Respiratory Assessment Flashcards
What are the 9 most important factors to look at for an End of Bed Assessment?
Age
Cyanosis
Dyspnoea (Shortness of Breathe)
Cough
Wheeze
Stridor
Pallor
Oedema
Cachexia
What are the two medical assessments models that can be used?
SAMPLER
&
The medical model
What does SAMPLER stand for?
S - Signs and Symptoms
A - Allergies
M - Medications
P - Past Medical History (relevancy)
L - Last oral intake (what/when)
E - Events leading up to the illness/injury
R - Risk Factors
What is the medical model?
PC - Presenting Complaint
HPC - History of Presenting Complaint
O/A - On arrival
O/E - On examination
PMx - Past Medical History
DHx - Drug History
SHx - Social History
FHx - Family History
SgHx - Surgical History
ROS - Review of Systems
IMP - Impression
PLAN - Plan (treatment/management plan)
What are the 8 Red Flags?
1) Respiratory rate change >30 or 10< breathes per minute
2) O2 saturation drops <90 (non COPD)
3) Use of multiple accessory muscle groups
4) Inability to lie supine
5) Change in mental statuses
6) Cyanosis
7) Inability to clear mucus
8) Exhaustion
What are the 6 main vital points?
Pulse Rate (PR)
Respiratory Rate (RR)
Oxygen Saturations (SPO2)
Blood Pressure (BP)
Blood Glucose (BG)
Temperature (T)
Why is Age an Important Factor in an End of Bed Assessment?
It tells you what diagnoses to expect. Younger patients are more likely to have diagnoses such as asthma or cystic fibrosis, whereas older patients are more likely to have chronic obstructive pulmonary disease (COPD), interstitial lung disease or malignancy.
What is Cyanosis?
Bluish discolouration of the skin due to poor circulation.
What is Dyspnoea and what are some possible underlying causes?
Dyspnoea (also known as shortness of breathe) - Nasal flaring, pursed lips, use of accessory muscles, intercostal muscle recession, the inability to speak in full sentences and the tripod position.
Underlying Causes - Possible underlying diagnoses could be asthma, pulmonary oedema, pulmonary oedema, pulmonary fibrosis, lung cancer and COPD.
Why is a cough Important in an End of Bed Assessment and what could be the underlying diagnosis?
Is it productive or dry?
A productive cough could be associated to diagnoses such as pneumonia, bronchiectasis, COPD and CF. A dry cough could be associated to diagnoses such as asthma or interstitial lung disease.
What is Wheezing Indicative of?
Wheezing is often associated to diagnoses of asthma, COPD and bronchiectasis
What is Stridor and what are some of the underlying causes?
A high-pitched extra-thoracic breath sound resulting from turbulent airflow due to narrowed upper airways.
This could be due to foreign body inhalation (acute) or subglottic stenosis (chronic).
What is Pallor and what could it indicate?
A pale colour of the skin.
Could indicate anaemia or poor perfusion. Note: some healthy individuals may have a pale complexion that mimics pallor.
What is oedema and where are the location to check for pulmonary oedema?
Typically presents with swelling of the limbs (e.g. pedal oedema) or abdomen (e.g. ascites) and is indicative of right ventricular failure. Pulmonary oedema often occurs secondary to left ventricle failure.
The two locations to check for oedema is pedal and sacral
What is Cachexia and what does it indicate?
Cachexia is a “wasting” disorder that causes extreme weight loss and muscle wasting, and can include loss of body fat.
Indicates underlying malignancy (e.g. lung cancer) and other end-stage respiratory diseases (e.g. COPD)
