16 RESPIRATORY PATIENT Flashcards
PTA RESPONSIBILITY
PTA IS NOT responsible for initial evaluation and treatment planning.
PTA IS responsible for doing a patient evaluation prior to chest treatment,
PTA IS also responsible for evaluating the results of the treatment.
PTA IS responsible for monitoring a patient respiratory status while doing other treatment.
COMPONENTS OF RESPIRATORY EVALUATION.
Inspection.
Palpation.
Percussion.
Auscultation.
Treatment activities.
Result of treatment.
CHEST EVALUATION
Important for assistant to know:
What is meant by assessment of each component.
What is “normal” for each component.
What is “abnormal” for each component.
INSPECTION
General appearance:
Vital signs: HR, RR, BP
Level of awareness: level of consciousness.
General observation: color, clubbing, hypertrophy of muscles, use of accessory muscles.
Posture.
Breathing pattern: rate, irregularity, location of breathing, patterns.
Chest mobility: symmetry of appearance, location of movement, chest deformities.
CHRONIC HYPOXIA
Digital clubbing from lack of oxygen over long periods of time.
BREATHING IRREGULARITY
Tachypnea: too much.
Bradypneas: not enough.
ORTHOPNEA
Getting shortness of breath in certain positions.
DYSPNEA
SOB
BARREL CHEST
Chronic hyperinflation.
Having problems with expiration.
PECTUS EXAVATUM
Sternum pushed in.
PECTUS CARNATUM
Sternum sticking out.
PALPATION & PERCUSSION
Palpation: feeling.
Chest mobility.
Tactile Fremitus.
Percussion:
A technique that is used to assess lung density.
Palm flat on area, tapping on the distal end of middle finger.
Sounds: hollow, dull, echo.
AUSCULTATION
Listening to lungs with a stethoscope, side to side.
Either normal or abnormal.
PLEURAL RUB
Creaking is heard at the end of inspiration and beginning of expiration due to the inflamed surfaces of the pleura rubbing together.
OTHER AUSCULTATION TECHNIQUES
Whispered pectoriloquy: whispered 1, 2, 3. or 99.
Egophony: eee
Bronchophony: 99.
BREATH SOUNDS
Normal: faint, low-pitched. Inspiration 2/3, expiration 1/3.
Bronchial breath sound: (normal to where bronchial is, not normal outside of it) loud, hollow, tubular, high pitched.
Reduced breath sounds.
Abnormal breath sounds: crackles, wheezes.
Stridor: crowing sound.
Pleural rub.
TYPE OF COUGH
Deep.
Sharp.
Weak.
Painful.
Hoarse.
Productive. (coughing stuff up)
SPUTUM/MUCUS
Colour: normal is clear.
Black/grey.
Red.
Consistency: normal.
Groups of something.
Frothy, bubbly.
Amount: normal 100 ml per day.
OTHER AREAS
ROM.
Muscle strength.
Endurance.
Functional independence.
Pain.
Blood gases.
SIGNS OF RESPIRATORY DISTRESS
Alteration in respiratory pattern.
Development in bronchospasm, breath sounds change.
Altered state of consciousness: light-headedness, confusion, dizziness.
Change in colour.
Increased use of accessory muscles.
Patient appears fatigued.
Weakening of cough.
Decreased ability to follow commands.
Decreased depth of respiration.
Development in pain level.
Change in sputum color or production.
Change in air entry.
