Cardio pulmonary assessment

Question 1

orthopnea

Answer 1

pt cannot lie flat

- has to have elevation to head for breathing purposes

Question 2

Tests and measures

Answer 2

1) pulmonary function test(PFT)
2) CXR
3) ABG analysis
4) Oximetry
5) blood cell count, electrolytes
6) cardiovascular imaging
7) GXT

Question 3

physical examination

Answer 3

1) inspection/observation
2) palpation/percussion
3) auscultation
4) cough assessment
5) functional capacity(response to activity, bed mobility)

Question 4

level of consciousness

Answer 4

alert, agitated, confused, semicomatous, comatous

Question 5

level of distress

Answer 5

chest discomfort, dyspnea, anxiety, fatigue, dizziness

Question 6

body type

Answer 6

obese, normal, cachectic

Question 7

skin tone and color

Answer 7

cyanosis, edema, pallor, digital clubbing

Question 8

edema in foot

Answer 8

poor venous return or CHF

- if pitting edema, probably CHF

Question 9

posture

Answer 9

kyphosis, scoliosis, positioning

Question 10

neck

Answer 10

jugular vein distension, accessory muscle use in breathing

Question 11

chest shape

Answer 11

A-P diameter, chests deformity(Barrel, pigeon, funnel chest)

Question 12

abdomen

Answer 12

enlarged liver, spleen, or ascites

Question 13

normal respiratory rate

Answer 13

newborns = 44 breaths per minute
infants = 20-40 Bpm
preschool = 20-30 Bpm
older children = 16-25 Bpm
adults = 14-18 Bpm

Question 14

indicators of increased work of breathing

Answer 14

• dyspnea
• increased TV
• increased respiratory time
• soft tissue retractions
• nasal flaring
• accessory muscle use
• adventitious breath sounds

Question 15

factors affecting respiratory pattern

Answer 15

• pain
• emotion
• body temp
• sleep
• body position
• activity level
• presence of disease

Question 16

diaphragmatic excursion

Answer 16

step 1 = pt breathes deeply and hold, locate diaphragm position
step 2 = pt exhales, locate diaphragm position again
step 3 = difference between the two levels(3-5 cm)

Question 17

cough assessment

Answer 17

effectiveness = ability to clear secretions
control = ability to start and stop coughs
quality = wet, dry, bronchospastic
frequency
color = hemoptysis, quantity, odor, consistency

Question 18

cough mechanism

Answer 18

4 phases:

1) full, deep inspiration
2) closure of glottis
3) abdominal contraction
4) rapid expulsion of air forcing sudden opening of glottis

Question 19

dyspnea scale: 0

Answer 19

not troubled with breathlessness except with strenuous exercise

Question 20

dyspnea scale: 1

Answer 20

troubled by shortness of breath when hurrying on level ground or walking up a slight hill

Question 21

dyspnea scale: 2

Answer 21

walks slower with people of the same age on level ground because of SOB, or has to stop for breath when walking at own pace on level ground

Question 22

dyspnea scale: 3

Answer 22

stops for breath after walking about 100 meters or after a few minutes on level ground

Question 23

dyspnea scale: 4

Answer 23

too SOB to leave the house or is SOB when dressing or undressing

Question 24

of MET’s for ADL’s

Answer 24

at least 5

Question 25

factors affecting the 6 minute walk test

Answer 25

• practice trials
• words of encouragement
• walkway layout
• treadmill vs. hallway
• underlying diseases

Question 26

BODE index

Answer 26

predicts likelihood of death after transplants

- higher number = worse