FULL REVIEW CRT/RRT (NBRC) EXAM
WITH ALL NEEDED TO PASS
Ascites t- tcorrect tanswers t-accumulation tof tfluid tin tthe tabdomen tcaused tby tLIVER
tFAILURE
Venous tdistention t- tcorrect tanswers t--occurs twith tCHF
-seen twith tobstructive tpatients t(seen tin texhalation tphase)
Capillary trefill t- tcorrect tanswers t--indication tof tperipheral tcirculation
-Normal t< t3 tseconds
Jaundice tskin tcolor t- tcorrect tanswers t--increase tin tbilirubin. t
-mostly tin tface tand ttrunk
Bradypnea t(oligopnea) t- tcorrect tanswers t--decreased trespiratory trate t(<12bpm)
tvariable tdepth tand tirregular trhythm
Hyperpnea t- tcorrect tanswers t--increased trate, tdepth, twith tregular trhythm
,Cheyne-Stokes t- tcorrect tanswers t--gradually tincreasing tthen tdecreasing trate tand
tdepth tin ta tcycle tlasting tfrom t30 t- t180 tsecs, twith tapnea tup tto t60 tsecs
-increased tICP, tmeningitis, toverdose
Biots t- tcorrect tanswers t--increased trate tand tdepth twith tirregular tperiods tof tapnea
-CNS tproblem, thead/brain tinjury
Kussmaul's t- tcorrect tanswers t--increased trate, tdepth, tirregular trhythm, tbreathing
tsounds tlabored
-Raspy tvoice
Apneustic t- tcorrect tanswers t-prolonged tgasping tinspiration tfollowed tby textremely
tshort, tinsufficient texpiration
-respiratory tcenter tproblems, ttrauma, ttumor
cachectic t- tcorrect tanswers t-muscle tatrophy/loss tof tmuscle ttone
retractions t- tcorrect tanswers t--chest tmoves tinward tduring tinspiratory tefforts tinstead
tof toutward
-blocked tairway tin tadults t= tINTUBATE
-RDS tin tinfants
Character tof tcough t- tcorrect tanswers t--dry, tnon-productive tcough tmay tindicate
ttumor tin tthe tlungs tor tasthma
-productive tcough tmay tindicate tinfection
evidence tof tdifficult tairway t- tcorrect tanswers t--short treceding tmandible t(chin)
-enlarged ttongue t(macroglossia)
-bull tneck
-limited tneck trange-of-motion
pulsus tparadoxus t- tcorrect tanswers t--pulse/blood tpressure tvaries twith trespiration.
tmay tindicate tsevere tair ttrapping t(status tasthmaticus tor tcardiac ttamponade)
tactile tfremitus t- tcorrect tanswers t--vibrations tfelt tby thand ton tchest twall
-vocal tfremitus: tvoice tvibrations ton tthe tchest twall
-pleural trub tfremitus: tgrating tsensation tdue tto troughened tpleural tspaces
-Rhonchial tfremitus(palpable trhonchi): tsecretions tin tairways
Crepitus t- tcorrect tanswers t--bubbles tof tair tunder tskin tthat tcan tbe tpalpated tand
tindicates tsubcutaneous temphysema
Resonant tpercussion t- tcorrect tanswers t--hollow tsound
,-normal tlungs
Flat tpercussion t- tcorrect tanswers t--heard tover tsternum, tmuscles, tor tareas tof
tatelectasis
Dull tpercussion t- tcorrect tanswers t--heard tover tfluid-filled torgans tsuch tas theart tor
tliver t(thudding)
-pleural teffusion tor tpneumonia
Tympanic tpercussion t- tcorrect tanswers t--heard tover tair-filled tstomach. t
-drum-like tsound tand twhen theard tover tlung t= tincreased tvolume
Hyperresonant t- tcorrect tanswers t--found twhere tpneumothorax tor temphysema tis
tpresent.
