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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
Pigeon chest
Sternum is anteriorly displaced
26
Funnel chest
Lower sternum is depressed
27
Kyphosis
Forward bending of a vertebral column
28
Scoliosis
Lateral being of vertebral column
29
Adult normal RR
12-20
30
Child normal RR
12-24
31
Infant normal RR
20-30
32
Neonate normal RR
30-60
33
If you pt is not caucasian where/how would you look for cyanosis
Look for grey colour, specifically at the eyelids
34
PMI
Point of maximal impulse
35
How to find the apex beat of PMI
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
Vesicular sounds are found where
Typical lung lobe locations
37
What do vesicular lung sounds sound like
Low pitch, quieter, rustling sound, should be no gap between inspiration and expiration
38
If vesicular sounds are heard with prolonged expiration is it indicative of what
Obstruction/asthma
39
Bronchial sounds are found where
At the neck
40
Bronchial lung sounds sound like
High pitched, harsh sounds
41
Bronchial sounds in lung lobes is indicative of
Disease or consolidation
42
Bronchovesicular sounds
Mid pitch (normally heard over mid thorax region)
43
How many points are required to auscultate for a full respiratory assessment
8-10
44
How are neonates anatomically different than adults in regards to the respiratory system
Chest is more round, nose breathers, periodic breathing is common, breathing is more diaphragmatic and abdominal
45
S/S of respiratory distress in neonates
Stridor, grunting (using PEEP to their advantage), nasal flaring, sternal indrawing
46
In infants and young children why may we hear louder bronchovesicualr sounds all throughout the chest
Because their chest wall is thinner and still round until 2, everything is also squished into smaller spaces
47
Cardiogenic pulmonary edema is what
The accumulation of excessive fluid in the alveolar wall and space of the lungs (high mortality rate and is more common in males)
48
Cardiogenic means there is a change in capillary permeability, explain
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
How does afterload potentially impact fluid in the lungs
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
Non cardiogenic pulmonary edema causes
Drowning, fluid overload, aspiration, inhalation injury, OD, nephrogenic pulmonary edema, AKI, ARDS, anaphylaxis, allergy (mass cell destruction with fluid shifts)
51
Pneumonia crackles are usually on what side
Right
52
Course crackles are typical of what diseases
COPD, pneumonia, ACPE
53
Presentation of left sided HF
Paraoxysmal nocturnal dyspnea, restlessness, confusion, orthopnea, tachycardiac, exertional dyspnea, fatigue, cyanosis, blood-tinged sputum, crackles, pulmonary congestion (cough)
54
Presentation right sided HF (cor pulmonale)
Fatigue, distended JVD, anorexia, complaints of GI issues, weigh gain, enlarged liver/spleen, ascites
55
Indications for PPV
Pt in need of O2 and help w gas exchange
56
How do you know if ventilations are working well
Chest rise, improved pt condition, improving vital signs
57
What can aggressive ventilations cause
Breath stacking, barotrauma, pneumothorax, vomit/aspiration
58
Tidal volume
How much air goes in/out in one breath (6-8mL/Kg)
59
Minute volume
Air moved in and out in a minute
60
Functional residual capacity
Amount of air left at the end of functional exhalation
61
Lungs parenchyma is the compromise of
A large number of thin-walled alveoli affecting a large surface area which makes for poor gas exchange
62
Anatomical dead space
Volume of air that fills the conducting zone of respiration made up by the nose/trachea/bronchi
63
Physiological dead space
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
Pulmonary shunting is the rediversion blood from its usual path, which can be caused by
Gestational diabetes, high exposure to ibuprofen or vitamin A, influenza, weed use, rubella
65
Two types of V/Q mismatches
-perfusion w/o ventilation (clot/blockage) -ventilation w/o perfusion (hypovolemia)
66
Classic clinical asthma triad
Dyspnea, cough, wheeze
67
Pathophysiological triad of asthma
Chronic A/W inflammation, bronchial hyperactivity, bronchospam (resulting in excess mucous production)
68
What does salbutamol do
Bronchodilates to tx bronchospasm by working on beta-2 receptors
69
Presentation of PE
Sudden onset pleuritic CP, dyspnea increasing on exertion, tachypnea, equal A/E, cough/hemoptysis, JVD, localized wheezes/crackles, diaphoresis, syncope
70
What is a pneaumothorax
The presence of air/gas in the cavity between the lungs and the chest wall, causing collapse of the lung
71
Presentation of a simple pneumo
Sudden pleuritic CP, dyspnea/tachypnea, decreased A/E unilaterally, JVD, tracheal deviation, cough
72
Presentation of tension pneumo
Sudden pleuritic CP, severe dys/tachypnea, decrease A/E unilaterally, JVD, tracheal deviation, cough (ruptured bleb = hemoptysis)
73
Acute respiratory distress syndrome is a pulmonary OR systemic inflammation that can lead to what and present with?
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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