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RET1024C- Respiratory Therapy Fundamentals > Chapter 16- Beside Assessment of the Patient > Flashcards

Chapter 16- Beside Assessment of the Patient Flashcards

1
Q

Diagnosis

A

The process of identifying the nature ands cause of illnesses.

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2
Q

Differential diagnosis

A

Refers to a situation when many diseases share the similar signs and symptoms maike their exact cause unclear.

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3
Q

Signs

A

The objective manifestation of illnesses

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4
Q

Symptoms

A

The sensation or subjective experience of some aspect of an illness.

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5
Q

Factors affecting communication between the RT and the patient should include what?

A
  • Sensory and emotional factors
  • Envriomental factors
  • Verbal and non Verbal communication
  • Cultural values, beliefs, feelings, habitats and preoccupations of the RT and the patient.
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6
Q

Dyspnea

A

The general term to describe the sensation of breathing discomfort.

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7
Q

Breathing is a complex balance along these three factors?

A
  • the nueral drive to breathe coming from the brainstem.
  • the tension in the respiratory muscles.
  • the corresponding displacement of the lungs and the chest wall.
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8
Q

Breathlessness

A

The unpleasant urge to breathe. Can be triggered by acute hypercapnia, acidosis or hypoxemia.

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9
Q

Orthopnea

A

Dyspnea when the person reclines

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10
Q

Platypnea

A

Dyspnea triggered by assuming an upright position.

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11
Q

Orthodeoxia

A

oxygen desturation on assuming an upright positon.

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12
Q

Trepopnea

A

Occurs when a patient with unilateral lung disease lies on the affected side.

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13
Q

What are the 4 major questions to be asked when a patient experiences dyspnea?

A
  • What daily activites trigger it.
  • How much exertion can the patient handle before they have to stop to catch their breath.
  • Does the qaulity of dyspnea vary with different activities.
  • When did your dyspnea become apparant , has it evolved over time, slowly or rapidly, Has there been a recent change in the dyspnea?
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14
Q

Psychogenic hyperventilation syndrome

A

Associated with panic disorders

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15
Q

Cough

A

A forceful expiratory maneuvuer that expels mucus, foregin materials from the airways.

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16
Q

Where are your cough receptors located?

A

The larynx, trachea and larger bronchi

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17
Q

4 factors necessary for an effective cough

A
  • the ability to take a deep breath
  • lung elastic recoil
    -expiratory muscle strength
    -level of airway resistance.
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18
Q

Atelectasis

A

a complete or partial collapse of the entire lung or area (lobe) of the lung

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19
Q

5 Important cough characteristics that an RT should know.

A
  • if cough is dry or loose
    -productive or non productive
  • acute or chronice
  • freqency
  • is it provoked by a particular position
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20
Q

How long does a chronic cough last

A

More than 8 weeks.

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21
Q

Phlegm

A

uncontaminated mucus from oral secreations

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22
Q

Sputum

A

Mucus expectorated from the mouth contains pus cells.

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23
Q

Purlent

A

suggesting a bacterial infection

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24
Q

What does purlent sputum look like?

A

Thick, coloured and sticky.

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25
Q

Fetid

A

Fowl smelling sputum

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26
Q

Mucoid

A

Clear thick sputum- commonly seen in ashtma patients

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27
Q

Hemopytsis

A

Coughing up blood, can be caused by broncheostasis, lung abcess and acute tb

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28
Q

Massive hempotysis

A

A medical emergency defined by coughing a variable volume of blood over a define time period. More than 300ml with 24 hours.

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29
Q

Non Massive hempotysis

A

Can occur in many conditions such as airway infections, pneumonia, lung cancer, TB, chest trauma and pulmonary embolism.

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30
Q

Infection- associated hemoptysis

A

Usually present as blood streaked, purulent sputum.

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31
Q

Hematemesis

A

Refers to blood vomited from the gastrointestinal tract often occurs in patients wth gastrointestinal dieases.

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32
Q

Pleuritic chest pain

A

Located laterally or posteriorly. Sharp stabbing pain that worsens with deep breaths.

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33
Q

Non-pleuritic chest pain

A

located in the center of the anterior chest and may raidate to the shoulder , neck or back. dull ache or pain not affected by breathing.

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34
Q

Angina

A

is chest pain or discomfort that occurs when part of your heart muscle does not get enough oxygen-rich blood.

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35
Q

Define fever

A

Elvated body temperature greater than 38.3 degress celcius or 101 Fahrenheit.

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36
Q

Pedal edema

A

Heart failure characterized by the lower extremities becoming swollen.

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37
Q

Pitting edmea

A

Finger pressure is applied and it leaves an indentation mark of the skin, the higher it occurs the more severe the heart failure.

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38
Q

Weeping edmea

A

When finger pressure is applies and it causes a small fluid leak.

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39
Q

How is smoking history recorded

A

In pack years.

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40
Q

How to calculate pack years.

A

number of packs smoke per day multipled by the amount of years they smoked.

41
Q

Advance directive

A

DNR, DNI , AND (allow for natural death)

42
Q

What are the 4 important indicators used when assesing a patients overall apperance.

A
  • level of conciousness
    -facial expressions
  • level of anxiety or distress
  • Postioning
43
Q

Cachexia

A

Weakness and malnutrition

44
Q

Disphoresis

A

Sweating

45
Q

Tripod sign

A

Patient with sever hyperinflation tend to sit upright while bracing their elbows on a table.

46
Q

Senorism

A

The cognitive functioning level of a patient and level of conciousness.

47
Q

What information do you need to collect for vital signs.

A

Body temperature, pulse rate, respiratory rate, blood pressure, pulse oximotery.

