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RT Tech > PATIENT ASSESSMENT > Flashcards

PATIENT ASSESSMENT Flashcards

1
Q

Edema, hemoptysis, hematemesis are also symptoms of….

A

Pulmonary disease

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2
Q

Is shortness of breath subjective or objective?

A

Subjective, and is one of the most common pulmonary complaint and is a primary symptom of cardiopulmonary disease. So its related to both pulmonary and cardiopulmonary.

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3
Q

Which is the cardinal symptom of cardiac disease? And is the most distressing symptom of respiratory disease.

A

SOB

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4
Q

What 2 things does sensation of SOB are experienced.

A

It’s a product of physiological impairment and the psychological makeup.

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5
Q

The sensation of dyspnea via Sensory input to cerebral cortex varies directly from….and inversely from…..

A

Directly from ventilator demand…more exercise more demand more sensation.
And inversely with ventilator capacity…less capacity more sensation

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6
Q

T/f, the more stimulation of the drive to breathe when ventilator abnormalities exist, the greater the dyspnea.

A

T, because more stimulation is due to pulling of air more inside, hence the dyspnea is greater.
Goes hand in hand

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7
Q

T/f, you can never assume that a patient with a rapid respiratory rate is dyspneic.

A

True, because it is very subjective. He might not be and thinks he is, or may b he is and denies. Always check it yourself through physical assessment.

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8
Q

2 pathway of perception of SOB

A

Sensory input to the cerebral cortex
Perception of the sensation

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9
Q

Kidney causes whci type dyspnea?

A

Chemical, becuase chemical imbalance causes dyspnea which is due to kidney failure (uremia)

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10
Q

Increased intracranial pressure causes dsypnea or not?

A

Yes.

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11
Q

CHF, ASTHMA AND COPD, how do they describe dyspnea?

A

Asthma- chest tightness
CHF- air hunger, suffocation
COPD &ILD- increased effort to breathe.

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12
Q

A decrease in Paco2 leads to decrease in….

A

Cerebral blood flow.

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13
Q

Chronic CHF and COPD are the most common types of acute or chronic dyspnea?

A

Chronic.

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14
Q

Inspiratory dyspnea is associated with…….where as expiratory is associated with…

A

Inspiratory is with the upper airway obstruction, expiratory with smaller bronchi and bronchioles obstruction.
Opp MRI AND OE

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15
Q

PND Is associated with….

A

Cough

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16
Q

PND is in ….position

A

Recumbent

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17
Q

In……, PND occurs 1- 2 hrs after lying down

A

CHF, due to fluid transfer to lower extremities

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18
Q

What is orthopnea?

A

Jolie, Julie…she associated it with number of pillows!
Inability to breathe lying down so increasing pillows help.

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19
Q

Which dyspnea is associated with CHF/left heart failure>

A

PND and orthopnea.

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20
Q

Trepopnea occurs in which position?

A

When lying on side cause dyspnea but lying on other relieves it.

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21
Q

Disorders associated with chest unilaterally- unilateral plueral effusion, unilateral airway obstruction, unilateral lung disease

A

Trepopnea.

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22
Q

Opp of orthopnea?

A

Platypnea- dyspnea due to upright position and relieved by recumbent position.

23
Q

Orthodeoxia is caused due to..

A

Upright position and relieved in recumbent position…just like platypnea….in this increased shunting from right to left heart happens due to congenital heart disease, and venous to arterial shunts due to severe lung disease or cirhossis. It is more severe when standing. And also can occur after pneumonectomy.

24
Q

What are the various measurement scale for dyspnea

A

Simple rating- 1-10
Modified borg scale- 0-10
American thoracic society- 0-4
Dyspnea-12

Still subjective!!!

25
Q

Asthma is inflammation?

A

Yes

26
Q

Mechanical cough is due to…

A

Direct stimulation by substance, inhaled dusts, food, suction catheter.

27
Q

T/f, cough can be caused by decreased tactile pressure

A

False, it is due to increased tactile pressure.

Note: increased ICP leads to dyspnea.

28
Q

How long does acute cough takes?

A

<3weeks

29
Q

How long does chronic cough occurs?

A

> 3 weeks.

30
Q

T/f post nasal drip comes under acute and chronic categories

A

True

31
Q

How many phases of cough?

