Approach To Resp Complaint Flashcards
Where do chest tubes and needles need to be placed?
Over the superior margin of the rib to avoid the neurovasculature bundle which runs along the inferior margin of each rib
What is the normal breathing rate?
20/min
What is tachypnea?
> 25/min
What is bradypnea?
Slow breathing rate
What is Cheyne-stokes breathing?
Abnormal breathing pattern
Tachypnea
Gradual hyper apnea, then hypopnea
Followed by periodic apnea
In which conditions is Cheyne-strokes breathing seen?
Often seen in heart failure
Hypoperfusion of the brain (respiratory center)
What is Kussmaul breathing?
Abnormal respiratory pattern
Deep rapid breathing
Seen in pts with metabolic acidosis (DKA) so this mechanism tries to bring the pH back up
What can Cheyne-Stokes breathing cause?
CO2 narcosis
Pt becomes delirious may try to rip off mask and IVs
Increase in pH causing acidosis
What are some causes for Kussmaul breathing?
K - Ketones (DKA) U - uremia S - sepsis S - salicylate as M - methanol A - aldehydes U L - lactic acid/lactic acidosis
What is the primary muscle of breathing?
Diaphragm
What are the accessory muscles of breathing?
Supraclavicular (scalene and sternocleidomastoid)
Intercostal and subcostal muscles
What is pleural effusion?
Pus that collects in the pleural space
Transudates (fluid leaking from blood vessels)
Exudates (fluid leads from inflammation of the pleura and lung)
CHF, pneumonia, malignancies, and PE
What is empyema?
An abscess in the lung parenchyma
Requires drainage (chest tube)
Can collect in pleural space (pleural effusion)
What are some abnormal (adventitious [added]) breath sounds?
Stridor, wheezes (rhonchi [low pitched wheezes), crackles (rales)
Depend on the structure and pathology affecting it
What are normal breath sounds?
Vesicular, bronchovesicular, bronchial and tracheal
What does CTAB stand for?
Clear to auscultation bilaterally
What are some conditions associated with unilateral abnormal or decreased breath sounds?
Pneumothorax
Lung full of fluid (hemothorax, pleural effusion, empyema, etc)
What are some conditions associated with bilateral abnormal or decreased breath sounds?
Extreme COPD and asthma (secondary to not moving any air)
What is stridor?
Generally an inspiratory sound but can be expiratory or biphasic
Result from narrowing in the upper airway
What are common causes for stridor?
Croup, epiglottis, upper airway foreign body, anaphylaxis
What is wheezing?
Generally an expiratory sound but can be inspiratory or biphasic
Continuous musical sounds
Caused by rapid airflow through a narrowed bronchial airway
What are common causes for wheezing?
RAD (reactive airway disease), asthma, COPD
What are crackles?
An inspiratory sound
Thought to be caused by small airway closed during expiration, “popping” open during inspiration
What are common causes for crackles?
Pneumonia, CHF, atelectasis, pulmonary fibrosis, asthma bronchiectasis, COPD
What does pulse oximetry measure?
Peripheral arterial oxygen saturation (SpO2)
Known as the 5th vital sign
What are causes for a bad waveform in pulse oximetry?
Improper placement, hypoperfusion, hypothermia, motion artifact
What is end tidal CO2?
The concentration of CO2 in exhaled air at the end of respiration
Measures ventilation
What is the normal PETCO2?
35-40
What is a normal PaCO2?
35-45 (40)
What is atelectasis?
The loss of lung volume due to a collapse of alveolar lung tissue affecting O2 absorption
What PE findings would you find in someone with atelectasis?
Low O2 saturation, tachypnea, using accessory muscles to assist breathing, in distress, could be in a tripod position
