1. Normal Oral Temp
    98.6 degrees
  2. Normal Rectal Temp
    97.5-100.4 degrees
  3. Causes of increased respiratory rate.
    hyperthermia, acidosis, hypoxemia, anxiety, pain
  4. Causes of reduced respiratory rate.
    hypothermia, alkalosis, hyperoxia, sedation, coma
  5. Components of blood pressure.
    • LV contractility
    • Arterial resistance
    • Blood volume
  6. ECG changes with hyperkalemia.
    • high, peaked T waves
    • depressed ST segments
    • widening QRS complex
    • bradycardia
  7. ECG changes with hypokalemia.
    • flat/inverted T waves
    • depressed ST segments
    • PVC's
    • ventricular fibrillation
  8. Causes of hypokalemia.
    diuretic medications
  9. ECG changes with hyperchloremia.
    • prolonged ST segment
    • prolonged QT interval
  10. ECG changes with hypochloremia.
    • shortened QT interval
    • wide and rounded T waves
  11. Causes of hypernatremia.
    • dehydration
    • vomiting
    • NG Tube drainage
    • diarrhea
  12. Causes of hyponatremia.
    fluid overload
  13. ECG changes with hypercalcemia.
    • shortened QT interval
    • wide, rounded T waves
  14. ECG changes with hypocalcemia.
    • lengthened ST segment
    • lengthened QT interval
  15. Normal Chloride level.
    95-106 mEq/L
  16. Normal Potassium level.
    3.5 - 5.5 mEq/L
  17. Normal Sodium Level.
    135 - 145 mEq/L
  18. Normal Calcium level.
    4.5 - 5.5 mEq/L
  19. Normal Bicarb level.
    22 - 25 mEq/L
  20. Normal Glucose level.
    70-110 mg/100 mL
  21. Significance of increased creatine kinase.
    elevates 4-6 hours after MI.
  22. Significance of increased troponin I and troponin T.
    elevates 2-4 hours after MI
  23. Significance of increased natriuretic peptide.
    seen in CHF.
  24. Normal adult Hemoglobin level.
    13.5 - 18.0 g/100 mL
  25. Normal adult Hematocrit level.
    40% to 54%
  26. Normal adult RBC.
    4.6 - 6.2 million.mL
  27. Definition of polycythemia.
    increased number of circulating erythrocytes
  28. Significance of leukocytosis.
    active bacterial infection is present
  29. Significance of neutrophilia.
    acute, severe bacterial infection is present
  30. Normal adult WBC,
    4500 - 11,000 mm3
  31. Significance of leukopenia.
    acute viral infection
  32. Normal PT value.
    11 - 12.5 seconds
  33. Normal PTT value.
    60 - 70 seconds
  34. Signs of dehydration.
    tachycardia, hypotension, high urine specific gravity, oliguria, low CVP, low PCWP, tenting of skin, slow capillary refill, mental confusion
  35. Signs of fluid overload.
    tachycardia, hypertension, low urine specific gravity, increased urine output, increased CVP, increased PCWP, peripheral edema, pulmonary edema (crackles/rales)
  36. Normal ICP.
    < 10 cm Hg
  37. Inidcations CXR.
    post ETT/Trach intubation, post jugular/subclavian line insertion, post chest tube insertion, hemoptysis, sudden deleterious change in CP condition, suspected pulmonary infarct, suspected pneumothorax, post invasive thoracic procedure
  38. Signs of Pneumothorax.
    sudden chest pain, increase in dyspnea/SOB, absent breath sounds over a lung field, tracheal deviation, shifted heart sounds,asymmetrical chest movement, hyperresonant percussion, sudden increase in peak or plateau pressure (or both), sub-Q emphysema
  39. Indications Upper-airway radiograph.
    aspirated foreign body, laryngeal edema, laryngeal tumor, croup
  40. Indications for Thoracic CT Scan.
    tumor, hematoma, abscess, cyst, pleural effusion, aortic/bascular abnormality, trauma
  41. Indications for MRI Scan.
    imaging of head, spinal cord & surrounding structures, imagin of heart & great vessels, imaging of kidneys, liver & other organs
  42. Indications for PET Scan.
    determining the regional metabolism of heart or brain, measuring the size of an MI, measuring the effects of treatment on a cancerous tumor, determining pulmonary perfusion or ventilation
  43. Indications for perfusion scan.
    pulmonary embolism, tumor or vascular problem, pulmonary hypertension
  44. Indications for ventilation scan.
    airway obstruction, atelectasis
  45. Indications for Lateral CXR.
    visualization behind heart & hemidiaphragms, localize lesions, measure A-P diameter
  46. Indications for Oblique CXR.
    visualization of heart borders, mediastinal structures, hilar structures and lung mases
