Respiratory Assessment & Emergencies Flashcards
Name indicators of possible respiratory involvement
- Shortness of breath
- Cough
- Wheeze
- Cyanosis
- Tight chest
- Chest pain
- Signs of infection
Name signs of difficulty breathing
- Tripod position
- Unable to complete sentences
- Use of accessory muscles
- Recession
- Flaring nostrils
- Purse lip breathing
- Wheezing
- Stridor (high pitched noise when breathing through narrowed airway)
- Cyanosis
- Reduced consciousness
When doing a physical assessment for a respiratory condition, what must you inspect?
- RR, depth and rhythm (Kussmaul, Cheyne stokes)
- Chest shape (Barrel, pectus excavatum, pectus carinatum)
- Accessory muscle use
- Recession
- Chest wall markings
- Medication patches
- Rashes
What is Kussmaul breathing?
It is a deep and laboured breathing pattern associated with severe metabolic acidosis, especially diabetic ketoacidosis
What is Cheyne stokes respiration?
It is a pattern of shallow and deep breaths that alternate with pauses, it is a common sign of the terminal phase of dying
What is barrel chest?
Barrel chest is a rounded and enlarged appearance of the chest, usually caused by lung conditions like asthma or COPD
What is pectus excavatum?
Also known as funnel chest - an abnormal condition in which the breastbone sinks into the chest
What is pectus carinatum?
Pectus carinatum known as pigeon chest - a condition where the front of the chest is prominent, this is caused by abnormally shaped ribs
When doing a physical assessment for a respiratory condition, what must you palpate?
Chest wall - anterior, axilla and posterior aspects feeling for:
- Tenderness
- Crepitus
- Surgical emphysema
What is crepitus?
Characterised by palpable or audible popping, crackling, grating, or crunching in the chest
What is surgical emphysema?
Known also as subcutaneous emphysema, it is the presence of gas in the subcutaneous tissues, which may be detected by swelling of the affected area and crepitus on palpation
When doing a physical assessment for a respiratory condition, what are you looking for when percussing?
- Hyper-resonance
- Normo-resonance
- Hypo-resonance
What does hyper-resonance sound like when percussing the chest?
What does hypo-resonance sound like when percussing the chest?
When doing a physical assessment for a respiratory condition, what do you listen for when auscultating?
- Normal breath sounds
- Wheeze
- Fine crackles
- Coarse crackles
- Reduced breath sounds
- Pleural rub
What condition is indicated by fine crackles?
What condition is indicated by course crackles?
What tests may be carried out as part of a respiratory assessment?
- Peak flow metre
- ETCO2
- ECG
- Cardiac assessment
What is the pathophysiology of asthma?
Immune reaction to an allergen causing:
- Acute airway inflammation
- Bronchoconstriction
- Bronchospasm
- Bronchiole oedema
- Mucus production
What are risk factors to developing asthma?
- More common in women (though in childhood, more likely to be found in boys)
- Lower socio-economic status
- Obesity
- Smoke exposure
- Respiratory infection in childhood
- Allergies, industrial exposure to chemicals
- Family history (especially maternal)
Signs + symptoms of asthmas (attack)
- Rapid breathing
- SOB
- Chest tightness
- Wheezing
What are the characteristics of a mild asthma event?
- Below best level of functioning due to wheeze
- PEFR (peak expiratory flow rate) >75% best or predicted
- No features of moderate or acute severe asthma
What are the characteristics of moderate asthma exacerbation?
- Able to speak in sentences
- Increasing symptoms
- PEF >50–75% best or predicted
- No features of acute severe asthma
What are the characteristics of acute severe asthma?
Any one of the following:
- PEF 33–50% best or predicted
- SpO2 ≥ 92%
- Inability to complete sentences in one breath
- Pulse >110/minute in adults
- Respiration >25/minute in adults