-booming tsound
vesicular tbreath tsounds t- tcorrect tanswers t-normal tsounds tin tlungs
bronchial tbreath tsounds t- tcorrect tanswers t--normal tsounds tover tairways. t
-breath tsounds tover tlungs tindicate tLUNG tCONSOLIDATION
Egophony t- tcorrect tanswers t--patient tinstructed tto tsay tE tand tsounds tlike tA. t
-lung tconsolidation
Bronchophony t/ twhisphered tpectoriloquy t- tcorrect tanswers t--increased tintensity tor
ttransmission tof tthe tspoken tvoice tand tindicate tCONSOLIDATION tor tPNEUMONIA
-increase tin tspoken tvoice t= tconsolidation
-decrease tin tspoken tvoice t= tobstructon, tpneumo, temphysema
Rales t- tcorrect tanswers t--crackles t
-secretions/fluid
Coarse trales t- tcorrect tanswers t--rhonchi
-LARGE tairway tsecretions
-needs tsuctioning
medium trales t- tcorrect tanswers t--middle tairway tsecretions
-needs tCPT
Fine trales t- tcorrect tanswers t--fluid tin talveoli
-CHF, tpulmonary tedema
-IPPB, theart tdrugs, tdiuretics tand tO2
Wheeze t- tcorrect tanswers t--due tto tbronchospasm
-bronchodilator tTx
-unilateral twheeze tindicative tof ta tforeign tbody tobstruction
, stridor t- tcorrect tanswers t--upper tairway tobstruction
-supraglottic tswelling t(epiglottitis) t(thumb tsign)
-subglottic tswelling t(croup, tpostextubation) t(steeple tsign)
-foreign tbody taspiration
-Racemic tepinephrine
-intubation tif tMARKED tstridor
-Lateral tneck tXray tfor tconfirmation
Pleural tfriction trub t- tcorrect tanswers t--coarse tgrating tor tcrunching tsound
-visceral tand tparietal tpleura trubbing ttogether
-associated twith tTB, tpneumonia, tpulmonary tinfarction, tcancer
-steroids tand tantibiotics
Heart tSound tS₁ t- tcorrect tanswers t--closure tof tthe tmitral tand ttricuspid tvalves tat tthe
tbeginning tof tventricular tcontraction
Heart tSound tS₂ t- tcorrect tanswers t--closure tof tpulmonic tand taortic tvalves
-occurs twhen tsystole tends; tventricles trelax
Heart tSound tS₃ t- tcorrect tanswers t--abnormal tand tmay tsuggest tCHF
Heart tSound tS₄ t- tcorrect tanswers t--abnormal tand tindicative tof tcardiac tabnormality
tsuch tas tmyocardial tinfarction tor tcardiomegaly
Heart tmurmurs t- tcorrect tanswers t--sounds tcaused tby tturbulent tblood tflow
-heart tvalve tdefects tor tcongenital theart tabnormalities
-can toccur twhen tblood tis tpushed tthrough tan tabnormal topening t(ASD, tPDA)
Bruits t- tcorrect tanswers t--sounds tmade tin tan tartery tor tvein twhen tblood tflow
tbecomes tturbulent tor tflows tat tan tabnormal tspeed. t
-usually theard tvia tstethoscope tover tthe tidentified tvessel t(carotid tartery)
Blood tpressure t- tcorrect tanswers t--systolic tand tdiastolic tpressures
-sphygmomanometer tto tmeasure tcuff tpressures
-↑BP t= tcardiac tstress t= thypoxemia
-↓BP t= tpoor tperfusion t= thypovolemia, tCHF
Costophrenic tAngle t- tcorrect tanswers t--angle tmade tby tthe touter tcurve tof tthe
tdiaphragm tand tthe tchest twall
-obliterated tby tpleural teffusions tand tpneumonia
Diaphragm t- tcorrect tanswers t--dome tshaped tnormally
-flattened twith tCOPD
-hemidiaphragms tmay tshift tdownward twith tpneumothorax
