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Exam (elaborations)

NSG 500 Quiz 2 – Correct Solutions To All Questions

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NSG 500 Quiz 2 – Correct Solutions To All Questions

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NSG 500 Quiz 2 – Correct Solutions To All Questions

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it is noncardiac chest pain if: constant achiness, does not radiate, worsens with
pressing on chest wall, fleeting/needle like jab that
lasts a few seconds, situated in shoulders or between
shoulder blades in the back


dullness on percussion present in pleural effusion or lobar pneumonia


tactile fremitus decreased or absent if excess air in lungs
(emphysema), pelural thickening or effusion, bronchial
obstruction
increased if presence of fluids, solid mass,
consolidation


trachea exam eviation: volume loss from fibrosis or atelactasis will
pull the trachea that direction. mau also be anterior
mediastinal tumor, inlammation

,lung percussion dull=cardiac, luver
tympany--stomach
resonant--lungs
flat--muscles and bones


lung percussion order back (10 areas), right lateral--4 areas, left lateral 4
areas, front8 areas


classification of breath sounds vesicular--low pitched, low intesity (normal healthy
tissue)
bronchovesicular--over major bronchi, moderate in
pitch and intensity
bronchial breath soudns--highest in pitch and
intensity--over trachea


bronchovesicular and bronchial breath ABNORMAL
sounds over peripheral lung tissue


breath sounds like blowing across the amphoric=stiff pulmonary caivty or tension
mouth of a bottle pneumothorax


rub sound--lungs cratchy and high pitched


types of crackles fine: high pitched discrete with end of inspiration,
doesn't clear with cough
medium: lower more in middle stage of inspiration
coarse: bubbly with inspiration, loud


rhonchi deeper rumbling more pronounced during expiration.
d/t thick secretions


vocal resonance with lung bronchophony--consolidation in lungs--even a
ausculatation whisper can be heard clearly
egophony--consolidation of lung tissue--ee turns into
"a"

,bronchial breath sounds harsh, hollow sound - best heard over trachea and
larynx


bronchovesicular breath s over bronchi, med pitch and loudness


vesicular sounds heard every where else, softest and lowest pitch


fine crackles are more often in bases of lungs


coarse crackles more often in trachea and large bronchi


rhonchi are due to airway obstruction from mass, secretions, muscular
constriction


wheezes are due to constriction, mass, secretions


stridor strained, high-pitched sound heard on inspiration
caused by obstruction in the pharynx or larynx


S1 heart sound mitral and tricuspid valve closure with ventricular
contraction


s2 initiation of diastole aortic and pulmonic valves
closing after ventricles have emptied


s3 sometimes occurs when ventricular filling is almost
complete. due to RAPID ventricular filling. low pitch,
use bell


s4 occurs with atria contraction to ensure ejection of any
remaining blood. Due to forceful atrial ejection into
distended ventricle. low pitch, use bell

, chest pain: cardiac substernal provoked by effort, emotion, eating and
relieved by rest, nitro, often accompanied by
diaphoresis and sometimes nausea


chest pain: pleural with breathing or coughing: sharp, present with
respiration, absend when holding breath


chest pain: esophageal burning, substernal, radiation to shoulder,
nocturnal/lying flat, releived with food, antacids and
sometimes nitro


chest pain: peptic: almost always infradiaphragmatic and epigastric. PM
and AM attacks relieved by food


chest pain: biliary under right scapula, prolonged, after eating, will
trigger angina


chest pain: arthritis/bursitis local tender/pain with movement


chest pain: cervical pain with movement, associated with injury


chest pain musculoskeletal with movement, twisting, bending, focal tenderness


sequence of chest assessment inspection, palpation, percussion, auscultation


what is a thrill? palpable vibration it feels like the throat of a purring
cat. the thrill signifies turbulent blood flow and directs
you to locate the origin of loud murmurs
-use your palm aspect of your four fingers
with grade 4 murmur or higher

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