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RSPT chp 15 egans

QuestionAnswer
What is dyspnea Subject patient discomfort, unpleasant discomfort
Breathlessness Sensation of unpleasant urge to breath, triggered by acute hypercapnia, acidosis and hypoxemia
orthopnea dyspnea in the reclining position, assoc. with CHF
platypnea dyspnea in the upright position, assoc. with arteriovenous malformation
Weak cough is caused by High RAW, poor lung recoil, weak muscles or pain
Cough receptors in air way are triggered by Inflammation, mucus, foreign materials or noxious gases
Mucus from the lower airway that is expectorated through the mouth sputum
Foul smelling sputum fetid
Clear and thick mucus mucoid
Sputum that contains pus purulent
hemoptysis Coughing up blood or bloody sputum
pleuritic chest pain Sharp in nature and increases with deep breathing (pneumonia, pulmonary edema)
Non- pleuritic chest pain Center of chest, may radiate to shoulder or arm often caused by coronary artery disease and known as angina may be herd or esophageal spasm
Pedal edema Swelling of lower extremities, pitting edema- mark left after pressure is applied, weeping edema- small fluid leak at pressure point
Pack-year history Multiply the number of packs smoked per day by the number of years smoked, have to know how many are in a pack
sensorium Level of consciousness and orientation to time place person and situation times 4
Confused patient Slow mental response, dulled perception, incoherent thoughts
Delirious patient Easily agitated, irritable, hallucinations
Lethargic patient Sleepy, arouses easily, responds when aroused
obtunded patient Awakens only with difficulty, responds appro. when aroused
stuporous patient Does not awaken completely, decreased mental and physical activity, responds slowly to verbal stimuly
Comatose patient Unconscious, does not respond, does not move voluntarily, loses reflexes with deep coma
Normal body temp 98.6 f or 37 c
hyperthermia Increased temperature
hyperpyrexia fever
hypothermia Decreased body temperature
Places to measure body temp Mouth, axilla ear or rectum
tachycardia HR greater than 100 beasts/min
bradycardia HR less than 60 beats/min
Pulses alternans Alternating between strong and weak heartbeats
Pulses paradoxus Abnormal decrease in pulse pressure with each inspiratory effort
Normal adult respiratory rate 12-18 breaths a min
tachypnea Greater than 20 breaths a min
bradypnea Less than 10 breath a min
Pulse pressure Difference between systolic and diastolic usually 30-40 mmhg
Hypertension characteristic Usually anything over 140/90
Hypotension characteristic Systolic less than 90 mmgh or mean art. Pressure less than 65mmg
mean art. pressure (1) systolic+(2)diastolic divided by 3
Nasal flaring Often seen in infants sign of increased WOB
cyanosis Bluish color of mucosa
Pursed lip breathing Often seen in patients with COPD to help prevent the collapse of small airways
Barrel chest Often seen in COPD, exhale effectively and lungs stay inflated much easier
pectus carinatum Abnormal protrusion of sternum
pectus excavatum Abnormal depression of sternum
kyphoscoliosis Abnormal curvature of the spine, restrictive lung disease
apnea No breathing
apneustic Deep, gasping inspiration with brief partial expiration
Ataxia breathing Irregular breathing pattern with variable periods of apnea
Biot's breathing Clustering of rapid shallow. Breathed with regular or irregular periods of apnea
cheyne-stokes breathing Breaths increasing and decreasing in depth and rate with periods of apnea
Paradoxical breathing Abdominal paradox- abdominal wall moves inward on insp. And outward on exp. Chest paradox- part or all of the chest wall moves in with inhalation and out with exhalation (flail chest)
Acute diaphragmatic fatigue tachypnea, respiratory Alternans
Vocal and tactile fremitus increased Increased with pneumonia and atelectasis (consolidation)
Vocal and tactile fremitus decreased With emphysema, pneumonia, and pleural effusion
Subcutaneous emphysema Air leaks under the skin
Increased resonance More air inside with emphysema or pneumothorax
2 types of lung sounds Breath sounds and adventitious lung sounds
Adventitious lung sounds Anything not normal, fine crackles, course rhonci, wheezes
Discontinuous adventitious lung sounds Intermittent crackling, crackles
Continuous adventitious lung sounds Wheezes, strider upper air way or above the vocal chords
Different types of wheezes Consistent with airway obstruction, monophonic- indicated one airway if affected. Polyphonic-indicated many airways are involved.
stridor upper airway, chronic strider- laryngomalacia Acute strider- croup Inspiratory strider- narrowing above glottis Expiration strider- narrowing of lower trachea
heave Abnormal pulsation felt over precordium
murmur Leaking valve often heard over precordium, small valve stenotic blood flowing through a narrowed opening
Systolic murmurs Caused by stenotic semilunar valves and incompetent AV valves
Diastolic murmur stenotic AV valves or incompetent semilunar valves
S1 heart sound Closure of the AV valves
S2 heart sound Closer of semilunar vavles
S3 heart sounds Abnormal in adults caused by rapid filling of stiff left ventricle
S4 heart sounds Atrial "kick" of blood into non compliant left ventricle when patients have S3 and S4 patient has a gallop rhythm
Digital cyanosis Aka acrocyanosis often sigh of poor perfusion hands and feet are cool to the touch
Central cyanosis o2 issue treat with o2 on until returns to normal
Created by: pearlekg