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Nursing 2910 > Respiratory Assessment > Flashcards

Respiratory Assessment Flashcards

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1
Q

What does the pulmonary system consist of

A

the airway and lungs

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2
Q

What does the airway consist of

A

nasal passages, mouth, pharynx, larynx, trachea, bronchi, and bronchioles

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3
Q

What is the function of the airway

A

to moisten, warm, and filter the air

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4
Q

What do the lungs contain

A

the apex, base, and alveoli

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5
Q

How many lobes does the right lung have and what are they

A

3
Superior/upper, middle, inferior/lower

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6
Q

How many lobes does the left lung have and what are they

A

2
superior/upper, inferior/lower

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7
Q

What does the left lung have that the right lung doesn’t

A

the cardiac notch (makes space for the heart)

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8
Q

Where are the lower lobes heard best

A

posterior

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9
Q

What does inhalation do

A

draws air in through the mouth and nose, expands the chest cavity and lungs, creates a negative pressure

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10
Q

What anatomy does inhalation use

A

diaphragm, intercostal muscles, pleural membrane

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11
Q

What does exhalation do

A

relaxes diaphragm and intercostal muscles, returning the lungs and chest to a normal size

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12
Q

Respiration

A

gas exchange within the lungs

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13
Q

How does gas exchange happen and where

A

occurs in the alveoli, O2 goes to the blood which carries O2 to the body, and CO2 is brought back to the alveoli to be breathed out

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14
Q

What is external respiration

A

alveolar –> capillary

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15
Q

What is internal respiration

A

capillary –> tissues

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16
Q

What do chemoreceptors do

A

measure the CO2 and O2 concentrations in our blood

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17
Q

Primary stimulus

A

measure increased levels of CO2 (hypercapnia)

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18
Q

Secondary stimulus

A

measure low levels of O2 (hypoxia)

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19
Q

Ventilation

A

the mechanical act of breathing

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20
Q

Thorax

A

the area of the body between the neck and abdomen containing the heart and lungs

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21
Q

Trachea

A

where air is transported through and is lined with mucous membranes and cilia

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22
Q

Mediastinum

A

the area between the lungs that contains the heart and great vessels

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23
Q

What is the pathway of air

A

trachea –> bronchus –> bronchiole –> alveoli

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24
Q

What are the respiratory assessment interview questions (10)

A

health history, medications, vaccines, family history, allergies, smoking, occupation (exposure to chemicals), demographic data, respiratory, environmental

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25
Q

Factors that influence oxygenation (9)

A

stress, allergies, air quality, altitude, temperature, pregnancy, obesity, exercise, smoking

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26
Q

How do allergies effect the respiratory system

A

cause inflammation to the nasal passage

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27
Q

How does air quality affect the respiratory system

A

trigger respiratory problems

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28
Q

How does the temperature affect the respiratory system

A

cold temperatures require the air to be moistened

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29
Q

How does pregnancy affect the respiratory system

A

increase the need of oxygen

30
Q

How does exercise affect the respiratory system

A

increase metabolic demand

31
Q

How does smoking affect the respiratory system

A

chemicals block airways and kill hairs, and decrease elasticity

32
Q

What signs do the face give about respiratory status (4)

A

breathing effort and quality, pursed lips (abnormal), flared nostrils (abnormal), grunting (abnormal)

33
Q

What signs does body position give about respiratory status (2)

A

client should be sitting up relaxed, tripod position (abnormal)

34
Q

What signs do skin and nails give about respiratory status (2)

A

cyanosis is a sign of hypoxia (abnormal), clubbing indicates long term hypoxia (abnormal)

35
Q

What signs does the chest give about respiratory status (4)

A

Breathing appears effortless, retractions (abnormal), accessory muscle use (abnormal), 1:2 anteroposterior to lateral ratio (equal in infants)

36
Q

What signs does the thorax give about respiratory status (4)

