*NURSING > QUESTIONS & ANSWERS > FULL EXAM REVIEW CRT/RRT (NBRC) 100% Correct Questions and Answers (All)

FULL EXAM REVIEW CRT/RRT (NBRC) 100% Correct Questions and Answers

Document Content and Description Below

FULL EXAM REVIEW CRT/RRT (NBRC) 100% Correct Questions and Answers Ascites - accumulation of fluid in the abdomen caused by LIVER FAILURE Venous distention - -occurs with CHF -seen with obstructi... ve patients (seen in exhalation phase) Capillary refill - -indication of peripheral circulation -Normal < 3 seconds Jaundice skin color - -increase in bilirubin. -mostly in face and trunk Bradypnea (oligopnea) - -decreased respiratory rate (<12bpm) variable depth and irregular rhythm Hyperpnea - -increased rate, depth, with regular rhythm Cheyne-Stokes - -gradually increasing then decreasing rate and depth in a cycle lasting from 30 - 180 secs, with apnea up to 60 secs -increased ICP, meningitis, overdose Biots - -increased rate and depth with irregular periods of apnea -CNS problem, head/brain injury Kussmaul's - -increased rate, depth, irregular rhythm, breathing sounds labored -Raspy voice Apneustic - prolonged gasping inspiration followed by extremely short, insufficient expiration -respiratory center problems, trauma, tumor cachectic - muscle atrophy/loss of muscle tone retractions - -chest moves inward during inspiratory efforts instead of outward -blocked airway in adults = INTUBATE -RDS in infants Character of cough - -dry, non-productive cough may indicate tumor in the lungs or asthma -productive cough may indicate infection evidence of difficult airway - -short receding mandible (chin) -enlarged tongue (macroglossia) -bull neck -limited neck range-of-motion pulsus paradoxus - -pulse/blood pressure varies with respiration. may indicate severe air trapping (status asthmaticus or cardiac tamponade) tactile fremitus - -vibrations felt by hand on chest wall -vocal fremitus: voice vibrations on the chest wall -pleural rub fremitus: grating sensation due to roughened pleural spaces -Rhonchial fremitus(palpable rhonchi): secretions in airways Crepitus - -bubbles of air under skin that can be palpated and indicates subcutaneous emphysema Resonant percussion - -hollow sound -normal lungs Flat percussion - -heard over sternum, muscles, or areas of atelectasis Dull percussion - -heard over fluid-filled organs such as heart or liver (thudding) -pleural effusion or pneumonia Tympanic percussion - -heard over air-filled stomach. -drum-like sound and when heard over lung = increased volume Hyperresonant - -found where pneumothorax or emphysema is present. -booming sound vesicular breath sounds - normal sounds in lungs bronchial breath sounds - -normal sounds over airways. -breath sounds over lungs indicate LUNG CONSOLIDATION Egophony - -patient instructed to say E and sounds like A. -lung consolidation Bronchophony / whisphered pectoriloquy - -increased intensity or transmission of the spoken voice and indicate CONSOLIDATION or PNEUMONIA -increase in spoken voice = consolidation -decrease in spoken voice = obstructon, pneumo, emphysema Rales - -crackles -secretions/fluid Coarse rales - -rhonchi -LARGE airway secretions -needs suctioning medium rales - -middle airway secretions -needs CPT Fine rales - -fluid in alveoli -CHF, pulmonary edema -IPPB, heart drugs, diuretics and O2 Wheeze - -due to bronchospasm -bronchodilator Tx -unilateral wheeze indicative of a foreign body obstruction stridor - -upper airway obstruction -supraglottic swelling (epiglottitis) (thumb sign) -subglottic swelling (croup, postextubation) (steeple sign) -foreign body aspiration -Racemic epinephrine -intubation if MARKED stridor -Lateral neck Xray for