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RRT terms
Terms WB a15 -18
| Question | Answer |
|---|---|
| Tracheal Deviation | Palpation may be used to determine tracheal position To determine tracheal position, place the index finger into the sura-sternal notch Compare the space between the left clavicle and the left border of the treachea |
| Causes of Tracheal Deviation Pulled to Abnormal Side (toward pathology) Problem in lung | Pulmonary atelectasis Pulmonary fibrosis Pneumonectomy Diaphragmatic paralysis |
| Causes of tracheal Deviation Pushed to Normal Side (away from pathology) Problem outside of lung | Massive pleural effusion Tension pneumothorax Neck or thyroid tumors Large mediastinal mass |
| Tactile fremitus | vibrations that are felt by the hand on the chest wall |
| Vocal fremitus | voice vibration on the chest wall |
| Pleural rub fremitus | a grating sensation felt on the chest wall due to roughened pleural surfaces rubbing together |
| Rhonchial fremitus (palpable rhonchi) | secretions in the airways |
| Crepitus | Bubbles of air under the skin that can be palpated and indicates the presence of subcutaneous emphysema |
| Resonant | normal air filled lung hollow sound |
| Flat (Loss of air) (more Fluid) | heard over the sternum, muscle or areas of atelectasis |
| Dull (Loss of air) (more Fluid) | Heard over fluid filled organs such as the heart or liver Pleural effusion or pneumonia will give this thudding sound |
| Tympanic (Extra Air) | heard over air filled stomach. drum like sound and when heard over lungs indicates increased volume |
| Hyperresonant (Extra Air) | found in areas of the lung where pneumothorax or emphysema is present Booming sound |
| Normal Breath Sounds | Vesicular |
| Bilateral vesicular sounds | Normal breath sounds in both lungs |
| Bronchial breath sounds | normal sounds heard over the trachea or bronchi (right and left mainstem) Indicate: Consolidation |
| Egophoney | The patient is instructed to say E and is sounds like A. Indicate: Consolidation of the lung tissue as with a pneumonia-like condition |
| Abnormal Breath Sounds (adventitious) | Abnormal Breath Sounds(adventitious) |
| Crackles | secretion/fluid |
| Coarse Crackles (Rhonchi) | large airway secretions Patient needs suctioning |
| Medium Crackles | Middle airway secretions Patient needs chest physical therapy |
| Fine Crackles | Alvioli Fluid Patient Has CHF/Pulmonary edema Patient needs IPPB, Heart drugs, diuretic and oxygen |
| Wheeze | due to bronchospams Patient needs bronchodilator |
| Unilateral wheeze | Foreign body obstruction -(bronchcoposcopy) |
| Stridor | upper airway obstruction Supraglottic swelling (epiglottitis) Subglottic swelling (croup,post extubation) Foreign body aspiration (solids or fluids) |
| Stridor Treatment | Topical decongeestant (racemic epinephrine) for swelling and edema Suctioning and or bronchoscopy for secretions and foreign body aspiration intubation for severe swelling and epiglottitis |
| Pleural friction rub | Coarse grating or crunching sound Cause: inflamed surface of the visceral and parietal pleura rubbing together May be associated with pleurisy, TB, Pneumonia, pulmonay infarction, cancer Treat: steroids and antibotics |
| S3 Heart sound | is abnormal congestive heart failure |
| S4 Heart Sound | Cardiac abnormality (myocardial infarction or cardiomegaly) |
| Both S3 and S4 are | low pitched and may be difficult to discriminate |
| Heart Murmurs are | sounds caused by turbulent blood flow. May be caused by heart valve defects or congenital heart abnormalities and should be investigated |
| A murmur can occur | when blood is pushed through an abnormal opening such as an atrial septal defect or a patent ductus arteriosus |
| Bruits | sounds made in an artery or vein when blood flow becomes Turbulent or flows at and abnormal speed A bruit is usually heard through a stethoscope over the identified vessel such as the carotid artery |
| Blood Pressure | Normal: 120/80 mmHg Range: 90/60 to 140/90 Measure of the systolic and diastolic pressures Use a Sphygmomanometer to measure cuff pressures |
| Hypertension | increased blood pressure Indicates: cardiac stress (hypoxemia) |
| Hypotension | Decreased blood pressure Indicates:poor perfusion (hypovelemia, CHF) |
| Normal Heart Rate Range | 60 -100 |
| Tachycardia | Heart Rate over 100 Indicate: hypoxemia, anxiety, stress Recommend: O2 theraphy |
| Bradycardia | HR less than 60 Indicates: heart failure, shock, code/emergency Recommend: Atropine |
| Paradoxical pulse/pulsus paradoxus | Pulse/blood pressure varies with respiration Indicate: severe airtrapping status asthmaticus, tension pneumothorax, cardiac tamponade |
| Breath Sounds in a patient with Pulmonary Edema are... | Fine crackles (moist creptant rales) Alveoli / fluid |
| First Sound S1 | Created by the normal closure of the mitral and tricuspid valves at the beginning of ventricular contraction Normal Heart sound |
| Second Sound S2 | Normal Heart Sound Occurs when systole ends, Ventricles relax and the pulmonic and aortic valves close |
| cardiac stress will increase | blood pressure |
| hypoperfusion will decrease | blood pressure |
Created by:
Max912