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PulmonaryJan2018
Tuesday Test 1/9/18
| Question | Answer |
|---|---|
| Types of Assessment (4) | 1) Initial 2) Emergency 3) Focused 4) Ongoing |
| What is Initial Assessment? | 1st encounter with patient |
| What is Emergency Assessment? | Life threatening (immediate) problems |
| What is Focused Assessment? | Detailed examination |
| What is Ongoing Assessment? | Every subsequent visit with pt after the 1st visit |
| Types of Data ........... (2) | 1) Subjective 2) Objective |
| Assessment is the process of ........ (3) | 1) Collecting Data 2)evaluating data 3)developing a treatment plan |
| What is subjective data? | Symptoms the pt tells you |
| What is Objective data? | Signs that you observe or collect |
| Role of Respiratory Practitioner (3) | Collect data to determine: 1) degree of anatomic alterations & clinical manifestations 2) Select optimal treatment/dlvy therapy 3) Document Everything |
| Optimal Treatment / Therapy | To correct anatomic alterations and pathophysiologic mechanisms caused by disease |
| 4 Life Functions in order of importance | 1) Ventilation 2) Oxygenation 3) Circulation 4) Perfusion |
| 6 Major Vital Signs | 1) Temperature (T) 2) Pulse (P or PR) 3) Respiration (R or RR) 4) Blood Pressure (BP) 5) Pulse Ox (SpO2) 6) Blood Glucose Level |
| Normal Body Temperature | 37 degrees C +/- 0.5 degrees (98.6 degrees F +/- 2 degrees) |
| Normal Temp Ranges | Adult = 97-99 Child 98.6-99.6 Infant 96-99 Geriatrics 95-99 |
| Why does Increased temp causes vasodilation? | Allows more warm blood to flow near the surface of the skin, where the heat can be lost to the air. |
| Decreased temp causes vasoconstriction why? | Blood vessels supplying warm blood to the skin become narrow or constrict (vasoconstriction). This reduces the flow of warm blood near the surface of the skin, and reduces heat loss. |
| Febrile | Having or showing symptoms of fever |
| Afebrile | Not feverish |
| Hyperthermia | Having a body temperature greatly above normal. Synonym of Pyrexia. |
| Pyrexia | Raised body temp; fever. Synonym of Hyperthermia. |
| Hypothermia | Abnormally low body temperature, usually dangerously low. |
| Induced Hypothermia | (aka targeted temp mgmt) deliberate reduction of core body temp in pts who don't regain consciousness after cardiac arrest. |
| Factors that affect temperature | 1) age 2) environment 3) Time of day 4) exercise 5) stress 6) hormones |
| Sites to check temperature | 1) oral 2) rectal 3) ear (aural) 4) axillary (armpit or groin) |
| Nine pulse sites | 1) Radial 2) brachial 3) carotid 4) femoral 5) dorsalis pedis 6) apical (apex of heart) 7) posterior tibial (back ankle) 8) popliteal (back knee) 9) temporal (temple) |
| Normal Ranges of pulses | Adult = 60-100 Child = 60-130 Infant >= 100 |
| Rhythm of pulse is described as ...... | Regular or irregular |
| Strength of pulse is described as ....... | Strong, Weak, or Bounding (unable to palpate) |
| Conditions that may alter strenghth of pulse | Pulsus alternans, Pulsus paradoxus, Stimulation of SNS, Stimulation of PNS |
| Pulsus alternans | Arterial pulse alternating strong and weak beats. |
| Pulsus paradoxus | Abnormally large decrease in stroke volume, systolic blood pressure and pulse during inspiration. |
| Tachycardia | Heart rate that exceeds the normal resting rate. +100 BPM |
| Bradycardia | Slow heart rate, below 60 BPM, but usually does not cause symptoms until the rate drops below 50 BPM. |
| Inspiration is ...... | active |
| Expiration is ....... | passive |
| Inspiration and expiration together equal....... | one whole respiration |
| Correct way to count respiration | Start counting with first inspiration• Infants and children: count a full minute. • Adults: count for 30 seconds x2 or 15 seconds x4 |
| Normal Ranges for breaths per minute (BPM) | Adult = 12-20 Child = 20-40 Infant = 30-60 |
| Tachypnea | Abnormally fast breathing |
| Bradypnea | Abnormally slow breathing |
| Apnea | Not breathing |
| Hypoventilation | Breathing at abnormally slow rate, causes increased CO2 in blood |
| Hyperventilation | Breathing at abnormally fast rate, causes decreased CO2 in blood |
| Cheyne Stokes | Abnormal breathing; gradual increase in rate & depth, followed by decrease resulting in apnea |
| Kussmaul | Deep and labored breathing pattern |
| Biots | Abnormal breathing; groups of quick, shallow breaths, followed by regular or irregular periods of apnea |
| Systolic Blood Pressure definition and Range | The maximum arterial pressure during contraction of left ventricle; 100-139 |
| Diastolic Blood Pressure definition and Range | The minimum arterial pressure during relaxation and dilation of ventricles when they fill with blood; 70-89 |
| What is pulse pressure and Range? | Difference between systolic and diastolic pressures. Represents the force the heart generates when contracting; 30-50 |
| Pulse pressure equation | PP = SBP - DBP |
| Blood pressure is determined by ....... | Flow and resistance |
| Blood flow is equal to ...... | Cardiac output |
| Cardiac Output equation | CO = SV x HR |
| Why would there be decreased SV? | 1) poor pumping action 2)decreased blood volume |
| What decreases both CO and flow? | Bradycardia |
