Test & Measures and Breath Sounds Flashcards
What are the values on the Angina Scale?
(1 good, 4 bad)
1 - Mild, barely noticeable
2 - Mod, bothersome
3 - Mod severe, very uncomfortable
4 - Most severe or intense pain ever experienced
What is “normal” on the Ankle Brachial Index (ABI)?
1.0-1.30 = Normal, no blockage
What does a high # on the Ankle Brachial Index (ABI) indicate?
> or = 1.30 indicates rigid arteries
What does a low # on the Ankle Brachial Index (ABI) indicate?
< 1.0 indicates blockage
lower # = more severe (ex: <0.4 in severe block)
Where do you auscultate the Aortic Area?
2nd intercostal space at the RIGHT sternal border
*A before P
Where do you auscultate the Pulmonic Area?
2nd intercostal space at the LEFT sternal border
*A before P
Where do you auscultate the Mitral Area (bicuspid valve)?
Apex of the heart
(5th intercostal space, medial to the left midclavicular line)
*Tri before your Bi
Where do you auscultate the Tricuspid Area?
4th intercostal space at level of the sternal border
*Tri before your Bi
When does an S3 heart sound occur in the cardiac cycle?
- Diastole (passive ventricle filling)
“Ventricular gallop”
What CAN an S3 heart sound indicate in adults?
- Key for Chronic Heart Failure (CHF)
When does an S4 heart sound occur in the cardiac cycle?
- 2nd phase of diastole due to atrial contraction
“Atrial gallop”
What CAN an S4 heart sound indicate in adults?
- Previous MI or CABG
- HTN
- CAD
- Pulmonary Disease
What are normal breath sounds heard over the Trachea?
Tracheal and Bronchial sounds
- loud, tubular
What are normal breath sounds heard over the Distal Airways?
Vesicular
- high pitched, breezy
What are abnormal breath sounds?
Sounds heard outside of their normal location or phase
What are adventitious breath sounds?
Never normal
- continuous and discontinuous odd breath sounds
What do Crackles sound like?
Discontiuous, high-pitched
Base of lungs
What pathology causes Crackles?
Fluid or secretions
- Atelectasis
- Fibrosis
- Pulmonary Edema
- Pleural Effusion
What does Pleural Friction Rub sound like?
Dry, crackling
What pathology causes Pleural Friction Rub?
Inflammed visceral and parietal pleurae rubbing together
What does Rhonchi sound like?
Continuous, low-pitched
What pathology causes Rhonchi?
Secretions, bronchial spasm, neoplasm
What does Stridor sound like?
Continuous, high-pitched wheeze
What pathology causes Stridor?
Upper airway obstruction
What does Wheezing sound like?
Continuous “musical” or whislting
What pathology causes Wheezing?
Narrowing of airways
- bronchospasms, edema, collapse, secretions, neoplasms
What sounds will you hear with pneumonia?
bronchial breath sounds where vesicular should be
When will you hear Decreased breath sounds?
severe congestion
emphysema
hypoventilation
What sounds will you hear with pneumothorax?
Absent breath sounds
What is bronchophony?
Increased vocal resonance - greater clarity and loudness (ex: 99)
What is Egophony?
E to A change
What is Whispered Pectoriloquy?
Recognition of whispered words “1,2,3”
What is “normal” on the BMI?
18.5 - 24.9
What is normal capillary refill time?
Full color in < 2 seconds
What is abnormal capillary refill time?
> 2 seconds
capillary blood flow compromised
What in the range and major classifications for the Borg Dyspnea scale?
Range: 0-10 0 - No breathlessness 3 - Moderate 5 - Severe 10 - Max
What does a positive stress indicate?
High probability of coronary artery disease
What are the absolute indications for terminating a stress test?
- Drop in SBP > 10 mm Hg
- Moderately severeangina (3/4)
- Inc nervous system symptoms (ataxia, dizziness)
- Cyanosis, pallor
- Sustained v-tach
What is the number that describes a normal amplitude or volume of the pulse?
2+
3+ bounding
1 small or reduced
0 absent
What is the normal adult respiratory rate?
12 - 20 breaths/min
What is Apnea?
absence of spontaneous breathing
What is Biot’s breathing pattern?
Irregular breathing
- vary in depth and rate
What is Bradypnea?
< 12 breaths/min
What is Tachypnea?
> 20 breaths/min
What is Cheyne-Stokes (periodic) breathing?
dec rate and depth of breathing with periods of apnea
CNS damage
What is Eupnea?
Normal rate and depth of breathing
What is Hyperpnea?
Inc rate and depth of breathing
What is Hypopnea?
Dec rate and depth of breathing
What are Kussmaul’s respirations?
Deep and fast breathing
Metabolic acidosis
What is Paradoxical breathing?
Chest wall moves in with inhalation and out with exhalation
chest trauma or paralysis of diaphragm
If a patient post-op lung resection has audible crackles, what do you do?
Initiate bronchopulmonary hygiene
- Postural drainage
- Vibration
- Shaking
- Suctioning