Health Assessment Exam 2 Flashcards
Nose: Nares, Septum, Turbinates, Adenoids
Nares: Lined with mucous membranes
Septum: Midline, Made up of cartilage & blood vessels, Receptors for olfactory nerve located here
Turbinates: Clean, moistens, and warms the air passage
Adenoids: Clusters of lymphatic tissue behind the nose, Part of immune system
Mouth: Oral Mucosa, Hard Palate, Soft Palate, Stenson’s Ducts, Wharton’s Ducts, Gums, Tongue
Oral mucosa: first portion of the alimentary canal for ingestion and food digestion
Hard palate: roof of the mouth
Soft palate: responsible for closing the nasal passage during swallowing; uvula hangs midline
Stenson’s ducts: route saliva flows from the parotid gland into the mouth
Wharton’s ducts: transport saliva produced in the submandibular gland; drains saliva produced in the sublingual glands
Gums: area around the root of a tooth
Tongue: symmetrical halves; thousands of taste buds; aids in swallowing and speech
Pharynx (Throat): Nasopharynx, Oropharynx, Laryngopharynx, Tonsils
Nasopharynx: behind the nose
Oropharynx: back of the mouth
Laryngopharynx: consist of pharynx, larynx, trachea, & esophagus
Tonsils: back of pharynx, part of the body’s immune system
Sinuses of the Face: Frontal, Ethmoid, Sphenoid, Maxillary
Frontal: above the eyes, center of the forehead
Ethmoid: between the eyes, deeper in the skull, not palpable
Sphenoids: behind the nasal cavity; not palpable
Maxillary: largest, located in the cheekbone below the eyes
Neck: Sternocleidomastoid, Trapezius, Trachea, Thyroid Gland, Carotid Arteries, Jugular Veins, Lymph Nodes
Sternocleidomastoid: connects the sternum, clavicle, and mastoid process of the temporal bone and serve to turn and nod the head
Trapezius muscles: Triangular muscles extending over the back of the neck and shoulders and moving the head and shoulder blade
Trachea: windpipe; extend from larynx to bronchi
Thyroid gland: largest endocrine glade; major role in metabolism, iodine absorption, and hormone production
Carotid arteries: Transport oxygenated blood supply to the brain
Jugular veins: bilateral; veins transport deoxygenated blood from the brain, face, and neck to the heart through the superior vena cava
Lymph nodes: part of lymphatic system; clusters are found in head and neck area
Health History: OPQRST
Onset
Provokes
Quality of Pain
Region/Radiation
Severity
Timing
Headaches: Tension, Cluster, Sinus, Migraine
Tension: feeling of pressure in the front of the head, both sides of the head, or neck related to muscular contraction
Cluster: vascular headache; stabbing pain on one side of the face or behind one eye or at the temple near the forehead; pain is constant; occurs in “clusters” or periods of time.
Sinus: throbbing pain and pressure in front of the face and sinuses; accompanied by upper respiratory symptoms, such as nasal congestion.
Migraine: vascular headaches with/without aura; produce unilateral, pulsating, intense pain lasting from a few hours to 3 days; cause nausea and is worse with activity/precipitating factors. Individuals have sensitivity to light, noise, and smells
Rhinorrhea
Thin, watery nasal discharge
Epistaxis
Nosebleeds
Xerostomia
Dry mouth with decreased saliva. (Many medications can cause dry mouth)
Dysphagia
Problems with swallowing
Goiter
Enlargement of thyroid gland
Sequence of Assessment
Inspection, Palpation, Auscultation
Insepecting and Palpating the Head
Inspect for: Size, Shape, Configuration, Movement
Palpate for: Tenderness, Masses, depressions
Normal Findings:
- Symmetrical, midline, and round
- Normacephalic (normal shaped head)
- Erect and still
- No pain, tenderness, masses, or depressions during palpation
Abnormal Findings:
Pain, Tenderness, Mass, Depression, Involuntary movements, Macrocephaly
Inspecting the Face
Assess facial appearance and symmetry
Nasolabial folds: creases in your skin extending from both sides of your nose to the corners of your mouth
Palpebral fissures: area between the open eyelids
Normal Findings:
- Face (round, oval, square)
- Symmetrical features
- Nasolabial folds are equal
- Palpebral fissures are equal
- No involuntary muscle movement
- Skin smooth and clear
- No edema
Abnormal Findings:
- Asymmetry of the face
- Flat affect
- Acromegaly
- Mask-like facial appearance
- Swelling of the face
- Different facial changes reflective of cardiac, respiratory, or autoimmune disorders
Palpating the Face
Assess tenderness, swelling, and inflammation
Use finger pads to palpate earlobes, temporal arteries, zygomatic arch (have patient open/close mouth)
Normal Findings:
- No tenderness
- Temporal artery non-tender
- The TMJ has no clicking sounds or limited ROM
Abnormal Findings:
- Tenderness or swelling
- Temporal arteritis: inflammation of the temporal arteries and blood vessels
- TMJ disorder causes a clicking, popping, or grating sound
Inspecting/Palpating the Nose
Assess for tenderness, inflammation, or deviation.
