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Patient Care Theory (Sem 2) > Respiratory Assessment Details (W1) > Flashcards

Respiratory Assessment Details (W1) Flashcards

1
Q

Ventilation is the movement of air out of the lungs by

A

Pressure changes (negative to atmospheric pressure makes air go in which results in the lungs no longer getting the signal allowing them to return to normal and contract)

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2
Q

Acidosis (CO2 build up in the blood) can be caused by

A

Hypoventilation

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3
Q

Alkalosis (too much CO2 blown off) can be caused by

A

Hyperventilation

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4
Q

Name the signal locations that van trigger changes to breathing

A

Respiratory center in pons/medulla, stretch receptors in the lungs, chemoreceptors in the carotid body

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5
Q

PEEP, what is it

A

Positive end expiratory pressure, aka reserve volume, is the amount of air remaining in the lungs so that they don’t collapse

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6
Q

External PEEP is used for

A

Mechanical ventilation

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7
Q

Intrinsic PEEP

A

What holds up the lungs on their own

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8
Q

Anterior chest reference lines for respiratory assessment !

A

Midsternal line, anterior axillary lines, midclavicular line

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9
Q

Posterior chest reference lines for respiratory assessment /!

A

Vertebral line, midscaplar line

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10
Q

Axilla reference lines for respiratory assessment —

A

Anterior axillary lines, midaxillary line, posterior axillary line

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11
Q

Right vs left lung lobes

A

Right = 3, left = 2

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12
Q

What are the primary muscles of inspiration

A

Sternocleidomastoid, scalenes, pectoral is minor, external intercostals, diaphragm

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13
Q

What are the primary muscles of expiration

A

Clavicle, internal intercostals, abdominal muscles, diaphragm relaxed

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14
Q

C3, 4, 5 __ & S2, 3, 4 __

A

Keeps the diaphragm alive // keeps shit off the floor

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15
Q

Components of a respiratory assessment (golfing ladies pee every possible chance cause peeing changes chemical hormones monthly)

A

General appearance, LOA, posture, effort, pallor, cyanosis, clubbing, PMHx, current c/c & HPI, meds (compliance/change)

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16
Q

How long do antibiotics typically take to kick in (pts will call 911 bc they are not seeing a difference)

A

24hr

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17
Q

East Indians (genetic predisposition)

A

Weaker blood vessels and have heart attacks younger

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18
Q

Asians (genetic predisposition)

A

Often have strokes younger than

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19
Q

What are areas of loud lung sounds or crackles indicative of

A

Disease (that is the area of pathology)

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20
Q

ASSPN wit respiratory conditions

A

Sneezing, dyspnea, fever, chills, congestion, CP, edema, cyanosis

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21
Q

Productive sputum colours (green, brown, white, red, rusty)

A

Green (infection) brown (smoker) thick white/frothy (COPD) red (blood) rusty (TB)

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22
Q

Social habits that have the potential to impact pt respiratory condition

A

Diet, smoking, alcohol, drugs, occupational environment, acuity levels

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23
Q

IPPA (IPAP)

A

Inspection (of chest shape) palpation (oh chest movement) percussion auscultation (any adventitious sounds)

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24
Q

Barrel shaped chest

A

Increase in anteroposterior diameter

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25
Q

Pigeon chest

A

Sternum is anteriorly displaced

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26
Q

Funnel chest

A

Lower sternum is depressed

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27
Q

Kyphosis

A

Forward bending of a vertebral column

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28
Q

Scoliosis

A

Lateral being of vertebral column

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29
Q

Adult normal RR

A

12-20

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30
Q

Child normal RR

A

12-24

31
Q

Infant normal RR

A

20-30

32
Q

Neonate normal RR

A

30-60

33
Q

If you pt is not caucasian where/how would you look for cyanosis

A

Look for grey colour, specifically at the eyelids

34
Q

PMI

A

Point of maximal impulse

35
Q

How to find the apex beat of PMI

A

At pts back put thumbs at roughly 7th rib along spinal process, grip back with fingers and allow pt to take deep death to observe bilateral movement of thumbs outwards

36
Q

Vesicular sounds are found where

A

Typical lung lobe locations

37
Q

What do vesicular lung sounds sound like

A

Low pitch, quieter, rustling sound, should be no gap between inspiration and expiration

38
Q

If vesicular sounds are heard with prolonged expiration is it indicative of what

A

Obstruction/asthma

39
Q

Bronchial sounds are found where

A

At the neck

40
Q

Bronchial lung sounds sound like

A

High pitched, harsh sounds

41
Q

Bronchial sounds in lung lobes is indicative of

A

Disease or consolidation

42
Q

Bronchovesicular sounds

A

Mid pitch (normally heard over mid thorax region)

