Download CRT TMC RRT Latest Study Guide with Answers 2025 Graded A+.pdf and more Exams Nursing in PDF only on Docsity!
Answers 202 5 Graded A+
CRT TMC RRT Latest Study Guide with
Answers 2024 - 2025 Graded A+
extra pulmonary air indicates: - ANS
- pneumothorax
- pneumoperitoneum
- pneumomediastinum
- pneumopericardium
- sub cu. emphysema Epiglottitis: - ANS
- above glottis
- confirm with lat. neck cxr; supraglottic narrowing with enlarged flattened epiglottis
- thumb sign Tx: intubate Croup (laryngotracheobronchitis) - ANS infection of upper airway characterized by a barky cough seen in children CXR: tracheal narrowing with subglottic swelling (steeple sign, picket fence, pencil point, hour glass) Treatment: racemic epi and O ETT Placement: - ANS 2 - 6 cm above carina-- level of aortic arch To confirm- first listen to breath sounds, then CXR AP radiograph: - ANS front to back PA radiograph - ANS back to front
Answers 202 5 Graded A+
Lateral radiograph - ANS sides Oblique CXR - ANS standing/diagonal- lesions Lateral decubitus - ANS lying on AFFECTED side-- pleural effusions Apical lordotic - ANS tops of lungs used to confirm TB End exp. image - ANS detect small pnuemos Confirming quality of CXR image - ANS
- clavicles are level
- penetration- vertabrae visible just behind heart
- mediastinum- area between lungs, heart, blood vessels and bronchi are found
- vascular markings Enlarged Heart in CXR - ANS cardiomegaly--- CHF- pericardial effusion Normal CXR - ANS
- hemidiaphragms
- R diaphragm elevated (liver underneath)
- L diaphragm at level of 6 anterior rib
- trachea midline
- bilateral radiolucent appearance
- sharp costophrenic angles
- heart not consuming 50% of picture
Answers 202 5 Graded A+
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alveoli/fluid indicative: CHF, pulm. edema Tx: o2, ppv, inotropic therapy, diuretics Bronchial breath sounds - ANS normal breath sounds over trachea or bronchi vesicular breath sounds - ANS Normal breath sounds made by air moving in and out of the alveoli. percussion - ANS tapping on surface resonant- normal flat/dull- less air tympanic/hyperresonant- high pitch, extra air; COPD crepitus - ANS bubbles of air under the skin typically subcu emphysema Rhonchal fremitus - ANS secretions in the airway pleural rub fremitus - ANS A grating sensation felt on the chest wall due to roughened pleural surfaces rubbing together vocal fremitus - ANS Voice Vibrations on the chest wall. tactile fremitus - ANS vibrations felt on chest wall by hand tracheal deviation: Pushed to normal side -
Answers 202 5 Graded A+
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(away from pathology; outside the lungs)
- pleural effusion
- pneumothorax
- tumor
- mass paradoxical pulse - ANS pulse and BP varies on respiration indicative of severe air trapping ;; status asthmaticus, cardiac tamponade Change in HR > 20 bpm is considered an adverse reaction - ANS Heart Rate - ANS normal- 60 to 100 bpm tachy- >100 bpm; hypoxemia, stress, anxiety (O2) brady <60 bpm; Heart fx, shock, code (atropine) Mallampatti classification: - ANS
- full visibility of tonsils, uvula, soft palate=OPEN
- can see uvula, hard palate, soft palate, and upper portion of tonsils=SOMEWHAT OPEN
- only hard & soft palate and base of vallecula are visible
- only hard palate is visible 1&2 good, 3&4 bad. retractions; - ANS ask yourself, what is going on? retractions in adult are BAD caused by upper airway obstruction/ Resp distress hypertrophy - ANS increase in muscle size
Answers 202 5 Graded A+
- lung resection, pneumonectomy (post)
- atelectasis
- pneumo
- flail chest
- ETT in R or L mainstem bronchus Barrel Chest - ANS Increase in AP diameter COPD patientq Pectus excavatum - ANS sternum sunk in pectus carinatum - ANS pigeon chest; sternum sticking outward scoiliosis - ANS lateral curvature of the spine Kyphosis- - ANS leaning forward cyanosis - ANS blue/gray- hypoxemia from decrease hgb erythema - ANS redness of the skin jaundice - ANS yellow, increased bilirubin, - liver dysfunction ashen/pallor - ANS due to anemia or acute blood loss
Answers 202 5 Graded A+
diaphoresis - ANS profuse heavy sweating A- heart failure (diuretics, poss. inotropic agents) B- fever, infection (antibx) C- anxiety, nervousness (sedative) D- TB (anti tb agents) venous distention - ANS caused by heart failure clubbing - ANS chronic hypoxemia ascites - ANS abnormal accumulation of fluid in the abdomen caused by liver failure edema - ANS swelling from fluid peripheral edema - ANS The swelling of tissues, usually in the lower limbs, due to the accumulation of fluids. Grades of dyspnea - ANS 1 - dyspnea after usual exertion 2 - breathless after going up hill or stairs 3 - dyspnea while walking normal speed 4 - dyspnea slowly walking short distances 5 - dyspnea at rest, shaving, dressing general malaise - ANS Run down feeling, nausea, weakness, fatigue, headache indicative- electrolyte imbalance
Answers 202 5 Graded A+
sensible water loss - ANS can be measured (vomit and urine) normal urine output - ANS 40 mL/hr (approximately 1 Liter/day) tobacco use equation - ANS pack year= # of pack per day * # of yrs. smoked subjective signs/symptoms - ANS patient must tell you objective signs/symptoms - ANS what you can see and measure first issue to cause tachycardia - ANS low O Strong and bounding pulse - ANS = hypoxic weak and thready- Heart fx. 4 life functions: - ANS Ventilation- VT, RR, chest movement, BS, Paco Oxygenation- HR, color, sensorium, pao2, spo Circulation- HR, strength, CO Perfusion- BP, sensorium, temp, urine output Feco testing - ANS
Answers 202 5 Graded A+
heavy smoker >20 ppm (5 min later) Moderate smoker- 11 - 20 ppm (5 min later) Light smoker- 7 - 10 ppm Non-smoker <7 ppm Exhaled nitric oxide (FEno) testing - ANS inflammation- response to steroids --asthma, COPD, CF pt's Tx for elevated ICP - ANS
