Cardio Observation Flashcards
Observation
look at breathing rate breathing pattern posture fatigue distress malnourished SOB pale: low blood pressure or anaemia ruddy: increased RBC accessory muscle contraction
Palpation
Shape of chest
Applying a flat hand, palpate gently just bellow the rib cage
looking to see if the diaphragm is soft and mobile and can descend fully
chest expansion
feeling for crackles
body temperature
pain
Fluid balance
Urine
Electrolytes
Auscultation
hearing for different sounds
How is paradoxical breathing evident?
indrawing of soft tissues
hoover’s sign: flattened diaphragm pulls in the lower ribs on inspiration
abdominal paradox where the abdomen is sucked in during inspiration instead of swelling outwards
Chest shape
barrel chest: hyper inflated, flat diaphragm and horizontal ribs
Hands
nicotine stains
poor cardiac output- cold hands
warm hands- C02 retention
tremor may be a side effect of bronchodilator drugs
Colour
cyanosis- sky blue colour of the skin
desaturation of haemoglobin
Oedema
swelling in interstitial spaces ankles, sacral area depending on posture caused by kidney failure COPD heart failure
Haemoptysis
sputum containing blood
pulmonary oedema- pink and frothy
pulmonary embolus- bright red
pneumonia- rusty red
bronchiectasis- fresh
Abdomen palpation
causes of distention: pain, guarding spasm, obesity, wind, constipation
distended diaphragm inhibits pragmatic movement, decreases lung volume and increasing WOB.
chest expansion palpation
palpate from behind, unequal expansion, suggests loss of lung volume
may feel crackling of sputum
Paradoxical breathing
hoovers sign: hyperinflated chest, flattened diaphragm pulls in lower ribs during inspiration
Finger clubbing
reduced angle between the nail and nail bed
abnormal capillary growth
may be the first sign of lung cancer if it appears unexpectedly in a smoker