Inspect: Symmetry, Alignment of septum, Color, Swelling, Drainage
Palpate: Tenderness, Swelling
Normal Findings:
- Nose is symmetrical
- Septum straight and midline
- Skin color same as face
- No lesions, swelling, deformity or drainage
Abnormal Findings:
- Asymmetry
- Deviated septum
- Redness, bruising, lesions
- Tenderness or swelling while palpating
- Nasal drainage
Assessing Patency of the Nose
Assess for nasal passage occlusion
Have patient occlude each naris, close mouth, and breath in
Normal Findings:
- Passageway is patent
Abnormal Findings:
- Absence of sniff
- Rhinitis
- Nasal polyp
Palpating Maxillary/Frontal Sinuses
Assess for tenderness or pain
Frontal sinuses: Palpate slightly below the eyebrows
Maxillary sinuses: Palpate below the cheekbones
Normal Findings: No tenderness
Abnormal Findings: Tenderness is present
Inspecting/Palpating the Mouth
Assess the structures of the mouth for redness, tenderness, lesions, or abnormalities
Inspect from the front of the mouth and work toward the back of the throat.
SENC Patient-Centered Care: This assessment takes time. If the patient is having difficulty leaving their mouth open, have them close their mouth for a rest period.
Inspecting Lips
Assess shape and integrity of the lips
Inspect for:
- Color
- Lesions
- Moisture
- Swelling
- Symmetry
Normal Findings:
- Pink, moist
- No lesions, swelling, or cracking of skin
- Lips are symmetric
- Upper lip is everted
Abnormal Findings:
- Lips are inverted
- Swelling, erythema, lesions, cracking of skin
- Pallor of the lips
- Angular cheilitis: inflammation of the corners of the mouth
- Angioedema: rapid swelling of the deeper layers of the skin, mucous membranes, and subcutaneous tissues
- Herpes simplex virus
Inspection of Teeth
Assess for position, number, and integrity of teeth.
Inspect for:
- Color
- Dentures, caps, or missing teeth
- Tooth decay
- Ask patient to clench teeth and assess for malocclusion, malposition of the teeth
Normal Findings:
- Color of teeth white to ivory color
- Clean, free of debris
- Smooth edges
- 32 teeth or 28 teeth if wisdom teeth have been removed
Abnormal Findings:
- Color dark brown or black
- Loose, broken, painful teeth
- Malocclusion (misalignment) of the teeth
Inspecting/Palpating Buccal Mucosa
Assess for inflammation, lesions, or abnormalities
Normal Findings:
- Pink, smooth, moist, no lesions, swelling, or bleeding
- Tight margin around each tooth
- No tenderness with palpation
Abnormal Findings:
- Red or white, inflamed or bleeding mucosa; lesions
- Tenderness with palpation
- Aphthous stomatitis: recurrent ulcers
- Gingivitis: gum inflammation
- Gingival hyperplasia: overgrowth of gum tissue
- Periodontal disease: infection of tissues that surround and support the teeth
- Thrush: fungal infection (Candida yeast)
Inspecting/Palpating Hard and Soft Palates
Normal Findings:
- Transverse rugae, irregular ridges are firm, pink to light red; moist
- No tenderness
- Soft palate is pink, moist; no lesions or ulcerations
- Integrity of hard and soft palate intact
- Nodular bony ridge down the middle of the posterior hard palate
Abnormal Findings:
- Deep red color, ulcerations, lesions or growths
- Hard palate is a shade of yellow if jaundice is present.
