The most commonly prescribe aerosolized antibiotic used against pneumocystis jeroveci(Cabrini) is?	Pentamidine isethionate (nebupent)
The most commonly prescribed therapeutic agent used against respiratory syncytial virus RSV?	Virazole (ribavirin)
What is the most important in determining the cause of the patient's pneumonia?	Sputum examination
Just assessment findings on a patient with pneumonia would include?	Increase vocal fremitus, door precaution note, whispered pectoriloquy
Your patient has bilateral pneumonia. What findings can be expected on a CT scan?	Air broncograms, consolidation
Aspiration pneumonia results in all the following anatomical alterations?	Alveolar consolidation, Atelectasis, inflammation of the alveoli
What term applies to the feeling of Avalor spaces in the result of pneumonia?	Consolidation
The expression walking pneumonia is generally applied to patients with what type of pneumonia?	Mycoplasma pneumoniae
What is the most commonly found bacterial cause of pneumonia?	Streptococcus pneumoniae
Your patient has been hospitalized for two weeks and has a tracheostomy tube. Her secretions have a sweet smell and or green in color. What is most likely organism causing her infection?	Pseudomonas aeruginosa
A 75-year-old patient has had a stroke leaving him with dysphasia. What type of pneumonia is he at risk of developing?	Aspiration
A patient with the common cold and associated chest infection would be treated with all the following?	Bed rest, ample fluids, over the counter cold and cough medicine
You have given supplemental oxygen to a patient with pneumonia. What would cause a patient to be hypoxemic?	Capillary shunting, alveolar consolidation
When auscultating over an area of pneumonia, what breath sounds can be expected?	Bronchial
During the early stages of a lung abscess the pathological process is the same as that of?	Pneumonia
If a patient with the lung abscess develops a cavity, the structure may also be called?	Pyogenic membrane
In response to the patient having a lung infection, how does the body respond?	Polymorphonuclear leukocytes go to the area
In severe cases of tissue necrosis related to an abscess, what can occur?	Fluid ruptures into the bronchus, fluid ruptures into the intrapleural space
You're into baited, unconscious patient has accidentally had the cuff deflated. This has resulted in the aspiration of oral secretions. What micro organisms are likely to be found in the tracheal secretions now?	Peptococci, bacteroides fragilis
Predisposing factors that frequently lead to the aspiration of gastrointestinal fluids (and anaerobes) are usually related to what?	General anesthesia, head trauma, seizure disorder, alcohol abuse
A lung abscess maybe caused by what?	Penetrating chest wound, septic embolism, aspirated foreign body, bronchogenic cyst
A patient who is had a stroke is lying supine in bed when he vomits and aspirate. He is most likely to develop a lung abscess in the?	Posterior segment of the upper lobes
What antibiotic agent would be appropriate for treating an anaerobic lung abscess infection?	Metronidazole (flagyl)
Your patient's lung infection is caused by klebsiella. What would be appropriate to treat it?	Cephalosporin agent cefotaxime
A patient with an abscess has coughed out a large volume of brown colored, putrid sputum. What is the most likely classes of micro organism that would cause this?	Anaerobic bacteria
While performing an assessment of your female patient, pleural effusion rub is heard. What does this indicate?	An abscess is near the pleural surface
When a lung abscess is seen on a chest radiograph, a distinguishing factor is the?	Air fluid level in the cavity
Chest radiograph findings in a patient with the lung abscess include ?	Pleural effusion, fibrosis and Calcification
Your patient has post primary TB. What are the major pathologic or structural changes associated with it?	Cavity formation, dilated and distorted bronchi, fibrosis of lung parenchyma
Mycobacterium tuberculosis is most readily transmitted through?	Coughing
The preferred stain that is used to identify the TB organism is?	Fluorescent acid-fast stain
When a person has tuberculosis spread through the body, it Will not be found in?	Lower lobes
Risk factors predisposing a person to tuberculosis will not include?	African-American or Hispanic heritage
A patient with an advance case of tuberculosis may have what radiological findings?	Retraction of lung segments right sided heart enlargement
Clinical manifestations associated with tuberculosis, Dull percussion note, bronchospasm, hyperresonant percussion note, crackles?	Dull percussion note, crackles
Major pathological structural changes associated with post primary tuberculosis?	Caseous tubercles, increased secretions
A positive tuberculosis test begins with a wheal of what size?	10 mm or greater
And excepted medical treatment for tuberculosis involves the taking of anabiotic's for? (Length)	6 months
Because of the effects of the reaction to infection and the healing process, tuberculosis causes what type of lung pathology?	Restrictive
Fungal infection of the lungs is closest in similarity to?	Tuberculosis
What parts of the lungs are most commonly affected by a fungal infection?	Upper lobes
Anatomic alterations found in the lungs of patients with fungal infections include?	Mucosal edema? Fibrosis of lone parenchyma, alveolar capillary destruction
Fungal lung infections are usually spread by?	Inhaling spores
Your patient lives in Chicago and has HIV and a weakened immune system. What fungal infection is the patient at risk for developing?	Blastomycosis
Which type of fungal lung infection frequently results in productive cough with purulent sputum?	Blastomycosis
After cleaning out his chicken coop, a farmer has developed a fungal lung infection. What type of infection is it most likely to be?	Histoplasmosis
Opportunistic yeast pathogen's?	Candida albicans, cryptococcosis neoformans, aspergillus
In the mid western part of the United States, what is the most common fungal infection of the lungs?	Histoplasmosis
The drug of choice for the treatment of fungal lung diseases is?	Amphotericin B (fungizone)
During the advanced stages of a fungal lung infection, what is commonly seen on a chest radiograph?	Cavities
The fungus coccidioides immitis is found in what area of the United States?	Southwest
In a reaction to a severe fungal lung infection what can be expected in the patient?	Increased heart rate, increased respiratory rate, increased blood pressure
