Surgical Skills Flashcards
What is the correct order for assessment of the posterior chest?
inspection, palpation, percussion, auscultation
What is the purpose of posterior chest auscultation?
to detect airflow within the resp. tract.
When is posterior chest auscultation performed?
every 4 hours and PRN on a stable post-op pt. and may be performed frequently with abnormal resp. findings
Where can bronchial sounds be heard?
over the trachea
Describe bronchial sounds
high pitched loud sounds like air blowing through a follow pipe. short I and long E
Describe bronchovesicular sounds
medium pitch and intensity. blowing sound. = I and E
Where can bronchovesicular sounds be heard?
main bronchi
Describe vesicular sounds
soft low pitched gentle rustling sound. best heard on inspiration. I longer than E
Where can vesicular sounds be heard?
Best heard at best of lungs. can be heard in all lung areas except major bronchi.
Describe crackles
crackling sound like hair near ear. best heard on inspiration but can be heard on both I and E
Cause of crackles
air passing through fluid which may indicate fluid or mucous in air passage
Rhonchi (gurgles)
continuous low pitched rumbling, snoring, gurgling or rattling sounds. best heard on E but can be heard both I and E
Cause of rhonchi (gurgles)
air passing through a narrowed passage. may be a result of secretions, tumors. Ex. pneumonia, chronic obstructive pulmonary disease
Wheezes
continuous high pitched musical sounds. best heard on E but can be heard on I as condition worsens
Cause of wheezes
air passing through a constricted bronchus as a result of secretions, swelling, tumors. Ex. asthma, airway obstruction
Emphysema
chronic pulmonary condition in which the air sacs (alveoli) are dilated and distended
Adventitious breath sounds
air passes through narrowed airways or airways filled with fluid or mucous when pleural linings are inflamed
Pleural Space
The potential space between the visceral and parietal layers of the pleurae. The space contains a small amount of fluids that acts as a lubricant, allowing the pleurae to slide smoothly over each other as the lungs expand and contract with respiration
Pleural Effusion
An abnormal accumulation of fluid in the intrapleural spaces of the lungs. The fluid is an exudate or a transudate from inflamed pleural surfaces and may be aspirated or surgically drained. May result from pulmonary infarction, trauma, tumor, or infection (TB).
Assessment data pleural effusion
dyspnea, chest pain, adventitious lung sounds (crackles), non-productive cough.
TNI pleural effusion
administer ordered medications (corticosteroids, diuretcs, vasodilators), oxygen therapy, intermittent positive-pressure breathing, or use of a pleurx catheter
Subcutaneous emphysema
The presence of air or gas in the subcutaneous tissues. The air or gas may originate in the rupture of an airway or alveolus and migrate though the subpleural spaces to the mediastinum and neck.
Assessment data subcutaneous emphysema
swollen face, chest, neck. painful skin tissues and may produce a crackling/popping sound as air moves under them. dyspnea, cyanosis is air leak is severe.
Treatment for subcutaneous emphysema
an incision to release the trapped air (aerodermectasia)