- Torus palatinus: bony growth on the hard palate
Inspecting/Palpating the Tongue
Ask the patient to touch the roof of the mouth with the tongue
inspect tongue:
- Floor
- Frenulum: thin fold tissue connects underside to the floor of the mouth
- Ventral surface: inferior aspect of tongue
- Wharton’s ducts: saliva tube from submandibular gland to mouth
Using gauze, gently palpate the tongue for lumps
Normal Findings:
- Color pink and saliva present
- Papillae on dorsal surface
- Midline position
- Ventral surface smooth, pink, moist
- No lumps or nodules with palpation
- Wharton’s and Stensen’s ducts visible
Abnormal Findings:
- Cracked, dry, red, presence of ulcers or lesions, bleeding, thick white or yellow coating
- Atrophic glossitis
- Hairy tongue
- Leukoplakia
- Squamous cell carcinoma
Inspecting the Pharynx/Tonsils
Assess for redness/inflammation
Normal Findings:
- Uvula rises midline symmetrically
- Throat pink
- Tonsils pink; may partially protrude or be absent
+ (presence of) gag reflex
Abnormal Findings:
- Asymmetrical rise of the uvula
- Throat deep red, inflamed, with drainage
- Throat pain
- Tonsils protruding with or without drainage
- Tonsilitis (Grading 1–4 scale)
- Pharyngitis
Inspecting the Neck
Assess symmetry, movement, swelling of the neck
ROM: range of motion
Normal Findings:
- Symmetrical, no swelling
- No pain with ROM
- Full ROM of neck
Abnormal Findings:
- Asymmetrical
- Pain with movement
- Unable to perform ROM movements
- Torticollis: tilted, asymmetrical head/neck
Inspecting/Palpating the Trachea
Assess for tracheal shift or deviation.
- Ask the patient to sit up straight and bend her or his head slightly forward.
- Inspect the trachea below the thyroid isthmus.
- Gently place your right index finger in the sternal notch.
- Slip your finger off to each side, noting distance from the sternomastoid muscle.
- Assess the symmetrical spacing on each side and note any deviation from midline.
Normal Findings:
- Trachea is midline
- space is symmetric on each side
Abnormal Findings:
- Trachea is deviated from midline
Auscultating the Thyroid Gland
Further assessment of an enlarged thyroid gland is necessary to check for presence of a bruit, increased, turbulent blood flow.
- Patient sits up straight with neck slightly flexed.
- Using the bell of the stethoscope, auscultate both lobes of the thyroid gland for a bruit (sound when blood flows through narrowed artery).
- Assess for a “whooshing” sound
Normal Findings:
- No bruit is heard
Abnormal Findings:
- A bruit is heard
Healthy People 2030: Mouth
Goal: Improve oral health by increasing access to oral healthcare, including preventative services
Inspection/Palpation of Skin Color
Normal Findings:
- Hyperpigmentation: birthmarks, sun damage, freckles, tan lines
- Hypopigmentation: scars, stretch marks, vitiligo
Abnormal Findings:
- Pallor: face, conjuctivae, lips, buccal, mucosa (causes: anemia, shock, lack of blood flow)
- Erythema: face, skin, pressure sore areas (causes: inflammation/infection, vasodilation, sun exposure, rash)
- Cyanosis: best place to note in darker skin tones is mucous membranes and nail beds (causes: hypoxia, impaired venous return)
- Jaundice: skin, sclera, mucous membranes (causes: liver dysfunction)
Inspection/Palpation of Skin: Temp, Texture, Moisture, Turgor
Abnormal Temp: hyperthermia, hypothermia
Abnormal Texture: velvety skin (thyroid disease), roughness, xerosis (dryness), flakiness (dehydration)
Abnormal Moisture: diaphoretic
Abnormal Turgor: edema, tenting
Inspection/Palpation of Edema
Accumulation of fluid in the tissue, skin is shiny and tight
Assess over a boney area (shin):
- +1: trace, 2mm, rapid return
- +2: mild, 4mm, 10-15 sec return
- +3: moderate, 6mm, prolonged return
- +4: severe, 8mm, prolonged return
Vascular Lesions
Results from blood leaking into the dermis
Petechiae: infection or trauma
Ecchymosis: trauma (collection of blood in dermis >3mm in diameter); purple fading to green or yellow
Purpura: infection or bleeding disorder
ABCDEs of Melanoma
Asymmetry
Border: irregular, scalloped/poorly defined
Color: varied from one area to another
Diameter: usually greater than 6mm when diagnosed