20 Mmhg --HYPERVENTILATE- Co2= 25- 30 stop after 48 hr.
- avoid moving/turning head
- HOB- 30 degree
- mannitol and hypertonic saline ICP - ANS 5 - 10 mmhg pulmonary angiography - ANS risky! only do if other tests are inconclusive V/Q scan - ANS ventilation-perfusion scan detects PE (good ventilation, poor perfusion) MRI - ANS magnetic resonance imaging; useful in detecting anuerysms USE NON FERRATOUS (no metal) TUBING AND VALVES CT scan - ANS shows specific parts of body in slices
Answers 202 5 Graded A+
Pulmonary edema CXR - ANS
- fluffy infiltrate
- butterfly or batwing appearance TX: diuretics, digitalis, O opaque - ANS fluid, solid-- consolidation diffuse- CXR - ANS spread throughout (atelectasis) Hyperlucency means? - ANS Extra pulmonary air COPD, asthma attack, pneumothorax Consolidation means? - ANS Solid white area Pneumonia/pleural effusion Infiltrate means? - ANS any ill-defined radio density (atelectasis) Radiodensity means? - ANS white pattern, solid-fluid, normal for bones and organs radiolucent means? - ANS normal- dark pattern- air Mantoux test - ANS TB test
Answers 202 5 Graded A+
BNP values - ANS normal- <100 pg/l/ml
300- mild heart failure 600 moderate heart failure 900 severe heart failure recommend--- diuretics, +inotropic agents (digitalis, digoxin) troponin - ANS 0.1 mg/mL TX OMAN- oxygen, morphine, nitrogylcerin, aspirin APTT -
ANS activated partial thromboplastin time 24 - 32 seconds --monitor heparin therapy Acid fast stain - ANS TB Gram Stain takes - ANS 1 hour senstivity takes: - ANS 48 - 72 hr tells what antibx will kill bacteria sputum culture takes: - ANS 48 - 72 hours green stagnant sputum - ANS gram - ; bronchiectasis, pseudomonas
Answers 202 5 Graded A+
high- kidney fx, spiked t-wave, met acid. monocytes - ANS WBC associated with TB 3% of WBC Eisenophils - ANS WBC associated with allergic reaction;; think asthmatic 2% of WBC Neutrophils - ANS WBC- major bands-- babies 4 % of cells. increased = bacterial segs-- mature 60% of cells. decrease bacerial. WBC value - ANS 50,000-10,000 per mm increased; leukocytosis (bacterial) decreased; leukopenia (viral) Hematocrit (hct) - ANS % of RBC in blood volume 40 - 50% Normal hemoglobin - ANS 12 - 16 g/dL low= anemia high=polycythemia !!!* by 3 to get hematocrit value Normal RBC - ANS 4 - 6 mill/mm low=anemia
Answers 202 5 Graded A+
high=polycythemia; occurs with chronic tissue hypoxemia (copd) hb and hct= exact same Look at heart rhythm strips! - ANS Know ECG placement - ANS V1- 4th IC space R side of sternum (R heart) V2- 4th IC space L side of sternum (L heart) V3- between V2&V4 on L side V4-5th IC space L midclavicular line V5-between v4&v6 on L side V6- 5 IC space midaxillary line Calculating HR on ECG - ANS HR= 300 / # of lg boxes between R waves Axis of heart - ANS down and to the left electrocardiogram also known as - ANS oscilloscope Infarct- - ANS tissue death Ischemia - ANS lack of blood supply (shows inverted t-wave) HEART attack; tx- MONA APGAR Scoring - ANS A-appearance P-pulse
Answers 202 5 Graded A+
L/S ratio - ANS lethicin/sphingomyellin 2:1 or higher is good ratio < 2:1 indicates high risk of HMD/ IRDS Preductal Pao2- - ANS 15 torr higher than post ductal (umbillical artery) = PDA Blood glucose for infant - ANS
30 mg/dL premature- >20 mg/dL Dubowitz Score - ANS 40 = 40 weeks. Uses clinical signs to determine correct gestational age Silverman Score - ANS 0 - 10 the higher the score, the greater the distress birth wt - ANS term >3000 grams 28 wk- 1000 grams BP for infant - ANS 60/ preterm- 50/ Respiration in infant - ANS 30 - 60 resp. pause- 5 - 10 sec is normal 10 - 20 sec may be normal 20 never normal HR term infant -
Answers 202 5 Graded A+
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tachy> 170 brady < Normal temp in infant - ANS 36.5 C Transillumination - ANS Recommended when a pneumo may be present. entire hemothorax will light up if pneumo is present APGAR score 0- 3 - ANS resuscitate APGAR score 4- 6 - ANS support, stimulate, warm, administer O APGAR score 7- 10 - ANS routine care
