Week 1 Flashcards

Question

Clubbing

Answer 1

common in chronic cystic fibrosis**** | Note: clubbing disappears in CF patients after lung transplant

Answer 2

Used for Neurological Observation - Eye opening - Best verbal response - Best motor response

Answer 3

Class 1 (mild) - No limitation of physical activity. Ordinary physical activity does not cause undue fatigue, palpitation, dyspnea (shortness of breath). Class 2 (mild) - Slight limitation of physical activity. Comfortable at rest. Ordinary physical activity results in fatigue, palpitation, dyspnea (shortness of breath). Class 3 (moderate) - Marked limitation of physical activity. Comfortable at rest. Less than ordinary activity causes fatigue, palpitation, or dyspnea. Class 4 (severe) - Unable to carry on any physical activity without discomfort. Symptoms of heart failure at rest. If any physical activity is undertaken, discomfort increases.

Answer 4

RPE Scale Method 0-10 used for respiratory conditions 6-20 used for cardiac conditions - coincides with heartbeat (60-200)

Answer 5

A whistling or musical sound produced by turbulent airflow through narrowed airways.

Answer 6

Heartrate >100 beats/min

Answer 7

60-‐100 beats/min

Answer 8

Musculoskeletal, pleural or tracheal inflammation

Answer 9

Lung disease Cardiac Disease Other - like familial

Answer 10

Bluish discolouration of the skin caused by hypoxemia | - Increased haemoglobin not bound to oxygen

Answer 11

(cigarettes per day x years smoked) / 20 = # pack years

Answer 12

When gas or air is in the layer under the skin of chest wall

Answer 13

an assessment technique which produces sounds by the examiner tapping on the patient's chest wall. Normal aerated lung gives 'resonance' Consolidated lung sounds 'dull'

Answer 14

Vibratory tremors that can be felt through the chest by palpation.

Answer 15

The process of listening to and interpreting sounds produced in the thorax

Answer 16

``` Coarse, early inspiratory - Bronchiectasis - Bronchitis ***Coarse = when bronchioles open –Thought to represent the passage of a bolus of gas through a lightly closed, fluid filled airway, which opens intermitently when the upstream gas pressure rises ``` Fine, late inspiratory - Pulmonary odema - Pulmonary fibrosis ***Fine = when alveoli and respiratory bronchioles open –Generated at the alveolar level by the sudden equalisation of gas pressure between 2 compartments – when a closed section of the airway suddenly opens

Answer 17

-Bronchial Breathing

Answer 18

``` –Pneumothorax/haemothorax –Pleural effusions –Atelectasis –Hyperinflated –Decreased air entry –obesity ```

Answer 19

- bronchospasm | - actue asthma

Answer 20

from airway obstructions ie oedema, foreign objects, mucous, tumours.

Answer 21

background information Medical chart Bed chart Subjective assessment Physical assessment

Answer 22

``` Important to ensure you have the correct paCents chart • This informaCon will guide assessment and treatment • Checklist – PresenCng condiCon – Past medical Hx – Social Hx – FuncConal Hx – InvesCgaCons – Medical Management – +/- Surgical notes or Special orders ```

Answer 23

Busy chart • Includes: – Observation Chart – Medication chart – Pain chart – Fluid balance – Neurological – GCS – Blood glucose sliding scale – normal 4-8mmol/L – Falls risk Ax – Nursing care plans

Answer 24

``` MedicaCons • Lots of different medicaCons • Examples – Cardiac – Respiratory – Analgesic – AnCemeCc • Consider – Timing – Side effects ```

Answer 25

``` Checklist – At rest, with movement/cough – Area – Type • Sharp, dull, blunt – Severity • VAS – History ```

Answer 26

``` Specific Questions – ask were relevant • Smoking History – Pack years – If/when ceased • Alcohol consumption • Previous respiratory conditions/infections – If any – MedicaCon – Previous Rx – including physio – Hospitalisation previously • Incontinence • Headaches • Peripheral oedema ```

Answer 27

1 pack = 20 cigarettes • Number of pack years = packs per day x years • 1 pack smoked per day for 40 years = 40 pack yrs • Or • (cigarettes per day x yrs) / 20 • (15cigsx40yrs)/20=30packyears

Answer 28

Important • Checklist – ADL’s – Employment/Hobbies – Exercise Tolerance • Regular exercise • Distance mobilised – Flat, incline, stairs • Use of aides – Inside home – Community ambulaCon • Use of supplemental O2 – DuraCon of use – Mode of delivery

Answer 29

• Post operaCvely – Nausea – Dizziness – Drowsy – VomiCng – Pain • CondiCon specific

Answer 30

``` patient's main problems dyspnoea Cough, sputum, wheeze pain PMHx function, mobility SHx Specific Questions ```

Answer 31

observation auscultation palpation cough and sputum

Answer 32

``` environment -– Attachments • Oxygen – mode of delivery and concentration • IV lines and medications • Analgesia (PCA, epidural) • Indwelling catheter (IDC) • Nasogastric tube (NG tube) • Intercostal Catheter (ICC) • Wound drains ```

Answer 33

* Nasal prongs * Hudson mask * Non-rebreather mask * Venturi mask * High flow humidified oxygen • Endotracheal tube (ETT) * Tracheostomy

Answer 34

``` – Posture – in bed/siTng – Facial expression – fa/gue, pain etc – Speech paEern (SOB) – Level of consciousness (GCS) – Body Shape – Muscle tone – Colour – cyanosed, flushed, pallor – Peripheral – clubbing, oedema – Jugular venous pressure (JVP) – Respiratory Rate (RR) – Pursed lip breathing ```

Answer 35

– Shape | – Breathing pattern – Chest movement – Accessory muscle use – Paradoxical movements

Answer 36

``` • Hand placement – Bilaterally at ribs 7-10 – Antero-posterior at sternum and thoracic spine • Palpa/ng for: – Movement (quality, quan/ty, symmetry) • Bibasal expansion • Apical – Temperature – Fremitus – Subcutaneous emphysema ```

Answer 37

* Process of listening to and interpreting the sounds produced within the thorax * Use to verify observed and palpated findings before and after treatment. * “Breathe in and out through your mouth, slightly deeper than usual” * Position – high sittng * Stethoscope to skin contact

Answer 38

``` – Pneumothorax/ haemothorax – Pleural effusions – Atelectasis – Hyperinflated – Decreased air entry – obesity ```

Answer 39

* Wheezes * Crackles (fine or coarse) • Stridor * Rubs * Transmitted sounds * Surgical emphysema

Answer 40

* Generated by the vibration of the walls of a narrowed airway. * Pitch is determined by the diameter and elasticity of the airway * Expiratory wheezes – bronchospasm * Inspiration and expiration wheezes – from airway obstructions ie oedema, foreign objects, mucous, tumours.

Answer 41

• Discon/nuous, short, explosive sounds • Fine – Generated at the alveolar level by the sudden equalisa/on of gas pressure between 2 compartments – when a closed sec/on of the airway suddenly opens • Coarse – Thought to represent the passage of a bolus of gas through a lightly closed, fluid filled airway, which opens intermittently when the upstream gas pressure rises

Answer 42

``` • Strength – Weak, fair, strong • Wet / Dry • Effective / non-effective • Productive / non-productive – Sputum expectorated (table 1.1 Pryor and Prasad page 4) • Quality • Quantity ```