Respiratory Flashcards
Respiratory: PMH and FH
Allergies
Emphysema
Bronchitis
Asthma
Pneumonia
Recurrent infections
TB
Malignancy
Heart Failure
GERD
Respiratory: Habits
Smoking
Occupational exposure to toxins
Travel
Pet exposure
Current medications
Recreational drug use
CC: Common Respiratory problems in Primary care
Cough
Chest pain
dyspnea
abnormal respiratory rate
Cough
Usually preceded by _____
May be d/t ____ ____ or more general problems
Usually spontaneous response to an ____
May be an indication of ____
Medications?
Inspiration
Localized causes
irritant
anxiety
ACE inhibitors
Cough is one of the most common symptoms for which patients seek health care:
Acute cough is classified as?
Chronic cough is classified as?
< 3 weeks
>3 weeks
Cough:
Quality of the cough can be?
Dry
Wet
Hacking or barking or hoarse
Sputum production questions
When did it start?
How long has it been going on?
Has it changed?
Associated symptoms?
Characteristics?
Treatments?
Characteristics of sputum to ask about are?
Amount
Color
Odor
HPI Chest Pain
Onset
Duration
Precipitating factors
Associated symptoms
Alleviating and aggravating factors
Platypnea is what?
How common is it?
What causes it?
Dyspnea that increases in the upright position
Rare
R to L atrial shunting
Additional questions about dyspnea to consider?
Severity?
Anxiety related to breathing?
Edema?
Pain?
Associated with CV dysfunction?
What is Hyperpnea?
Deep breathing
Components of Resp Physical Exam?
Inspection
Palpation
Percussion
Auscultation
Equipment needed for Resp Physical Exam?
Stethoscope
Ruler and washable marker
Draping for patient privacy
Optional additional equipment
Inspection components to consider are?
Rate, Rhythm, Depth, Effort
Listen for audible wheezing, gurgling
Retractions, accessory muscles
Chest movement
When will you see retractions?
asthma
COPD
Pneumonia
additional respiratory inspection components away from chest are?
is trachea midline?
Assess face and mouth for cyanosis or pursed lip breathing
Look at the nares for any sings of flaring
smell the patient’s breath
look at the fingers for signs of clubbing
Chest Configurations:
Observe chest for?
Asymmetry, deformity, increased A/P diameter
Barrel chest
Pigeon Chest (pectus carinatum)
Funnel Chest (pectus excavatum
Spinal deformity
Asymmetry of chest seen with?
Scoliosis
Kyphosis
Increased A/P diameter is seen with?
COPD
Pectus Carinatum
Palpation is used to identify?
areas of tenderness or deformity
Intercostal tenderness could indicate?
Inflamed Pleurae
Costal sternal border pain could indicate?
Costochondritis
What is Costochondritis?
Inflammation of the cartilage that connects the ribs to the sternum
What is crepitus?
Coarse vibrations felt on inspiration.
What does crepitus suggest?
Pleural friction rub d/t inflammation of the pleura
SubQ emphysema
Tactile Fremitus is what?
Palpable vibration of the chest wall from verbalization of “99”
Use what surface of the hands for detecting tactile fremitus?
Palmar or ulnar surface of hands
Best place tactile fremitus is felt is where?
Posteriorly at the 2nd or 3rd ICS