confirmation Pleural friction rub - -coarse grating or crunching sound -visceral and parietal pleura rubbing together -associated with TB, pneumonia, pulmonary infarction, cancer -steroids and antibiotics Heart Sound S₁ - -closure of the mitral and tricuspid valves at the beginning of ventricular contraction Heart Sound S₂ - -closure of pulmonic and aortic valves -occurs when systole ends; ventricles relax Heart Sound S₃ - -abnormal and may suggest CHF Heart Sound S₄ - -abnormal and indicative of cardiac abnormality such as myocardial infarction or cardiomegaly Heart murmurs - -sounds caused by turbulent blood flow -heart valve defects or congenital heart abnormalities -can occur when blood is pushed through an abnormal opening (ASD, PDA) Bruits - -sounds made in an artery or vein when blood flow becomes turbulent or flows at an abnormal speed. -usually heard via stethoscope over the identified vessel (carotid artery) Blood pressure - -systolic and diastolic pressures -sphygmomanometer to measure cuff pressures -↑BP = cardiac stress = hypoxemia -↓BP = poor perfusion = hypovolemia, CHF Costophrenic Angle - -angle made by the outer curve of the diaphragm and the chest wall -obliterated by pleural effusions and pneumonia Diaphragm - -dome shaped normally -flattened with COPD -hemidiaphragms may shift downward with pneumothorax -right hemidiaphragm is level of 6th anterior rib and slightly higher than the left -right lung: 55% and appear larger than left lung Lateral decubitus CXR - -patient lying on affected side -detecting small pleural effusions End expiratory film - -taken when patient is at end-exhalation -detecting small pneumothorax/foreign body aspiration (FBA) Position of ET/Tracheostomy tube - -tip should be positioned below the vocal chords and no closer than 2 cm or 1 inch above the carina. -approx same level of the aortic knob/arch -observation and auscultation will quickly determine adequate ventilation before CXR is taken -cuff should not extend over the end of the ET or tracheostomy tube Pacemaker, catheters, Etc. - -pacemaker should be positioned in the right ventricle -PAC should appear in right lower lung field -central venous catheters are placed in the right or left subclavian or jugular vein and should rest in the vena cava or right atrium -chest tubes should be located in the pleural space surrounding the lung -NG tubes should be in stomach 2-5 cm below the diaphragm Croup (laryngotracheobronchitis) - -viral disorder -narrowing subglottic swelling -steeple/picket fence/pencil sign -gradual onset -infants -Mist tent, O2, Racemic epi, corticosteroids -barking cough Epiglottitis - -bacterial infection -supraglottic swelling with an enlraged and flattened epiglottis and swollen aryepiglottic folds -Thumb sign -Rapid onset -pediatrics -provide airway and antibiotics Computerized Tomography (CT scan) - -X-ray through a specific plane and appear as slices of organs/body parts -diagnosis of bronchiectasis -spiral CT scan w/ contrast dye for PE Magnetic Resonance Imaging (MRI) - -2D view without use of radiation -used for determining thoracic aneurysms, congenital abnormalities of the aorta and major thoracic vessels esp. the hilar area -able to locate precise position of tumors V/Q scan - Ventilation scan -Radioisotope (xenon) gas is inhaled -and obstruction to airflow will allow little gas to enter Perfusion scan -albumin, tagged with radioactive iodine is injected into a peripheral vein and lodges in the pulmonary capillaries -scanned over chest and shows distribution and volume of perfusion Ventilation with no perfusion = PE (deadspace disease) Barium swallow (esophagram) - -for diagnosing of abnormalities in