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RSPT chp 15 egans
| Question | Answer |
|---|---|
| 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
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