CRT TMC RRT EXAM STUDY QUESTIONS AND ANSWERS GRADED A 2024

extra pulmonary air indicates: - -pneumothorax -pneumoperitoneum -pneumomediastinum -pneumopericardium -sub cu. emphysema Epiglottitis: - -above glottis -confirm with lat. neck cxr; supraglottic narrowing with enlarged flattened epiglottis -thumb sign Tx: intubate Croup (laryngotracheobronchitis) - infection of upper airway characterized by a barky cough seen in children CXR: tracheal narrowing with subglottic swelling (steeple sign, picket fence, pencil point, hour glass) Treatment: racemic epi and O2 ETT Placement: - 2-6 cm above carina-- level of aortic arch To confirm- first listen to breath sounds, then CXR AP radiograph: - front to back PA radiograph - back to front Lateral radiograph - sides Oblique CXR - standing/diagonal- lesions Lateral decubitus - lying on AFFECTED side-- pleural effusions Apical lordotic - tops of lungs used to confirm TB End exp. image - detect small pnuemos Confirming quality of CXR image - - clavicles are level - penetration- vertabrae visible just behind heart -mediastinum- area between lungs, heart, blood vessels and bronchi are found -vascular markings Enlarged Heart in CXR - cardiomegaly--- CHF- pericardial effusion Normal CXR - -hemidiaphragms -R diaphragm elevated (liver underneath) -L diaphragm at level of 6 anterior rib -trachea midline -bilateral radiolucent appearance -sharp costophrenic angles - heart not consuming 50% of picture Blood Pressure - 120/80 90-140 systolic acceptable 60-90 diastolic acceptable hypertension- O2 hypotension- fluids, hypovolemia, chf Heart sounds: - S1- ventricles contract S2-ventricles relax (LUB-DUB) S3 & S4 not good; recommend echo pleural friction rub - Coarse grating raspy or crushing sound TB, pneumonia, PE, and hemothorax Recommend steroids and antibiotics stertor: - snoring sound produced when patients are unable to cough up secretions from the trachea or bronchi adventitous breath sounds: - abnormal breath sounds coarse crackles: - loud, bubbly noise heard during inspiration; not cleared by a cough medium crackles - middle airway- clear with CPT fine crackles - alveoli/fluid indicative: CHF, pulm. edema Tx: o2, ppv, inotropic therapy, diuretics Bronchial breath sounds - normal breath sounds over trachea or bronchi