EXIT EXAM, NBRC RRT EXAM ALREADY PASSED

EXIT EXAM, NBRC RRT EXAM ALREADY PASSED Signs ✔✔Things you can see or measure symptoms ✔✔Subjective information (The patient must tell you) Pack years ✔✔Packs per day multiplied by the number of years. Advanced dire ...

EXIT EXAM, NBRC RRT EXAM ALREADY PASSED Signs ✔✔Things you can see or measure symptoms ✔✔Subjective information (The patient must tell you) Pack years ✔✔Packs per day multiplied by the number of years. Advanced directives are? ✔✔documents that provide instructions incase the patient is unable to. These instructions should be notarized and copies given to the family and physician. If a patient has a DNI order you can still? ✔✔Provide non invasive ventilation ( BiPAP) A durable power of attorney allows? ✔✔A person to make decisions for the patient. What is normal urine output? ✔✔40mL per hour or 1 Liter per day. Where does sensible water loss occur? ✔✔Through the urine or vomiting, Diarrhea. Where does insensible water loss occur? ✔✔Through the skin or exhalation. What is normal Central venous pressure? ✔✔2 to 6 mmHg What should you recommend for patients with an elevated CVP? ✔✔Diuretics What should you recommend for a patient with a low CVP? ✔✔Fluids. The abbreviation ADL stands for? ✔✔Activities of daily living. What is Orthopnea? ✔✔Difficulty breathing while laying flat. Often seen in CHF patients. What is general malaise? ✔✔A generalized run down feeling, nauseas, weak, fatigued, headache. Think electrolyte imbalance. What does Dysphagia mean? ✔✔Difficulty swallowing. Why does peripheral edema most commonly occur? ✔✔edema is most likely caused by CHF or renal failure. What is Acites? ✔✔Acites is fluid in the abdomen. Typically caused by liver failure. What causes clubbing of the fingers? ✔✔Chronic hypoxemia. How fast should color return to a finger during a capillary refill test? ✔✔Blood should return in less than 3 seconds. What is Diaphoresis? ✔✔A state of profuse sweating. What is Jaundice? ✔✔A yellowish appearance of the skin caused by increased bilirubin in the blood and tissue. What is Erythema? ✔✔Redness of the skin due from capillary congestion, inflammation, or infection. Cyanosis is caused by? ✔✔Reduced oxyhemoglobin. How much oxyhemoglobin loss is required to cause cyanosis? ✔✔5 Grams. Barrel chest is caused by? ✔✔Air trapping in the lungs for long periods of time. Cheyne stokes respirations ✔✔gradually increasing then decreasing rate and depth with periods of apnea. Biot's respirations ✔✔Increased rate and depth with irregular periods of apnea. Each breath has the same depth. Kussmauls respirations ✔✔Fast and Deep The normal muscles of ventilation are? ✔✔The Diaphragm and external intercostals. Retractions and nasal flaring mean? ✔✔An obstructed airway. What is macroglossia? ✔✔an enlarged tongue. What is the most common cause of tachycardia? ✔✔Hypoxemia. How much change in heart rate signifies an adverse reaction. ✔✔A change of 20bpm indicates an adverse reaction. What is pulsus paradoxus? ✔✔A pulse or blood pressure that varies during respiration. What is tactile fremitus? ✔✔Vibrations that can be felt on the chest wall. Such as rhonchi, pleural rubbing, vocal. What is crepitus? ✔✔Bubbles of air under the skin that can be palpated (Subcutaneous emphysema) A resonant chest percussion is ? ✔✔Normal sound A flat or dull sound during chest percussion indicates? ✔✔Fluid or solid. A tympanic or hyperresonant sound during chest percussion indicates? ✔✔Air in the pleural space. Vesicular breath sounds are? ✔✔Normal breath sounds Adventitious breath sounds are? ✔✔Abnormal breath sounds. If you hear a murmur you should recommend? ✔✔An echocardiogram Hypertension indicates? ✔✔Hypoxemia. Hypotension indicates? ✔✔Hypovolemia, CHF In a normal XRAY the right hemidiaphragm should be? ✔✔Slightly higher than the left. Over exposed xrays will look? ✔✔Dark Underxposed xrays will look? ✔✔White. What is a lateral decubitus xray? ✔✔Having a patient lay on their side for the xray. Helps evaluate fluid or pleural effusions. An ET tube should be positioned how many centimeters above the carina? ✔✔2 to 6 centimeters above the carina. Or at the level of the aortic arch or notch. A lateral neck xray will help determine? ✔✔Croup or Epiglottitis. A steepling on an xray indicates? ✔✔Croup or subglottic swelling. A thumb print on an xray indicates? ✔✔Epiglottitis. The thumb print is caused by supraglottic swelling or swelling of the glottis. A butterfly pattern or batwing pattern on a xray indicates? ✔✔Pulmonary edema. Ground glass on an xray indicates ? ✔✔ARDS Blunting of the costophrenic angles on an xray indicate? ✔✔Pleural effusions or fluid, atelectasis. Air bronchograms on an xray are often seen in what conditions? ✔✔Atelectasis, Pneumonia, ARDS. CT scans should be used to find? ✔✔Tumors or pulmonary emboli.... Not pneumonia. Pneumonia can be seen with what kind of imaging? ✔✔An X ray. Normal Intracranial