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Clinical skills > cardiorespiratory assessment > Flashcards

cardiorespiratory assessment Flashcards

1
Q

what is the A to E assessment?

A
  • Airway
  • Breathing
  • Circulation
  • Disability
  • Exposure
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2
Q

why is the A- E assessment used?

A
  • provides a systematic approach to assessment
  • universally understood in health care
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3
Q

who can the A-E assessment be used on?

A
  • clinically deteriorating patients
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4
Q

describe the airway section

A
  • is the airway patent?
  • what of airway, tracheostomy, laryngectomy
  • are they self- ventilating or requiring respiratory support
  • any obstruction?
  • are they able to talk to you?
  • are they talking in full sentences or is it labored?
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5
Q

describe the breathing section

A
  • look, listen & feel
  • respiration rate, depth
  • SpO2
  • are there any respiratory support> oxygen, ventilation
  • is the respiratory rate rhythmical?
  • diaphragmatic movement
  • chest deformity
  • palpate
  • cyanosis
  • ABG’s
  • Radiography
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6
Q

describe circulation section

A
  • skin> is it mottled, blue, pink or pale
  • CAP refill time (CRT)
  • heart rate
  • blood pressure
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7
Q

describe disability section

A
  • level of consciousness
  • ACVPU
  • Glasglow Coma score
  • blood glucose
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8
Q

what does ACVPU stand for in relation to disability?

A
  • alert
  • new confusion
  • voice
  • pain
  • unreponsive
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9
Q

describe exposure section

A
  • temperature
  • review any wounds, bleeding
  • catheters
  • chest drains
  • ensure that there is dignity maintained throughout
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10
Q

what should you ensure for the A to E assessment? (3)

A
  • ensure it is documented
  • ensure that a good clinical history is taken
  • ensure that there is a continue monitoring and that there is response recorded
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11
Q

what are the five simple physiological measurements?

A
  • heart rate
  • blood pressure
  • saturation
  • arterial blood gases
  • temperature
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12
Q

what does the subjective assessment identify?

A
  • if patient is in immediate danger
  • does patient have/ present with increased risk of developing sputum retention, loss of lung volume, increased WOB, or respiratory failure
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13
Q

what are common symptoms of cardiorespiratory patients?

A
  • cough
  • sputum
  • breathlessness/ dyspnoea
  • chest pain
  • wheeze
  • history of falls
  • anxiety and depression
  • fatigue
  • swelling
  • cyanosis
  • reduced exercise tolerance
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14
Q

what should you ask about the cough?

A
  • is it with sputum> productive cough
  • is it without sputum> dry
  • identify if patient is wasting energy on unproductive cough
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15
Q

what should you ask about sputum?

A
  • colour
  • consistency
  • has it changed
  • quantity produced daily
  • blood present
  • mucoid, mucopurulent, purulent
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16
Q

what should you ask about wheezing?

A
  • when do you wheeze?
  • is it on activity?
  • at rest?
  • cause> swelling, bronchospasm, sputum
  • are there clues in PMH
17
Q

what should you ask about chest pain?

A
  • cardiac pain described as central, crushing & radiating to left arm and neck
  • MSK pain due to cough but should be explored in detail to establish
  • can also be due to heart related condition
18
Q

what should you ask about breathlessness/ dyspnoea?

A
  • when?
  • position dependent?
  • do you have anything that eases this?
19
Q

what people are anxiety & depression common in?

A
  • patients with respiratory disease
20
Q

what may you notice in extreme cases of cyanosis?

A
  • fingers are blue
21
Q

what does HPC involve?

A
  • summary of problems including information from medical notes
22
Q

what does PMH involve?

A
  • all medical and surgical conditions
23
Q

what does DH involve?

A
  • all medications and allergies
24
Q

what does FH involve?

A
  • is there a family history of cardiorespiratory conditions?
25
Q

what does SH involve?

A
  • lifestyle factors> does patient smoke? alcohol intake? physically active?
  • does patient have stairs at home or are there factors that are going to present challenge
26
Q

what are the main objective assessment components?

A
  • observation
  • palpation
  • heart rate
  • auscultation
  • oxygen saturations
  • temperature
  • respiration rate
27
Q

what should you deal with first in observation?

A
  • is patient comfortable and well positioned with regards to lung volume/ sputum clearance
28
Q

describe the observation of cardiorespiratory patients

A
  • general appearance
  • are they using accessory muscles of breathing?
  • chest expansion
  • can you see diaphragmatic movement?
  • does the patient appear restless?
  • are they talking in full sentences?
  • colour> pallor
  • cyanosis is a warning sign
  • clubbing a loss of angle between nail bed and nail
  • oedema
  • clammy
  • work of breathing
  • are they on a ventilator?
  • do they need oxygen?
29
Q

what should you consider when observing cardiorespiratory patients?

A
  • size of patient and manual handling implications
  • structural posture changes affecting lung capacity (chest shape, kypotic posture, scoliosis)
30
Q

describe palpation

A
  • feel fremitus
  • chest expansion> is it equal
  • diaphragmatic vs apical breathing
  • pump handle and bucket handle movement
  • percussion
  • resonant (well aerated, normal), hyper- resonant, dull (consolidated), stony dull (pleural effusion)
  • any pain
31
Q

what is auscultation?

A
  • completed across the lung fields to listen to different sounds
  • are breaths sounds present through chest
  • any missing or added sounds?
32
Q

what is normal auscultation?

A
  • inspiration phase longer than expiration phase
33
Q

what is not normal auscultation?

A
  • added sounds
  • reduced breath sounds
  • wheeze
  • crackles
  • stridor
  • plural rub
34
Q

what trends should you look at?

A
  • look at temp, BP, HR, RR
  • do they fall within normal values
  • any recent changes e.g., sudden increase or decrease
35
Q

what impact would extreme values have on physio? - give examples

A
  • patient who has low BP will you want to get them out of bed?
  • if patient has tachycardia how much physical exertion is appropraite
36
Q

what three results does a spirometer give you?

A
  • FEV1
  • FVC
  • PEF
37
Q

what results does ABGs give you?

A
  • 02 removal
  • C02 removal

Clinical skills (13 decks)

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