NUR 622 (Adult_Gero Acute) MOD #6, pleural effusion_pneumothorax, ARDS, quiz questions
Questions with CORRECT Answers (Grade A+)
Question 1:
excess fluid in pleural space (normal is 5-20 ml)
Answer:
pleural effusion
Question 2:
patient comes in with CHF and pleural effusion, what's your first step?
Answer:
diagnostic thoracentesis -check for protein, LDH, cell count, pH, glucose, cytology -r/o infection vs
malignancy
Question 3:
Light's criteria for exudative vs transudative pleural fluid (PF)
Answer:
transudative - excess fluid buildup (CHF, ascites, nephrotic syndrome) exudative- fluid caused by
inflammation, infection, malignancy, tissue injury, post CABG, PE
Question 4:
transudative vs exudative markers for Light's criteria
Answer:
transudative: -PF protein/serum protein ratio <0.5 -PF LDH/normal LDH ratio <0.6 exudative:
-PF/serum protein ratio >0.5 -PF LDH/normal LDH ratio >0.6
Question 5:
normal serum protein and LDH
Answer:
Protein (6-8) LDH (140-280)
Question 6:
, so, if you remove 1.5 liters, and PF protein is 20.5g/l and PF LDH is 244, is it transudative or
exudative?
Answer:
-using PF protein/serum protein ratio: 20.5/7 = 2.9 (exudative) -using the PF LDH/serum LDH ratio:
244/200= 1.2 (exudative)
Question 7:
causes pleural effusion
Answer:
-HF (most common transudative) -cirrhosis -cancer -hemothorax -empyema -chylothorax
Question 8:
s/s pleural effusion
Answer:
dyspnea, pleuritic chest pain, decreased percussion, decreased breath sounds
Question 9:
remember, a low glucose on a thoracentesis could indicate
Answer:
infection/malignancy (likes to eat the sugar)
Question 10:
a PF pH less than 7.2 can indicate:
**normal PF pH is 7.6
Answer:
empyema (pus) - likely infection
Question 11:
air in pleural space -unilateral chest pain and dyspnea -tachycardia and tachypnea -no breath
sounds, no lung sliding on US -unequal chest movement, trachea displaced to opposite side -subq
emphysema -blackness with no lung markings on CXR
Answer:
Pneumothorax
Questions with CORRECT Answers (Grade A+)
Question 1:
excess fluid in pleural space (normal is 5-20 ml)
Answer:
pleural effusion
Question 2:
patient comes in with CHF and pleural effusion, what's your first step?
Answer:
diagnostic thoracentesis -check for protein, LDH, cell count, pH, glucose, cytology -r/o infection vs
malignancy
Question 3:
Light's criteria for exudative vs transudative pleural fluid (PF)
Answer:
transudative - excess fluid buildup (CHF, ascites, nephrotic syndrome) exudative- fluid caused by
inflammation, infection, malignancy, tissue injury, post CABG, PE
Question 4:
transudative vs exudative markers for Light's criteria
Answer:
transudative: -PF protein/serum protein ratio <0.5 -PF LDH/normal LDH ratio <0.6 exudative:
-PF/serum protein ratio >0.5 -PF LDH/normal LDH ratio >0.6
Question 5:
normal serum protein and LDH
Answer:
Protein (6-8) LDH (140-280)
Question 6:
, so, if you remove 1.5 liters, and PF protein is 20.5g/l and PF LDH is 244, is it transudative or
exudative?
Answer:
-using PF protein/serum protein ratio: 20.5/7 = 2.9 (exudative) -using the PF LDH/serum LDH ratio:
244/200= 1.2 (exudative)
Question 7:
causes pleural effusion
Answer:
-HF (most common transudative) -cirrhosis -cancer -hemothorax -empyema -chylothorax
Question 8:
s/s pleural effusion
Answer:
dyspnea, pleuritic chest pain, decreased percussion, decreased breath sounds
Question 9:
remember, a low glucose on a thoracentesis could indicate
Answer:
infection/malignancy (likes to eat the sugar)
Question 10:
a PF pH less than 7.2 can indicate:
**normal PF pH is 7.6
Answer:
empyema (pus) - likely infection
Question 11:
air in pleural space -unilateral chest pain and dyspnea -tachycardia and tachypnea -no breath
sounds, no lung sliding on US -unequal chest movement, trachea displaced to opposite side -subq
emphysema -blackness with no lung markings on CXR
Answer:
Pneumothorax