  47. Indications for Lateral Decubitus CXR.
    visualize fluid within pleural space
  48. Indications for lordotic (apical lordotic) CXR.
    visualzation of upper lung fields, apices, middle lobe & lingula
  49. On CXR, Radiopaque items appear:
  50. On CXR, Radiolucent items appear:
  51. Identification of Pneumothorax on CXR,
    Black area (oneumothorx) surrounding collapsed lung, no lung markings visible in air-filled space, edge of lung can be visualized, lung/structures shifted to opposite side
  52. Mediastinal shifts:
    AWAY from pneumothorax or pleural fluid; TOWARD atelectasis or pulmonary fibrosis
  53. Unilateral elevation of hemidiaphragms:
    seen in atelectasis & pulmonary fibrosis
  54. Unilateral depression of hemidiaphragms:
    pleural fluid, tension pneumothorax, FB obstruction, airway tumor
  55. Bilateral elevation of hemidiaphragms:
    free abdominal fluid
  56. Bilateral depression of hemidiaphragms:
    asthma, COPD
  57. Normal adult Cardiothoracic Ratio:
    < 50%
  58. CXR sign of pleural effusion:
    obscured costophrenic angle & hemidiaphragm
  59. CXR sign of Pulmonary Edema:
    fluffy white infiltrates in either or both lungs, usually more extensive in LL
  60. Asymmetric chest wall movement may indicate:
    pneumothorax or atelectasis
  61. Eupnea
    normal breathing
  62. Normal I:E Ratio
  63. Hypopnea
    shallow breathing
  64. Hyperpnea
    deep breathing
  65. bradypnea
    slow breathing
  66. tachypnea
    fast breathing
  67. Obstructed Inspiration
    Inspiratory time is equal to or greater than expiratory time. Seen in FB Aspiration, postextubation laryngeal edema, croup, epiglotitis
  68. Obstructed Expiration
    Expiratory time is longer than normal. Seen in asthma, COPD, CF, status asthmaticus
  69. Kussmaul's Respiration
    rapid, parge breaths; usually secondary to acidosis from diabetes ketoacidosis
  70. Cheyne-Stokes Respirations
    waning and waxing tidal volumes; associated with head injury, stroke, increased ICP, CHF
  71. Biot's Respiration
    unpredictably variable with periods of apnea; associated with meningitis, head injury, brain tumor, increased ICP
  72. Sputum changes in color from white/yellow to green:
    indicates pneumonia
  73. Green, foul-smelling sputum is indicative of:
    pulmonary abcess
  74. Pink-tinged, frothy, bubbly secretions may indicate:
    pulmonary edema
  75. A thready pulse is indicative of:
    heart disease
  76. A bounding pulse is indicative of:
  77. Atelectasis causes the trachea to shift:
    toward the affected side
  78. Pulmonary fibrosis causes the trachea to shift:
    toward the affected side
  79. Pneumothorax causes the trachea to shift:
    away from the affected side
  80. Hemothorax, pleural effusion & empyema cause the trachea to shift:
    away from the affected side
  81. Decreased vesicular breath sounds may be caused by:
    pleural effusion, hemothorax, empyema, pulmonary fibrosis, emphysema, pleural thickening
  82. Greatly decreased breath sounds may be caused by:
    pneumothorax, severe atelectasis, bronchial intubation, large pleural effusion, obese patient
  83. Unequal vesicular breath sounds may be caused by:
    pneumonia, consolidation, atelectasis, FB, tumor, spinal or thoracic deformity
  84. Characteristics of Wheezing (Rhonchi):
    continuous sounds, more commonly heard on expiration, low pitched commonly associated with secretions in airways, high pitched momphonic expiratory sounds commonly associated with closure of one large airway (?tumor), high pitched polyphonic expiratory sounds associated with closure of many small airways
  85. Characteristics of Crackles (Rales):
    more commonly heard on inspiration; discontinuous poping sounds; early inspiratory crackles are common in asthma, COPD; late inspiratory crackles are common in atelectasis, pneumonia, pulmonary edema or fibrosis
  86. Early inspiratory crackles:
    asthma, COPD
  87. Late inspiratory crackles:
    atelectasis, pneumonia, pulmonary edema, fibrosis
  88. Characteristics of Stridor:
    harsh, monophonic, high-pitched, inspiratory sound, heard over larynx; if inspiratory & expiratory, may be caused by FB
  89. Characteristics of Friction Rub:
    loud, grating, clicking, creaking sound most commonly heard over lower lung areas; not affected by coughing or suctioning; associated with pulmonary infarct, pneumonia, abscess or empyema
  90. S1
    lub sound when mitral & tricuspid valves close
  91. S2
    dub sound when pulmonary and aortic valves close
  92. Gallop Rhythm
    addition of S3 and/or S4 sounds; suggests CHF
  93. A hyperresonant percussion note is indicative of:
  94. APGAR 7-10
  95. APGAR 4-6
  96. APGAR 0-3
  97. Dubowitz Score 35-45
    between 38 & 42 weeks gestation: normal term infant
  98. Dubowitz Score < 35
    preterm infant
  99. Dubowitz Score > 45
    postterm infant
  100. Componants of APGAR Score
    heartrate, respiratory effort, muscle tone, reflex response, color
  101. Siiverman Scoring System
    assesses newborn's level of respiratory distress: 0 = no respiratory distress and 10 = great respiratory distress
  102. Transillumination of Neonatal Chest
    halo sign indicative of pneumothorax
  103. Epiglottitis:
    pediatric emergency: dx on hx & pe: rx = intubation; 2-4 years old, sudden onset, fever, drooling, hazy subglottic neck radiograph, low-pitched stridor, difficulty swallowing, elevated WBC
  104. Croup: Rx
    cool, bland aerosol
  105. Signs: Foreign Body Aspiration
    sudden breathing difficulty, cough, inspiratory stridor
  106. Positive Mantoux Test
    wheal > 10 mm
Card Set