-right themidiaphragm tis tlevel tof t6th tanterior trib tand tslightly thigher tthan tthe tleft
WITH ALL NEEDED TO PASS
Ascites t- tcorrect tanswers t-accumulation tof tfluid tin tthe tabdomen tcaused tby tLIVER
tFAILURE
Venous tdistention t- tcorrect tanswers t--occurs twith tCHF
-seen twith tobstructive tpatients t(seen tin texhalation tphase)
Capillary trefill t- tcorrect tanswers t--indication tof tperipheral tcirculation
-Normal t< t3 tseconds
Jaundice tskin tcolor t- tcorrect tanswers t--increase tin tbilirubin. t
-mostly tin tface tand ttrunk
Bradypnea t(oligopnea) t- tcorrect tanswers t--decreased trespiratory trate t(<12bpm)
tvariable tdepth tand tirregular trhythm
Hyperpnea t- tcorrect tanswers t--increased trate, tdepth, twith tregular trhythm
,Cheyne-Stokes t- tcorrect tanswers t--gradually tincreasing tthen tdecreasing trate tand
tdepth tin ta tcycle tlasting tfrom t30 t- t180 tsecs, twith tapnea tup tto t60 tsecs
-increased tICP, tmeningitis, toverdose
Biots t- tcorrect tanswers t--increased trate tand tdepth twith tirregular tperiods tof tapnea
-CNS tproblem, thead/brain tinjury
Kussmaul's t- tcorrect tanswers t--increased trate, tdepth, tirregular trhythm, tbreathing
tsounds tlabored
-Raspy tvoice
Apneustic t- tcorrect tanswers t-prolonged tgasping tinspiration tfollowed tby textremely
tshort, tinsufficient texpiration
-respiratory tcenter tproblems, ttrauma, ttumor
cachectic t- tcorrect tanswers t-muscle tatrophy/loss tof tmuscle ttone
retractions t- tcorrect tanswers t--chest tmoves tinward tduring tinspiratory tefforts tinstead
tof toutward
-blocked tairway tin tadults t= tINTUBATE
-RDS tin tinfants
Character tof tcough t- tcorrect tanswers t--dry, tnon-productive tcough tmay tindicate
ttumor tin tthe tlungs tor tasthma
-productive tcough tmay tindicate tinfection
evidence tof tdifficult tairway t- tcorrect tanswers t--short treceding tmandible t(chin)
-enlarged ttongue t(macroglossia)
-bull tneck
-limited tneck trange-of-motion
pulsus tparadoxus t- tcorrect tanswers t--pulse/blood tpressure tvaries twith trespiration.
tmay tindicate tsevere tair ttrapping t(status tasthmaticus tor tcardiac ttamponade)
tactile tfremitus t- tcorrect tanswers t--vibrations tfelt tby thand ton tchest twall
-vocal tfremitus: tvoice tvibrations ton tthe tchest twall
-pleural trub tfremitus: tgrating tsensation tdue tto troughened tpleural tspaces
-Rhonchial tfremitus(palpable trhonchi): tsecretions tin tairways
Crepitus t- tcorrect tanswers t--bubbles tof tair tunder tskin tthat tcan tbe tpalpated tand
tindicates tsubcutaneous temphysema
Resonant tpercussion t- tcorrect tanswers t--hollow tsound
,-normal tlungs
Flat tpercussion t- tcorrect tanswers t--heard tover tsternum, tmuscles, tor tareas tof
tatelectasis
Dull tpercussion t- tcorrect tanswers t--heard tover tfluid-filled torgans tsuch tas theart tor
tliver t(thudding)
-pleural teffusion tor tpneumonia
Tympanic tpercussion t- tcorrect tanswers t--heard tover tair-filled tstomach. t
-drum-like tsound tand twhen theard tover tlung t= tincreased tvolume
Hyperresonant t- tcorrect tanswers t--found twhere tpneumothorax tor temphysema tis
tpresent.
