Respiratory Assesment

Question 1

What to Look for/What patients tell us?

Answer 1

wheezing, chocking, spluttering, shortness of breath, coughing (productive-produces mucus or non-productive). Pain when inhaling/exhaling, fatigue, night sweats

Question 2

4 Different Types of Respiration Rhythms and What Causes them

Answer 2

Tachypnoea - Rapid Breathing Caused by; cold weather, pain, drugs, shock, anxiety, exercise, chest, infection

Bradypnea - Slow Breathing Caused by; drugs usually opioid overdose

Apnea - Not Breathing Caused by; cardiac arrest, chocking

Cheyne-Stokes Respiration Respiration increase in rate/depth then become shallow and slow, Apneas may occur. Seen at end of Life

Kussmaul Respirations Caused by; Hyperventilating, Metabolic Issues

Question 3

Observations in Effort of Breathing (7)

Answer 3

• Bent Forward
• Tripoding
• Use of Accessory Muscles
• Fatigue/Tiredness
• Hypernea - Abnormal rapid or deep
• Diaphragmatic - Belly breathing
• Costal Breathing - Intercostal Driven

Question 4

What are we Listening For? (Normal Sounds)

Answer 4

• Bronchial Sound (loud, snorkel like sound)
• Bronchovesicular (Medium, sound of narrowing airway)
• Vesicular (Soft, low pitch - lung bases/soft high pitch - apical)

Question 5

What are we Listening For? (Adbnormal Sounds)

Answer 5

Adventitious Sounds:

• Wheeze
• Narrow airways or turbulent airflow
• Upper Respiratory/broncho & Broncho-vesicular areas
• Fluid
• Lung Bases

Walking on Snow Sound = Pleurisy

Question 6

What Respiratory Support can we Offer?

Answer 6

• Give oxygen
• Pain relief
• Coach breathing
• Change positioning

Question 7

Different Oxygen Delivery Devices (8)

Answer 7

• Nasal cannula
• Face mask
• Face tent
• Oxymizer
• Venturi mask
• Non-rebreather
• High flow nasal cannular
• Bipap

Question 8

Saturation Levels in Patients (Healthy vs Type 2 Respiratoy Failure)

Answer 8

• If 94%+ in healthy patient good
• If a patient is at risk of type two respiration failure should get oxygen levels up to 88% to 92%

Question 9

2 Types of Respiratory Failure

Answer 9

Type1 - Hypoxic Failure Caused by damage to lungs eg infection, trauma, oedema therefore respond well to oxygen therapy

Type 2 - Hypercapnic Failure Caused by ventilation being inadequate to clear CO2 therefore doesn’t respond well to oxygen therapy

Question 10

What happens when you ventilate COPD Patients

Answer 10

• In COPD patients, O2 exchange is reduced due to damage to alveolar sacs
• The body responds by remodelling the capillary beds by pulmonary vasoconstriction to the sacs
• This means that they don’t get O2 nor can’t expel CO2
• So when we ventilate the blood vessels will dilate in the presence of O2
• AAR more CO2 will build and any O2 will be expelled backwards
• Secondarily the Haldane effect when blood increases acidity, the ability to hold O2 decreases while the affinity for O2 decreases (changes)