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FULL REVIEW CRT/RRT (NBRC) exam
with verified answers
Ascites |- |VERIFIED |ANSWERS |✔accumulation |of |fluid |in |the |abdomen |caused |by |LIVER |FAILURE Venous |distention |- |VERIFIED |ANSWERS |✔-occurs |with |CHF -seen |with |obstructive |patients |(seen |in |exhalation |phase) Capillary |refill |- |VERIFIED |ANSWERS |✔-indication |of |peripheral |circulation -Normal |< | 3 |seconds Jaundice |skin |color |- |VERIFIED |ANSWERS |✔-increase |in |bilirubin. | -mostly |in |face |and |trunk Bradypnea |(oligopnea) |- |VERIFIED |ANSWERS |✔-decreased |respiratory |rate |(<12bpm) |variable |depth |and |irregular |rhythm Hyperpnea |- |VERIFIED |ANSWERS |✔-increased |rate, |depth, |with |regular |rhythm Cheyne-Stokes |- |VERIFIED |ANSWERS |✔-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 |- |VERIFIED |ANSWERS |✔-increased |rate |and |depth |with |irregular |periods |of |apnea -CNS |problem, |head/brain |injury
Kussmaul's |- |VERIFIED |ANSWERS |✔-increased |rate, |depth, |irregular |rhythm, |breathing |sounds | labored -Raspy |voice Apneustic |- |VERIFIED |ANSWERS |✔prolonged |gasping |inspiration |followed |by |extremely |short, | insufficient |expiration -respiratory |center |problems, |trauma, |tumor cachectic |- |VERIFIED |ANSWERS |✔muscle |atrophy/loss |of |muscle |tone retractions |- |VERIFIED |ANSWERS |✔-chest |moves |inward |during |inspiratory |efforts |instead |of | outward -blocked |airway |in |adults |= |INTUBATE -RDS |in |infants Character |of |cough |- |VERIFIED |ANSWERS |✔-dry, |non-productive |cough |may |indicate |tumor |in |the | lungs |or |asthma -productive |cough |may |indicate |infection evidence |of |difficult |airway |- |VERIFIED |ANSWERS |✔-short |receding |mandible |(chin) -enlarged |tongue |(macroglossia) -bull |neck -limited |neck |range-of-motion pulsus |paradoxus |- |VERIFIED |ANSWERS |✔-pulse/blood |pressure |varies |with |respiration. |may | indicate |severe |air |trapping |(status |asthmaticus |or |cardiac |tamponade) tactile |fremitus |- |VERIFIED |ANSWERS |✔-vibrations |felt |by |hand |on |chest |wall -vocal |fremitus: |voice |vibrations |on |the |chest |wall
Bronchophony |/ |whisphered |pectoriloquy |- |VERIFIED |ANSWERS |✔-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 |- |VERIFIED |ANSWERS |✔-crackles | -secretions/fluid Coarse |rales |- |VERIFIED |ANSWERS |✔-rhonchi -LARGE |airway |secretions -needs |suctioning medium |rales |- |VERIFIED |ANSWERS |✔-middle |airway |secretions -needs |CPT Fine |rales |- |VERIFIED |ANSWERS |✔-fluid |in |alveoli -CHF, |pulmonary |edema -IPPB, |heart |drugs, |diuretics |and |O Wheeze |- |VERIFIED |ANSWERS |✔-due |to |bronchospasm -bronchodilator |Tx -unilateral |wheeze |indicative |of |a |foreign |body |obstruction stridor |- |VERIFIED |ANSWERS |**✔-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 |- |VERIFIED |ANSWERS |✔-coarse |grating |or |crunching |sound -visceral |and |parietal |pleura |rubbing |together -associated |with |TB, |pneumonia, |pulmonary |infarction, |cancer -steroids |and |antibiotics Heart |Sound |S₁ |- |VERIFIED |ANSWERS |✔-closure |of |the |mitral |and |tricuspid |valves |at |the |beginning | of |ventricular |contraction Heart |Sound |S₂ |- |VERIFIED |ANSWERS |✔-closure |of |pulmonic |and |aortic |valves -occurs |when |systole |ends; |ventricles |relax Heart |Sound |S₃ |- |VERIFIED |ANSWERS |✔-abnormal |and |may |suggest |CHF Heart |Sound |S₄ |- |VERIFIED |ANSWERS |✔-abnormal |and |indicative |of |cardiac |abnormality |such |as | myocardial |infarction |or |cardiomegaly Heart |murmurs |- |VERIFIED |ANSWERS |✔-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 |- |VERIFIED |ANSWERS |✔-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 |- |VERIFIED |ANSWERS |✔-systolic |and |diastolic |pressures -sphygmomanometer |to |measure |cuff |pressures -↑BP |= |cardiac |stress |= |hypoxemia -↓BP |= |poor |perfusion |= |hypovolemia, |CHF