the hypopharynx, esophagus, or stomach -ingested and traced through the hypopharynx and into the esophagus via fluoroscope and xray at the end -suspected esophageal malignancy, dysphagia, congenital defect in hypopharync, esophagus, gastric reflux, esophageal varices. Positron Emission Tomography (PET scan) - -for determining cancer, brain disorders and heart disease -injected with radioactive substance bronchography (bronchogram) - -injection of radio-opaque contrast into tracheobronchial tree -study of OBSTRUCTING LESIONS (tumors) and BRONCHIECTASIS -better administration of postural drainage Electroencephalography (EEG) - -measures electrical activity in the brain -brain tumors, traumatic brain injuries, retardation, loss of brain function, epilepsy/seizures, -EVALUATION OF SLEEP DISORDERS Pulmonary Angiography - -most definitive for DX of pulmonary embolism -pressures in cardiac chambers can be measured -inserted into the femoral vein and advanced through the right heart and into the pulmonary artery which could identify filling defects ultrasonography of the heart (Echocardiogram) - -noninvasive for monitoring cardiac performance -doppler color flow mapping with 2D and M-Mode achocardiography to assess overall ventricular function including LEFT VENTRICULAR VOLUME and EJECTION FRACTION -Valvular disease or dysfunction -myocardial disease -abnormalities of cardiac blood flow -cardiac anomalies in the infant -abnormal heart sounds ICP monitoring - -track the dynamics inside the skull such as volume-pressure relationships, pressure waves, and cerebral perfusion pressures -ICP > 20 mm Hg = hyperventilated until PaCO2 is 25-30 mmHg CAUSES -Intracranial tumors -Abscesses -Meningitis -Cerebral Edema -Subdural Hematoma 3 types of ICP monitoring - -Ventricular Catheter: inserted through a burr hole (surgical opening into the skull -Subarachnoid bolt: metal screw with sensor chip that is inserted through a hole drilled into the subdural or subarachnoid space -Epidural Sensor: consists of placement of a fiberoptic sensor, radio transmitter, or tiny balloon in the epidural space through a burr hole in the skull Cerebral Perfusion Pressure (CPP) - -Pressure gradient that determines cerebral perfusion -CPP = MAP - ICP -Normal Value 70 - 90 mmHg Exhaled Nitric Oxide (NIOX) Testing - -Measurement of nitric oxide concentration (FENO) in patient's exhaled breath -used to monitor asthma patient's response to anti-inflammatory (corticosteroid) treatment -decrease in FENO suggests a decrease in airway inflammation Sputum colors - Clear = normal Mucoid = white/gray, chronic bronchitis Yellow = presence of WBC, bacterial infection Green = stagnant sputum, gram neg bacteria (Bronchiectasis, pseudomonas Brown/dark = old blood Bright red = hemoptysis (bleeding tumor, TB) Pink frothy = pulmonary edema Sputum tests - sputum culture = identify bacteria present (days) Sensitivity = identify what antibiotics will kill bacteria Gram Stain = whether Gram positive or negative (5mins) Acid Fast Stain = identify mycobacterium tuberculosis can be done on blood, urine, and pleural samples. collect samples prior to mouthcare, meals, and treatments Oscilloscope - -provides a continous visual image of the electrical activity of the heart on a screen -displays rapid changes in voltage as a moving line on a phosphorescent screen Four Critical Life Functions - -Ventilation -Oxygenation -Circulation -Perfusion Signs - -Objective information -things that can be seen or measured Symptoms - -subjective information -things that the patient must tell you Respiratory care orders - -type of treatment -frequency -medication dosage and dilution -physician signature CALL