Evolving: mole/skin lesion that looks different from the rest
Flat Lesions: Macule & Patch
Macule: freckles, mole, measles, scarlet fever
Patch: birthmark, vitiligo, hormonal changes
Raised Lesions: Plaque & Papule
Plaque: psoriasis, eczema
Papule: wart, elevated mole, skin tag
Raised, Solid Lesions: Tumor, Wheal, Nodule
Tumor: neoplasm
Wheal: insect bites, allergic reaction, hives
Nodule: melanoma
Raised, Fluid Filled Lesions: Pustule, Cyst, Bulla, Chickenpox, Shingles, Acute Eczema
Pustule: acne, cold sore
Cyst: cystic acne, sebaceous cyst
Bulla: blister, medication reaction
Assessing Pressure Injuries: Color, Size, Exudate, Surrounding Skin
Color:
- Red: healthy regeneration
- Yellow: presence of purulent drainage/slough
- Black: presence of eschar
Size: length, width, depth, undemining, tunneling
Exudate:
- odors, amount, consistency
- Serous: clear
- Sanguineous: blood
- Serosanguineous: clear & bloody
- Purulent: pus
Surrounding Skin: intact, macerated (soft, white, wrinkled), edematous (edema), erythematous (red/flushed)
Stage 1 Pressure Ulcer (PU)
- Reddened area, does not blanch at pressure
- Skin intact
- Texture firmer/softer than surrounding tissue
- Darker skin tones (blue/purple hue)
- Never rub a reddened area
Stage 2 Pressure Ulcer
- Partial thickness loss to dermis
- Skin breakdown of the epidermis/dermis
- Red/pink, shiny wound bed
- Appears as a blister, abrasion, very shallow crater
Stage 3 Pressure Ulcer
- Full thickness skin loss with damage to subcutaneous tissue
- Dead tissue may be present in wound bed
- Deep without exposed muscle or bone
Stage 4 Pressure Ulcer
- Full thickness skin loss resulting in exposed bones, tentions, muscles
- Tissue necrosis/damage to muscle, bone, or underlying structures
- Slough, eschar, tunneling, undermining
Unstageable Pressure Ulcer
- Ulcer covered with eschar or slough
- Depth unknown
Deep Tissue Injury
- Discoloration but skin intact
- Damage to underlying tissue
- Appears as a bruse with intact skin
Pressure Injuries/Ulcers Prevention
- Inspect skin daily
- Wrinkle free linen
- Reposition q2h, shift weight q15min
- <1hr in chair
- Head Of Bed (HOB) <30
- Float heels, Ambulate ROM
- Lift Device
- Speciality Mattress
- Assess: Braden Scale
- Clean skin with warm water & little friction, moisture barrier cream
- Nutrient dense foods: high protein diet
- Provide wound care per facility guidelines
Ear A&P: Auricle, Helix, Tragus, Lobule, Malleus, Incus, Stapes, Cochlea, Semicircular Canal
Auricle: helps direct sound to the eardrum
Helix: prominent outer rim of the auricle
Tragus: protuberance anterior to the auditory canal
Lobule: soft lobe on the bottom of auricle
Malleus, Incus, Stapes: bones transmit sound waves from the eardrum to the inner ear and the eustachian tube
Cochlea, Semicircular Canal: transmits sound waves through the auditory nerve to the brain
Cranial Nerve 8 (Vestibulocochlear) transmits sound and information
Sound Frequence:
- Pitch of sound
- measured in Hertz (Hz)
Sound Intensity:
- Volume of sound
- Measured in Decibels (dB)
Inspecting the Ears
Normal Findings:
- Color same as facial skin
- Equal size and shape bilaterally; normal size (4 cm to 10 cm)
- Symmetrical
- No deformities, inflammation, nodules, or drainage
- Angle of attachment < 10 degrees
Abnormal Findings:
- Color is blue, red, white, or pale
- Asymmetrical
- Lesions
- Drainage
- Cauliflower ear
- Microtia: malformed outer ear (birth defect)
- Macrotia: abnormally large ears (medical condition)
- Tophi: uric acid crystals form around joints, causes inflammation and pain
Assessing Hearing
Cranial Never 8 (Vestibulocochlear)
Assess for impaired/loss of hearing
- Conductive:
- Sound isn’t conducted through the outer ear canal to the eardrum & ossicles
- Earwax buildup, fluid, ear canal rupture, obstruction, middle ear infection, otosclerosis, sinus infection
- Sensorineural:
- Damage to the inner ear (cochlea) or never pathways from the inner ear to the brain
- Congenital rubella syndrome, cytomegalovirus (CMV), toxoplasmosis, certain meds, multiple sclerosis, inner ear disorders
Weber Test
Assess unilateral hearing loss
