Breathing Flashcards

1
Q

What are your main breathing observations?

A

Effort, efficacy and effects of inadequate respiration

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2
Q

What does RIPPAS stand for?

A

Rate
Inspection
Palpate
Percuss
Auscultate
Saturations

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3
Q

What vital signs are you assessing for in breathing?

A

Respiratory rate
Oxygen saturations

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4
Q

What are you observing when assessing respiratory rate?

A

Rate (high or low,) rhythm (irregular or regular) and depth (shallow or deep)

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5
Q

What are the normal respiratory rates for patients aged 1-9 ?

A

1-2 Years- 25-35bpm
2-5 Years- 25-30bpm
5-12 Years-20-25bpm

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6
Q

What position would you be standing in to assess your patient?

A

At the end of the bed

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7
Q

What other observations are you making in effort of breathing?

A

Accessory muscle usage
Recessions
Breathing sounds

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8
Q

What are the accessory muscles?

A

Head bobbing
Nasal flaring
Shoulder shrugging
Abdominal breathing
Tripod position

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9
Q

Name the recessions

A

Tracheal tug
Sternal recession
Intercostal recession
Subcostal recession

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10
Q

What breathing sounds are you looking for?

A

Grunting, Gasping, Wheezing, Stridor

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11
Q

What is the rationale behind grunting?

A

To prevent alveoli from collapsing - creating positive airway pressure

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12
Q

What is the rationale behind gasping ?

A

Trying to intake as much oxygen as possible showing there is an issue with gaseous exchange

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13
Q

What are you looking at when observing the chest?

A

Equal/bilateral expansion
Seesaw breathing

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14
Q

Why would you be observing skin colour in breathing?

A

To check for signs of cyanosis indicating inadequate perfusion OR
Skin pallor due to vasoconstriction from hypoxia

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15
Q

What are you observing when ausculatating?

A

How much air movement there is- a silent chest is very worrying
To determine equal air entry
To hear for crackles and wheeze

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16
Q

What are you observing when percussing?

A

Percuss the patient’s chest, listening to the resulting percussion note which should be resonant (deep and clear)

Dullness

Stony dullness

Hyper-resonance

17
Q

What interventions would you make for a child who isn’t breathing?

A

5 rescue breaths via bag-valve mask connected to 15L 02

18
Q

What would you do to correct low SpO2?

A

High flow oxygen 15L via non-rebreathe mask with reservoir (that is inflated prior to administration)

19
Q

What other considerations may you make?

A

Steroids, nebulisers (adrenaline or bronchodilators)
Sitting the patient upright (to lower abdominal contents)