43
Q

How many points are required to auscultate for a full respiratory assessment

A

8-10

44
Q

How are neonates anatomically different than adults in regards to the respiratory system

A

Chest is more round, nose breathers, periodic breathing is common, breathing is more diaphragmatic and abdominal

45
Q

S/S of respiratory distress in neonates

A

Stridor, grunting (using PEEP to their advantage), nasal flaring, sternal indrawing

46
Q

In infants and young children why may we hear louder bronchovesicualr sounds all throughout the chest

A

Because their chest wall is thinner and still round until 2, everything is also squished into smaller spaces

47
Q

Cardiogenic pulmonary edema is what

A

The accumulation of excessive fluid in the alveolar wall and space of the lungs (high mortality rate and is more common in males)

48
Q

Cardiogenic means there is a change in capillary permeability, explain

A

Elevated hydrostatic pressures along the capillary wall due to decreased osmotic pressures in the fluid put pressure on the walls and water will move through the permeable membrane and potentially into alveoli

49
Q

How does afterload potentially impact fluid in the lungs

A

As afterload is increased the heart has to work harder to pump it to the body and if it is too challenging blood can back up and pool into the lungs (left sides HR/CHF)

50
Q

Non cardiogenic pulmonary edema causes

A

Drowning, fluid overload, aspiration, inhalation injury, OD, nephrogenic pulmonary edema, AKI, ARDS, anaphylaxis, allergy (mass cell destruction with fluid shifts)

51
Q

Pneumonia crackles are usually on what side

A

Right

52
Q

Course crackles are typical of what diseases

A

COPD, pneumonia, ACPE

53
Q

Presentation of left sided HF

A

Paraoxysmal nocturnal dyspnea, restlessness, confusion, orthopnea, tachycardiac, exertional dyspnea, fatigue, cyanosis, blood-tinged sputum, crackles, pulmonary congestion (cough)

54
Q

Presentation right sided HF (cor pulmonale)

A

Fatigue, distended JVD, anorexia, complaints of GI issues, weigh gain, enlarged liver/spleen, ascites

55
Q

Indications for PPV

A

Pt in need of O2 and help w gas exchange

56
Q

How do you know if ventilations are working well

A

Chest rise, improved pt condition, improving vital signs

57
Q

What can aggressive ventilations cause

A

Breath stacking, barotrauma, pneumothorax, vomit/aspiration

58
Q

Tidal volume

A

How much air goes in/out in one breath (6-8mL/Kg)

59
Q

Minute volume

A

Air moved in and out in a minute

60
Q

Functional residual capacity

A

Amount of air left at the end of functional exhalation

61
Q

Lungs parenchyma is the compromise of

A

A large number of thin-walled alveoli affecting a large surface area which makes for poor gas exchange

62
Q

Anatomical dead space

A

Volume of air that fills the conducting zone of respiration made up by the nose/trachea/bronchi

63
Q

Physiological dead space

A

An atomic plus alveolar dead space which is the volume of air in the respiratory zone not in part with gas exchange (bronchioles, alveolar duct, alveolar sac, alveoli)

64
Q

Pulmonary shunting is the rediversion blood from its usual path, which can be caused by

A

Gestational diabetes, high exposure to ibuprofen or vitamin A, influenza, weed use, rubella

65
Q

Two types of V/Q mismatches

A

-perfusion w/o ventilation (clot/blockage)
-ventilation w/o perfusion (hypovolemia)

66
Q

Classic clinical asthma triad

A

Dyspnea, cough, wheeze

67
Q

Pathophysiological triad of asthma

A

Chronic A/W inflammation, bronchial hyperactivity, bronchospam (resulting in excess mucous production)

68
Q

What does salbutamol do

A

Bronchodilates to tx bronchospasm by working on beta-2 receptors

69
Q

Presentation of PE

A

Sudden onset pleuritic CP, dyspnea increasing on exertion, tachypnea, equal A/E, cough/hemoptysis, JVD, localized wheezes/crackles, diaphoresis, syncope

70
Q

What is a pneaumothorax

A

The presence of air/gas in the cavity between the lungs and the chest wall, causing collapse of the lung

71
Q

Presentation of a simple pneumo

A

Sudden pleuritic CP, dyspnea/tachypnea, decreased A/E unilaterally, JVD, tracheal deviation, cough

72
Q

Presentation of tension pneumo

A

Sudden pleuritic CP, severe dys/tachypnea, decrease A/E unilaterally, JVD, tracheal deviation, cough (ruptured bleb = hemoptysis)

73
Q

Acute respiratory distress syndrome is a pulmonary OR systemic inflammation that can lead to what and present with?

A

Capillary and alveolar epithelium damage, which can cause edema, fluids and proteins in the lungs distrusting gas exchange

Patient Care Theory (Sem 2) (10 decks)

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