Use 512 Hz tuning fork
Normal Findings:
- Sound quality is heard equally in both ears
Abnormal Findings:
- Sound is perceived louder in the good ear & softer in the bad ear (Sensorineural hearing loss)
- Sound is perceived louder in the bad ear (Conductive hearing loss)
Rinne Test
Assess hearing by bone conduction vs air conduction
Use 512 Hz tuning fork
- Place fork on mastoid bone 1 inch from the ear
Normal Findings:
- Positive Rinne: Air conduction is 2x bone conduction
Abnormal Findings:
- Negative Findings: Bone conduction is longer than air conduction
Assessing Ear using Otoscope
Normal Findings:
- External ear canal patent
- No inflammation or drainage
- Small amount of pale yellow, moist wax
- Tympanic membrane intact, pearly gray color; translucent; contour slightly conical
- Bony landmarks visible
- Cone of light present
Abnormal Findings:
- Excessive ear wax
- Otitis externa: redness/swelling of external ear canal
- Otitis media: infection of middle ear
- Serous otitis media: middle ear fluid without acute infection
- Otomycosis: fungal infection in the ear canal
- Scarred/perforated tympanic membrane
Healthy People 2030: Ear
- Prevent sensory & communication disorder & improve quality of life for people
- Wear ear protection
- Get hearing test regularly
Cranial Nerves (9)
CN 1: Olfactory - recognize smell
CN 2: Optic - visual acquity, Snellan Test
CN 3: Oculomotor - PERRLA
CN 4: Trochlear - up & down eye movement
CN 5: Trigeminal - facial sensation
CN 6: Abducens - side to side eye movement
CN 7: Facial - smile, frown, raise eyebrows
CN 8: Vestibulocochlear - cover ear & whisper or snap, assess patients gait
CN 9: Glossopharyngeal - gagging & swallowing, have patient say “ah” and yawn
Inspecting the Eyes
Assess the external eye structures
Abnormal Findings:
- Asymmetrical/protruding
- Drainage
- Cornea is not smooth
- Unequal pupils
- Lacrima ducts red/inflamed
- Palpebral fissures unequal
- Abnormal spasms
- Belpharitis: inflammed eyelids
- Cataract: clouded lens
- Conjuctivitis: inflammed conjuctiva
- Corneal abrasion
- Ectopion: lower eyelid turns outward
- Entropion: eyelids roll inward
- Exophthalmos: bulging eyeball from sockets
- Hordeolum: infection of oil gland in eyelid
- Icterus: jaundice
- Pterygium: fleshy growth develops in the conjuctiva and can extend to the cornea
- Ptosis: upper eyelid droops
Assessing Visual Acuity
Measure & assess visual acuity using Snellen Chart
Abnormal Findings:
- Higher denominator = poorer distant acuity
- Myopia: nearsightedness
- Hyperopia: farsightedness
- Presbyopia: gradual loss of the ability to focus on nearby objects
- Legal blindness: vision 20/200
Assessing for Color Blindness
Assess the ability to distinguish colors using Ishihara Plate
Abnormal Findings:
- Patient incorrectly identifies the colors/doesn’t see the colors
Assessing Central Vision
Assess using Amsler Grid
- Checks everyday eyesight
- Can help diagnose & monitor conditions that distort the surface of the macula
- Focus on the dot in the middle, ask if any lines are distorted, broken, blurred, missing, mark the areas not seen
Confrontation Test
Assess peripheral vision, overall field of vision, blind spots
Move fingers at the following angles:
- Temporal: 90 Degrees
- Nasal: 60 Degrees
- Superiorly: 50 Degrees
- Inferiorly: 70 Degrees
Abnormal Findings:
- Scotoma: blind spot in one/both eyes
- Hemianopia: loss of vision/blindness in half the visual field
Testing for Ocular Motility
Assess the functioning of the ocular muscles
Have patient follow pen/finger with eyes from 12-14 inches away in an “H” & “star” pattern
Abnormal Findings:
- Patient is unable to follow the movement in each of the six cardinal directions
- Diplopia: double vision
- Nystagmus: uncontrolled eye movement
Inspecting Pupil Size & Consensual Reponse
Assess pupillary light reflex & integrity of optic pathways
Abnormal Findings:
- Anisocoria: one pupil bigger than the other
- Mydriasis: dilated pupil
- Miosis: excessive pupil constriction
- Horner’s Syndrome: rare neurological syndrome, drooping upper eyelid, constricted pupil, bloodshot eye, lack of sweating
Lungs
- Cone-shaped, air-filled structure