During the early stages of a fungal lung infection, what is commonly seen on a chest radiograph?	Spherical nodules
As pulmonary edema progressively worsens, the fluid moves in the following sequence?	Alveoli, bronchioles, bronchi
Pulmonary edema manifests itself clinically as an?	restrictive pulmonary disorders
The major pathologic or structural changes seen in the lungs with pulmonary edema include?	atelectasis, high surface tension of alveolar fluids, alveolar flooding
All of the following are causes of cardiogenic pulmonary edema Except? a.myocardial infarction b.mitral valve disease c.allergic reactions to drugs d.congenital heart defects	allergic reaction to drugs
What is the normal hydrostatic pressure in the pulmonary capillaries?	10-15mmHg
What are considered noncardiogenic causes of increased capillary permeability?	Acute respiratory distress syndrome(ARDS), Inhaled phosgene, Therapeutic lung radiation
Management of cardiogenic pulmonary edema includes the following?	giving a patient a low salt intake diet, giving a patient a medication to lower blood pressure, giving a patient a diuretic drug
Your patient has a decreased oncotic pressure. What can be done to increase it?	Mannitol
Your patient with pulmonary edema is cyanotic & complaining of difficulty breathing, What should be recommended by the respiratory therapist?	Provide supplemental oxygen
Mask CPAP is used with pulmonary edema patients because it does what?	decrease vascular congestion, reduce work of breathing, improve lung compliance
Your patient with cardiogenic pulmonary edema would be expected to have what radiograph findings?	pleural effusion, cardiomegaly, bilateral"butterfly"pattern fluffy infiltrates
Your patient has noncardiogenic pulmonary edema. what chest radiograph findings would be expected?	batwings"pattern fluffy infiltrates, normal cardiac silhouette, fluffy densities near the hilum
pulmonary edema involves?	fluid moving from thee pulmonary vascular system to the air spaces
If a patient has pulmonary edema, the sputum is?	frothy white or pink
The most common cause of pulmonary edema is?	left-heart failure
pulmonary edema can occur when the hydrostatic pressure within the pulmonary vascular system is?	>25-30mmHg
What is considered noncardiogenic casues of increased capillary permeability?	head injury, pneumonia, sulfur dioxide, alveolar hypoxia
decreased oncotic pressure can be caused by what?	severe malnutrition, excessive intravenous fluids, uremia
When a patient has left sided heart failure, what is usually done to increase cardiac output?	give digitalis
Your patient with pulmonary edema is in respiratory failure. She doesn't want to be put onto a mechanical ventilator. What should be tried first?	Mask CPAP
A patient with pulmonary edema may show what unusual breathing pattern?	Cheyne Stokes respiration
When a patient with pulmonary edema lays flat to go to sleep, What pathological problems might make them wake up?	Orthopnea, paroxysmal nocturnal dyspnea
The death of lung tissue that may result from an obstruction of the pulmonary artery is called?	pulmonary infarction
Bronchospasm may happen after a pulmonary embolism. what can lead to this bronchospasm?	localized hypoxemia, localized hypercapnia, release of cellular mediators from platelets
A pulmonary embolism causes what major pathological & structural changes in the lungs?	Alveolar consolidation, alveolar atelectasis
What is associated with the formation of a deep vein thrombosis?	blood vessel injury, hypercoagulability, venous stasis
Predisposing factors of pulmonary emboli include?	varicose veins, smoking, obesity, congestive heart failure
The sudden onset of what signs & symptoms indicate a pulmonary embolism?	wheezing, coughing out blood streaked sputum, cyanosis, sudden shortness of breath
The best test for diagnosing pulmonary embolism?	spiral computerized tomography scan
A pulmonary angiogram is usually ordered when?	when other tests for a pulmonary embolism are inconclusive
Your patients D-dimer blood test results show a value of 250ng/mL. How should these results be interpreted?	The patient doesn't have a pulmonary embolism
The duplex venous ultrasonography test is used to?	diagnose a blood clot behind the knee or thigh
What fibrinolytic agents is/are used to treat a pulmonary embolism?	urokinase, heparin, streptokinase
A patient fully recovered from a pulmonary embolism would take what anticoagulant medication for a few months at home?	Warfarin
A blood that travels from one part of the body to another is called?	embolus
The prognosis for a patient with a saddle embolus?	Poor; recovery is not expected
The major anatomic alterations associated with pulmonary embolism include?	Pulmonary tissue death, blockage of the pulmonary vascular system, Alveolar atelectasis
The most common cause of a pulmonary embolism is?	Blood clot
Predisposing factors of pulmonary emboli include?	Inactivity, Long bone fractures of the legs, hypercoagulation disorders such as polycythemia, pelvic, hip or abdominal operation
Sudden onset signs and symptoms that indicate a pulmonary embolism?	Chest pain, lightheadedness or fainting, weak pulse
The general management of a patient with a pulmonary embolus him would not include?	Bedrest
The safest and most effective class of fast acting anticoagulant medication to prevent a pulmonary embolism is?	Low molecular weight heparin
The arterial blood oxygen level of a pulmonary embolus him patient will be?	Decreased from normal
A pulmonary embolus him initially results in?	Increase dead space ventilation
While assessing a patient who was involved in a serious car crash and hit his steering wheel, you notice that his left anterior chest wall caves during inspiration. What could cause this?	Flail chest segment
What is a possible lung finding under the fractured ribs of a flail chest?	Contusion
A flail chest is defined as?	Three or more adjacent fractured ribs, double rib fractures
Major pathologic & structural changes associated with a flail chest include?	Pneumothorax, secondary pneumonia
Causes of a flail chest include?	Blast injury, motor vehicle accident, fall from high altitude
It's mechanical ventilation is required, how long will it be needed to allow sufficient time for bone healing?	5 to 10 days
Your flail chest at patient require supplemental oxygen. What is the usual cause of hypoxemia in a flail chest patient?	Alveolar atelectasis
Your patient with a flail chest has developed consolidation. What should be implemented to help manage it?	Hyperinflation therapy protocol