A

4 phases.
Stimulation- through the afferent and efferent pathways.
Inspiration- increase length of bronchi, increase volume of lung, reflex opening of glottis, contraction of diaphragm, abdominal muscles and thoracic.
Compression-closure of the glottis, relaxation of diaphragm , contraction of expiratory muscles against closed glottis generates high intra thoraci pressure, and narrowing of trachea and bronchi.
Expulsion-opening of the glottis, explosive release of trapped intra thoracic air, vibration of vocal cords and mucosal lining of the posterior laryngeal wall shake secretion loose from larynx and move undesired debris out of the resp tract.

32
Q

Afterrent and efferent pathways which nerve is also part of other nerves….

A

Phrenic nerve is the only nerve in both pathways.

33
Q

What is the normal peak cough flow?

A

Normal is 360-400 L/min
Effective is >160-200

34
Q

Is phlegm and sputum different?

A

Yes phlegm are secretions strictly from lungs and trachebronchial tree, whereas sputum is expelled from sinuses, tracheobronchial tree, pharynx etc. and can be cleared with coughing or clearing of throat.

35
Q

Normal sputum production by tracheobronchial tree?

A

The tracheobronchial tree normally secretes up to 100 ml of sputum each day.

36
Q

Abnormal Sputum production is caused due to

A

Smoking, infection, allergies.

37
Q

Differentiate between hemoptysis and hematemesis

A

Hemoptysis
• Symptom: Coughing
• Originates from: Pulmonary system
• Colour: Bright red
• Timing: Acute or chronic
• Cause – Pulmonary bleed
Hematemesis
• Symptom: Vomiting
• Originates from: GI Tract
• Colour: Dark red
• Timing: Acute or chronic
• Cause – GI bleed
So think when we cough, it is pulmonary system and when we vomit it is GI system.

38
Q

Based on diff bacteria describe the color of sputum

A

Purulent- means it contains pus- infection or pneumonia. All these fall under:
Red currant jelly- klebsiella
Green apple- H.Influenza
Pink, thin blood streaked- streptococci or staphylococci
Rusty- pneumococci
Yellow or green copious- pseudomonas

39
Q

Foul odor (fetid) comes with…

A

Anaerobic infections, Bronchiectasis when standing up, aspiration, lung abscess when patient position is changed.

40
Q

Non purulent sputum is due to

A

Asthma.

41
Q

Large amount of sputum is seen in….

A

Bronchopleural fistula

42
Q

Hemoptysis is also called

A

Frankly bloody…

43
Q

Pleuritis and P.E causes chest pain….

A

True

44
Q

Chest pain can be caused by pulmonary sources such as

A

Chest wall or parietal pleura….but not lung parenchyma as it doesnt have pain receptors.

45
Q

T/f, skin, mediastinal, tracheal, and gastric are some of other sources of chest pain

A

True.

46
Q

What is other term for temporary LOC

A

Syncope, due to decrease blood flow and decrease O2 flow to the brain.

47
Q

Some pulmonary causes of syncope..

A

Thromboembolism, truss I’ve syncope, valsalva manoeuvre.

48
Q

Most common cause of syncope

A

Vasovagal response…leads to decrease BP and HR, less O2 to brain. Due to stress, emotion or pain, hence syncope.

49
Q

Chronic sputum production is most often related to….

A

Irritation or disease of the airway.

Such as asthma or chronic bronchitis.

50
Q

Hemoptysis is due to

A

A pulmonary system….it is coughing out of blood from anywhere in the respiratory tract, including nose or mouth. It can be due to tissue eg or ent by inflammation or back pressure from heart failure or other cardiac problems. Trauma, tissue bruise, chronic or repeated resp infections, Bronchiectasis. Tumor, or granuloma. In acute it can be infective process creating abscess around bronchial tree or lung parenchyma, which erode into another structure. Eg: bronchopleural fistula.

51
Q

Most common cause of hemoptysis

A

Tb, Bronchiectasis.

52
Q

When is it alarming during hemoptysis

A

When 400ml in 3 hrs or 600ml in 24 hrs is seen, which is seen in lung cancers, tb,Bronchiectasis and trauma.

53
Q

Frothy, blood tinged sputum is associated with …..

A

Paroxysmal cough accompanies cardiac induced pulmonary edema.(cardiogenic edema)

54
Q

Is metabolic and hormonal a causes of edema?

A

Yes, apart from tissue trauma, kidney disease, cardiac disease, pulmonary disease, and obstruction.

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