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NREMT® Paramedic > EMT-P (1) Airway, Respiration and Ventilation > Patient Assessment - Respiratory > Flashcards

Patient Assessment - Respiratory Flashcards

Learn proper Assessment techniques for Airway, Respiration and Ventilatory emergencies

1
Q

Define:

Adventitious Breath Sounds

A

Abnormal airway sounds.

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2
Q

What position do patients sit in when experiencing respiratory distress?

A
  • Tripod position
  • Semi-Fowler position
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3
Q

What is the normal respiratory rate in infants?

A

25-50 breaths/min.

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4
Q

What is the normal respiratory rate in children?

A

15-30 breaths/min.

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5
Q

What is the normal respiratory rate in adults?

A

12-20 breaths/min.

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6
Q

Define:

Orthopnea

A

Shortness of breath when lying flat.

Typical in obese and patients with heart failure.

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7
Q

List visual assessment questions for the Respiratory Distress patient.

A
  • Patient position?
  • How adequate is the rise and fall of the chest?
  • Gasping for air?
  • Skin color?
  • Flaring of nostrils?
  • Pursed Lips?
  • Retractions?
  • Accessory muscle use?
  • Is the chest wall moving symmetrically?
  • Rate or rhythm of breathing?
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8
Q

Define:

Paradoxical Motion

A

Chest segment moves:

  • IN during inhalation.
  • OUT during exhalation.
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9
Q

What causes Paradoxical Motion?

A

flail chest

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10
Q

Define:

Pulsus Paradoxus

A

Systolic BP drops more than 10 mmHg during inhalation.

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11
Q

What causes Pulsus Paradoxus?

A
  • Pericardial tamponade
  • Severe COPD
  • Tension pneumothorax

Increased intrathoracic pressure

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12
Q

What commonly exacerbates Asthma?

A
  • cold weather
  • stress
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13
Q

What is a good assessment tool for indication of an intact gag reflex?

A

eyelash reflex

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14
Q

How do you assess breath sounds?

A
  • Anteriorly
  • Posteriorly

Key areas:

  1. Apex
  2. Base
  3. Bilaterally
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15
Q

Define:

Cheyne-Stokes respiration

A

Increasing rate and depth of breathing, followed by a decrease, and a period of apnea.

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16
Q

What indicates Cheyne-Stokes respiration?

A

brainstem insult

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17
Q

Define:

Kussmaul respiration

A

Rapid and deep breathing.

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18
Q

What indicates Kussmual respiration ?

A

Diabetic Ketoacidosis

DKA

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19
Q

Define:

Biot respiration

A

Irregular rate and depth of breathing, with periods of apnea.

20
Q

What indicates Biot respiration?

A

Increased intracranial pressure.

21
Q

Define:

Agonal respiration

A

Shallow, slow and irregular breathing.

22
Q

What indicates Agonal respiration?

A

Near death, caused by cerebral hypoxia.

23
Q

If there is concern for upper airway obstruction, what breath sounds should you also obtain?

A

Tracheal breath sounds

24
Q

Define:

I/E ratio

A

The ratio between inhalation and exhalation in terms of time.

25
Q

What is the normal I/E Ratio?

A

1 : 2

1: inhalation

2: exhalation

26
Q

What I:E ratio will be seen in patients who have difficulty exhaling?

A

1:4 or 1:5

27
Q

Fill in the blank.

Always auscultate directly on the patient’s ____.

A

skin

28
Q

Define:

wheezing

A

High-pitched breath sound.

29
Q

What causes wheezing?

A
  • COPD
  • Anaphylaxis
  • Asthma
30
Q

Define:

Rhonchi

A

Perfuse crackles throughout the larger lower airways.

Rhonchi are worse than crackles.

31
Q

What causes rhonchi?

A
  • Pulmonary edema
  • Bronchitis
32
Q

Define:

crackles

A

Popping sounds from the lower airway and often clear from coughing.

33
Q

Define:

stridor

A

High pitched and loud heard during inhalation.

34
Q

What causes stridor?

A
  • Foreign body obstruction
  • Upper zirway obstruction

Inflammation of structures,

35
Q

What does a pulse oximeter measure?

SpO2

A

Percentage of hemoglobin that is saturated with oxygen in arterial blood.

36
Q

What is the target SpO2?

A

> 94%

37
Q

List causes of erroneous SpO2 readings?

A
  • bright light
  • patient movement
  • poor perfusion
  • nail polish
  • abnormal Hgb
38
Q

Define:

carboxyhemoglobin

A

The amount of carbon monoxide loaded onto hemoglobin.

39
Q

What are the normal ABG values?

A
  • pH: 7.35-7.45
  • PaO2: 80-100 mmHg
  • PaCo2: 35-45 mmHg
  • HCO3: 22-26 mEq/L
40
Q

What does the End-Tidal CO2 measure?

EtCO2

A

It measures CO2 in exhaled air.

41
Q

What is the normal EtCO2?

A

35-45 mmHg

42
Q

Define:

normal waveform capnography

A

Sudden increase during exhalation, with a gradual plateau at end exhalation.

43
Q

During hyperventilation, the EtCO2 reading _____.

A

decreases

Pt is blowing off CO2.

44
Q

During hypoventilation, the EtCO2 reading _____.

A

increases

Pt is retaining excess CO2.

45
Q

How is the patient placed in the recovery position?

A

Left Lateral Recumbent position

46
Q

What are the procedures for performing the Head Tilt Chin Lift?

A
  1. Ensure the pt is in the supine position.
  2. One hand is on the forehead, and the other is under the jaw.
  3. Lift the chin upward, lifting the entire mandible with it.

EMT-P (1) Airway, Respiration and Ventilation (7 decks)

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