HPI/PE

Question 1

When pt is SOB it is important to establish…?

Answer 1

Present at rest
Walking on level or climbing the stairs
Necessary to stop and rest
What activities of daily life bring on dyspnea

Question 2

Orthopnea

Answer 2

SOB increased when laying down

-how many pillows used at night?

Question 3

Paroxysmal Nocturnal Dyspnea

Answer 3

Sudden loss of SOB after a period of sleep

Question 4

Platypnea

Answer 4

SOB increased in an upright position

Question 5

Kussmaul Breathing

Answer 5

Deep and labored breathing pattern, gasping, form of hyperventilation

Question 6

Kussmaul Breathing is most commonly associated with..?

Answer 6

DKA- diabetic ketoacidosis

Question 7

Cheyne-Stroke Respiration

Answer 7

Progressively deep and sometimes faster breathing followed by a gradual decrease that results in a temporary state of apnea

Question 8

Cheyne-Stroke Respiration is precipitated by…?

Answer 8

CVA, TBI, sleeping at altitude, CHF, etc.

Question 9

Coarse Crackles (previously known as rhonchi)

Answer 9

Coarse rattling respiratory sounds

Rolling thunderstorm

Question 10

Coarse Crackles is caused by…?

Answer 10

secretions in bronchial airways (ie. pneumonia)

Question 11

Fine crackles (previously known as rales)

Answer 11

sofe, high-pitched, and very brief sound

opening a velcro fastener

Question 12

Fine crackles indicate what?

Answer 12

Interstitial process- pulmonary fibrosis or CHF

Question 13

Fremitus

Answer 13

Vibrations transmitted through the body generally referring to an assessment of lungs.

Question 14

An increase in fremitus intensity indicates

Answer 14

Consolidation or fibrosis

Question 15

A decrease in fremitus intensity indicates

Answer 15

Fluid or air (effusion, pneumothorax)

Question 16

Tactile Fremitus

Answer 16

Vibrations felt on the chest wall

- pt says “99”

Question 17

Vocal Fremitus

Answer 17

Vibrations heard with stethoscope on the chest wall with spoken words

Question 18

Pleural rub

Answer 18

Outside lung tissue rubbing against the chest wall, heard during inspiration

Question 19

Stridor

Answer 19

Heard when a foreign body is present

Question 20

Wheezes

Answer 20

Whistling heard in reaactive airway disease or asthma

Question 21

Anoxia

Answer 21

The total absence of oxygen in body tissue

-think end organ damage

Question 22

Pneumothorax

Answer 22

Air in pleural cavity

- can cause complete or partial collapse of lung

Question 23

Hemothorax

Answer 23

Blood in pleural cavity

-can cause complete or partial collapse of lung

Question 24

Pleural Effusion

Answer 24

Abnormal presence of fluid in pleural cavity

Question 25

Causes of pleural effusion

Answer 25

Trauma or spontaneous

Question 26

Spontaneous is common in what age/gender/race?

Answer 26

25-30 yo white males who have a h/o smoking

Question 27

Pink Puffer

Answer 27

• Break down of elastin in connective tissue in lungs

- less surface area for gas exchange d/t gradual destruction of the pulmonary capillary bed

Question 28

S/S of pink puffer

Answer 28

Older, thin, severe dyspnea, barrel chest, pursed-lip breathing, pink skin
- Emphysema

Question 29

Blue Bloater

Answer 29

• excessive mucus production with airway obstruction resulting from hyperplasia of mucus producing glands
• chronic inflammation around bronchi

Question 30

S/S of blue bloater

Answer 30

Overweight, cyanotic, elevated Hbg, peripheral edema, coarse crackles, and wheezing
- Chronic bronchitis