pressure value is? ✔✔5 to 10 mmHg How does hyperventilating a patient decrease ICP? ✔✔Hyperventilation causes vasoconstriction, temporarily decreases ICP. Normal Red blood cell count? ✔✔5 mill/mm3 Normal Hemoglobin? ✔✔12- 16 g/100 mL blood. Normal Hematocrit is? ✔✔40-50% What is polycythemia? ✔✔An increase in hemoglobin, hematocrit, and RBC. Normal White blood cell range? ✔✔5 to 10 thousand per mm3 Increase white blood cell count is called? and is indicative of? ✔✔Leukocytosis. Indicative of a bacterial infection. A decrease in White blood cell count is called? and is indicative of? ✔✔Leukopenia. Indicative of a viral infection. The two types of neutrophils are? ✔✔Bands and segs Band neutrophils are? ✔✔Immature cells, they increase with a bacterial infection. Band neutrophils increase during a? ✔✔bacterial infection. Segs neutrophils are? ✔✔Mature neutrophils. An increase of Eosinophils are often seen with? ✔✔Asthma patients or allergic reactions. Kidney failure can be evaluated with what tests? ✔✔Creatinine and Blood Urea Nitrogen, (BUN) Yellow sputum is indicative of? ✔✔Bacterial infection, It has white blood cells in it. Green sputum is indicative of? ✔✔Gram negative bacteria (pseudomonas) What type of test is used to evaluate TB? ✔✔Acid fast staining. Normal clotting time is? ✔✔up to six minutes. Normal Troponin levels are? ✔✔Less than 0.1 ng/ mL Brain Natriuretic Peptide (BNP) is associated with? ✔✔Helps determine if the patient's symptoms are the result of CHF or COPD. BUN Levels ✔✔Greater than 300 pg/mL indicate mild heart failure Greater than 600 indicate moderate greater than 900 indicate severe Normal sodium levels are? ✔✔135-145 mEq/L Normal Potassium levels are? ✔✔3.5-4.5 mEq/L Normal Chloride levels are? ✔✔80-100 mEq/L What does a sputum culture identify? ✔✔The type of bacteria present. What does sputum sensitivity identify? ✔✔the type of antibiotics that will kill the bacteria. What are mucoid secretions? ✔✔White/ gray commonly from chronic bronchitis. What causes yellow secretions? ✔✔Yellow is caused by the presence if Eosinophils, or bacterial infection. What causes green secretions? ✔✔Caused by stagnant sputum, gram negative bacteria. Pseudomonas, bronchiectasis Pink frothy sputum is most likely from? ✔✔pulmonary edema. Normal platelet count is ? ✔✔150,000-400,000/mm3 Normal prothrombin time is ? ✔✔12-15 seconds. What is hematuria? ✔✔Blood in the urine, associated with kidney damage. Depressed or inverted T waves indicate? ✔✔Myocardial ischemia. Elevated S-T segment indicates? ✔✔Myocardial injury. Significant Q waves indicate? ✔✔Myocardial infarction. Definition of ischemia? ✔✔Reduced blood flow to the tissue. Normal end tidal CO2 is ? ✔✔30 torr. Normal COHb levels are? ✔✔0-1 % COHb levels of a smoker are? ✔✔2-12 % COHb poisoning levels are? ✔✔>20% What instruments can be used to measure COHb levels? ✔✔CO-oximeter, Multi-wavelength spectrophotometer, Hemoximeter. Transcutaneous monitors are heated to around? ✔✔43-45 degrees Celsius. Hemodynamics refer to? ✔✔Circulation and perfusion Common vasodilators for the treatment of hypertension are? ✔✔ACE inhibitors (Lisinopril, perindopril) Direct vasodilators (Nitroprusside, hydralazine) Normal pulmonary artery pressure is? ✔✔25/8 mmHg Normal CVP pressure is? ✔✔2-6 mmHg Normal right ventricle pressure is? ✔✔25/0mmHg Normal capillary pressure is? ✔✔20mmHg 10mmHg as it leaves the capillary bed and enters venous. Normal pulmonary capillary wedge pressure is? ✔✔About 8mmHg The Mitral (Bicuspid) valve is located? ✔✔The left heart. The Tricuspid valve is located? ✔✔The right heart. Mean arterial pressure forumla ✔✔MAP = (2x diastolic) + systolic / 3 Normal cardiac output is? ✔✔4-8 L/ min. Normal systemic vascular resistance is? ✔✔< 20 mmHg/L/min or 1600 Dynes Normal pulmonary vascular resistance is? ✔✔<2.5 mmHg/L/min or 200 Dynes Acronym for obstructive lung diseases ✔✔CBABE Cystic fibrosis Bronchitis Asthma Bronchiectasis Emphysema To drain AIR from the pleural space, where should the needle or chest tube be placed? ✔✔In the 2nd or 3rd intercostal space Mid-clavicular. To drain FLUID from the pleural space, where should you insert the chest tube? ✔✔In the 4th or 5th intercostal space Mid- Axillary. Thoracentesis means to? ✔✔Drain fluid from the pleural space. The normal Arterial-venous oxygen content difference is? ✔✔4-5 percent volume. What is the formula for Arterial- venous oxygen content difference? ✔✔C(a-v)O2 CaO2-CvO2 What does shunting mean? ✔✔perfusion without ventilation. As arterial-venous oxygen content difference goes up in percent, cardiac output does what? ✔✔Cardiac output goes down. A normal A-a gradient on 100% is what torr? ✔✔25-65 torr An A-a gradient of 66-300 means? ✔✔The patient has a V/Q mismatch An A-a gradient of greater than 300 means? ✔✔The patient has a shunting problem. Normal air to oxygen ration on 40% is? ✔✔3:1 Three parts air one part oxygen The factor is 4.... 3+1 = 4