MD IF MISSING CVP abnormalities - -decreased CVP = hypovolemia -increased CVP = hypervolemia Katz ADL - -Activities of Daily Living: Bathing, eating, dressing, toilet, transferring, urine and bowel continence -patient is unable to perform or needs assistance = score of ZERO -patient needs no direction or assistance = score of ONE -6 = independent -4 = impairment -2 = severe impairment General malaise - -run down feeling, nausea, weakness, fatigue, headache -ELECTROLYTE IMBALANCE Diagnosis of Pulmonary Embolism (PE) - -Pulmonary Angiography -V/Q Scan -Spiral CT Scan Chest ECG electrodes - -V1 = 4th intercostal space on right side of sternum -V2 = 4th intercostal space on left side of sternum -V3 = between V2 and V4 on left side -V4 = 5th intercostal space, left mid-clavicular line -V5 = between V4 and V6 on left side -V6 = 5th intercostal space, left mid-axillary line Estimating heart rate on ECG - -two R waves between 3-5 large boxes = normal -two R waves closer and 3 large boxes = tachycardia -two R waves wider than 5 large boxes = bradycardia Sinus Bradycardia - Rate less than 60 Treat with Oxygen/Atropine Multifocal PVC - Premature Ventricular Contraction (PVCs) - Ventricular Tachycardia (V-Tach) - Ventricular Fibrillation (V-Fib) - Asystole - 1st Degree AV Block - 2nd Degree AV Block - 3rd Degree AV Block - Ischemia - -reduced blood flow to tissue -indicated by a depressed or inverted T-WAVE Injury - -indicated by an elevated ST segment Infarction - -diagnosed by significant Q waves APGAR Score - -1 minute will determine neonatal survival -5 minute predicts future neurological outcome -0-3 resuscitate -4-6 Stimuiate (stimulate, warm, O2) -7-10 Monitor (Routine care) Transillumination - -Normally a small lighted halo around point of contact -a pneumothorax or pneumomediastinum will cause the entire hemithorax to light up (LARGE HALO) Dubowitz Method - -assessment of gestation age - >40 = post term (meconium) - <40 = pre term (IRDS) New Ballard Score (NBS) - -modification of dubowitz -score of 40 = 40 weeks Pre and post ductal blood gas - -R to L shunt across ductus arteriousus, PaO2 from preductal(right arm) often exceeds PaO2 from post-ductal(umbilical or legs) -pre ductal is 15 torr higher than post ductal = PDA w/ R to L shunt -echocardiogram recommended Capnography - -PaCO2 = 40 torr/PetCO2 = 30 torr -increase in PECO = decreased ventilation (vent failure) -decrease in PECO = increase in ventilation (PE, hypovolemia) -low petco2 after intubation = esophagus -during CPR, PETCO would increase Transcuataneous Monitoring - PO2 and PCO2 measurement -heat to 43-45 °C -correlates well with arterial values as long as perfusion is adequate Pressure Transducer - -if transducer is above the catheter, readings are LOWER -if transducer is below the catheter, readings are HIGHER Hemodynamics - Swan-Ganz Catheter - -When the balloon is inflated, the catheter will WEDGE and the back pressure from the pulmonary capillary will be measured -measuring PAP = balloon deflated -double spike (dicrotic notch) is normal for PAP -Pressure Dampening = obstructed catheter (blood clot, bubble, kink) -if a blood clot occurs: ASPIRATE-FLUSH-ROTATE catheter Oropharyngeal Airway - -UNCONSCIOUS PATIENT -supports base of tongue -Bite block -facilitate oral suctioning -should be left unsecured -gagging: remove-suction-oxygen Nasopharygeal Airway - -CONSCIOUS PATIENT -supports base of tongue -facilitate deep tracheal suctioning -decrease trauma during NT suctioning -increased airway resistance (USE LARGEST SIZE) -inserted anatomically shaped with lubricant NARCAN - -Narcan - Narcotic overdose -Atropine - Bradycardia -Valium/Versed - Sedatio [Show More]