48
Q

Hyperthermia/ Hyperpyrexia

A

Elevated body temperature.

49
Q

Hypothermia

A

Body temperature is below normal.

50
Q

Pulsus paradoxus

A

Is a significant decrease in pulse strength during spontaous inspiratorion that ca be qaulifed with a blood pressure cuff.

51
Q

Pulsus alterans

A

Is an altering sucession of strong and weak pulses that suggest ledt sided heart failure.

52
Q

What is the normal respiratory rate in a healthy adult

A

12 to 18 breathes an minute

53
Q

Tacypnea

A

Breathing greater than 20 breaths per minute

54
Q

Bradypnea

A

Breathing less than 10 breaths a minute.

55
Q

Arterial blood pressure

A

forced exercted by the heart against the systemic arteries as blood moves through them.

56
Q

Arterial systolic pressure

A

is the peak force exerted in major arteries during contraction of the left ventricle.

57
Q

Diastolic pressure

A

is the force in the major arteries remianing after the relaxation of the ventricles.

58
Q

In a normal adult what is the range for systolic pressure

A

90 to 140 mmHG

59
Q

In a normal adult what is the range for Dyastolic pressure

A

60 to 90 mm HG

60
Q

Hypertension

A

Arterial blood pressure, persistently greater than 140/90 mm Hg.

61
Q

Hypotension

A

Low blood pressue

62
Q

lymphadenopathy

A

Enlarged lymph nodes

63
Q

Pectus Crainatum

A

abnormal pertusion of the sternum

64
Q

Pectus excavatum

A

Depression of part or the entire sternum

65
Q

Kyphosis

A

Spinal deformity in which the spine has an abnormal anterior posieror curvature.

66
Q

Scoliosis

A

Spinal deformity when the spine has a lateral curve

67
Q

Kyphoscoliosis

A

Combination of kyphosis and scroliosis.

68
Q

Retraction

A

Inward sinking of the chest wall during inspiration.

69
Q

What are the three types of retraction?

A
  • Intercostal
    -Supraclavicular
    -subcostal
70
Q

Tracheal tugging

A

downward movement of the thyroid cartilage towards the chest during inspiration in concert with sternocleidomastoid recuitment.

71
Q

Kassmaul breathing

A

Observed during severe metabolic acidosis where by patients breath rapdily and deeply simliar to a normal person during strenous exercise.

72
Q

Cheyen Stokes respiration

A

Is when the respiratory rate and tidal volume gradually increases in intensity and then gradually decrease to produce apnea which can last several seconds.

73
Q

Biot Respiration

A

occurs with damage to the medulla resulting in chacotic breathing patterns, characterized by frequent irregularity in both rate and tidal volume

74
Q

Agonal breathing

A

Intermittent prolonged gasps

75
Q

Apnesutic breathing

A

Chracterized by a prolonged inspiratiory pause at full inspiration lasting for 2 to 3 seconds.

76
Q

Central neurogenic hyperventilation

A

Chracterized by persistent hyperventilation driver by abnormal neural stimuli.

77
Q

Central neurogenic hypoventilation

A

Means respiratory centers do not respond appropriately to ventilatory stimuli such as CO2 .

78
Q

Hoover sign

A

Contraction of a flat diaphragm tends to draw in the lateral costal instead of normal outward expansion.

79
Q

Respiratory alternans

A

Where the diaphragm and the rib cage muscles alternately power breathing in an attempt to rest each muscle group.

80
Q

Abdominal paradox

A

Occurs when the diagphragm is drawn upwards with insparotry effort of the intercostal musles.

81
Q

Vocal fremitus

A

Vibrations created by the vocal cord during speech

82
Q

Tactile fremitus

A

when vocal fremitus vibrations are felt on the chest wall

83
Q

Subcutaneous emphysema

A

Fine airbubbles leaking into tissue create crackling sound and sensation when paplitated.

84
Q

Tympanic

A

Percussion over normal lung fields produces easily heard, moderlay low pitched, resonate sound .

85
Q

Pneumothorax

A

When the pleural space contains large amounts of air.

86
Q

For basic parts of a stethoscope

A
  • A bell
  • A diaphragm
  • tubing
  • ear pieces
87
Q

Tracheal breath sounds

A

Loud tubular quality are heard when ausculatating the trachea, equal duration between inspiration and expiration.

88
Q

Bronchovesiular breath sounds

A

heard around the upper half of the sternum between the sacpular, slightly lower in pitch also have equal inspiratory and expiratory sounds

89
Q

Vesicular breath sounds

A

heard over normal lung parencgyma , characterized bya soft muffeled sound qaulity that is lowe in pitch and intensity.

89
Q

Adventitous lung sounds

A

Additional sounds or vibrations produced by air movement through diseased airways.

90
Q

Wheezing

A

Continous adventitious lung sounds

91
Q

Stridor

A

A loud high sound associated with upper airway obstructio and often heard without a sethoscope.

92
Q

Lung Sounds

A

Audible vibrations primarily generated by turbulent airflow in larger airways

93
Q

What the two sources of diminished breath sounds

A

Diminished airflow velocity or when sound transmission through the lung or chest wall is blunted.

94
Q

Crackles

A

Inspiratoy sound produced when airflow moves secreations of fluid in the airways or when collasped airways pop open during inspiration.

95
Q

What is another name for Corse crackles

A

Rhonchi

96
Q

Plueral ficton rub

A

Typically heard during inspiraton and is usually localized to a discreete site on the chest wall.

97
Q

How long should digital perfusion be in a Capillary refill test?

A

3 seconds or less

RET1024C- Respiratory Therapy Fundamentals (9 decks)

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