NSER 7110 Exam with Complete
Solutions
Red flags for airway - ANS-- unable to complete sentences
- audible wheezing
- needs to sit in high fowlers or tripod
Red flags for breathing - ANS-- Pale
- increased RR
- increased WOB
- decreased O2 sat
- wheezes and lung sounds
Red flags for circulation - ANS-- irregular, fast pulse
- skin colour and temp
peripheral cyanosis - ANS-results from peripheral vasoconstriction, reduced cardiac
output or vascular occlusion
central cyanosis - ANS-occurs when there is an increased amount of hemoglobin not
bound to oxygen and is best assessed by observed the oral mucosa, lips, and tongue
vesicular breath sounds - ANS-soft, fine, breezy, low-pitched sounds when air flows in
alveoli and small bronchioles; heard on inspiration and continue without pause through
to 1/3 of expiration
bronchovesicular breath sounds - ANS-heard in expiration and inspiration
moderate in intensity and pitch and are located over major bronchi where fewer alveoli
are located
bronchial breath sounds - ANS-loud and high pitched and are heard around trachea and
larynx
crackles (rales) - ANS-clicking sounds heard during inspiration caused by the opening
of closed small airways during inspiration
often heard in bronchitis, bronchiectasis and pulmonary edema and fibrosis
wheezes (Rhonchi) - ANS-caused by flow through narrowed airways
causes of narrowing including bronchoconstriction, mucosal edema, sputum or foreign
bodies
, palpation - ANS-assessment of tracheal position, palpation of thorax, checking for
expansion, tactile fremitus
percussion - ANS-loud sounds indicate air and quieter sounds suggest consolidated
tissue
mild hypoxemia - ANS-60-79 PaO2
moderate hypoxemia - ANS-40-59 PaO2
severe hypoxemia - ANS-PaO2 < 40 mmHg
typical CAP presentation - ANS-sudden onset of fever, productive cough, SOB, signs of
pulmonary consolidation, occasional pleuritic chest pain
atypical CAP presentation - ANS-gradual onset of dry cough, SOB, rales, general
myalgias and fatigue
two factors that determine oxygen supply - ANS-1. arterial oxygen
2. cardiac output
arterial oxygen - ANS-the amount of oxygen that is present in the arterial blood when it
leaves the lungs
cardiac output - ANS-the effectiveness of the pump to circulate blood throughout the
body
% of oxygen delivered - ANS-NP: 1-6L -> 24-44%
SFM: 6-10L -> 50-60
NRB: 12-15L -> 60-100
oxygen demand factors - ANS-Temperature, activity, stressors
Temperature - ANS-an increase in body temp results in an increase cellular demand for
oxygen
same for low body temp --> drop in cellular oxygen demand
Acitivity - ANS-increase in demand for oxygen
lack of activity results in decrease in oxygen demand
emotional stressors - ANS-and increase in emotional stressors increases cellular
oxygen demand
ventilation - ANS-movement of air in and out of the lungs
- primary determinant of arterial o2 content and is influenced by respiratory rate and
tidal volume
Solutions
Red flags for airway - ANS-- unable to complete sentences
- audible wheezing
- needs to sit in high fowlers or tripod
Red flags for breathing - ANS-- Pale
- increased RR
- increased WOB
- decreased O2 sat
- wheezes and lung sounds
Red flags for circulation - ANS-- irregular, fast pulse
- skin colour and temp
peripheral cyanosis - ANS-results from peripheral vasoconstriction, reduced cardiac
output or vascular occlusion
central cyanosis - ANS-occurs when there is an increased amount of hemoglobin not
bound to oxygen and is best assessed by observed the oral mucosa, lips, and tongue
vesicular breath sounds - ANS-soft, fine, breezy, low-pitched sounds when air flows in
alveoli and small bronchioles; heard on inspiration and continue without pause through
to 1/3 of expiration
bronchovesicular breath sounds - ANS-heard in expiration and inspiration
moderate in intensity and pitch and are located over major bronchi where fewer alveoli
are located
bronchial breath sounds - ANS-loud and high pitched and are heard around trachea and
larynx
crackles (rales) - ANS-clicking sounds heard during inspiration caused by the opening
of closed small airways during inspiration
often heard in bronchitis, bronchiectasis and pulmonary edema and fibrosis
wheezes (Rhonchi) - ANS-caused by flow through narrowed airways
causes of narrowing including bronchoconstriction, mucosal edema, sputum or foreign
bodies
, palpation - ANS-assessment of tracheal position, palpation of thorax, checking for
expansion, tactile fremitus
percussion - ANS-loud sounds indicate air and quieter sounds suggest consolidated
tissue
mild hypoxemia - ANS-60-79 PaO2
moderate hypoxemia - ANS-40-59 PaO2
severe hypoxemia - ANS-PaO2 < 40 mmHg
typical CAP presentation - ANS-sudden onset of fever, productive cough, SOB, signs of
pulmonary consolidation, occasional pleuritic chest pain
atypical CAP presentation - ANS-gradual onset of dry cough, SOB, rales, general
myalgias and fatigue
two factors that determine oxygen supply - ANS-1. arterial oxygen
2. cardiac output
arterial oxygen - ANS-the amount of oxygen that is present in the arterial blood when it
leaves the lungs
cardiac output - ANS-the effectiveness of the pump to circulate blood throughout the
body
% of oxygen delivered - ANS-NP: 1-6L -> 24-44%
SFM: 6-10L -> 50-60
NRB: 12-15L -> 60-100
oxygen demand factors - ANS-Temperature, activity, stressors
Temperature - ANS-an increase in body temp results in an increase cellular demand for
oxygen
same for low body temp --> drop in cellular oxygen demand
Acitivity - ANS-increase in demand for oxygen
lack of activity results in decrease in oxygen demand
emotional stressors - ANS-and increase in emotional stressors increases cellular
oxygen demand
ventilation - ANS-movement of air in and out of the lungs
- primary determinant of arterial o2 content and is influenced by respiratory rate and
tidal volume