Last updated: 7 months ago

Preview 1 out of 33 pages

Reviews( 0 )

Recommended For You

 *NURSING> QUESTIONS & ANSWERS > NHA CCMA, Questions with accurate answers, Graded A+. 2022/2023. (All)

NHA CCMA, Questions with accurate answers, Graded A+. 2022/2023.

NHA CCMA, Questions with accurate answers, Graded A+. 2022/2023. CC - ✔✔Chief Complaint Segment - ✔✔Line between two wave forms P-wave - ✔✔Atrial Depolarization How many 1mm boxes are in...

By bundleHub Solution guider , Uploaded: Sep 19, 2022


 *NURSING> QUESTIONS & ANSWERS > Med Admin 1 ATI questions and answers with rationale (All)

Med Admin 1 ATI questions and answers with rationale

Med Admin 1 ATI questions and answers with rationale With which route of drug administration are there no barriers to absorption? - - Intravenous * The definition of absorption is the movement of...

By Professor Lynne , Uploaded: Aug 09, 2022


 *NURSING> QUESTIONS & ANSWERS > Critical Care Nursing Ch 13 All answers 100% correct aid grade ‘A’ (All)

Critical Care Nursing Ch 13 All answers 100% correct aid grade ‘A’

1. The nurse admits a patient to the critical care unit following a motorcycle crash. Assessment findings by the nurse include blood pressure 100/50 mm Hg, heart rate 58 beats/min, respiratory rate 30...

By Allan100 , Uploaded: Mar 23, 2021


 *NURSING> QUESTIONS & ANSWERS > NR 509 Final Exam Q&A With Complete Solution(100% VERIFIED) (All)

NR 509 Final Exam Q&A With Complete Solution(100% VERIFIED)

NR 509 Final Exam Q&A With Complete Solution(100% VERIFIED) Appendicitis Correct Answer- 1. McBurney point tenderness 2. Rovsing sign 3. the psoas sign 4. the obturator sign --Appendicitis is tw...

By Excel , Uploaded: Jul 13, 2022


 *NURSING> QUESTIONS & ANSWERS > ATLS Written Review Latest 2021 Graded A (All)

ATLS Written Review Latest 2021 Graded A

ATLS Written Review Latest 2021 Graded A What is the primary goal of treating TBI? How is this done? Correct Answer- preventing secondary brain injury. This is done by maintaining blood pressure and...

By Alphascore , Uploaded: Dec 05, 2022


 *NURSING> QUESTIONS & ANSWERS > NR 509 Advanced physical assessment -Final examination with complete solution (100% guaranteed A+) (All)

NR 509 Advanced physical assessment -Final examination with complete solution (100% guaranteed A+)

NR 509 Advanced physical assessment -Final examination with complete solution (100% guaranteed A+) A 37-year-old nurse comes for evaluation of colicky right upper quadrant abdominal pain. The pain i...

By Excel , Uploaded: Jul 13, 2022





By Gabjay , Uploaded: Nov 15, 2022


 *NURSING> QUESTIONS & ANSWERS > Evidence Base Practice Midterm Exam, Questions and answers, Questions and answers, 2022/2023 (All)

Evidence Base Practice Midterm Exam, Questions and answers, Questions and answers, 2022/2023

Evidence Base Practice Midterm Exam, Questions and answers, Questions and answers, 2022/2023 The nurse is functioning in what role when he uses systematic inquiry to develop evidence about issu...

By Topmark , Uploaded: Oct 10, 2022




CPT TEST 2022/ CPT FINAL EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS 1) Which of the following blood specimen tests are photosensitive and should be protected from light during handling and...

By bundleHub Solution guider , Uploaded: Sep 11, 2022





By luzlinkuz , Uploaded: Aug 20, 2022



Add to cart

Instant download

Can't find what you want? Try our AI powered Search



Document information

Connected school, study & course

About the document

Uploaded On

May 05, 2023

Number of pages


Written in


bundleHub Solution guider

Member since 1 year

279 Documents Sold

Additional information

This document has been written for:


May 05, 2023





Document Keyword Tags


Avoid resits and achieve higher grades with the best study guides, textbook notes, and class notes written by your fellow students

custom preview

Avoid examination resits

Your fellow students know the appropriate material to use to deliver high quality content. With this great service and assistance from fellow students, you can become well prepared and avoid having to resits exams.

custom preview

Get the best grades

Your fellow student knows the best materials to research on and use. This guarantee you the best grades in your examination. Your fellow students use high quality materials, textbooks and notes to ensure high quality

custom preview

Earn from your notes

Get paid by selling your notes and study materials to other students. Earn alot of cash and help other students in study by providing them with appropriate and high quality study materials.


What is Browsegrades

In Browsegrades, a student can earn by offering help to other student. Students can help other students with materials by upploading their notes and earn money.

We are here to help

We're available through e-mail, Twitter, Facebook, and live chat.
 Questions? Leave a message!

Follow us on
Useful links
  • Courses
  • Categories
  • We accept

    payment cards

    Copyright © Browsegrades · High quality services·