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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 |