-
-
the right hemidiaphragm is slightly
higher than the left
the right has the liver
-
right hemidiaphragm is at the level of the
sixth aterior rib
-
trachea is midline, bilateral radiolucency with
sharp costophrenic angles
-
head of clavicles should be
level
-
trachea is seen as a
dark are midline
-
area btwn the lungs where the heart, lymphatics, blood vessels and major bronchi are found
mediastinum
-
a-p diameter is increased with
- COPD
- barrel chest
- hyperinflation
-
flat diaphragm means
COPD
-
vascular markings are
- blood vessels
- lymphatics
- lung tissue
(white area)
-
where is the film located with AP projection
film behind back
-
where is the film located with PA projection
film touching the chest with the back to xray
-
lateral decubitus position is valuable for detecting
small pl effusions
-
the tip of the ETT should be positioned below the vocal cords and no closer than
2cm or 1inch above the carina
-
what is the quickest way to determine adequate ventilation once the ETT is in
- observation
- auscultation
- cxr
-
diagnostic tool for identifying an upper airway obstruction in children with coup or epiglottitis
later neck xray
-
viral disorder common in infants and young children
croup
-
xray of the neck will reveal tracheal narrowing w/ subglottic in a pattern:
- steeple sign
- picket fence sign
- pencil point sign
-
bacterial infection is
epiglottitis
-
lateral neck xray will reveal
thumb sign
-
xray through a specificplane of the body part to be examined. images appear as narrow slices of the organ or body part
computerized tomography CT
-
spiral CT scan with contrast dye may be used for the diagnose of
pulm embolism
-
determines the precise position of tumors and the involvement of surrounding structures
magnetic resonance imaging (MRI)
-
v/q scan- if the results indicate a normal ventilation scan but abnormal perfusion scan=
pulm emboli
-
perform and diagnose of abnormalities in the hypopharynx, esophagus, or stomach
barium swallow
-
determines the presence of cancer, brain disorders and heart disease
PET scan
-
by outlining the airways it will allow study of obstructing lesions (tumors) and bronchiectasis (main indication)
bronchography (bronchograms)
-
electroencephalography EEG is an indication of
- brain tumors
- epilepsy/seizures
- sleep disorder
-
pulmonary angriography is a definitive test for diagnosing a
pulm embolism
-
noninvasive method for monitoring cardiac performance
ultrasonography of the heart (echocardiogram)
-
monitoring that is performed to track the dynamics inside the skull such as volume pressure relationships, pressure waves, and cerebral perfusion pressures
intracranial pressure monitoring
-
normal value for ICP
5-10 mmHg
-
most researchers recommend initiating treatment if ICP
>20 mmHg
-
pt should be hyperventilated until the paCo2 is
25-30 torr
-
FEno
exhaled Nitric oxide NIOX testing
-
a decrease in FEno suggests a decrease in
airway inflammation
-
measurement of all major ingredients of the blood
CBC
-
RBC normal value
4-6 mill/mn
-
high RBC (polycythemia) occurs with
chronic tissue hypoxemia (COPD)
-
low RBC (anemia) occurs with
blood loss, hemorrhage
-
-
hemoglobin normal value
12-16 gm/100 ml blood
(THINK 15)
-
hematocrit normal value
40-50%
(THINK 45)
-
-
-
WBC are used by the body to fight
infections
-
WBC normal value
5,000-10,000 per mm
-
increased WBC
leukocytosis=bacterial infection
-
decreased WBC
leukopenia=viral infection
-
to treat high WBC you should give
antibiotics-penicillin
-
-
electrolytes elements required by the body for normal
metabolism
-
electrolytes is closely associated with
- fluid levels
- kidney function
-
clinical application of electrolyte imbalance
- muscle weakness
- soreness
- nausea
- mental changes/lethargic/dizziness/drowsiness
-
normal value of K
3.5-4.5
(think 35-45)
-
-
if pt whines and complains give
K
-
major INTRAcellular cation
K
-
normal value Na
135-145
(just put 1 in front over K)
-
major EXTRAcellular cation controlled by kidneys
Na
-
normal range of Cl
80-100
-
normal range of HCO3
22-26
-
creatine is excreted by the
kidneys
-
BUN evaluates
kidney function
-
-
yellow sputum
presence of WBC, bacterial infection
(WBC= allergic response)
-
green sputum
gram negative bacteria
-
brown/dark sputum
old blood
-
bright red sputum
hemoptysis (bleeding tumor, TB)
-
-
identify the bacteria is present
sputum culture
-
identify what antibiotics will kill the bacteria
sensitivity
-
identify whether it is gram positive or gram neg
gram stain
-
identify mycobacterium TB
acid fast stain
-
used for monitoring heparin therapy (blood thinner)
activated partial thromboplastin time APTT
-
used for monitoring Warfarin (coumadin) therapy
prothrombin time PT
-
reflects metabolic status of patient and is a screening test for kidney disease
urinalysis
-
urinalysis can indicate
urinary tract infection before blood culture results
-
visual image of the electrical activity of the heart on a screen
oscilloscope
-
instrument used for recording the electrical activity of the heart
electrocardiograph
-
portable version of an electrocardiograph that is worn under the clothes by the pt for a 24-48 hr period to detect cardiac arrhythmias
holter monitor
-
the electrical impulse is generated by which node
SA node (pacemaker)
-
the wave of depolarization moves through
atria causing contraction (p wave)
-
the impulse is received by the AV node where it is delayed for a shore time is which interval
P-R interval
-
the stimulus is sent through the
bundle of his and the bundle branches to the perkinjie fibers
-
the heart repolarizes at which wave
T wave
-
an object placed on the skin to conduct electric current from the body to a monitoring or measuring device
electrode
-
a positive and a negative electrode that allows electrical current to flow
lead
-
best picture for QRS complex
lead II
-
V1 4th intercostal space is located on
right side of sternum
-
V2 4th intercostal space on
left side of sternum
-
V4 5th intercostal space,
left mid-clavicular line
-
V6 5th intercostal space,
lest mid axillary line
-
sinus tachycardio common cause is
hypoxemia treat with oxy
-
treat sinus bradycardia with
- oxygen
- atropine (increase hr)
-
premature ventricular contraction PVC treat with
lidocaine
-
v-tach with pulse treat with
-
v-tach with no pulse treat with
defibrillate
-
v-fib (always pulseless) treat with
defibrillate
-
-
axis of an ECH measures the net direction of all the electricity through the heart during
contraction
-
the normal asix is in a direction of
down and to the left
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