PN 4006 MT UPDATED ACTUAL Questions and CORRECT Answers
1. Neurological As- PERRLA & GCS
sessment inspect palpate head for bruises bumps etc
2. resp assessment WOB
nasal flarring
accessory muscle us
hx
allergies
cough sputum
chest rising
tactile fremitus
breath sounds
o2 therapy
color of skin nail beds lips
3. CV assessment hx
meds
chest pain?
pulse points - temporal carotid brachial radial femoral popliteal dorsalis pedis
posterior tibialis
heart sounds S1,2
extra heart sounds S3,4
Vitals
arrythmias
CO
EF
4. Auscultation: 2nd intercostal space, right sternal border
Aortic area
5. Auscultation of 2nd intercostal space to the left of the sternum
pulmonary valve
,6. Auscultation: 3rd left intercostal space
Erb's point
7. Auscultation of 4th left intercostal space at the sternal border
tricuspid valve
8. Auscultation of 5th intercostal space, mid-clavicular line
mitral valve
9. ABG normal val- pH 7.35 - 7.45 decreased is acidic
ues PaCO2 35 - 45 mmHg decreased is basic
HCO3 22-26 mEq/L decreased is acidic
10. ABG compensa- FULL COMP if pH is back to normal
tion PARTIAL COMP if all values are abnormal
UNCOMP if PaCO2 or HCO3 is normal while the other is abnormal
11. resp acidosis Build-up of carbon dioxide in the lungs that causes acid-base imbalances and the
body becomes acidic
Can be acute or chronic
Caused by excess carbonic acid which causes the blood pH to drop
12. resp acidosis Post op abdominal surgery
causes Mechanical ventilation
Analgesics or sedation
Pneumothorax
Hemothorax
Pulmonary edema
Acute bronchial asthma
Atelectasis
Pneumonia
Some drug overdoses and head injuries
Emphysema
, Bronchiectasis
Bronchial asthma
CF
13. resp acidosis s/s Extreme resp insuflciency
Frantic ettorts to breath
Breathe slowly irregularly or stop breathing
Expiratory volume is decreased
Lung sounds may be moist or absent
Tachycardia and other cardiac arrhythmias
Cyanosis in later stages
Confusion
Disorientation
Hallucinations
Tremors
Muscle twitching
Flushed skin
Headache
Weakness
Stupor
Coma
Chronic resp acidosis s/s are less prominent and include increased breathing
ettort, lack of energy, reduced activity, dull headache, weakness
14. resp acidosis Depending on the cause and whether its acute or chronic
management Mechanical ventilation may be necessary
IV sodium bicarb may be administered when ventilation ettorts do not adequately
restore a balanced pH
HR and rhythm are monitored to detect sudden cardiac changes
In less acute situations tx may include bronchodilators, abx, airway suctioning if
pt is too weak to cough
, 15. resp alkalosis hyperventilation
16. resp alkalosis acute anxiety
causes High fever
Overactive thyroid
Aspirin poisoning
Hypoxia
Mechanical ventilation
use of nicotine or aminophylline
17. resp alkalosis s/s Increased RR
Lightheadedness
Anxiety
restlessness
Diaphoresis
Dyspnea (Ñrate and depth)
EKG changes
Hyperreflexia
paresthesia
Tachycardia
Tetany
Dry mouth
Convulsions
18. resp alkalosis Breathe into paper bag
management Make them calmer decrease anxiety
19. met acidosis Results in decreased plasma pH b/c of increased organic acids (acids other
than H2CO3) or decreased bicarb organic acids increase in periods of anaerobic
metabolism when cells attempt to produce ATP without o2
Anaerobic metabolism is much less eflcient than aerobic metabolism and pro-
duces by-products such as lactic acid
Occurs during shock and cardiac arrest
1. Neurological As- PERRLA & GCS
sessment inspect palpate head for bruises bumps etc
2. resp assessment WOB
nasal flarring
accessory muscle us
hx
allergies
cough sputum
chest rising
tactile fremitus
breath sounds
o2 therapy
color of skin nail beds lips
3. CV assessment hx
meds
chest pain?
pulse points - temporal carotid brachial radial femoral popliteal dorsalis pedis
posterior tibialis
heart sounds S1,2
extra heart sounds S3,4
Vitals
arrythmias
CO
EF
4. Auscultation: 2nd intercostal space, right sternal border
Aortic area
5. Auscultation of 2nd intercostal space to the left of the sternum
pulmonary valve
,6. Auscultation: 3rd left intercostal space
Erb's point
7. Auscultation of 4th left intercostal space at the sternal border
tricuspid valve
8. Auscultation of 5th intercostal space, mid-clavicular line
mitral valve
9. ABG normal val- pH 7.35 - 7.45 decreased is acidic
ues PaCO2 35 - 45 mmHg decreased is basic
HCO3 22-26 mEq/L decreased is acidic
10. ABG compensa- FULL COMP if pH is back to normal
tion PARTIAL COMP if all values are abnormal
UNCOMP if PaCO2 or HCO3 is normal while the other is abnormal
11. resp acidosis Build-up of carbon dioxide in the lungs that causes acid-base imbalances and the
body becomes acidic
Can be acute or chronic
Caused by excess carbonic acid which causes the blood pH to drop
12. resp acidosis Post op abdominal surgery
causes Mechanical ventilation
Analgesics or sedation
Pneumothorax
Hemothorax
Pulmonary edema
Acute bronchial asthma
Atelectasis
Pneumonia
Some drug overdoses and head injuries
Emphysema
, Bronchiectasis
Bronchial asthma
CF
13. resp acidosis s/s Extreme resp insuflciency
Frantic ettorts to breath
Breathe slowly irregularly or stop breathing
Expiratory volume is decreased
Lung sounds may be moist or absent
Tachycardia and other cardiac arrhythmias
Cyanosis in later stages
Confusion
Disorientation
Hallucinations
Tremors
Muscle twitching
Flushed skin
Headache
Weakness
Stupor
Coma
Chronic resp acidosis s/s are less prominent and include increased breathing
ettort, lack of energy, reduced activity, dull headache, weakness
14. resp acidosis Depending on the cause and whether its acute or chronic
management Mechanical ventilation may be necessary
IV sodium bicarb may be administered when ventilation ettorts do not adequately
restore a balanced pH
HR and rhythm are monitored to detect sudden cardiac changes
In less acute situations tx may include bronchodilators, abx, airway suctioning if
pt is too weak to cough
, 15. resp alkalosis hyperventilation
16. resp alkalosis acute anxiety
causes High fever
Overactive thyroid
Aspirin poisoning
Hypoxia
Mechanical ventilation
use of nicotine or aminophylline
17. resp alkalosis s/s Increased RR
Lightheadedness
Anxiety
restlessness
Diaphoresis
Dyspnea (Ñrate and depth)
EKG changes
Hyperreflexia
paresthesia
Tachycardia
Tetany
Dry mouth
Convulsions
18. resp alkalosis Breathe into paper bag
management Make them calmer decrease anxiety
19. met acidosis Results in decreased plasma pH b/c of increased organic acids (acids other
than H2CO3) or decreased bicarb organic acids increase in periods of anaerobic
metabolism when cells attempt to produce ATP without o2
Anaerobic metabolism is much less eflcient than aerobic metabolism and pro-
duces by-products such as lactic acid
Occurs during shock and cardiac arrest