A

scapula should be symmetric, shoulders at equal positions, straight spine, midline and straight sternum

37
Q

Scoliosis

A

spine deviates laterally

38
Q

Kyphosis

A

increased curve of the thoracic spine

39
Q

What signs does palpation give about respiratory status (2)

A

lumps/masses (abnormal), pain/tenderness (abnormal)

40
Q

Crepitus

A

air trapped under skin, feels like crackling when you touch skin

41
Q

Fremitus

A

vibration that can be felt across the lung field

42
Q

What does increase vibration in the lungs indicate

A

extra fluid

43
Q

How to measure expansion of the lungs

A

place hand on anterior chest wall with thumbs pointed towards xiphoid process/place hands on posterior chest wall at T9 or T10

Thumbs should move apart symmetrically 5-10 cm

44
Q

What do you percuss when you percuss the lungs and where

A

tone
over intercostal spaces

45
Q

Resonance

A

the tone heard over normal lung tissue

46
Q

How do you auscultate the lungs

A

instruct client to breathe slowly through their mouth, move stethoscope from side to side, compare sounds bilaterally, listen for one full respiration in each spot

47
Q

Developmental variations in infants (6)

A

Immature lower airway/nervous system/immune system, narrow airways, breathe out of nose only until 6 months, diaphragmatic breathers (check rr in stomach until 1), normal rr=30-53, chest sound is smooth and round

48
Q

Developmental variations in children (4)

A

upper respiratory infections are common, asthma presents, short/small airways, drowning in small amounts of water

49
Q

Developmental variations in school-aged (3)

A

mature heart/lungs/circulatory system, URIs resolve easily, asthma

50
Q

Developmental variations in older adults (7)

A

reduced lung expansion/less alveolar inflation, difficulty clearing airways because of weak muscles, declining immune response, chemoreceptors respond more slowly, kyphosis is common, loss of skeletal/accessory muscles and elasticity, calcification of cartilage,

51
Q

What are the normal lung sounds (3)

A

bronchial, bronchovesicular, vesicular

52
Q

Describe bronchial lung sounds

A

high pitched and harsh, short during inspiration and long during expiration

53
Q

Describe bronchovesicular lung sounds

A

moderate pitch and amplitude, same length during both inspiration and expiration (1:1)

54
Q

Describe vesicular lung sounds

A

low, breezy, and soft, expiration is shorter than inspiration, heard best on bases and periphery of lungs

55
Q

What are the adventitious breath sounds (3)

A

crackles, wheezing, pleural rub

56
Q

Describe crackle lung sounds

A

caused by fluid in small airways or atelectasis, intermittent popping sounds

57
Q

Describe wheezing lung sounds

A

caused by air moving through narrowed airways, heard continuously on inspiration or expiration
sounds like a whale

58
Q

Describe pleural rub lung sounds

A

low pitched dry grating sound, caused by restricted air flow or due to body type
sounds like rubber rubbing together

59
Q

What is a normal rr rate

A

12-20 breaths per minute

60
Q

What is normal rr rate called

A

eupnea

61
Q

What is a normal oxygen saturation

A

95-100

62
Q

Bradypnea

A

slow respirations, <10 per minute

63
Q

Tachypnea

A

fast respirations >24 per minute

64
Q

Apnea

A

absence of breathing

65
Q

hypoxia

A

low oxygen in tissue

66
Q

hypoxemia

A

low oxygen in blood

67
Q

tympany

A

high, drum like sound
common over the stomach

68
Q

dullness

A

present over fluid or solid tissue

69
Q

flatness

A

heard over muscle mass or bones

70
Q

hyperresonance

A

overly-resonant sounds, can indicate trapped air

71
Q

What are some nursing interventions to support and maintain adequate oxygenation

A

end smoking, vaccinations, avoid pollutant, exercise weekly

72
Q

What does hyperventilation cause

A

a decrease of CO2 in the body

Nursing 2910 (15 decks)

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