Module 10: Respiratory tract Flashcards
what is sputum
Mucus produced by cells of the lungs
Hypercapnia
to much CO2 in the blood
Hypoxemia
to little O2 in the blood
Developmental considerations for infants and children
by week 16 same amt of conducting airways as adults
crying shows the resp works
smokers give their babies more risks, sudden infant death or asthma
Developmental considerations for pregnant women
Circumference of thoracic cage + 6cm
deeper breathing
Developmental considerations for older adults
- reduced mobility of thorax
- harder to inflate
- decreased capacity
- increased residual volume that they can’t release
- decreased ability to cough, loss of protective reflexes and increased secretions
Subjective data
- Cough
- SOB
- chest pain with breahting
- History of resp. infection
- Smoking history
- environemental exposure
- self care behaviour
Additional subjective data for child/infant
1) illness
2) allergy
3) Chronic resp. illness
4) safety
5) Environmental smoke
additional subjective data for older adults
1) activity intolerance
2) level of activity
3) lung disease
4) pain
Tactile fremitus
palpable vibrations should be symmetrical
Factors that affect tactile fremitus:
-Location of bronchi in relation to chest wall
-thickness of chest wall
-pitch and intensity
What is crepitus
Cracking sensation palpable over the surface of skin
-could mean subcutaneous emphasema
What is pleural friction fremitus
Palpable inflammation from the visceral and parietal pleura rubbing together
What does increased fremitus mean
compression/ consolidation of the lung tissue
What does decreased fremitus mean
When anything obstructs transmission of vibrations
What is resonance (while percussing)
Low pitched hollow sound (Normal)
What is hyper resonance
low pitched booming sound
too much air
what is a dull note
abnormal, muffled thud
Could mean pneumonia, pleural effusion or tumor
The 3 types of breath sounds
- Bronchial - loud, high pitched @ trachea and larynx
- Bronchovesicular - moderate @ near spine
- Vesicular - low soft * peripheral of lung
What could decreased breathing sounds mean
1) Obstruction of bronchial tree (Foreign body, secretion)
2) Emphysema (enlarged airsacs in lungs)
3) Obstruction of sound (pleural thickening, pneumothorax (air or gas between lungs and chest wall), or pleural effusion
What would cause increased breath sounds
- Pneumonia
- fluid in intrapleural space
What are adventitious sounds
Additional sounds not usually heard
-secretions of thracheoobronchial passageways collide with air or popping open of closed airway
What causes crackles
excessive fluid
What causes wheeze/rhonchi
asthma
What does retraction and bulging of the interspaces suggest
- Retraction could mean obstruction & increased effort
- Bulging suggests trapped air
- In COPD these muscles are used to fore expiration
Developmental considerations for infants and children
- Let parent hold infant
- crying enhances palpation of tactile fremitius and auscultation of breath sounds
- Offer the stethoscope to older children to test out
- Barrel shaped chest till age 6
- Infants are nose breathers
- mostly breath in abdomen
Developmental considerations for older adults
- kyphosis
- barrel shaped chest
What is pectus excavatum
sunken sternum
what is pectus carinatum
forward protrusion of sternum, ribs slope
What is scoliosis
S shaped spine, uneven scapular height, ribs, hips
What are discontinuous sounds
- Descrete fine crackles during inspiration
* Pneumonia, heart failure, interstitial fibrosis
Whats the cascade cough
Hold breath for 2 seconds then contract expiration muscles, cough through exhalation
What is the huff cough for
your central airway
What is the quad cough
Push in and up on ab muscles toward diaphragm to cause a cough
How to train respiratory muscles
Use incentive spirometer for resistive breathing training
Pused lip breathing(increased oxygen saturation) and diaphragmatic breathing
