Thorax and Lungs Flashcards
What is a noted difference in respiration and lung maturation of infants as compared to normal healthy adults?
Infants are noted to have fluid filled lungs upon birth that should be cleared within the first few breaths. But infant lungs are small and immature so they are much more susceptible to foreign substances such as viruses or second hand smoke.
How does respiration in Older Adults differ from that of normal healthy adults?
Older adults are often more vulnerable to breathing difficulties as their thoracic cage becomes calcified and less mobile.
This also means that respiratory muscles become weakened and the lungs lose elasticity, which means alveoli cannot promote gas exchange as effectively as before. Therefore insuiting breathing problems.
How does a pregnant womans respiration differ from that of a normal healthy adult?
Typically speaking, pregnant women are able to breath more deeply due to the extra demands of the growing fetus.
But their lung expansion is quite infringed by the developing fetus, therefore estrogen levels are increased in order to relax thoracic ligaments and allow the lungs to expand more towards a horizontal direction.
What is Subjective Data collected in cases of Respiratory concerns?
Subjectively we would want to gather information on whether
a patient is experiencing;
Cough
Shortness of Breath
Chest Pain with breathing
History of Respiratory illness
Smoking History (Do they smoke? Any exposure to second hand smoke?)
Any Enviromental Exposures (where does the patient work or regularly spend their time?)
And patient centered care questions concerning when a patient last had TB testing, Chest X-ray, and Pneumonia and flu vaccines.
What objective Data do you collect in patient assessments?
Objective Data is a nurses assessment of the patient through;
Inspection
Palpation
Percussion
Auscultation
Often zoning in on the area of reported symptoms.
What are Normal Breathing Sounds? Describe each ones Pitch, Amplitude, Duration, Quality, and Normal Location at which they can be heard.
Normal Breathing Sounds include;
Bronchail (Trachail) sounds which are;
high pitched, loud, harsh/hollow/tubular, with insipriation occuring shorter than expiration and can normally be found in the trachea and larynx.
Bronchovesicular which is typicaly found posteriorly between scapulae (especially on the right) and anteriorly in the 1st and 2nd intercostal spaces around the upper sternum. It is noted to be Modertely pitched, Moderately amplified, Mixed in quality, and Inspiration is equal to expiration.
Vesicular Breathing sounds are typically found over peripheral lung fields and are low in pitch, soft, and noted to have a rustling sound “like wind through the trees” with inspiration durating longer than expiration.
Describe Crackles in the case of Abnormal Breathing by what they sound like and Clinical examples of what they can point to.
Abnormal breathing sounds include;
Crackles (which can be either fine or coarse) With fine crackles resembling rolling hair between your fingers. It is high pitched, short, and not cleared by a cough. Fine crackles in early inspiration can indicate obstructive diseases such as chronic asthma, bronchitis, and emphysema. Late inpiratory crackles are associated with pnuemonia, heart failure, and interstitial fibrosis.
Coarse Crackles on inhalation are loud, low-pitched with bubbling and gurgling, and on exhalation sound like opening a velcro fastner. Often these crackles are associated with penumonia, pulmonary fibrosis, and Pulmonary Edema.
Atelectatic Crackles are short lived and non pathological crackles that one might hear in an older adult or a patient just woken from sleep.
what can cause decreased or absent breathing sounds?
Decreased or absent breathing sounds are often associated with obstructions of the bronchial tree
AND
Emphysema (or decreased elasticity of lung fibers) which causes the lungs to be hyper inflated and therefore air coming in makes less noise upon entering.
Which abnormal breathing sound would you almost always start the hymlic maneuver on?
Stridor, as it most frequently associated with lodged foriegn objects and choking.
List 5 factors that can cause extraneous noise while auscultating breathing.
1) Examiner breathing on the tube of the stethoscope,
2) stethoscope tubing bumping together.
3) Patient shivering
4) Hairy chest- as it will cause crackling against the stethoscope.
5) Rustling of gown, drapes, or clothing.
6) Breast tissue.
When auscultating the Posterior in a thoracic and lung assessment what is the pattern at which you will auscultate the patient? How long you should listen to each auscultation point.
You should listen to each auscultaion point for at least one full respiration and ensure you are doing a side to side comparison as you auscultate. Practice the points of auscultation on your quizzer if they are comfy with it.
Show your quizzer how you auscultate the lungs and describe how it works.
Give you a 5!
Differentiate the signs of Chronic V. Acute breathing problems.
Chronic breathing problems are often noted by normal inspiration and prolonged expiration, wheezing, accessory muscle use, and event he patient attempting to lean forward to get more air.
Signs of Acute breathing problems (Which are considered emergent) involve sounds such as stridor, unusually rapid and labored breathing, changes in pallor, and severe dyspnea.