Croup |(laryngotracheobronchitis) |- |VERIFIED |ANSWERS |✔-viral |disorder -narrowing |subglottic |swelling -steeple/picket |fence/pencil |sign -gradual |onset -infants -Mist |tent, |O2, |Racemic |epi, |corticosteroids -barking |cough Epiglottitis |- |VERIFIED |ANSWERS |✔-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) |- |VERIFIED |ANSWERS |✔-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) |- |VERIFIED |ANSWERS |✔-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 |- |VERIFIED |ANSWERS |**✔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) |- |VERIFIED |ANSWERS |✔-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) |- |VERIFIED |ANSWERS |✔-for |determining |cancer, |brain | disorders |and |heart |disease -injected |with |radioactive |substance bronchography |(bronchogram) |- |VERIFIED |ANSWERS |✔-injection |of |radio-opaque |contrast |into | tracheobronchial |tree -study |of |OBSTRUCTING |LESIONS |(tumors) |and |BRONCHIECTASIS -better |administration |of |postural |drainage Electroencephalography |(EEG) |- |VERIFIED |ANSWERS |✔-measures |electrical |activity |in |the |brain -brain |tumors, |traumatic |brain |injuries, |retardation, |loss |of |brain |function, |epilepsy/seizures, | -EVALUATION |OF |SLEEP |DISORDERS Pulmonary |Angiography |- |VERIFIED |ANSWERS |**✔-most |definitive |for |DX |of |pulmonary |embolism -pressures |in |cardiac |chambers |can |be |measured
Cerebral |Perfusion |Pressure |(CPP) |- |VERIFIED |ANSWERS |✔-Pressure |gradient |that |determines | cerebral |perfusion -CPP |= |MAP |- |ICP -Normal |Value | 70 |- | 90 |mmHg Exhaled |Nitric |Oxide |(NIOX) |Testing |- |VERIFIED |ANSWERS |✔-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 |- |VERIFIED |ANSWERS |✔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 |- |VERIFIED |ANSWERS |✔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 |- |VERIFIED |ANSWERS |**✔-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 |- |VERIFIED |ANSWERS |✔-Ventilation -Oxygenation -Circulation -Perfusion Signs |- |VERIFIED |ANSWERS |✔-Objective |information -things |that |can |be |seen |or |measured Symptoms |- |VERIFIED |ANSWERS |✔-subjective |information -things |that |the |patient |must |tell |you Respiratory |care |orders |- |VERIFIED |ANSWERS |✔-type |of |treatment -frequency -medication |dosage |and |dilution -physician |signature CALL |MD |IF |MISSING CVP |abnormalities |- |VERIFIED |ANSWERS |✔-decreased |CVP |= |hypovolemia -increased |CVP |= |hypervolemia Katz |ADL |- |VERIFIED |ANSWERS |✔-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
Ventricular |Fibrillation |(V-Fib) |- |VERIFIED |ANSWERS |✔ Asystole |- |VERIFIED |ANSWERS |✔ 1st |Degree |AV |Block |- |VERIFIED |ANSWERS |✔ 2nd |Degree |AV |Block |- |VERIFIED |ANSWERS |✔ 3rd |Degree |AV |Block |- |VERIFIED |ANSWERS |✔ Ischemia |- |VERIFIED |ANSWERS |✔-reduced |blood |flow |to |tissue -indicated |by |a |depressed |or |inverted |T-WAVE Injury |- |VERIFIED |ANSWERS |✔-indicated |by |an |elevated |ST |segment Infarction |- |VERIFIED |ANSWERS |✔-diagnosed |by |significant |Q |waves APGAR |Score |- |VERIFIED |ANSWERS |✔-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 |- |VERIFIED |ANSWERS |✔-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 |- |VERIFIED |ANSWERS |**✔-assessment |of |gestation |age