- Acid-base balance maintains blood pH through the release of carbon dioxide from the lungs during each respiratory cycle
- Pleura is a serous membrane
- Parietal Pleura: produces pleural fluid between the two pleurae to keep the area lubricated for easy movement
- Visceral Pleura: secretes a serous fluid that also lubricates the pleural cavity to help keep the lungs expanded
Arterial Blood Gas Test
- Blood test that takes a sample from the artery to measure the levels of oxygen and carbon dioxide
- Checks the balance of acids and bases in your blood
- Test can help interpret conditions that affect your respiratory, circulatory and metaboli processes
Thoracentesis
- Using a needle to take fluid out from around your lungs (pleural space)
- Some medical conditions/diseases cause fluid to leak into the pleural space (pleural effusion), making it hard to breathe
Bronchoscopy
- Uses a bronchoscope through the nose or mouth to look directly at the airways in the lungs
- Can see the larynx (voice box), trachea, bronchi (large airway to the lungs), bronchioles (smaller branches of the bronchi)
Rigid Bronchoscope:
- remove large amount of secretions/blood, foreigh objects, lesions (diseased tissue)
- control bleeding
- do procedures such as stents
Flexible Bronchoscope:
- can move to the bronchioles
- used to place breathing tube
- suction out secretions, take tissue samples, put medicine in lungs
Dyspnea
uncomfortable awareness of the act of breathing
Orthopnea
Difficulty breathing while lying down
Paroxysmal Nocturnal Dyspnea
shortness of breath when the patient is asleep in bed
Inspecting the Thoracic Cage
Normal Findings:
- AP-transverse ratio is approximately 1:2
- Conical shape
- Symmetrical
- Skin color uniform
- Respiratory rate 12 to 20 breaths per minute
Abnormal Findings:
- AP-transverse ration is approximately 1:1
- Pectus excavatum: sternum/ribs curve inward
- Pectus carinatum: sternum/ribs protrude outward
- Muscle retractions
- Abnormal respirations
- Abnormal skin color
- Clubbing of nail plates (COPD symptom)
Palpating the Thorax
Normal Findings:
- Skin dry
- Surface smooth and uniform
- Warm skin
- No tenderness
Abnormal Findings:
- Excessive moisture
- Irregular surface
- Temperature cool or clammy
- Tenderness
- Crepitus: light crackling or popping feeling under the skin caused by leakage of air into the subcutaneous tissue
Auscultating the Lungs
Crackles:
- Produced by air passing over retained airway secretions
- Usually heard at the end of inspiration but may be heard on inspiration or expiration
- May be cleared by coughing
- Fine crackles are soft, high-pitched sounds; sounds like crunching, or a fine rubbing sound
- Coarse crackles are louder, low-pitched lung sounds (sounds like ripping open Velcro)
Rhonchi:
- Louder, deeper, lower-pitched wheezes occurring in the upper bronchi
- May be related to obstruction of the larger airways
- Commonly heard during exhalation
- Sounds like snoring.
Wheezes:
- Caused by narrowed passageways in the trachea-bronchial tree by secretions, inflammation, obstruction, or a foreign body
- High-pitched, whistling or musical sound
Pleural Friction Rub:
- Caused by inflammation of the parietal and visceral pleurae that normally slide without friction
- Deep loud, harsh, leathery sound
- Heard during inspiration and expiration
Stridor:
- Caused by inflammation of the parietal and visceral pleurae that normally slide without friction
- Deep loud, harsh, leathery sound
- Heard during inspiration and expiration
Assessing Peak Expiratory Flow Rate (PEFR)
Assess lung functioning & forced expiratory volume of air in the lungs
- Have patient take a deep breath, place PFM in mouth with tongue under the mouth peice
- Have patient close lips tightly and blow hard/fast as possible
- Take few normal deep breaths and repeat process 2x
- Record highest number
Normal Findings:
- Green Zone: 80-100% highest peak flow
Abnormal Findings:
- Yellow Zone: 50-80% personal best
- Red Zone: <50% personal best
Healthy People 2030: Respiratory
- Stop smoking
- Avoid exposure to environmental pollutants
- Prevent infection
- Get vaccinated
- Exercise