The major anatomic alterations of the lungs associated with flail chest include?	Atelectasis, consolidation
Your patient with a flail chest has paradoxical chest movement. What would be seen with this?	During inspiration, the fractured ribs move inward
When a patient has a flail chest, what happens during the ventilatory cycle?	Airy shunted from one lung to the other
Your patient with a flail chest is experiencing pendelluft. what are the effects?	Hypoventilation, rebreathing dead space gas
While assessing your patient with flail chest, you would expect to hear what kind of breath sounds?	Diminished over both lungs
What chest radiograph findings would be expected on a patient with a flail chest?	Decreased Opacity, tracheal narrowing or deviation
What are the anatomic alterations that occur when a person has a pneumothorax?	The lung on the affected side collapses, the visceral & parietal pleura separate, The chest wall moves outward
A pneumothorax manifest itself clinically as?	Restrictive pulmonary disorder
According to the way gas enters the pleural space, a pneumothorax will be classified as?	Open, closed
A patient chest wall puncture, has resulted in a check valve so the room air is drawn into the chest during each inspiration and cannot get out. Type of pneumothorax?	Tension
Hey 17-year-old male has been brought to the hospital because he fell short of breath after being tackled in a football game. A chest radiograph she has a broken rib and a 10% pneumothorax. Type of pneumothorax?	Closed
A 6 foot tall, 130 pounds, 22-year-old female patient has come to the emergency department with a complaint of sudden sharp pain in the right upper chest followed by shortness of breath. Type of pneumothorax?	Spontaneous
An iatrogenic Pneumothorax would not be caused by?	Endotracheal intubation
Treatment of a 30% pneumothorax may include?	Giving the patient supplemental oxygen, placing a chest tube into the pleural space
You're 40-year-old patient is having a chest tube placed to remove the air from the plural space.where do you not want to place a tube?	Do not place the tube at the base of the lung
Your patient has a pneumothorax with a sucking chest wound resulting in the movement of air from one lung to another. This is called?	Pendelluft
Which of the following just assessment findings would be expected in a patient with a tension pneumothorax?	Tracheal shift away from the pneumothorax
A pneumothorax will be identified on a chest x-ray film by?	Darker lung fields on the affected side
Clinical manifestations of a pneumothorax may include?	Hyperresonant percussion note, decreased breath sounds over the affected lung , cyanosis, displaced heart sounds
Management of a patient with a pneumothorax may include?	Supplemental oxygen, mechanical ventilation, lung expansion therapy
A chest radiograph she was your patient to have a 25% pneumothorax of the left lung. What should be done?	Remove the air through a chest tube placed into the left pleural space
Gas can enter the pleural space by the following ways?	Perforation of the chest wall, gas forming bacteria in an empyema, perforation of the visceral pleura
The most serious type of a pneumothorax is?	Tension
Your patient suffered a gunshot to the chest and has a hole into the chest wall. What type of pneumothorax do you have?	Open
A pneumothorax occurs when the free air accumulates in the?	Pleural space
The anatomic alterations caused by a pleural effusion is?	Separation of the visceral parietal pleural
The major pathologic and structural changes associated with a significant pleural effusion include all the following except; a)diaphragm elevation b) atelectasis c) compression of the great vessels d)Lung compression	Diaphragm elevation
Your patient has a large pleural effusion. It will act as?	Restrictive lung disorder
Which of the following are associated with transudative pleural effusion? a) thin and watery fluid b) fluid has a lot of cellular debris c)fluid has a high protein count d)few blood cells	Thin and watery fluid; few blood cells
The causes of a tranudative pleural effusion include
The causes of a transudative pleural effusion include? a)congestive heart failure b)fungal pneumonia c)pulmonary embolism d)Hemothorax	Congestive heart failure; pulmonary embolism
Which of the following are major causes of an exudative pleural effusion? a)empyema b)chylothorax c)pancreatitis d)peritoneal dialysis	Empyema; chylothorax; pancreatitis
Your patient with a large pleural effusion will have a chest tube inserted. How will this be done?	Tube placement in the 4th to 5th intercostal space; tube placement in the midaxiliary line
Treatment of an empyema usually includes?	Anabiotic for bacterial infection, lung transplant
You are assisting the physician who is performing a thoracentesis. It is suspected that the patient has a hemothorax. If that is the case, how would the pleural effusion fluid appear?	Red color
A large pleural effusion, and we demonstrate which of the following findings during a chest assessment? a)increased tactile and vocal fremitus b) hyperresonant percussion note c) diminished breath sounds d)tracheal shift	Diminished breath sounds; tracheal shift
Your patient with pneumonia of the left lung and related empyema has a distinctive bread sound heard over the affected area. What is the name of this characteristic breath sound?	Pleural friction rub
While reviewing the upper right chest radiograph of your patient, you see a fluid density in the right lung area that extends upward around the anterior, lateral, and posterior the thoracic walls.what is this sign of pleural effusion called?	Meniscus sign
Usual chest radiograph findings on a patient with a large pleural effusion include?	Fluid level on the affected side; blunting of the costophrenic angle
A pleural effusion is caused by?	Fluid accumulation in the pleural space
In a severe case of pleural effusion, all of the following anatomic alterations will be found except?a) diminished cardiac venous return b)mucosal edema c)atelectasis d)Great vein compression	Mucosal edema
A transudate is?	Is thin and watery, contains bacteria
The causes of an exudative pleural effusion include?	Bacterial pneumonia, cancer of the pleura, tuberculosis
Empyema refers to?	Pus in the pleural space
Trauma to the neck commonly causes what?	Chylothorax
Hemothorax is?	Blood in the pleural space
