S1_L5_Obj - 4-6 Flashcards
elevated; within the boundaries of scar
hypertrophic
Beyond boundaries of scar
keloid
CHECK THE EXTREMITIES for _
limb swelling
Decreased amount of oxygen that’s why there’s swelling in the digits
digital clubbing
ATTACHMENTS: INVASIVE MONITORING
OR MEDICATION/FLUID ADMINISTRATION (4)
Arterial Line (A line)
Peripheral Intravenous Catheters (IV Line)
Central Line / Central Venous Catheter
Pulmonary Artery Balloon Flotation / Swan-Ganz Catheter
Commonly inserted on radial artery or femoral artery
as an invasive monitoring of BP
Arterial Line (A line)
arterial or a line is commonly inserted on _ or _ as an invasive
monitoring of BP
radial, femoral
Seen in patients in the ICU and if moved can
lead to inaccuracy in the BP monitoring
arterial line
Used for therapeutic purposes such as administration of
medications, fluids and/or blood products as well as blood sampling
Peripheral Intravenous Catheters (IV Line)
peripheral intravenous catheters is usually attached to the _
dorsal hand
Commonly inserted through subclavian or jugular vein;
direct monitoring of central venous pressure (CVP)
or right atrial pressure (RAP)
Central Line / Central Venous Catheter
Central Line / Central Venous Catheter is commonly inserted
through what vein
subclavian or jugular vein
central venous catheter is for direct monitoring of _ or _
central venous pressure (CVP)
or right atrial pressure (RAP)
CVP is seen in what part of the body
neck
Determines mixed venous oxygen saturation (SvO2)
& cardiac output (CO)
Pulmonary Artery Balloon Flotation / Swan-Ganz Catheter
swan ganz catheter indirectly measures what
Indirectly measures Left Atrial Pressure (LAP)
swan ganz cathete is the calculation of _ and _
Calculation of systemic and pulmonary vascular resistance
swan ganz Permits direct measurement of:
■ Right atrial pressure (RAP)
■ Pulmonary arterial pressure (PAP)
Swan-Ganz Catheter is introduced via _
internal jugular or subclavian vein
swan ganz catheter in the body:
internal jugular or subclavian vein →
vena cava →
R atrium →
tricuspid valve →
R ventricle →
pulmonary valve →
pulmonary artery
ATTACHMENTS: NON-INVASIVE LIFE SUPPORT (2)
Non-Invasive Positive-Pressure Ventilation (NPPV)
Oxygen Delivery Devices
Non-Invasive Positive-Pressure Ventilation (NPPV) (3)
Continuous Positive Airway Pressure (CPAP)
Bilevel Positive Airway Pressure (BiPAP)
Manual Resuscitators (Ambu Bag)
Oxygen Delivery Devices (4)
Nasal Cannula
Simple Mask
Aerosol Mask
Venturi Mask
Pt breathing through the mouth thru face piece at flow rates of 5-10 L/min
simple mask
Used for aerosolized medications or >10 L/min
aerosol mask
Allows room air through a side port
venturi mask
Used for the administration of medicines
aerosol mask
O2 flow between 1-6 L/min for adults & 1/16 L for
neonates; if >6 L = high-flow nasal cannula (HFNC)
Nasal Cannula
for nasal cannula o2 flow for adults is
1-6 L/min
for nasal cannula, o2 flow for neonates is
1/16 ;
if >6 L of airflow for nasal cannula this is called
high-flow nasal cannula (HFNC)
for simple mask what is the flow rates?