| What increases both CO and flow? | Increased HR or blood volume |
| What happens when heart is compensating to maintain CO and flow? | Increased HR develops in response to decreased SV or BV |
| Resistance increases as....... | vessels constrict |
| Resistance decreases as...... | vessels dialate |
| What regulates and monitors vascular tone? | Autonomic nervous system |
| Hypertension | Abnormally high blood pressure; a state of great psychological stress |
| Factors for hypertension | Age, race, family history, overweight, not physically active, smoking, too much salt, too little potassium |
| Why does chronic hypertension lead to CHF? | It can cause ischemic heart disease; means that the heart muscle isn't getting enough blood; is usually the result of atherosclerosis, which impedes blood flow to the heart |
| Hypotension | Abnormally low blood pressure |
| Hypotension is associated with ...... | Causes inadequate flow of blood to the body's organs; can cause strokes, heart attacks, & kidney failure. It's most severe form is shock. Common causes of low blood pressure include a reduced volume of blood, heart disease, and medications. |
| Causes of Hypotension | Reduced volume of blood, heart disease, and medications. |
| Symptoms of Hypotension | fatigue. lightheadedness. dizziness. nausea. clammy skin. depression. loss of consciousness. blurry vision. |
| Orthostatic Hypertension | (aka postural hypertension) Sudden and abrupt increase in BP when person stands; a rise of 20 or more when standing. |
| Pulse Oximetry (SaO2 or Pox) Normal Range | Newborns = 88-90% All others >= 95% |
| Range of Mild hypoxia | Newborns = 86-88% All Others = 90-95% |
| Range of Moderate hypoxia | Newborns = 85-86% All Others = 85-90% |
| Range of Severe hypoxia | Newborns = 83-85% All Others = below 85% |
| What is sequence of Physical Exam of chest and lungs? | 1)Inspection 2)Palpation 3)Percussion 4)Auscultation |
| Inspection | Visual examination of the abdomen; shape of the abdomen, skin abnormalities, abdominal masses, and movement of the abdominal wall with respiration. |
| Palpation | Palpation of pts anterior and posterior chest walls; assesses for tenderness and degree of chest expansion |
| Percussion | Percussion of pts anterior and posterior chest walls; method of tapping on chest to determine the underlying structure |
| Ausculation | Listening to lung sounds, usually with a stethoscope |
| Types of Sputum Description | Color, Smell, Amount, Consistency |
| Descriptions used for color of sputum | Clear, white (opaque), yellow, yellow-green, green, brown, blood-tinged, pink, bloody |
| Descriptions used for smell of sputum | Odorless or Foul |
| Descriptions used for amount of sputum | Copious, moderate, small |
| Descriptions used for consistency of sputum | Thin, thick, tenacious (stick together), viscous (thick), watery, purulent (pus) , mucopurlent (sticky & pus), frothy (bubbly) |
| Types of patient cough efforts | Weak, poor, fair, good, strong, effective (clears or produces sputum), ineffective (nonclearing and no sputum) |
| Normal ABG's | PaO2 = 80 - 100 mmHg, PaCO2 = 35 - 45 mmHg, pH = 7.35 - 7.45, HCO3 =22-26 (28), SaO2 = 95 - 100% |
| Range of Sodium Na+ | 1.35-1.45 mEq/L |
| Range of Potassium K+ | 3.5 - 4.5 mEq/l |
| Rangle of Chlorine Cl- | 85 to 100 mEq/l |
| Range of Calcium Ca++ | 4.5 to 5.5 mEq/l |
| Glucose levels normal | 70 to 110 mg/dl <100 1st am <140 2hrs after meal |
| BUN (Blood Urea Nitrogen) | Test kidney function 7 to 20 mg/dl |
| Creatinine | Test kidney function 0.5 to 1.2 mg/dl |
| Bilirubin | Test liver function 0.1 to 1.2 mg/dL |
| Blood chemistry studies drawn in ...... | Red or Speckled top tube |
| Hematology Studies drawn in ....... | Purple top tube with EDTA |
| Coagulation Studies drawn in ........ | Blue top with heparin |
| RBC normal range | 4-6 mill/mm3 |
| Hgb normal range | 12-16 g% |
| Hct (hematocrit) normal range | 40-50% |
| WBC normal range | 5,000 to 10,000 mm3 |
| Neutrophils range WBC | 60-70% |
| Lymphocytes range WBC | 20-25% |
| Monocytes range WBC | 3-8% |
| Eosinophils range WBC | 2-4% |
| Basophils range WBC | 0.5 - 1% |
| Normal platelet count | 150,000 to 350,000 mm3 |
| Bronchoscopy | procedure where dr looks at your airway through a bronchoscope. Dr will examine your throat, larynx , trachea, & lower airways. Performed for diagnostic & therapeutic purposes |
| Thoracentesis | Procedure to remove fluid from the space between the lungs and the chest wall called the pleural space. Done for diagnostic and therapeutic purposes. |
| What does SOAP stand for? | S=Subjective Information O=Objective information A=Assessment of pt P=Plan for treatment modalities |
| Common information charted in Respiratory section of pts medical records | 1) Dr orders & f 2)Time/date 3)V/S (PR, RR &SpO2) pre & post 4) Chest inspection 5)Meds admin 6)O2 therapy 7)Sputum 8) ABG results 9) Comment section |
| Hypoxia Ranges in All except newborns | Mild = 90 - 95% Moderate = 85-90% Severe < 85% |
| Normal PaO2 Range | 75-100 mm Hg |
| Normal PaCO2 Range | 35-45 mm Hg |
| Normal pH Range | 7.35-7.45 |
| Normal HCO3 Range | 22-26 (28) |
Created by:
Beccaboop
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