-booming tsound
vesicular tbreath tsounds t- tcorrect tanswers t-normal tsounds tin tlungs
bronchial tbreath tsounds t- tcorrect tanswers t--normal tsounds tover tairways. t
-breath tsounds tover tlungs tindicate tLUNG tCONSOLIDATION
Egophony t- tcorrect tanswers t--patient tinstructed tto tsay tE tand tsounds tlike tA. t
-lung tconsolidation
Bronchophony t/ twhisphered tpectoriloquy t- tcorrect tanswers t--increased tintensity tor
ttransmission tof tthe tspoken tvoice tand tindicate tCONSOLIDATION tor tPNEUMONIA
-increase tin tspoken tvoice t= tconsolidation
-decrease tin tspoken tvoice t= tobstructon, tpneumo, temphysema
Rales t- tcorrect tanswers t--crackles t
-secretions/fluid
Coarse trales t- tcorrect tanswers t--rhonchi
-LARGE tairway tsecretions
-needs tsuctioning
medium trales t- tcorrect tanswers t--middle tairway tsecretions
-needs tCPT
Fine trales t- tcorrect tanswers t--fluid tin talveoli
-CHF, tpulmonary tedema
-IPPB, theart tdrugs, tdiuretics tand tO2
Wheeze t- tcorrect tanswers t--due tto tbronchospasm
-bronchodilator tTx
-unilateral twheeze tindicative tof ta tforeign tbody tobstruction
, stridor t- tcorrect tanswers t--upper tairway tobstruction
-supraglottic tswelling t(epiglottitis) t(thumb tsign)
-subglottic tswelling t(croup, tpostextubation) t(steeple tsign)
-foreign tbody taspiration
-Racemic tepinephrine
-intubation tif tMARKED tstridor
-Lateral tneck tXray tfor tconfirmation
Pleural tfriction trub t- tcorrect tanswers t--coarse tgrating tor tcrunching tsound
-visceral tand tparietal tpleura trubbing ttogether
-associated twith tTB, tpneumonia, tpulmonary tinfarction, tcancer
-steroids tand tantibiotics
Heart tSound tS₁ t- tcorrect tanswers t--closure tof tthe tmitral tand ttricuspid tvalves tat tthe
tbeginning tof tventricular tcontraction
Heart tSound tS₂ t- tcorrect tanswers t--closure tof tpulmonic tand taortic tvalves
-occurs twhen tsystole tends; tventricles trelax
Heart tSound tS₃ t- tcorrect tanswers t--abnormal tand tmay tsuggest tCHF
Heart tSound tS₄ t- tcorrect tanswers t--abnormal tand tindicative tof tcardiac tabnormality
tsuch tas tmyocardial tinfarction tor tcardiomegaly
Heart tmurmurs t- tcorrect tanswers t--sounds tcaused tby tturbulent tblood tflow
-heart tvalve tdefects tor tcongenital theart tabnormalities
-can toccur twhen tblood tis tpushed tthrough tan tabnormal topening t(ASD, tPDA)
Bruits t- tcorrect tanswers t--sounds tmade tin tan tartery tor tvein twhen tblood tflow
tbecomes tturbulent tor tflows tat tan tabnormal tspeed. t
-usually theard tvia tstethoscope tover tthe tidentified tvessel t(carotid tartery)
Blood tpressure t- tcorrect tanswers t--systolic tand tdiastolic tpressures
-sphygmomanometer tto tmeasure tcuff tpressures
-↑BP t= tcardiac tstress t= thypoxemia
-↓BP t= tpoor tperfusion t= thypovolemia, tCHF
Costophrenic tAngle t- tcorrect tanswers t--angle tmade tby tthe touter tcurve tof tthe
tdiaphragm tand tthe tchest twall
-obliterated tby tpleural teffusions tand tpneumonia
Diaphragm t- tcorrect tanswers t--dome tshaped tnormally
-flattened twith tCOPD
-hemidiaphragms tmay tshift tdownward twith tpneumothorax
-right themidiaphragm tis tlevel tof t6th tanterior trib tand tslightly thigher tthan tthe tleft