flow rates of 5-10 L/min
Side port in venturi mask allows _
exhalation
site port in venturi mask allows exhalation, but doesn’t allow air to go in
other than O2 t or f
t
mask for protection from infection
venturi mask
INVASIVE VENTILATORY DEVICES
Oropharyngeal airway/tube
Nasopharyngeal airway/tube
Endotracheal tube
Tracheostomy tube
Mouth to pharynx, just short
Oropharyngeal airway/tube
Nose to pharynx
Nasopharyngeal airway/tube
Oral or Nasal
endotracheal tube
endotracheal tube paths
mouth to trachea
nose to trachea
Tracheostomy tube is directly to _
trachea
tracheostomy has incision in the _
neck
Used to be negative pressure but now uses positive pressure
mechanical ventilation
mechanical ventilation used to be _ but now _
negative pressure, positive pressure
be careful when we try to move the area is
there is chest tube thoracostomy t or f
t
ATTACHMENTS: INVASIVE FEEDING DEVICES
Nasogastric Tube (NGT)
Nose to gastric area (stomach)
Nasogastric Tube (NGT)
For pt’s with difficulty swallowing, what tube to use
Nasogastric Tube (NGT)
CHEST DEFORMITIES (4)
Barrel chest
Pectus carinatum / Pigeon chest
Pectus excavatum / Funnel chest
Flail chest
Barrel chest is seen in
COPD like emphysema
Barrel chest –>
○ Prominent chest forward
○ The entire diameter expanded
○ AP and mediolateral are enlarged
sternum projects _ in pectus carinatum
forward
pectus carinatum also called as _
pigeon chest
Prominent projection of the sternum
pigeon chest
Sternum projects backward in _
pectus excavatum
depressed sternum
funnel chest
pectus excavatum also called as _
funnel chest
Flail chest positive finding
(+) hoover’s sign
flail chest happens in the _
lower ribs
normal rib position when we breathe
Normally when we inhale ribs go out then exhale ribs go
in
when there is fx in ribs, when inhaling, ribs go _
and when exhaling ribs go _
inside, outside
paradoxical movement of the chest;
hyperinflated
Hoover sign
in fx of ribs, what pulls the ribs inward
diaphragm
indentation that will retain is called _
pitting edeema
no indentation in
non pitting edema
Extra water inside: what edema
pitting edeema
Indication that it’s not just fluid, there might be
proteins found there in what edema
non pitting edema
tenderness gradings:
0
1
2
3
4
tenderness gradings: 0
no tenderness
tenderness gradings: 1
tender to palpation; no grimace
tenderness gradings: 2
pain with grimace
tenderness gradings: 3
withdrawal; (+) jump sign
tenderness gradings: 4
touch me not
t or f PERIPHERAL PULSES can be documented under palp or
cardio pulmo ax
t
BREATHING PATTERNS can also be documented under _
vital signs, cardiopulmo ax
Take note of (4) in breathing patterns
○ Character
○ Rate
○ Rhythm
○ Amplitude
Eupnea
Normal=12-20cpm
Apnea with concomitant mouth opening & Closing
fishmouth
Apnea, rate depth rhythm?
- rate, - depth, - rhythm
Bradypnea, rate depth rhythm?
dec rate, N or S depth, R rhythm
Tachypnea, rate depth rhythm?
inc rate, shallow depth, regular rhythm
Hyperventilation (kussmaul), rate depth rhythm?
inc rate, deep depth, regular rhythm
Hyperpnea, rate depth rhythm?
normal rate, deep depth, regular rhythm
Apneusis, rate depth rhythm?
dec rate, deep depth, irregular rhythm
Biot (Meningitis), rate depth rhythm?
dec rate, shallow depth, irregular rhythm
Cheyne-Stokes (Periodic) (Critically-ill), rate depth rhythm?
variable rate, variable depth, regular rhythm
Doorstop, rate depth rhythm?
normal rate, no depth, normal rhythm
Absence of breathing
apnea
Issue with respiratory rate
bradypnea
Medical emergency; critically ill
cheyne stokes
○ respiration suddenly stops d/t pain
○ Seen in post-op pts
doorstop
“Buntong hininga”
fishmouth
N rate, S depth, R rhythm
dyspnea
dyspnea is associated with _
accessory muscle activity
Prolonged Expiration associated with _
COPD
Fast inspiration, Slow and prolonged expiration
yet normal rate, depth and rhythm
prolonged expiration
N rate, regular intervals of sighing; associated with
anxiety
Psychogenic Dyspnea
psychogenic dyspnea associated with _
annxiety
Art of listening to sounds produced by the body, especially on chest:
auscultation
Breath sounds classified as (3)
normal, abnormal, adventitious
Extrapulmonary sounds classified as (2)
pleural or friction rubs
Voice sounds (3)
egophony, bronchophony, whispered pectoriloquy
Heart sounds (2)
normal or abnormal