Your patient is complaining of great chest pressure and shortness of breath. A chest radiograph shows a large pleural effusion. What is the best way to manage the sea fusion?	Thoracentesis
If a person has a transudate type pleural fusion, and changes from an upright to a lateral position for a chest x-ray, diffusion will?	Shift it's position to be more horizontal
Clinical manifestations associated with the plural effusion include?	Tracheal shift away from the effusion, decreased breath sounds over the affected area, decrease vital capacity
Posterior curvature of the spine best describes?	Kyphosis
Your patient has scoliosis. On her chest radiograph, this would be seen as?	An S or C shaped to the spine
Mild to moderate Kyphoscoliosis will manifest itself clinically as?	Restrictive pulmonary disorder
The major pathologic and structural changes of the lungs found with kyphoscoliosis include?	Mediastinal shift, lung compression, mucus accumulation
Chest assessment findings are associated with kyphoscoliosis include?	Crackles or rhonchi breath sounds, Hyperresonant percussion note
What pulmonary function values are likely to be found in a patient with kyphoscoliosis?	Normal or decrease Vt, decreased VC, decreased FVC
A patient with severe Kyphoscoliosis and chronic ventilatory failure with hypoxia will not have what laboratory findings?	Increased pH
In a case of severe Kyphoscoliosis what chest radiograph findings would be expected?	Enlarged heart, atelectasis, increased lung opacity, thoracic deformity
Posterior and lateral curvature of the spine best describes?	Kyphoscoliosis
Your patient has curvature of her spine to the left side. How will this affect the position of the mediastinal contents?	Shift to the left side
If a person has kyphoscoliosis, what anatomic alterations is likely to happen to the lungs?	Atelectasis
A patient with kyphoscoliosis will not require what type of respiratory care services?	Mechanical ventilation protocol
Patients with lateral and posterior curvature of the spine would tend to have?	Have small lung volumes in all age groups
Which of the following is/are associated with kyphoscoliosis? Diminished breath sounds, dull percussion note, decreased tactile fremitus, bronchial breath sounds	Bronchial breath sounds, dull percussion note
What anatomic alterations of the lungs may not be found with the chronic stage of interstitial lung disease ILD?	Edema
Generally, a patient with ILD will have a lung compliance that is?	Less than normal
Your patient has asbestosis. What major pathologic and structural changes are associated with this and other types of ILD?	Bronchospasm, mucus secretions, fibrocalcific pleural plaques
The interstitial lung diseases include?	Asbestosis, sarcoidosis, silicosis
What class of drugs has the largest group of agents that can cause interstitial lung disease?	Anti-cancer
Progressive systemic sclerosis affects the what organs?	Skin
Your patient has systemic lupus erythematosus (SLE) of the lungs. What is the most commonly found pulmonary complication of SLE?	Pleurisy
What group of people are the most likely to get sarcoidosis?	African-American women, 20 to 30 years of age
Crypto genic organizing pneumonia COP also known as bronchiolitis obliterans with organizing pneumonia BOOP has been associated with what?	Infections
Your patient has been diagnosed with Wegeners granulomatosis. Her long-term prognosis is?	Poor; recovery is not expected
What medication group is commonly administered to patients with interstitial lung disease?	Corticosteroids
Just assessment findings in a patient with ILD would include; pleural friction rub, increased vocal fremitus, vesicular breath sounds, hyperresonant percussion note?	Pleural friction rub, increased vocal fremitus
In a patient with coal workers pneumoconiosis or silicosis, The diffusing capacity would be?	Decreased
Chest radiograph findings in a patient with ILD can include?	Pleural effusion honeycombing, cavity formation, granulomas
The primary anatomic alteration found with interstitial lung disease is?	Inflammatory infiltration of alveolar walls
During the acute stage of any ILD, what is found in the patient?	White blood cell infiltration into interstitial spaces, Edema
Of the anatomic alterations of interstitial lung disease what will not be found?	Atelectasis
Hypersensitivity pneumonitis is most closely associated with what pulmonary event or condition?	Inhalation of antigens
The etiology of pulmonary sarcoidosis is?	Unknown
Your patient has been recently diagnosed with Goodpasture syndrome that has affected both of his lungs. His prognosis is?	Poor; recovery is not expected
General management of patients with ILD can include?	Supplemental oxygen, corticosteroids, mechanical ventilation
A patient with severe ILD will have a respiratory rate that is?	Faster than normal
What is used in the diagnosis of ILD?	Pulmonary function test showed decreased lung volumes, chest x-ray showing reticulonodular pattern, lung biopsy results
Most patients with ILD have an arterial oxygen level that is?	Below normal
Benign tumor's?	Grow slowly, are usually encapsulated
Malignant tumors?	Invade surrounding tissues, cause necrosis
When a person has a lung cancer, what may happen to the alveoli adjacent to the tumor?	Collapse, consolidation, fill with fluid
What major pathologic and structural changes are associated with bronchogenic carcinoma?	Airway obstruction, destruction of airways and Aveoli, atelectasis
The most common cause of lung cancer is?	Smoking tobacco
What are small cell lung cancer's?	Oat cell carcinoma
Staging of a lung cancer is based on its classification by these three criteria?	M for extent of metastasis; N for lymph node involvement; tea for extent of the primary tumor
Your patient with a lung tumor in his right lower lobe is going to need surgery. He is otherwise healthy and has good respiratory reserve. What is the preferred surgical method?	Lobectomy
Your patient has metastatic lung cancer that has been identified in several other locations. What is the best way to treat her?	Chemotherapy
During bronchoscopy, a tumor was found in the right mainstem bronchus. What is the best way to manage the problem?	Brachytherapy
Your patient with advanced lung cancer with metastasis to several organs has chosen palliative care. What does this mean?	Treating his symptoms
What chest radiograph findings with a lung cancer patient would not be expected?	An enlarged heart
A patient has gone to see her physician after recently developing hoarseness and difficulty swallowing. What does this indicate?	Mediastinal cancer
