Medical - Respiratory Flashcards
Significance of auscultating
Second intercostal space, midclavicular line
- airflow through the larger conducting airways
- Abnormal sounds heard best here include stridor and rhonchi.
Significance of auscultating
Third intercostal space, anterior axillary line, or fourth intercostal space, midaxillary line
- airflow through smaller conducting airways (bronchioles)
- maybe airflow into the air sacs (alveoli)
- abnormal breath sound heard best in this location is wheezing.
Significance of auscultating
Fifth or sixth intercostal space, posterior midscapular line
- sitting upright, the sounds heard here represent airflow into the alveoli.
- abnormal sound heard here most commonly is crackles (rales).
Wheezing
Sounds / Indicates / Heard in / Auscultate
Sounds like: high pitched whisteling on exhale. Sometimes Inhale.
Indication of: Bronchoconstriction swelling constriction of lower airways
Heard in: Asthma, emphysema, and chronic bronchitis, pneumonia, congestive heart failure
Auscultate: Third intercostal space, anterior axillary line, or fourth intercostal space, midaxillary line
Rhonchi
Sounds / Indicates / Heard in / Auscultate
Sounds like: snoring or rattling noises heard on auscultation
Indications: Obstruction of the larger conducting airways by thick mucus
Heard in: chronic bronchitis, emphysema, aspiration, and pneumonia
Auscultate: Second intercostal space, midclavicular line
Sound changes if the person coughs/changes position
Rales / Crackles
Sounds / Indicates / Heard in / Auscultate
Sounds like : Bubbly or crackling sounds heard during inhalation
Indicates: Fluid that has surrounded or filled the alveoli or small bronchioles
Heard in: pulmonary edema or pneumonia
Auscultate: Posterior base of lungs, Fifth or sixth intercostal space, posterior midscapular line
What causes
Crowing/Stridor
What does it sound like?
How to correct it
Swelling or muscle spasms that result from conditions
airway infections, allergic reactions, or burns to the upper airway
High-pitched sounds produced on inspiration
Typically cannot be relieved by manual maneuvers, suctioning, or insertion of an airway adjunct
What causes
Gurgling
How to correct
Liquid substance in airway
Suction airway
What causes
Snoring
How to correct it
Tongue or epiglottis blocking airway
Head tilt chin lift
Breathing assessment componants
- look
- listen
- feel
- rate
- positioning
Breathing OPQRST
O - when did it begin
gradual or sudden
what were you doing
P - does anything make it better or worse
Q - do you have a cough. is it productive
R - Pain anywhere else
S - 1-10 how bad is the breathing trouble
T - How long have you had this feeling
Define
Mediastinum
Central part of the thoracic cavity
Define
Hypercarbia
Increased carbon dioxide in the bloodstream
Define
Hypoxemia
Decreased oxygen in the bloodstream
Define
Dyspnea
Shortness of breath
Define
Apnea
No longer breathing
Define
Hypoxia
and what does it lead to celullarly
When the cells of the body aren’t getting enough oxygen and causes cellular dysfunction. This leads to cell death
Define
Tachypnea
Abnormally fast breathing
What does tripod position look like?
Leaning forward, braced with arms and elbows locked with hands on a hard surface
Define
MDI
And what kind of drug is administers
Metered-dose inhaler
Beta 2 specific bronchodilator
Define
SVN
What form is it
Small volume nebulizer
Form: Aerodol or mist
Define
Hypercarbic drive
Normal respiratory control that responds to CO2 levels in the arterial blood
Define
Hypoxic drive
Respiratory drive where the body uses chemoreceptors measuring oxygen in the blood instead of carbon dioxide receptors to regulate respirations
Define
Bradypnea
Abnormally slow respiratory rate
Define
Orthopnea
Difficulty breathing while lying down
Define
Flail chest
when broken ribs are isolated from the chest and interfer with normal chest movements
Paradoxical movement
Define
Pneumothorax
When the air that should only be in the lungs start leaking into the chest cavity
