Exam 1 Flashcards
What should be included in the history of present illness during a cardiopulmonary assessment?
Onset of symptoms, nature of symptoms (e.g., dyspnea, chest pain), factors that aggravate or relieve symptoms, and progression of the illness.
What are critical components of PMH and PSH in a cardiopulmonary assessment?
Previous diagnoses (e.g., COPD, hypertension), past surgeries (e.g., CABG, thoracotomy), and comorbid conditions.
Why is social history important in a cardiopulmonary assessment?
provides context for the patient’s lifestyle, living situation, occupation, and social support, which can influence treatment planning.
What should be observed in a systems review during a cardiopulmonary assessment?
Patient’s overall appearance, facial expression, body type (e.g., cachectic, obese), and breathing pattern.
What are the common abnormal chest shapes seen in cardiopulmonary conditions?
Barrel chest (common in COPD), pectus excavatum, and pectus carinatum.
What does the presence of JVD indicate?
Right-sided heart failure, as it suggests increased central venous pressure.
What does digital clubbing indicate in a patient?
Chronic hypoxemia, often seen in patients with chronic pulmonary diseases like COPD or cystic fibrosis.
What are the key vital signs to monitor during a cardiopulmonary assessment?
Heart rate, blood pressure, respiratory rate, and oxygen saturation.
What does the S1 heart sound represent?
The closure of the atrioventricular valves (mitral and tricuspid) at the start of systole, often described as “Lub.”
What does the S2 heart sound represent?
The closure of the semilunar valves (aortic and pulmonic) at the end of systole, often described as “Dub.”
What does the presence of an S3 heart sound indicate?
It suggests heart failure and is often heard as a “Lub-Dub-pah” sound during early diastole.
What does the presence of an S4 heart sound indicate?
It indicates stiff ventricles, often associated with systemic hypertension or left ventricular hypertrophy (LVH).
What are the three types of normal breath sounds?
Bronchial, bronchovesicular, and vesicular breath sounds.
What are the types of adventitious breath sounds?
Crackles, rhonchi, wheezes, pleural rub, and stridor.
What do crackles in the lungs indicate?
presence of fluid in the alveoli, commonly associated with pneumonia or heart failure.
What does the presence of rhonchi indicate?
consolidation or secretions in the larger airways, often described as a snoring sound.
What does the presence of wheezes indicate?
It indicates airway narrowing, often due to bronchospasm or secretions, commonly seen in asthma.
What does a pleural rub sound indicate?
It suggests inflammation or neoplasm of the pleura, heard as a grating sound.
What does the presence of stridor indicate?
It indicates a blockage or inflammation in the trachea, often heard as a high-pitched sound during inspiration.
What does a positive egophony finding indicate?
It suggests lung consolidation, where the “E” sound changes to an “A” sound during auscultation.
What are the key components of a cardiopulmonary assessment?
History, Systems Review, and Tests and Measures.
Where can you obtain a patient’s history during a cardiopulmonary assessment?
Patient chart, medical team (nurse, MD, PA, NP, social work), and patient interview.
What should be assessed during the functional mobility part of a systems review?
Transfers (supine to sit, sit to stand), ambulation, and stairs. Monitor vital signs with position change.
What is cachexia and in which patients is it commonly observed?
Cachexia is muscle loss or wasting, with or without loss of fat, often seen in patients with chronic, progressive diseases.
What does cyanosis indicate during a cardiopulmonary assessment?
Cyanosis indicates poor oxygenation, with central cyanosis suggesting hypoxemia and peripheral cyanosis suggesting decreased cardiac output.
How is pain level assessed during a cardiopulmonary systems review?
Using a pain scale (0-10), observing facial grimacing, and evaluating pain quality (sharp, dull, burning, or ache).
How do you assess a patient’s respiratory rate?
By observing the rise and fall of the chest and counting breaths per minute, with normal adult values being 12-20 breaths per minute.
What does an ABI measurement indicate?
ABI compares blood pressure at the ankle and arm to assess arterial narrowing and decreased blood flow, with values less than 0.9 indicative of peripheral artery disease (PAD).
What is mediate percussion used for in a cardiopulmonary assessment?
To assess the density of underlying tissues, producing sounds like resonant, dull, flat, tympanic, or hyperresonant.
What does increased tactile fremitus indicate during palpation?
Increased tactile fremitus suggests lung consolidation, while decreased fremitus may indicate air trapping or pleural effusion.
What conditions can cause tracheal deviation?
Conditions like tension pneumothorax, pleural effusion, atelectasis, or pneumonectomy can cause tracheal deviation.
When are systolic murmurs heard and what might they indicate?
Systolic murmurs are heard between S1 and S2 and may indicate conditions like aortic stenosis or mitral regurgitation.
When are diastolic murmurs heard and what might they indicate?
Diastolic murmurs are heard between S2 and S1 and may indicate conditions like aortic regurgitation or mitral stenosis.
What is the purpose of incentive spirometry in a cardiopulmonary assessment?
To increase lung volume and reverse atelectasis, often used post-surgically or in patients with pulmonary conditions.
What differentiates normal breath sounds from abnormal breath sounds?
Normal breath sounds include bronchial, bronchovesicular, and vesicular sounds, while abnormal sounds include adventitious sounds like crackles, rhonchi, and wheezes.
What does a positive bronchophony finding indicate?
A positive bronchophony, where voice sounds are clearly transmitted, indicates increased lung density, often due to consolidation.
What does assessing chest excursion involve?
Measuring the movement of the chest wall during breathing, with normal chest wall excursion being approximately 3 inches.
What does the presence of crepitus during palpation indicate?
Crepitus indicates an air leak from the respiratory system, often associated with chest tubes or pneumothorax.
What is apnea, and how is it detected?
Apnea is the absence of breathing, detected by observing a lack of chest movement and no detectable breath sounds.
What does tripod breathing indicate?
It indicates respiratory distress, where the patient leans forward with elbows on the knees to recruit accessory muscles for breathing.
What are common signs of respiratory distress?
Use of accessory muscles, tachypnea, cyanosis, pursed-lip breathing, nasal flaring, and changes in mental status.
What are the normal parameters for blood pressure?
Systolic: 90-120 mmHg; Diastolic: 60-80 mmHg.
In which patients is an S3 heart sound considered normal?
S3 can be normal in children and young adults but is often pathological in adults over 40, indicating heart failure.
How is pitting edema graded?
By the time it takes for the skin to rebound:
1+: slight depression
2+: <15 seconds
3+: 15-30 seconds
4+: >30 seconds