Signs and symptoms that a patient has metastatic lung cancer can include?	Weakness, bone pain, seizures, weight loss
What is true about cancer?	Uncontrolled multiplication of cells, benign or malignant, neoplasm, localized or invasive
All types of lung cancer are?	Malignant, metastatic
Lung cancer bronchogenic carcinoma originates in the?	Bronchial mucosa
The most common type of bronchogenic carcinoma is?	Adenocarcinoma
Which type of lung cancer has the poorest prognosis? (Cell type)	Small cell/oat cell
Techniques or procedures used to diagnose lung cancer can include?	Thoracentesis biopsy, bronchoscopy biopsy, sputum sample for cytology, chest x-ray
What can be used in the treatment of lung cancer?	Radiation therapy, chemotherapy, surgical resection
Your patient has small cell/oat cell carcinoma in both lungs. What are the usual treatment options for him?	Chemotherapy, radiation therapy
Depending on where a patient's lung cancer is located, pulmonary function testing results may show?	Either obstructive or restrictive values
Your patient has acute respiratory distress syndrome/ARDS. What materials will be found in her alveoli?	Cellular debris, fibrin, hyaline membrane
Your patient has a prolonged case of ARDS. What will happen to his alveolar cells?	Hyperplasia and swelling of the type 2 cells
The physiologic abnormalities down in the lungs of the ARDS patient include?	Abnormal surfactant, interstitial edema
The anatomic alterations found in the alveoli of a patient with ARDS are closely to those found with what other disease?	Hyaline membrane disease
A patient with massive blood transfusion or disseminated intravascular coagulation DIC is at risk for developing ARDS because of?	Blockages in pulmonary blood vessels
Inhalation of very dry air can lead to ARDS. True or false?	False
Burns, septicemia, hemorrhage pancreatitis can all lead to what?	ARDS
Your patient with ARDS has alveolar consolidation and atelectasis. What can be used to offset these problems?	Continuous positive airway pressure/CPAP; positive end expiratory pressure PEEP
The ventilation strategy used with most patients with ARDS include?	Small tidal volume, low respiratory rate
Commonly heard breath sounds in a patient with ARDS include?	Crackles, bronchial
Clinical manifestations of ARDS include?	Low or normal pulmonary capillary wedge pressure PCWP, intercostal retractions, cyanosis
Chest radiograph findings indicative of ARDS?	Ground glass appearance
The fundamental problem seen in acute respiratory distress syndrome ARDS is?	Damaged Alveolar capillary membrane
ARDS manifest itself clinically as?	Restrictive pulmonary disorder
The physiologic abnormalities found in the lungs of the ARDS patient are?	Atelectasis, Alveolar consolidation, hyaline membrane formation, decreased shunt
Pulmonary based causes of ARDS include?	Inhaled toxins, lung infection, oxygen toxicity
Circulation based causes of ARDS include?	Massive blood transfusions, shock/hypovolemia, Goodpasture's syndrome
Management of ARDS includes?	Mechanical ventilation, using the oxygen therapy protocol, antibiotics for bacterial infections
Positive end expiratory pressure PEEP is used with mechanical ventilation in order to?	Offset atelectasis
Clinical manifestations of ARDS include?	Hypoxemia refractory to oxygen therapy, decreased FRC, increased shunt
Your patient has severe ARDS and acute ventilatory failure with hypoxemia. Her arterial blood gas results include?	Increased PaCO2, decrease pH
The peripheral nervous system problems found with guillain barre syndrome include?	Los of reflexes, flaccid paralysis of skeletal muscles
Under microscopic inspection, the skeletal muscles and nerves of a guillain barre patient would not show?	Hypertrophy
The major pathologic or structural changes of the lungs associated with ventilator failure accompanying Guillain barre syndrome includes?	Alveolar consolidation, atelectasis
Guillain barre syndrome is most likely to be found in which demographic group?	White male=45 years of age
When a person has guillain barre syndrome,what happens to the peripheral nerves?	The myelin sheath is removed
Common non-cardiopulmonary manifestations associated with guillain barre are?	Difficulty swallowing, leg pain, distal paresthesia, absent deep tendon reflexes
The diagnosis of guillain barre syndrome is not based on what?	Urinalysis shows elevate blood urea nitrogen
Clinical indications that your patient has acute ventilatory failure include?	pH<7.35, vital capacity VC<20ml/kg, PaCO2>45mmHg, negative inspiratory force NIF<-25cmH2O
Your patient with Guillain barre is paralyzed and receiving mechanical ventilation and must lie in bed. A pulmonary risk of being in bed is?	Thromboembolism
What has been shown to shorten the course of a severe case of Guillain barre syndrome?	Plasmapheresis
Typical just assessment findings in a patient with guillain barre syndrome include?	Diminished breath sounds, crackles and rhonchi
Your guillain barre syndrome patient has automatic nervous system dysfunction and should be monitored for?	Tachycardia, hypotension, bradycardia
A patient with guillain barre syndrome Will have a pulmonary function test findings that show?	A restrictive pulmonary disorder
Your patient with guillain barre syndrome is developing atelectasis. His Chest radiograph findings would show?	Increase opacity
Myasthenia gravis?	Interferes with acetylcholine transmission, causes weakness of voluntary muscles
In a myasthenia gravis patient, what happens after a rest period?	Muscle strength improves
The major pathologic or structural changes of the long is associated with ventilatory failure accompanying myasthenia gravis include?	Bronchospasm, airway obstruction, mucus accumulation
Which demographic group is/are most likely to develop myasthenia gravis?	Males 40 to 70 years of age
What are signs and symptoms associated with myasthenia gravis?	Double vision, weakness of neck muscles, drooping of eyelids, difficulty speaking
What test is usually perform to confirm the diagnosis of myasthenia gravis?	Electromyography
If a patient with myasthenia gravis is given the drug Edrophonium (tension), what will happen?	Strength will improve for a short time
Clinical indications that a patient with myasthenia gravis has acute ventilatory failure include?	NIF<-25cmH2O, VC<20ml/kg, PaCO2>45mmHg, pH<7.35
Treatment and care of the myasthenia gravis patient include?	Plasmapheresis, thymectomy, mechanical ventilation, pyridostigmine