Define
Pulsus paradoxus
A drop in systolic blood pressure of 10 mmHg or more on inhalation
Define
Diaphoresis
Abnormal sweating that does not occure due to heat
Define
DVT
Deep vein thrombosis is a common source of a pulmonary embolism that travels and becomes lodged in the pulmonary vessels
Define
Syncope
Fainting
Define
URI
Upper respiratory infection which is a common way to refer to viral respiratory infections
Emphysema
Define
- COPD
- Lung tissue looses elasticity
- Alveoli walls destroyed
Emphysema
S/S
*Barrel-chest
* wheezing/rhonchi
* Pink puffers
* prolonged exhalation
* Tripod
Chronic Bronchitis
Define
- Bronchi + Bronchioles
- Inflimmation/swelling
Chronic Bronchitis
S/S
- Vigorous/sputum Cough
- JVD
- Peripheral Edema
- Blue Bloaters
- Rales/Rhonchi
- Wheezes at base of lungs
- Asterixis (inability to maintain posture, flapping like spasms, seen in hands) (Resp Failure)
COPD
Treatment
*Ensure open airway
*Position of Comfort
*Titrate O2
*Maintain SpO2
Asthma
Define
*Bronchospasm
*Lower airway lining inflammation/edema
*mucus plugs
Asthma
S/S
*Cough
*Wheezing exhale
*Anxiety
*Chest tightness
*Insomnia
Asthma
Treatment
*SABA
*CPAP - Caution
*Calming pt
Asthma
Mild/Moderate/Severe
Pneumonia
Describe
- Bacterial
- Viral
- Lung inflimmation
- Fluid/pus in Alveoli
Pneumonia
S/S
*low appetite
*Fever
*cough
*Sharp localized pain usually made worse when breathing deeply or coughing
*Crackles, Wheezing, Rhonchi
Pulmonary Embolism
Define
Blood clot in lungs
Pulmonary Embolism
S/S
- Long periods of immobility
- Sudden Dyspnea
- Sudden chest pain during Inhale
- Cough (Bloody)
*JVD
*Fever
*Swelling/pain/reddness/cold to one limb
Acute Pulmonary Edema
Define
*Cardiogenic = Left ventrical failure = fluid/blood back up
*Non cardiogenic = Infection/destruction of capillary beds
Acute Pulmonary Edema
S/S
*Orthopnea
*Pink/Frothy Sputum
*Crackles/wheezing
*JVD (Cardio)
*Swollen lower limbs (Cardio)
*Cough
CPAP uses
Disease/condition specific
Indication:
*Acute Pulmonary Edema
*Asthma - CAUTION
*COPD
*Toxic gas inhalation
*Drowning
*Pneumonia
Contraindication:
*Spontaneus pneumothorax
*Nausea/Vomiting
* Reduced consciousness
* pneumothorax
Spontaneous Pneumothorax
Define
Rupture of visceral lining
Primary = No underlying disease
Secondary = Underlying disease exmpl: COPD or Connective tissure dissorder
Spontaneous Pneumothorax
S/S
*Sudden SOB
*Sudden sharp chest/shoulder pain
*decreased Breath sounds on one side
*Subcutaneous Emphysema (Palpate for crepitus)
*Pale
Hyperventilation Syndrome
Define
Panic attack
too much Co2
Hyperventilation Syndrome
S/S
*Nervousness/Anxiety
*Numbness/tingling in mouth/hands/feet
*Foot/hand spasms/Cramps
*Tachypnea
Hyperventilation Syndrome
Treatment
- Talk down
- NRB @ 1-2 lpm
Epiglottitis
Define
*Bacterial Infection of upper airway
* swelling of the epiglottis, surrounding tissue, and the tongue
Epiglottitis
S/S
*4-7 YO
*RAPID onset
*Fever 102-104
*Painful to swallow
*Drooling
*Stridor inhale
* Cherry red epiglottis
Epiglottitis/Croup
Treatment
*light in open mouth to see swelling/redness
*DO NOT insert anything in airway
*O2 @ 15 lpm
*BVM - Slow squeeze
*Rapid transport
*ALS intervention
Croup
Define
Viral infection of upper airway
Croup
Symptoms
*6 months - 4 YO
*Slow onset
*Brassy cough
*no drooling
*Fever 100-101
CO Poisoning
S/S
- Oral or pharyngeal burns
- Dizziness
- Altered mental status
- Copious secretions
- History consistent with inhalation injury
- Cyanosis
Cystic Fibrosis
S/S
- Reacurrent cough
- Recurrent episodes or history of pneumonia, bronchitis, and sinusitis
- Abdonimal pain from intestinal gas
- Malnutrition
- Clubbing of the digits
- Trouble speaking and breathing with mucus buildup
Pertussis
S/S
- Coughing fits, usually more common at night
- On inspiration “Whoop” is heard at the end of coughing fit
- General malaise (weekness/fatigue)
- Sneezing, runny nose, low grade fever
- Vomitting
Whooping cough
Define
Bacterial infection
highly contagious
