Tina jones respiratory shadow health assessment Review Questions

Review Questions Activity Time: 11 min

If Tina had mentioned that she was just diagnosed with pneumonia, what would you have expected to find during percussion?

 Correct: Dull percussion sounds are expected over the areas of diffuse infiltrate (accumulation of fluid and by products of inflammation) in a patient with pneumonia.
  • Hyperresonance
  • Tympany
  • Resonant
  • Dullness (Correct Response)

If the results of Tina’s pulse oximetry had been 97%, which of the following would have been true?

 Correct: Pulse oximetry measures the percent of hemoglobin molecules that are filled with oxygen. Oxygen-saturated hemoglobin absorbs light wavelengths differently than unsaturated hemoglobin. The oximeter emits a light and reads the extent of wavelength absorption.
  • Partial pressure O2 = 97%
  • Unbound oxygen level = 97%
  • PaO2 = 97%
  • Arterial hemoglobin saturation = 97% (Correct Response)

Suppose that, during your lung exam on Tina, you had heard bronchial breath sounds in the left lower lung posteriorly. What would you have suspected based on this finding?

 Correct: Increased breath sounds are indicative of lung consolidation (fluid-filled alveoli) or pleural effusion (fluid accumulation in the pleural space) because fluid transmits sounds better than air. This finding is usually accompanied by abnormal transmitted voice sounds and increased tactile fremitus.
  • Normal lung exam
  • Atelectasis
  • Fluid filled region of the lung (Correct Response)
  • Narrowed upper airways secondary to asthma

Suppose that while auscultating, you assessed a few scattered expiratory wheezes. Why would this be an expected finding for a patient with Tina’s history?

Student Response: Scattered wheezes are to be expected because of Tina history of asthma. Asthma is a chronic condition in which hyperactive airways become narrowed by recurring inflammation and excess mucus production which results in wheezing.  

Model Note: Scattered wheezes are to be expected because of Tina’s history of asthma. Asthma is a chronic condition in which hyperreactive airways become narrowed by recurring inflammation and excess mucus production which results in wheezing.

When you observe a patient like Tina throughout an exam, there are many ways to determine whether a patient is experiencing respiratory distress. Identify one indicator of respiratory distress that can be assessed through observation alone.

Student Response: The respiratory distress signs includes use of accessory muscles, grunting or wheezing increased respiratory rates, audible respiration’s, sweating, bluish lips and fingernails discoloration, nasal flaring, inability to speak in fullness , chest retractions and tripod body positioning  

Model Note: Observable signs of respiratory distress include accessory muscle use, audible respirations, grunting or wheezing, increased respiratory rate, bluish coloration around the lips or fingernails, nasal flaring, chest retractions, sweating, tripod body positioning, and inability to speak in full sentences.

Describe how you would assess Tina for dyspnea.

Student Response: I would assess her by asking if she is having any shortness of breath or difficulty breathing? if she states so then i would ask what is the onset , environmental or physical factors related to the exacerbation, how long , body positioning, sleep disturbances and relieving factors that she currently use.  

Model Note: Dyspnea is a subjective complaint that must be elicited by asking the patient about her breathing. Ask your patient, “Do you ever have shortness of breath or difficulty breathing?” If dyspnea is detected, be sure to ask about onset, environmental or physical factors related to exacerbations, duration, body positioning, sleep disturbances, and relieving factors.

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