Your patient with myasthenia gravis is being given a corticosteroid medication. Long-term complications of this medication do not include?	Bronchodilation
The position is recommending a thymectomy in a patient. The benefit of this procedure is to?	Remove the source of anti-ACH receptor antibodies
Your patient has a severe case of myasthenia gravis. It is most important that she be monitored for?	Apnea
A patient with myasthenia gravis will have lung volume and capacity findings that show?	A restrictive pulmonary disorder
Because of respiratory failure, your patient with myasthenia gravis was placed on mechanical ventilation and now is stable. What will the chest radiograph most likely show?	Normal lungs
Signs and symptoms associated with obstructive sleep apnea include?	Morning headache, loud snoring
Clinical disorders associated with the central sleep apnea include?	Congestive heart failure, bulbar poliomyelitis
Apnea is defined as?	Absence of breathing for 10 seconds or longer
During a central sleep apnea episode, the patient shows?	No air movement and no chest movement
Treatment of obstructive sleep apnea includes?	Continuous positive airway pressure CPAP, weight reduction if the patient is obese, surgical removal of obstructive tissue in the upper airway
What relationship if any, exist between sleep apnea and systemic hypertension?	Sleep apnea causes the systemic hypertension
During sleep, there is loss of muscle tone in the upper airway. What could cause this?	Airway obstruction
Signs and symptoms associated with obstructive sleep apnea include?	Insomnia, excessive daytime sleepiness
Clinical disorders associated with central sleep apnea include?	Brainstem infarction, encephalitis
Sleep apnea in an adult?	Maybe caused by upper airway obstruction, may be due to an abnormal respiratory center, is characterized by periods of apnea during non-REM and REM sleep, lowers a persons oxygen level
Continuous positive airway pressure CPAP is useful in the management of the patient with obstructive sleep apnea because it?	Prevents airway collapse
Long-term management of central sleep apnea includes?	Adaptive servo ventilation VPAP
If a person should near drown in unclean, swampy water what are the possible pulmonary complications?	Pneumonia, acute respiratory distress syndrome ARDS
The pulmonary affects of a near drowning victim in hailing water included?	Alveolar consolidation, bronchospasm, production of Frothy white secretions
Many adult drowning victims have been shown to have?	Used alcohol
Favorable prognostic factors in cold water near drowning include?	Colder water, younger age
What water temperature has been shown to be favorable prognostic Factor in near drowning?	Less than 70Â°
A near drowning victim and cardiac arrest has been put into an ambulance. The primary goals of the paramedic should be?	High-quality CPR, giving 100% oxygen
Late stage complications of extensive body surface burns include?	Sepsis, pneumonia, pulmonary embolism
A 10-year-old patient has inhaled hot gases and an inspection of her mouth shows edema and blisters. What should be done?	Perform Endotracheal intubation
A 65-year-old patient has 3rdÂ° skin burns over 30% of his body and a smoke inhalation injury. How does the combination of skin burns and smoke and inhalation affect his prognosis?	It almost doubles the mortality rate
Your patient with carbon monoxide poisoning has a COHB level of 20%. If he is given 100% oxygen, what will be the approximate COHB level in one hour?	10%
What classes of medications are commonly used in the care of patients with smoke inhalation injury?	Parasympatholytics, mucolytics, sympathomimetic
Clinical signs that a patient has a thermal injury to the upper airway include?	Inspiratory stridor, painful swallowing
A throbbing headache, nausea, vomiting, and impaired judgment or common clinical manifestations when the blood COHB is at what level?	20% to 30%
Define COPD?	Refers to a disease state characterized by the presence of an completely reversible airflow obstruction. Airflow limitation is usually progressive.
*Chroinc bronchitits define?	chronic productive cough for 3months, 2 successive years
Emphysema define?	permanent enlargement of the airspaces distal to the terminal bronchioles, accompanied by destruction of alveoli walls w/out obvious fibrosis
Anatomic Alterations: Chronic bronchitits?	primary conducting airways affected, chonic inflammtion/ swelling of bronchial walls, excessive mucus production, mucus plugging, bronchospasm, late stage air trapping/hyperinflation
Anatomic Alterations: Emphysema?	weakening & permanent enlargement of air spaces distal to terminal bronchioles, destruction of alveolar walls/ pulmonary capillaires, weakend/distal airway collapse during expiration
2major types of Emphysema?	panacinar(panlolubar) & centriacinar(centrilobular)
panacinar(panlolubar)?	associated w/AAT deficiency, most severe type
centriacinar(centrilobular)?	most common, associated w/cigarette smoking & chronic bronchititis
Emphysema type a COPD pink puffer inspection/clinical manifestations?	Thin body build, barrel chest, diminished/decrease breath & heart sounds, prolonged expiration, diminish respiratory drive and hypo ventilation, pursed lip breathing in, cyanosis(reddish skin) accessory muscle use
Emphysema percussion note?	Hyper-resonance/air trapping
Emphysema chest x-ray?	Hyper inflation, narrow mediastinum, normal/small vertical heart, low flat diaphragm, presence of blebs or bullae(Air blisters)
Chronic bronchitis type B COPD blue bloater inspection/clinical manifestations?	Stocky, overweight, normal chest configuration, diminished respiratory drive hypoventilation w/ resultant hypoxia and hypercapnia,cough, sputum purulent amounts, cyanosis, peripheral edema, JVD
Chronic bronchitis auscultation?	Wheezes, crackles, rhonchi, depending on severity of disease
Chronic bronchitis percussion note?	Normal
Chronic bronchitis chest x-ray?	Congested lung fields, densities, increased bronchial vascular markings, enlarge the horizontal heart
Other factors associated with chronic bronchitis?	Polycythemia, infections, pulmonary hypertension, cor pulmonale
Treatment options for COPD?	Smoking cessation, physical activity, bronchodilators, inhaled corticosteroid's, methylxanthines, Mucolytic agents, O2 therapy, bronchopulmonary hygiene, aerosolized medication therapy
Asthma anatomic alterations?	Reversible bronchial airways smooth muscle construction, airway inflammation, increased airway responsiveness to an assortment to stimuli
