CMN 568 EXAM 2- PHYSICAL EXAM #1 QUESTIONS AND ANSWERS

CMN 568 EXAM 2- PHYSICAL EXAM #1
QUESTIONS AND ANSWERS

Physicalxexaminationx-xans---xInspectionx
-xPalpationx
-xPercussionx
-xAuscultation

Observexpatternxofxbreathingx-xans---xRRx(12-14rr/min)x
-xRhythmx(regularxwithxaxsighxeveryx90xbreathsxorxso)
-xDepthxofxbreathingx/xtidalxvolumex(5ml/kg)
-xRelativextimexspentxinspirationxandxexpirationx(ratiox2:3)

Inspectxforxextrapulmonaryxsignsxofxpulmonaryxdiseasex-xans--
Usexwhatxyouxfindxtoxperformxmorexdetailedxexam

Palpatex-xans---xTracheaxatxsuprasternalxnotch
-
xPosteriorxchestxwallx(gaugexfremitusx/

xtransmissionxthroughxlungsxofxvibrationsxofxspokenxwords)

-xAnteriorxchestxwallx(assessxcardiacximpulse)

Percussionx-xans--Identifiesxdullxareasxorxhyperresonantxareas

Auscultationx-xans--Lungxsounds

PulmonaryxFunctionxTestsx-xans--
Measuresxairflowxrates,xlungxvolumes,xabilityxofxlungxtoxtransferxgasxacrossxalveoli-
capillaryxmembrane

WhatxwouldxindicatextoxFNPxthatxpatientxneedsxPFT?x-xans---xAssessxtype/
extentxofxlungxdysfunction
-xDxxofxcausesxofxdyspneaxandxcough
-xDetectxearlyxevidencexofxlungxdysfunction
-xFollow-upxresponsextoxtherapy
-xPre-xopxassessment
-xDisabilityxeval

Patientxpresentsxwithxacutexasthmaxexacerbationxwithxmildxresp.xdistress.xYouxwantxtoxperf
ormxaxPFTxtoxseexhowxwellxgasxexchangexisxoccurring.xIsxthisxcorrectxmanagementxforxthex
patient?x-xans---xNo

, -
xPFTsxarexcontraindicatedxinxacutexseverexasthma,xresp.xdistress,xanginaxaggravatedxbyxte

sting,xpneumothorax,xongoingxhemoptysis,xactivexTB

HowxdoxyouxmeasurexyourxpatientsxPFTsxtoxestablishxifxtheyxarexnormalxorxnot?x-xans---
xTheyxarexmeasuredxagainstxpredictedxvaluesxderivedxfromxlargexstudiesxofxhealthyxsubject
x

-xVaryxwithxage,xgender,xheight,xweight,xethnicity

Tachypneax-xans--IncreasedxrespxratexandxdecreasedxTV

Irregularxrhythmx-xans---xRapid,xshallowxbreathingx
-xRestrictivexlungxdiseasex(precursorxtoxrespxfailure)

Kussmaulxrespx-xans---
xRapidxlargexvolumexbreathingxleadsxtoxintensexstimulationxofxrespxcenterx

-xR/Txmetabolicxacidosis

Cheyne-Stokesxrespx-xans---xRhythmic
-xWaxing/waningxofxratexandxTV
-xRegularxperiodsxofxapneax
-xSeenxinxend-stagexLVxfailure,xneurologicxdx,xsleepingxatxhighxaltitude

Extrapulmonaryxsignsxofxintrinsicxpulmonaryxdiseasex-xans---xDigitalxclubbing
-xCyanosis
-xIncreasedxCVP
-xBLExedema

Digitalxclubbingx-xans---xLungxabscess
-xEmpyema
-xBronchiectasis
-xCF
-xIdiopathicxpulmonaryxfibrosis
-xAVxmalformations
-xLatexpresentationxofxconcomitantxlungxcx

Cyanosisx-xans---xBluexorxbluish-
grayxdiscolorationxofxskinx&xmmxduextoxamountsxofxunsaturatedxHgB
inxcapillaryxblood

Anemiax-xans--Mayxpreventxcyanosisxfromxappearing

Polycythemiax-xans--Cyanosisxinxmildxhypoxemia

Cyanosisxnotxreliablexindicatorxofxhypoxemiax-xans--
GetxarterialxPO2xorxHgBxsaturationxmeasured