ch 16 RCP 100 Flashcards
the four functions that are critical for life
- ventilation- moving air in&out of lungs
2.oxygenation-oxygen into the blood
3.circulation-moving the blood through the body
4.perfusion-oxygen into the tissue
signs
vs
symptoms
sign:objective measure or observable: color, pulse, edema, blood pressure, fever
symptoms; subjective experiences felt by the patient: pain, nausea, muscle weakness
vital signs: heart/pulse rate
N: 60-100
bradycardia: <60
tachycardia: >100
vital signs:respiratory rate
N:12-20
bradypnea: <10
tachypnea: >20
vital signs:systolic blood pressure/ diastolic pressure
N: 90/60-140/90
hypertension > 140/90
hypotension <90/60
vital signs: temperature
37C
patient chart review
1.* occupation
2. *allergies
3. *prior surgeries
4. *vital signs
5. * physical examination
physical examination components
- inspection
*palpation - percussion
*ausculation
Pack years
1 pack= 20 cigs
fomula:
pk yr= # of pack/day X # years
ex. 45 cig for 10 year
45/20= 2.25 x 10yrs= 22.5 pack years
levels of consciousness
*ALERT/RESPONSIVE: normal
*LETHARGIC/SOMNOLENT: sleepy
*CONFUSED/STUPORUS: responds inappropriately
*SEMI COMATOSE: respond to painful stimuli
*OBTUNDED: drowsy state& aspiration risk
*COMA: do not respond to painful stimuli
social space
vs
personal space
Social: introduction , 4-12Ft
personal: 2-4 ft
purpose of the interview
- establish a rapport b/w clinician & patient
*obtain info essential for making diagnosis
*help monitor changes in the patients symptoms & respond to therapy
dyspnea
vs
breathlessness
Dyspnea: sensation of breathing discomfort by patient, most important symptom RT Is called to assess
Breathlessness: sensation of unpleasant urge to breath. triggered by acute hypercapnoia, acidosis, hypoxemia
characteristics of dyspnea
slightly bluish, and anxious
cough characteristics
- dry or loose
*productive or nonproductive - acute or chronic
- occurs more frequently at particular time
chronic cough
8 weeks or longer
Phlegm
vs
sputum
phlegm: muscus from the tracheobronchial tree not contaminated by the mouth
sputum: mucus from lower airway but expectorated through mouth
sputum colors and what it tells about patient
*CLEAR- normal
*MUCOID(GREY)-chronic bronchitis
*YELLOW-presence of wbc, bacterial infection
*GREEN- stagnant sputum: gram negative bacteria
* BROWN/DARK- old blood, anaerobic lung infection
*BRIGHT/PINK-hemoptysis
*PINK FROTHY-pulmonary edema
pleuritic
vs
nonpleuritic chest pain
pleuritic: located laterally or posteriorly,
-sharp increase w/ deep breathing
nonpleuritic: located in the center of chest& may radiate shoulder or arm, it is not affected by breathing
- angia, gerd, chest wall pain, espohageal spaspm
hypothermia common causes
prolonged exposure to cold
less likely: head injury, stroke, decreased thyroid act infection
where is the site to take temperature that is closest to core body temperature
rectum
piting edema
vs
weeping edema
Piting: indentation mark left on skin after pressure applied
weeping: small fluid leak occurs at point where pressure applied
most common cause of lower extremity swelling
heart failure
tachycardia cause
> 100 beat
*exercise, fear, anxiety, low blood pressure, anemia, fever, hypoxemia, hypercapnia, medication
bradycardia causes
<60 beats min
* hypothermia, side effect of meds, certain cardiac arrhythmia, traumatic brain injury
Pulsus paradoxus is most common in which patient
acute obstructive pulmonary disease asthma attacks
tachypnea what can cause this?
> 20 breaths/min
*exertion, fever, hypoxemia, hypercarbia, metabolic acidosis, anxiety, pulmonary edema, lung fibrosis, pain
bradypnea what can cause this
<10 breath/min
*brain injury, severs myocardial infraction, hypothermia, anesthetics, opiate narcotics& drug over doses
central cyanosis
what causes it? where is it found
- bluish discolor, respiratory failure due to low oxygen levels
- lips or mouth
pursed-lip breathing
what patient does this?
why do they do it?
patient with COPD
*create back pressure helps keep airways open longer during exhalation helps reduce feeling of shortness of breath
jugular venous distention (JVD)
where do you find it?
what is going on with your patient
neck, respiratory distress, conjestive heart failure
* fluid overload