Pathological changes associated with asthma?	Bronchospasm, bronchial wall inflammation, excessive production of thick whitish bronchial secretions, mucus plugging, hyperinflation of the alveoli, severe cases atelectasis by mucous plug in
Asthma clinical manifestations?	Increased (HR,RR,BP), accessory muscle use, pursed lip breathing in, retractions, increased AP diameter, cyanosis, cough with excessive white thick tenacious sputum
Asthma chest assessment findings?	Wheezing, rhonchi, decreased breath sounds, hyperresonant percussion note, decreased tactile and vocal fremitus prolonged expiration1:3
Asthma chest x-ray?	Increase AP diameter, translucent dark lung fields, depressed diaphragms
Asthma treatment options?	O2 therapy, bronchial high gene therapy, aerosolized medication therapy, mechanical ventilation for status asthmaticus
Bronchiectasis anatomic alterations?	Chronic dilation/distortion of bronchial airways, excessive production of foul smelling sputum, bronchospasm, hyperinflation of alveoli, atelectasis & parenchymal fibrosis, hemorrhage secondary to bronchial arterial erosion
Bronchiectasis clinical manifestations?	Increased(HR,RR,BP), accessory muscle use, pursed lip breathing, increased AP diameter, cyanosis, digital clubbing, polycythemia, cor pulmonale, Distended neck veins/pitting edema, enlarged/tender liver,sputum
Bronchiectasis sputum?	Large quantities of foul smelling sputum
Bronchiectasis, when primarily obstructive in nature (air trapping), chest assessment findings?	Wheezing and rhonchi, diminished breath sounds, hyperresonant percussion note, decreased tactile and vocal fremitus
Bronchiectasis, when primarily restrictive in nature (consolidation/ atelectasis), chest assessment findings?	Crackles, bronchial breath sounds, dull percussion note, increased tactile and vocal fremitus, whispered pectoriloquy
Bronchiectasis chest x-ray when primarily obstructive?	Translucent lung fields, depressed diaphragms, long/narrow heart, enlarged heart, May see areas of consolidation and/or atelectasis
Bronchiectasis chest x-ray when primarily restrictive?	Atelectasis or consolidation, infiltrates suggesting pneumonia, increased opacity
Bronchiectasis treatment options?	O2 therapy, bronco pulmonary hygiene, lung expansion (deep breathing, coughing, incentive spirometry), aerosolized medication therapy, mechanical ventilation, expectorants, antibiotics
Cystic fibrosis anatomic alterations of the lungs?	Excessive mucus production, partial or total bronchial obstruction (mucus plugging), atelectasis, hyper inflation of the alveoli
Cystic fibrosis clinical manifestations?	Increased (HR,RR,BP), accessory muscle use, pursed lip breathing in, increased AP diameter, cyanosis, digital clubbing, polycythemia, cor pulmonale, distended neck veins, pitting edema, enlarged/tender liver, cough, sputum, Malnutrition, foul stool
Cystic fibrosis chest assessment findings?	Crackles, rhonchi, wheezing, bronchial breath sounds over atelectasis, diminished breath sounds, hyperresonant percussion note, decreased/increased tactile and vocal fremitus
Cystic fibrosis chest x-ray?	Translucent lung fields, depressed diaphragm, right ventricular enlargement(cardiomegaly), areas of atelectasis and fibrosis, irregular densities, bronchiectasis, Pneumothorax, occasional abscess formation
Cystic fibrosis treatment options?	Special diet, oxygen therapy, bronchopulmonary hygiene, humidification, lung expansion, aerosolized medications (bronchodilator/dornase Alfa), mechanical ventilation, xanthines, expectorant, antibiotics, lung/heart transplant
Pneumonia anatomic alterations of lungs?	Inflammation of alveoli, increased AC membrane thickness, alveolar consolidation, atelectasis
Pneumonia clinical manifestations?	Increased (HR,RR,BP), chest pain, decreased chest expansion, cyanosis, cough, sputum (yellow), hemoptysis, fever w/chills, malaise
Pneumonia chest assessment findings?	Crackles, rhonchi, pleural friction rub, bronchial breath sounds, dull percussion note, increased tactile and vocal fremitus, whispered pectoriloquy
Pneumonia chest x-ray?	Increased density from consolidation and atelectasis maybe patchy or solid, air bronchograms, pleural effusion
Pneumonia treatment options?	oxygen therapy, bronchial hygiene, lung expansion, thoracentesis, antibiotics
Lung abscess anatomic alterations?	Alveolar consolidation, alveolar capillary/bronchial wall destruction, tissue necrosis, cavity formation, fibrosis/calcification of lung parenchyma, bronchopleural fistulas/empyema, atelectasis, excessive airway secretions
Lung abscess clinical manifestations?	Increased (HR,RR,BP), chest pain, decreased chest expansion, cyanosis, cough, sputum(foul smell, Green, yellow, brown, gray) hemoptysis,
Lung abscess chest assessment findings?	Crackles, rhonchi, increased tactile and vocal fremitus, directly over the abscess: bronchial breath sounds, whispered pectoriloquy, dull percussion note, pleural friction rub
Lung abscess chest x-ray?	Increased capacity, cavity formation, cavity with air fluid, fibrosis/calcification, pleural effusion
Lung abscess treatment options?	Oxygen therapy, bronchial hygiene, hyperinflation therapy, anabiotic's, pneumothorancentesis, surgical resection
Tuberculosis anatomical alterations?	Alveolar consolidation, AC membrane destruction, caseous tubercules/ granulomas, cavity formation, fibrosis and secondary calcification of lung parenchyma, distortion of bronchi, increased bronchial secretions
Tuberculosis clinical manifestations?	Increased (HR,RR,BP), chest pain, decreased chest expansion, cyanosis, digital clubbing, peripheral edema/ venous distention: polycythemia/cor pulmonale, cough, sputum,hemopytsis
Tuberculosis chest assessment findings?	Crackles, rhonchi, wheezing, bronchial breath sounds, tactile and vocal fremitus, whispered pectoriloquy, pleural friction rub, dull percussion note,
Tuberculosis chest x-ray?	Increased oh Pacitti, cavity formation, cavity lesion with air fluid level, calcification/fibrosis, pleural effusion, retraction of lung segments/lung, right ventricular enlargement
Tuberculosis treatment options?	Oxygen therapy, bronchopulmonary hygiene, mechanical ventilation, isoniazid, rifampin, pyrazinamide
Pulmonary edema clinical manifestations?	Increased (HR,RR,BP), peripheral edema, cyanosis, cheyne stokes respirations(severe left heart failure), dyspnea, orothopnea, cough, frothy pink sputum
Pulmonary edema chest assessment findings?	Increased tactile and vocal fremitus, crackle, rhonchi, wheezing
