Assessment Flashcards
Respiratory, Cardiac, Neurological
How can severe anemia impact the respiratory rate?
When there is not enough hemoglobin, the body attempts to maintain homeostasis by increasing oxygen input through increasing respiration
Are pregnant women at increased risk of pneumonia?
Yes
What pre-existing conditions are risk factors for serious respiratory illness in pregnancy?
Asthma, diabetes, cardiac disease, anemia, cystic fibrosis and renal disease
What are risk factors for venous thromboembolism (VTE)
Thrombophilia, immbility, c-section, swollen, DVT
Risk factors for serious respiratory illness in pg
-smoking
- substance abuse
- poor nutrition
- obesity
- HIV
When observing respiration the midwife should note
any use of accessory muscles, such as drawing up the shoulders, and listen for any abnormal breath sounds
How might you be able to observe a women with respiratory rate has increased at rest through talking
will begin to talk in short sentences, pausing to take a breath
What else will increase with increase in respiratory rate
a corresponding increase in heart rate in response to the increased work of breathing and diminished oxygen
Wheezing
Characteristically on expiration, as air is forced through a narrowed bronchial airway
What conditions are associated with wheezing
Asthma and pulmonary edema
Stridor
a croaking noise that is louder during inspiration and could indicate and obstruction of the airway
“rattly” breath sounds
noisy breathing caused by secretions. occurs with chest infection or more seriously pulmonary edema
Normal “sigh” of pregnancy vs breathlessness
Normal comes on gradually over a number of weeks and is not associated with other adverse signs or symptoms. breathlessness with an increased respiratory rate can indicate deteriorating conditions
Assessment of respiratory function by a midwife
Verbal response, change to rate, depth, and symmetry of breathing, breath sounds, skin color, decreased capillary refill, signs of respiratory distress, production of sputum?, pain, palpitations, change in level of consciousness, features of acidosis
How can verbal response be an assessment for respiratory function?
Asking the question is the woman able to complete a sentence in one breath?
How can skin color be an assessment of respiratory function by the midwife
May be initially pale (vasoconstriction), but may progress to peripheral or central Cyanosis
What are signs of respiratory distress
sitting upright and leaning forward, use of accessory muscles when breathing, pursed lip breathing
Color of sputum to potential cause
blood-stained (TB, pneumonia, PE), purulent green/yellow (infection), frothy or pink (pulmonary edema)
what could pain with deteriorating respiratory function mean?
chest pain with breathless could mean serious cardiac problems, life threatening PE, Pleuritic pain
what could a change in level of consciousness like agitation and confusion indicate?
increasing hypoxia
what is a feature of acidosis?
acetone breath noted with diabetic keoacidosis
What are features of deteriorating respiratory function
- increased OR reduced respirotrty rate
- breathlessness of sudden onset
-oxygen saturation less than 95% - increased supplemental oxygen required to keep oxygen saturation within range
- kussmaul breathing
- Drowsiness, headache, flushed face, tremor
“red flag “ features of serious breathlessness in pregnancy
- breathlessness of sudden onset
- breathlessness associated with chest pain
- orthopnea (difficulty breathing when lying flat)
- paroxysmal nocturnal dyspnoea (sensation of SOB that wakes the woman up at night)
