Respiratory Flashcards
observe with the patient seated, arms across chest, using tangential light
trachea, tracheal position, suprasternal notch, costal angle
observe characteristics
shape, size, symmetry, AP diameter, color, superficial venous patterns, costal angle, rib prominence
assess respiratory rate
note rhythm, any abnormal respirations
observe chest movement
symmetry, use of accessory muscles bulging or retractions
assess lips, nails, fingers, alae
signs of respiratory problems (cyanosis)
palpate the posterior chest (4 sites)
pulsations, tender areas, bulges, depressions, masses, rubs, unusual movements or positions
patient say “99” while palpating
tactile fremitis
auscultate 10 appropriate posteior sites and 8 lateral sites
vescular, bronchial, broncovesicular, or tracheal sounds
assess for abnormal breath sounds
wheezing, rhonchi, crackles, rubs stridor
evaluate for transmitted vocal sounsd
(+) “ee” sounds like “ay” egophony, (+) whispered wrods become clearer/louder (pectoriloquy), (+) muffled words become clearer/louder (bronchophony)
Assess FET
+ 5 seconds or greater.. 6 sec suggests COPD
measure PEFR
(+) outside of normal based on patients age, sex, and weight. for asthmatic patients >80% of personal best = well controlled, 50-80% of personal breast: caution; intervene with medication, <50% urgent referral.
paradoxical pulse
(+) you continue to hear the karakov sounds only during expiration, after lowering the pressure by >10-12 mmHg
Identification of a fractured rib
(+) increased local pain with the placement of a vibrating 128 Hz tuning fork a few cm away from site of injury along the rib.
assess chest expansion
(+) asymmetrical expansion
