Lower Respiratory CIS Flashcards
What can cause cyanosis?
chronic hypoxia
Pectus carinatum
pigeon chest
comes out
Barrel chest
increase in AP diameter
common w/ COPD
Pectus excavatum
funnel chest
Hemoptysis
coughing up blood
What is important about chief complaint?
should be in pt’s words
conversational dyspnea
how many words can get in for each breath
Epistaxis
bloody nose
Otalgia
ear pain
What is considered a palpation technique when examining a respiratory pt?
thoracic expansion
put hands on thoracic spine around ribs & feel for expansion/contraction w/ breaths
Order of respiratory exam
Inspection
Palpation
Percussion
Auscultation
Egophony
auscultation technique
as listen w/ stethoscope, ask them to say “E” and sounds more like an “A”
transmit of sound is being altered
Diaphragmatic excursion
percussion technique
how far diaphragm has moved during inspiration & expiration
Whispered pectoriloquy
auscultation technique
whisper & you are able to hear it really well is not normal (consolidation that is transmitting the sound better)
A 75 yr old male presents w/ shortness of breath & cough, what should be first obtained @ beginning of encounter?
pulse oximetry
measure oxygenation & pulse rate (esp for respiratory concern)
Arterial blood gas
invasive procedure done in radial artery
looks @ pH, oxygenation, CO2 of blood
PFT (pulmonary function test)
sitting in chamber & getting all information about lung function
can diagnose obstructive v restrictive lung disorders
A 32 yr old female admitted & has decreased breath sounds over lower lobes. Chest X ray shows atelectasis. What is best treatment for diagnosis?
Atelectasis leads to shallow breaths & may cause pneumonia (can occur post-surgery)
spirometry (so inhale & exhale fully)
What does atelectasis mean?
collapse of alveolar lung tissue affecting O2 absorption
What is absence of breathing?
apnea
If experiencing shortness of breath & decreased breath sounds in RLL. What PE finding would most likely be found with underlying diagnosis?
most likely underlying diagnosis will be atelectasis
diaphragmatic excursion is elevated on R (uneven diaphragm)
An 18yo presents w/ shortness of breath & pleuritic chest pain (inflammation of pleura). What would be found on exam?
chest pain should be worse w/ inhalation & exhalation
tension pneumothorax causing mediastinal shift to the R
hyper-resonance on percussion on L
Vesicular breath sounds
normal breath sounds of most of lung (auscultation technique)
