An 81years old female is brought in to the Emergency room by ambulance with complaint of difficulty with breathing. Primary diagnosis Respiratory Failure, Influenza A+..Secondary diagnosis: Home oxygen dependent, Asthma, Diabetes type 11,Hypertension, CHF.Resuscitation status limited treatment. Isolation Status Droplet precautions. Patient is at the risk of fall.Fall prevention protocol in place. No suicidal risk. She has no advance Directive and copy of advance Directive place on the chart. 02 at 4liters NC with Saturation of 94%F.Cpap at night.Transportation method is bed.Impaired skin intergrity due to immobility. Diet strict NPO, Allergy: NKDA. Patient is alert and oriented x2, confuse.InfluenzaA+.Intubated and Extubated, weak coughing, expiratory wheezing Cpap at night while in the hospital. Cadiac Catherization done.Patient uses Oxygen at home.Incontinient of urine. Use Purwick for urination. Purwick changes every twelve hours. Accucheck Q6hours. D545NS at 50ml/ hour while NPO. Dilaudid 1mg IV Q4hours prn severe pain. Zofran 4mg IV Q4hours prn nausea Vomiting. Respiratory treatment Q4hours scheduled +prn.Turn and reposition Q2hours to prevent skin breakdown. Tamiflu as ordered. Questions and Answers.
- The percussion you would expect to hear over the abdomen are as follows.
A.Tympany and dullness.
B.Resonance and Tympany.
C.Dullness and hyperresonance.
D.Tympany and Resonance.
Correct answer A.
2.A murmur like sound heard outside of the heart is called what?.
A.Thrill.
B.Friction.
C.Bruit.
D.None of the above .
Correct Answer C.
3.What are the characteristics of Chronic Obstructive Respiratory Disease?.
A.Smoking,age,family history, prognosis and wheezing.
B.Air trapping, hyperinflation, Increased lung compliance, Obstruction of airways, Increased airways resistance, Decreased Vital Capacity and Increased residual Volume.
C.clinical volume resistance, Increased airways resistance, deep airways Obstruction. D.Squamous cell metaplasia,Airways Increased pressure and exaggerated air movement.
Correct Answer B.
4.Restrictive Respiratory Diseases can be characterized by:
A.Decreased compliance with difficulty moving air in.Breathing is shallow and rapid with alveolar hyperventilation.Restriction can be present in pleural space,thoracic cage,or lung.Chest cage deformities with kyphoscoliosis,pestus excavatum(Congenital Malformation of the chest)Flail Chest.(Compromised Ventilation),Pickwickian syndrome.
B.Excess adipose tissues interfering with chest wall and diaphragmatic excursion,somnolencefrom hypoxema and C02 retention, polycythermia from chronic hypoxia. Decreased oxygen.
C. Oxygenated air,and increased airway.
D.Chonic lung disease.
Correct Answer A.
5.Wheezing is associated with bronchospasm and narrowing of the airways.
A.True.
B.False.
Correct answer A.
6. What is Homan’s sign?.
A. Homan’s sign is positive in a patient with deep vein thrombosis.
B.It is negative in patient with deep vein thrombosis.
C.Homan’s sign usually occurs in the left abdomen.
D.It is right ventricular sounds.
Correct answer A.
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