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Systemic III > Pulmonary > Flashcards

Pulmonary Flashcards

1
Q

Why should you check for lung dz?

A

Super common and undiagnosed

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2
Q

Why should you check for lung dz?

A

Super common and undiagnosed

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3
Q

What drugs exacerbate lung conditions?

A

Beta blockers
Aspirin and NSAIDs
Antihistamines
Narcotics

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4
Q

How much do beta blockers reduce lung function in healthy patients?

A

10%

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5
Q

What effect do Beta blockers have on lung function?

A

Bronchospasm

Cheap and used in many combos

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6
Q

What timeframe can bronchospasms occur with use of beta blockers?

A

Within 24 hours

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7
Q

What does aspirin and NSAIDs do to respiration?

A

Asthma Attack

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8
Q

What do antihistamines do to respiration?

A

Changes lung secretions

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9
Q

How do narcotics affect respiration

A

Decreases respiratory rate

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10
Q

What should you ask a patient about to determine their lung function?

A 
Coughing
     Onset - pattern - productive?
SOB
     Onset - pattern
     Can also occur in heart dz
Chest pain
     Onset - patterns - assoc symptoms 
     Rare in lung dz - more often in heart dz
Previous lung problems
     Asthma, TB, Allergies
     Ever use O2 tank?
Personal and social history
     Tobacco - Particulates - Exercise tolerance
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11
Q

What would you observe about a pt’s breathing to evaluate lung function?

A

Labored - distressed - wheezing
Use of accessory muscles
Pt ability to speak (no? Asthma attack, fool)

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12
Q

What would you observe about pt’s appearance to determine lung function?

A 
Posture 
     Upright - tripodding - upper body posture
Pursed lips
Color of nail beds and lips
     Nail beds only? Heart problem
     Nails and lips weird? Lungs
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13
Q

What order should you auscultate a patient?

A

Posterior Lowers then up
Anterior lower, side lower
Anterior middle an dup

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14
Q

Why do you listen to lowers first?

A

Tend to develop problems first

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15
Q

Would normal sounds be harsher lower or higher when listening to lungs?

A

Harsher Higher

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16
Q

How would you approach listening to posterior lung?

A

Pt does chicken wing arm to loosen shirt
Lower: Have pt find bottom of breast bone and trace around to back
Place steth right over that line in middle of side
Middle: Find “L” of scapula and put steth on angle - have pt hug self to move scapula out of way
Upper: Draw line from shoulders around, put steth right below

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17
Q

How would you approach listening to anterior lung?

A

Pt places steth and you hold it
Lower: Bottom of bone until middle
Can do side by moving over to bottom of arm
Middle: Bottom of breast bone, hand width up
Upper: Collar bone + 4 cm down

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18
Q

Normal breath sounds

A

Bronchovesicular
Will sound harsh
Vesicular
Louder on inspiration

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19
Q

Adventitious sounds

A

Rhonchi
Dry, low snores heard in normal people
Caused by secretions - clear with cough
Wheeze
Musical whistle from forced air
Louder with expiration
Can hear either
Rub
Mechanical rubbing sound from inflam
Inhale and Exhale
Crackles (AKA Rales)
Bubblefroth noise - spaces filled with fluid
Pulmonary edema, pneumonia, CHF
Comes and goes
Fine or coarse not cleared with cough
Inhale

20
Q

How do you measure forced expiratory flow?

A

Have pt blow in meter 3x and and choose the best number to record.
Blow fast and hard
Mouthpiece into biohazard

21
Q

What does forced expiratory flow measure?

A

Ease of air through bronchii

22
Q

How would you evaluate result of forced expiratory flow

A

Using table of norms
Measured in L/min
> is high
80% to expected is normal

23
Q

What could cause decreased forced expiratory flow?

A

Emphysema, asthma, COPD, etc

24
Q

When would you beware when Rxing beta blockers?

A
25
Q

What drugs exacerbate lung conditions?

A

Beta blockers
Aspirin and NSAIDs
Antihistamines
Narcotics

26
Q

How much do beta blockers reduce lung function in healthy patients?

A

10%

27
Q

What effect do Beta blockers have on lung function?

A

Bronchospasm

Cheap and used in many combos

28
Q

What timeframe can bronchospasms occur with use of beta blockers?

A

Within 24 hours

29
Q

What does aspirin and NSAIDs do to respiration?

A

Asthma Attack

30
Q

What do antihistamines do to respiration?

A

Changes lung secretions

31
Q

How do narcotics affect respiration

A

Decreases respiratory rate

32
Q

What should you ask a patient about to determine their lung function?

A 
Coughing
     Onset - pattern - productive?
SOB
     Onset - pattern
     Can also occur in heart dz
Chest pain
     Onset - patterns - assoc symptoms 
     Rare in lung dz - more often in heart dz
Previous lung problems
     Asthma, TB, Allergies
     Ever use O2 tank?
Personal and social history
     Tobacco - Particulates - Exercise tolerance
33
Q

What would you observe about a pt’s breathing to evaluate lung function?

A

Labored - distressed - wheezing
Use of accessory muscles
Pt ability to speak (no? Asthma attack, fool)

34
Q

What would you observe about pt’s appearance to determine lung function?

A 
Posture 
     Upright - tripodding - upper body posture
Pursed lips
Color of nail beds and lips
     Nail beds only? Heart problem
     Nails and lips weird? Lungs
35
Q

What order should you auscultate a patient?

A

Posterior Lowers then up
Anterior lower, side lower
Anterior middle an dup

36
Q

Why do you listen to lowers first?

A

Tend to develop problems first

37
Q

Would normal sounds be harsher lower or higher when listening to lungs?

A

Harsher Higher

38
Q

How would you approach listening to posterior lung?

A

Pt does chicken wing arm to loosen shirt
Lower: Have pt find bottom of breast bone and trace around to back
Place steth right over that line in middle of side
Middle: Find “L” of scapula and put steth on angle - have pt hug self to move scapula out of way
Upper: Draw line from shoulders around, put steth right below

39
Q

How would you approach listening to anterior lung?

A

Pt places steth and you hold it
Lower: Bottom of bone until middle
Can do side by moving over to bottom of arm
Middle: Bottom of breast bone, hand width up
Upper: Collar bone + 4 cm down

40
Q

Normal breath sounds

A

Bronchovesicular
Will sound harsh
Vesicular
Louder on inspiration

41
Q

Adventitious sounds

A

Rhonchi
Dry, low snores heard in normal people
Caused by secretions - clear with cough
Wheeze
Musical whistle from forced air
Louder with expiration
Can hear either
Rub
Mechanical rubbing sound from inflam
Inhale and Exhale
Crackles (AKA Rales)
Bubblefroth noise - spaces filled with fluid
Pulmonary edema, pneumonia, CHF
Comes and goes
Fine or coarse not cleared with cough
Inhale

42
Q

How do you measure forced expiratory flow?

A

Have pt blow in meter 3x and and choose the best number to record.
Blow fast and hard
Mouthpiece into biohazard

43
Q

What does forced expiratory flow measure?

A

Ease of air through bronchii

44
Q

How would you evaluate result of forced expiratory flow

A

Using table of norms
Measured in L/min
> is high
80% to expected is normal

45
Q

What could cause decreased forced expiratory flow?

A

Emphysema, asthma, COPD, etc

46
Q

When would you beware when Rxing beta blockers?

A

Systemic III (8 decks)

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