Pulmonary edema cardiogenic chest x-ray?	Butterfly/ bat wing appearance, dance fluffy opacities spread out from hair, enlarged pulmonary vessels, left ventricular hypertrophy, pleural effusion kurly A&B lines
Pulmonary edema noncardiogenic chest x-ray?	No cardiac enlargement and no pleural effusion
Pulmonary edema treatment options?	Oxygen therapy, bronchopulmonary hygiene, hyperinflation therapy, bronchodilators, diuretic agents, inotropic agents, myocardial contractibility, mechanical ventilation
Pulmonary embolism anatomic alterations?	Blockage of the pulmonary vascular system, pulmonary infarction, alveolar atelectasis, alveolar consolidation occasional bronchospasm
Pulmonary embolism clinical manifestations?	Increased (HR,RR), pulmonary hypertension, sudden onset dyspnea, severe chest pain, anxiety, diaphoresis, cyanosis, cough/Hemopytsis, syncope, light headedness, confusion, peripheral edema, venous distention
Pulmonary embolism chest assessment findings?	Crackles at emboli site, wheezes, pleural friction rub, abnormal heart sounds
Pulmonary embolism chest x-ray?	Increased density, hyper radiolucency distal to the embolus, dilation of the pulmonary arteries, pulmonary edema, right ventricular cardiomegaly, pleural effusion
Pulmonary embolism treatment options?	Oxygen therapy, anticoagulants(heparin,warfarin), thrombolytics
Flail chest anatomic alterations?	Double fracture of numerous adjacent ribs, rib irritability, lung restriction, atelectasis, lung collapse, lung contusion, secondary pneumonia
Flail chest clinical manifestations?	Increased (HR,RR,BP), paradoxical movement of chest wall, cyanosis, diminished breath sounds on both affected and unaffected sides
Flail chest x-ray?	Increased opacity atelectasis/pneumonia, rib fractures, increased ability affected side
Flail chest treatment options?	Mild cases meds for pain and routine of bronchial hygiene, oxygen therapy, long expansion/hyper inflation, severe cases mechanical ventilation
Pneumothorax anatomic alterations?	Lung collapse, atelectasis, asymmetrical chest wall expansion, compression of the great veins and decreased cardiac venous return
Pneumothorax:General classification?	Closed pneumothorax, open pneumothorax, tension pneumothorax
Close pneumothorax?	Gas in pleural space is not in direct contact with the atmosphere
Open pneumothorax?	Pleural Space is in direct contact with atmosphere; gas can move in and out
Tension pneumothorax?	One way valve like action of ruptured parietal pleura; Gas enters during inspiration, but cannot leave during expiration; most serious
Pneumothorax classifications based on origin?	Trumatic pneumothorax, spontaneous pneumothorax, Iatrogenic pneumothorax
Trumatic pneumothorax?	Caused by penetrating wounds from knife, bullet or impaling object
Spontaneous pneumothorax?	Occurs suddenly without an underlying cause; can be secondary to pneumonia, TB and COPD(blebs & bullae on surface of lung pop), often occurs in tall thin people 15 to 35 years old
Iatrogenic pneumothorax?	Occurs during diagnostic or therapeutic procedures
Pneumothorax clinical manifestations?	Increased (HR,RR,BP), hypoxemia, pain, anxiety, cyanosis
Pneumothorax chest assessment findings?	Hyperressonant percussion note over pneumothorax, diminished breath sounds over pneumothorax, tracheal shift away from affected side, displaced heart sounds, increased thoracic volume on affected side
Pneumothorax chest x-ray?	Increase translucency on the side of pneumothorax, mediastinal shift to unaffected side in tension pneumothorax, depressed diaphragm, atelectasis
Pneumothorax treatment options?	Oxygen therapy, lung expansion therapy, mechanical ventilation
Pleural effusion anatomic alterations?	Excess accumulation of fluid in pleural space that separate the visceral & parietal pleura & compress the lungs, lung compression, atelectasis, compression the great beans and decrease cardiac venous return
Transudative pleural effusion?	Fluid in from pulmonary capillaries moves into pleural state, commonly caused by congestive heart failure
Exudative pleural effusion?	Pleural surfaces diseased due to inflammation, high protein content in a great deal of cellular debris
Empyema?	Pus in pleural space develop as a result of inflammation
Pleural effusion clinical manifestations?	Increased (HR,RR,BP), chest pain/decrease chest expansion, cyanosis, cough dry nonproductive
Pleural effusion chest assessment findings?	Tracheal shift, decreased tactile and vocal fremitus, diminished breath sounds, displaced heart sounds, pleural friction rub, dull percussion note
Pleural effusion chest x-ray?	Blunting of the costophrenic angle, fluid level on the affected side, depressed diaphragm, mediastinal shift possibly to unaffected side, atelectasis, meniscus sign

Which of the following would you expect to find in a patient with cystic fibrosis?

Symptoms of CF Frequent lung infections including pneumonia or bronchitis. Wheezing or shortness of breath. Poor growth or weight gain in spite of a good appetite. Frequent greasy, bulky stools or difficulty with bowel movements.

What is the most common complication of cystic fibrosis?

The most serious and common complications of cystic fibrosis are problems with the lungs, also known as pulmonary or respiratory problems, which may include serious lung infections.

What causes respiratory alterations in cystic fibrosis?

The abnormal electrolyte transport system in CF causes the cells in the respiratory system, especially the lungs, to absorb too much sodium and water. This causes the normal thin secretions in the lungs to become very thick and hard to move. These thick secretions increase the risk for frequent respiratory infections.

What complicating pulmonary problem is likely to happen to a patient with cystic fibrosis?

Respiratory failure. Over time, cystic fibrosis can damage lung tissue so badly that it no longer works. Lung function usually worsens gradually, and it eventually can become life-threatening. Respiratory failure is the most common cause of death.

During the advanced stages of cystic fibrosis, the anatomic alterations cause the patient to have

Which of the following would you expect to find in a patient with cystic fibrosis?

What is the most common complication of cystic fibrosis?

What causes respiratory alterations in cystic fibrosis?

What complicating pulmonary problem is likely to happen to a patient with cystic fibrosis?

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