- |>40 |= |post |term |(meconium)
- |<40 |= |pre |term |(IRDS)
New |Ballard |Score |(NBS) |- |VERIFIED |ANSWERS |✔-modification |of |dubowitz -score |of | 40 |= | 40 |weeks Pre |and |post |ductal |blood |gas |- |VERIFIED |ANSWERS |✔-R |to |L |shunt |across |ductus |arteriousus, |PaO |from |pre-ductal(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 |- |VERIFIED |ANSWERS |✔-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 |- |VERIFIED |ANSWERS |✔PO2 |and |PCO2 |measurement -heat |to |43-45 |°C -correlates |well |with |arterial |values |as |long |as |perfusion |is |adequate Pressure |Transducer |- |VERIFIED |ANSWERS |✔-if |transducer |is |above |the |catheter, |readings |are | LOWER -if |transducer |is |below |the |catheter, |readings |are |HIGHER Hemodynamics |- |VERIFIED |ANSWERS |✔ Swan-Ganz |Catheter |- |VERIFIED |ANSWERS |**✔-When |the |balloon |is |inflated, |the |catheter |will |WEDGE |and |the |back |pressure |from |the |pulmonary |capillary |will |be |measured -measuring |PAP |= |balloon |deflated
- |>20 |- |artery |- |necrosis -Low |pressure, |high |volume, |high |compliance, |floppy |cuff |is |preferred Cricoid |Pressure |- |VERIFIED |ANSWERS |✔-Sellick |maneuver -indicated |if |larynx |is |in |an |anterior |location Assessment |of |Tube |Position |- |VERIFIED |ANSWERS |✔- |Inspect |for |bilateral |chest |expansion
- |Ausculate |for |bilateral |breath |sounds
- |Capnography |or |CO2 |detectors
- |Chest |X-ray |2cm |or | 1 |inch |above |carina |or |at |aortic |knob/notch Laryngoscope |- |VERIFIED |ANSWERS |✔-mac: |into |vallecula, |indirectly |raises |epiglottis -miller: |directly |under |and |lifts |the |epiglottis |(infants) -tighten |bulb, |check |handle |attachment, |change |blade, |check |batteries Stylet |- |VERIFIED |ANSWERS |✔-recessed | 1 |cm |above |tip |of |ET |tube Laryngoscope |Blade |Sizes |- |VERIFIED |ANSWERS |✔Adult: | 3 Pediatric: | 2 Term |infant: | 1 Pre-term |infant: | 0 ET |Tube |Size |- |VERIFIED |ANSWERS |✔pre-term: |2.5 |- | 3 Full |term: |3.0 |- |3. Adult: |wt |in |kg |/ | 10 Adult |male: | 8 |- | 9 Adult |female: | 7 |- | 8
Tube |Markings |- |VERIFIED |ANSWERS |✔Oral |Intubation: |21-25 |cm |mark |at |patient's |lips Nasal |intubation |26-29 |cm |mark |at |patient's |nares Double-Lumen |ET |tube |- |VERIFIED |ANSWERS |✔-Endobronchial/Carlen's |tube -can |ventilate |one |lung |separately -two |cuffs: |distal |cuff |is |high |pressure, |low |volume |for |mainstem |bronchus |tube -during |pneumonectomies, |lobectomies -for |bronchopleural |fistulas |etc Esophageal |Tracheal |Combitube |- |VERIFIED |ANSWERS |✔-for |emergency |airway |management -if |placed |in |trachea, |distal |balloon |will |seal |trachea(ET |tube) |and |clear |#2 |is |used |for |ventilation -if |placed |in |esophagus, |distal |balloon |will |occlude |esophagus -ventilation |will |be |provided |through |blue |#2 |longer |tube Laryngeal |Mask |Airway |(LMA) |- |VERIFIED |ANSWERS |✔-positioned |directly |over |trachea | (hypopharynx) -standard |ET |tube |can |be |inserted |directly |through |LMA |into |the |trachea -short |term |ventilation Hi-Lo |Evac |Tubes |- |VERIFIED |ANSWERS |✔-for |Continuous |Aspiration |of |Subglottic |Secretions |(CASS) -continuous |suction |via |separate |pilot |tube |@ | 20 |mmHg -reduce |VAP Extubation |- |VERIFIED |ANSWERS |✔-inspire |deeply -remove |tube |at |PEAK |INSPIRATION |to |prevent |vocal |cord |damage MARKED |distress/stridor |= |reintubate moderate |stridor |= |O2-Cool |Mist-Racemic |epinephrine mild |stridor |= |humidity, |O2, |Racemic |epinephrine
