Signs & Symptoms Flashcards
cyanosis:
bluish color of skin seen in earlobes, under eyelids, and in nail beds
- hypoxemia
- decreased oxygen transfr in the lungs
- decreased cardiac output
- Non-specific, unreliable indicator
ashen, pallor or dusky
anemia, shock (vasodilation)
jaundice
excessive bilirubin
erythema
infection, inflammation
Increased A-P diameter (barrel chest)
COPD, CF (or other chronic air-trapping)
Lateral curvature of the spine
scoliosis. Pulmonary function test will show a restrictive component.
hunch of the back; excessive outward curvature of the spine
kyphosis
Eupnea
normal breathing
- hyperpnea (increased rate and depth of breathing)
- regular rhythm
- associated with metabolic disorders
-
Type of breathing pattern: Kussmaul
- regular, rapid, and deep resprations
diabetic ketoacidosis
metabolic acidosis
allows body to increase CO2 excretion
-
Biots breathing
- increased rate and depth of breathing
- unpredicatable periods of apnea that vary in length and frequency
- apnea, rapid breathing, apnea
- neurological disorders of the CNS
- strokes
- brain infection
- encephalitis
- Breathing pattern: Cheyne-Stokes
- increasing and decreasing cycle of rate and rhythm of breathing
- each cycle takes 30 seconds to 3 minutes
- apnea lasts up to 60 seconds
- Drug overdose
- intracranial pressure problems (from head injury)
tachypnea
- rapid, regular breathing
- rate > 20 breaths/min; >25 in elderly
- panic
- fever
- hypoxemia
- pulmonary embolisms
- myocardial infarctions
- anything that increases WOB
- bradynpea
- alcholism, obesity
-
Cheyne-Stokes breathing pattern
- gradual increase then gradual decrease of rapid breath
- followed by apnea (up to 60 sec.)
- Cycle lengt: 30 sec. - 3 min.
- Drug overdose
- Intracranial pressure problems (head trauma)
- heart failure
- myocardial infarction
- hemoptysis (coughing up blood)
- Tuberculosis
- Differntial:
- lung cancer (will appear with dry, non-productive cough)
- Bronchitis
- Pneumonia
Asymmetrical chest movement upon exam
- COPD
- Flail chest (broken ribs)
- Pneumothorax
- ET tub advanced too far into one lung
- Atelectasis
A patient with no previous pulmonary disease history is reporting a dry cough over the last month. The patient denies expectoration of sputum. Which of the following could represent the patient’s condition?
a. vocal cord paralysis
b. cancerous mass in mainstream bronchus
c. tuberculosis
d. myasthenia gravis
b. cancerous mass in mainstream bronchus
lung cancer can present with a dry, non-productive cough, and sometimes hemoptysis.
Digital Clubbing
- increased depth, bulk, and spongines of distal digits
- associated chronic hypoxemia like that of COPD
- cystic fibrosis
- lung cancer
- bronchiectasis
Venous distension.
- veins of the neck protrude during breathing (JVD)
- CHF
- COPD
Symptoms:
-
Tiredness and fatigue
- due to the body not receiving enough oxygen
-
Palpitations
- heart beats harder and faster to compensate for lack of blood flow
- Edema in the lower extremities (swelling in ankles)
- JVD (jugular vein distention): venous pressure is increased due to backup of blood, causing pressure and swelling in the jugular vein.
- Weight gain: from extra fluid build-up
- Frequent urination at night or when lying down: fluid from lower extremities is able to go through the renal system.
Objective Clinical Data:
- Increased BNP
Right-sided Heart Failure
- Diaphoresis (heavy sweating)
- pay attention if the skin is cool to the touch and the patient hasn’t been exercising.
- Cold and clammy skin
- febrile (fever)
- CHF
- Myocardial infarction
- If this is suspected, patient should be immediately placed on a 12-lead ECG.
Patient is in the emergency room complaining of chest pain. Upon arrival, you notice that the patient is cold to the touch and diaphorectic. What should the therapist recommend?
a. administer Digitalis (Crystodigin)
b. administer fluid
c. administer dopamine
d. 12-lead ECG
d. 12-lead ECG
Patient is showing signs of CHF or myocardial infarction.
pursed-lip breathing
- exhalation through mouth with lips pursed together to slow exhalation.
- COPD
- asthma
Strategy taught to slow expiration, which will helps lessen dyspnea.
Tri-pod position
Indcates moderate to severe respiratory dstress
- COPD
- Asthma in exacerbation
- pulmonary edema
Accessory muscle use; intercostal retractions
Neck and shoulder muscles used to assist in breathing. Muscles b/t ribs pull in during inspiration.
Indicates severe respiratory distress.
COPD
Asthma in exacerbation
secretion retention
Hypoxemia
Splinting
(Voluntary decrease in tidal volume to lessen pain on chest expansion)
Thoracic or abdominal incision pain
Chest trauma
Pleurisy: (a condition in which the pleura — two large, thin layers of tissue that separate your lungs from your chest wall — becomes inflamed. Also called pleuritis, pleurisy causes sharp chest pain (pleuritic pain) that worsens during breathing.)
Increase in AP diameter
COPD
Asthma
Cystic Fibrosis
Lung hyperinflation
Advanced age
Peripheral Edema
Pitting Edema
CHF
Cor pulmonale
JVD
(Jugular venous distension)
cor pumonale
flail chest
pneumothorax
(Increase and decrase in vibrations)
increased over areas of consolidation and decreased or absent over areas of pleural effusion or pneumothorax (when there is air outside the lung in the chest cavity, preventing lung expansion).
Increased tactile fremitus:
- Over areas of consolidation:
- pneumonia
- atelectasis
- pulmonary edema
Decreased tactile fremitus:
- pleural effusion
- lung hyperinflation
Absent tactile fremitus:
- pneumothorax (air is outsie of the lung and in the chest cavity, preventing lung expansion)
