Shadow Health Assignments
Shadow Health Tina Jones Respiratory Review Questions
Review Questions Activity Time: 17 min
If Tina had mentioned that she was recently diagnosed with pneumonia, what would you have expected to find during percussion?
Correct: When someone has pneumonia, you would expect to hear dull sounds when you tap their chest. This is because there’s fluid and inflammation in the lungs.
– Hyperresonance
– Tympany
– Resonant
– Dullness (Correct Response)
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If Tina’s pulse oximetry results had been 97%, what would have been true?
Correct: Pulse oximetry tells us how much of the oxygen in our blood is bound to hemoglobin. Hemoglobin with oxygen absorbs light in a certain way, and the oximeter measures this light to give us the oxygen level.
– Partial pressure O2 = 97%
– Unbound oxygen level = 97%
– PaO2 = 97%
– Arterial hemoglobin saturation = 97% (Correct Response)
If, during Tina’s lung exam, you heard bronchial breath sounds in the left lower lung at the back, what might this finding suggest?
Correct: Hearing increased breath sounds could mean there’s fluid-filled lung tissue or fluid in the space around the lungs. Fluid conducts sound better than air. This might come with abnormal voice sounds and increased vibrations felt on the chest.
– Normal lung exam
– Atelectasis
– Fluid-filled lung area (Correct Response)
– Narrowed upper airways due to asthma
If you heard a few scattered expiratory wheezes while listening with a stethoscope, why would this be expected for Tina?
Student Response: Tina’s history of asthma means wheezing can happen on and off. Asthma makes the airways narrow due to inflammation and extra mucus, causing wheezing and breathing problems.
Model Note: Hearing scattered wheezing is expected because Tina has asthma. Asthma makes the airways narrow due to inflammation and extra mucus, causing wheezing.
When observing a patient like Tina during an exam, how can you tell if they’re having breathing problems?
Student Response: Signs of breathing problems include using extra muscles to breathe, loud breathing sounds, wheezing, faster breathing, bluish color around lips or nails, runny nose, chest sinking in, sweating, leaning forward, and difficulty talking.
Model Note: You can notice signs of breathing problems like using extra muscles to breathe, noisy breathing, wheezing, fast breathing, bluish lips or nails, nose flaring, chest retracting, sweating, leaning forward, and struggling to talk.
Describe how you’d check if Tina has difficulty breathing.
Student Response: To see if someone has trouble breathing, ask about their breathing patterns. Ask if they feel short of breath or have trouble breathing. If they do, ask about when it started, what makes it worse or better, how long it lasts, their body position, sleep issues, and what helps them feel better.
Model Note: Finding out if Tina struggles to breathe involves asking her about her breathing. Ask, “Do you ever feel short of breath or have trouble breathing?” If she does, ask about when it began, what triggers it, how long it lasts, her posture, sleep problems, and what makes it better.
Review QuestionsActivity Time: 17 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: Because Tina has a history of asthma, it is common for her to have intermittent wheezes. With chronic asthma, the airways become restricted as a consequence of recurrent inflammation and excessive mucus production, resulting in wheezing and other symptoms of respiratory distress.
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: Aspects of respiratory distress that may be seen include the use of auxiliary muscles, audible breathing, gurgling or wheezing, higher respiratory rate, blue coloring surrounding the lips or nails, rhinorrhea, chest retractions, perspiration, and tripod body orientation. 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: In order to determine if a patient has dyspnea, the practitioner needs to inquire about the patient’s breathing patterns. This includes asking whether they experience shortness of breath or difficulties breathing. If dyspnea is discovered, make certain to inquire about the commencement, environmental or physical variables that contribute to relapses, duration, body alignment, sleep disruptions, and factors that alleviate the symptoms of dyspnea
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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