Remove |Bronchopulmonary |Secretions |- |VERIFIED |ANSWERS |✔-remove/improve |mobilization |of | secretions -for |Bronchiectasis |& |CF -not |for |TB, |post-op, |unstable |pulmonary |and |cardiovascular |system Supine |- |VERIFIED |ANSWERS |✔for |post-craniotomy |patients Fowlers, |semi-fowlers, |reverse |trendelenburg |- |VERIFIED |ANSWERS |✔-for |hypoxic, |obese |with | dyspnea, |post-op |abdominal |patients, |and |pulmonary |edema Trendelenburg |- |VERIFIED |ANSWERS |✔-patients |with |very |low |blood |pressure Lateral |fowlers |- |VERIFIED |ANSWERS |✔-for |very |obese |patients |with |air |hunger Lateral |Flat |- |VERIFIED |ANSWERS |✔-best |position |to |prevent |aspiration -if |aspirating, |first |suction |and |then |place |in |opposite |position |for |postural |drainage unilateral |consolidation |- |VERIFIED |ANSWERS |✔-place |the |affected |lung |up |to |allow |it |to |drain |and | to |increase |perfusion |to |the |unaffected |lung -BAD |LUNG |UP, |GOOD |LUNG |DOWN Postural |Drainage |Position |- |VERIFIED |ANSWERS |✔Left |upper |and |right |middle |lobe: | 15 |degrees | and |12-14 |inches |up Lower |lobes: | 30 |degrees |and | 18 |inches |up Chest |Percussion |- |VERIFIED |ANSWERS |**✔-used |in |combination |with |postural |drainage not |for |PE, |pleural |effusion, |tuberculosis |and |untreated |pneumothorax
Positive |Expiratory |Pressure |(PEP) |Therapy |- |VERIFIED |ANSWERS |✔-applying |positive |pressure |using | a |one-way |inspiratory |valve |and |a |one-way |expiratory |resistor -expiratory |pressure |from | 10 |- | 20 |cmH20 |at |mid-exhalation -used |for |15-20 |mins |3-4x/day -improve |secretion |expectoration, |reduce |RV |(decrease |hyperinflation) |and |improve |airway | maintenance |(CF, |pneumonia) -discontinue |if |sinusitis, |epistaxis |or |ear |infection |occurs -inspire |larger |than |normal |VT |and |exhale |actively |but |NOT |forcefully. |exhalation |2-3x |longer |than | inspiration Autogenic |Drainage |- |VERIFIED |ANSWERS |✔-primarily |for |CF |and |bronchiectasis -breathe |at |low |lung |volumes |to |loosen |secretions |from |the |small |airways -helps |to |accumulate |secretions |in |the |middle |airways -during |the |last |stage |the |patient |breathes |at |high |lung |volumes Intrapulmonary |Percussive |Ventilation |- |VERIFIED |ANSWERS |✔-Combination |of |high |frequency |pulse |delivery |(100-250 |cycles/min |of |a |sub-tidal |colume |and |a |dense |aerosol -percussive |effect |of |gas |delivery |improves |ventilation |past |obstructions |in |the |airway |thereby | delivering |more |aerosol |to |the |distal |airways. -Dense |aerosol |delivery |promotes |bronchial |hygiene, |reduces |edema, |and |relieves |bronchospasm |with |the |appropriate |medications -starting |source |pressure |is | 30 |psi Discontinuing |bronchial |hygiene |- |VERIFIED |ANSWERS |✔-clear |breath |sounds |and |x-ray -ambulating |well -strong |cough -afebrile |for | 24 |hours -hazards |occur |(dizziness, |SOB, |cyanosis, |etc.) iatrogenic |hypoxemia |- |VERIFIED |ANSWERS |**✔induced |by |a |physician's |words |or |therapy |(used | especially |of |a |complication |resulting |from |treatment)
