week 2 Flashcards
Name some signs and symptoms of a cardiorespiratory dysfunction
shortness of breath
sputum
cough
wheeze
pain
changes in exercise tolerance
functional ability
psychological changes
What examination and assessment tools can you use in a cardiorespiratory objective assessment?
observation
palpation
auscultation
chest x-rays and imaging
pulse oximetry
arterial blood gases
pulmonary function tests
exercise tolerance tests
functional ability tests
information on nursing charts
name some exercise tolerance tests
6 minute walk test
incremental shuttle walk test
step test
Name some functional ability tests
elderly mobility scale
functional independence measure
acute care index of function
What do you look at during the observation part of a cardiorespiratory objective assessment?
general appearance
position
presence of lines. drains, evidence of surgical interventions
oxygen therapy and how much
respiratory rate
chest shape
chest wall movement
breathing pattern
work of breathing
abdomen - distended/incisions/post op drains/feeding tube
What charts may you look at during a cardiorespiratory assessment?
blood pressure
heart rate
temperature
oxygen requirements
oxygen saturations
respiratory rate
weight
AVPU
fluid balance
urine output
medications
What does it mean if skin is pallor?
potential anaemia/low BP
In what patients is pursed-lip breathing seen in?
patients with severe airway disease (COPD)
What do you need to look out for when observing eyes?
pallor - anaemia
redness (high bp levels)
jaundice - liver diseases/biliary obstruction
drooping of one eyelid and constricted pupil
oedema (excess fluid retained in interstitial spaces)
What do you need to look for when observing someone’s hands?
course flapping tremor (increase CO2)
fine tremor (medication related)
wastage
nicotine stains
cyanosis
clubbing
temperature - hot and cold
What are some causes of clubbing?
congenital heart diseases
endocarditis
cystic fibrosis
infective (bronchiectasis, lung abscess, empyema)
fibrotic lung disease
malignant lung disease
Crohn’s disease
ulcerative colitis
What diameter does the superior and anterior movement of the sternum increase?
increases the AO diameter of the chest
What diameter does the elevation of the ribs (moving them laterally) increase?
the lateral diameter of the chest
What does a distended abdomen do to the diaphragmatic movement?
inhibits the diaphragmatic movement and will restrict the lungs from expanding
What is the ratio of inspiration to expiration?
1:2
What are some abnormal signs of breathing?
indrawing/recession of intercostal space
tracheal tug
asymmetry
Hoovers sign
What is Hoover sign?
paradoxical movement of the lower chest wall which occurs in patients with severe chronic airflow limitation. As the dome of the flattened diaphragm cannot descend further any diaphragmatic contraction during inspiration pulls the lower ribs inward
Name the muscles of inspiration
diaphragm
external intercostals
Name the accessory muscles of inspiration
scalenes
sternocleidomastoid
trapezii
pectoralis major and minor
serratus anterior
lat dorsi
Name the muscles of expiration
passive elastic recoil of lungs
Name the accessory muscle of exhalation
rectus abdominis
external and internal oblique
transversus abdominis
internal intercostal
What do we want to listen to with someone’s quality of voice?
loudness
wet sounding
talking in full sentences
audible sounds
Normal breathing is described as what?
Rhythmic
At what rate does normal breathing occur?
12-16 breaths per minute
Which part of breathing is active?
inspiration
What is the bucket handle movement caused by?
upward and outward movement of ribs 8-10
What is the pump handle movement caused by?
elevation of ribs 2-5 and sternum
What is paradoxical breathing?
It is when the chest wall moves inward on inspiration and outward on expiration
Name some examples of paradoxical breathing
Hoovers sign
flail chest
abdominal paradox
What are fissures (in the lungs)?
a double fold of visceral pleura that fold back on one another to either completely or incompletely separate lung parenchyma to form lung lobes
What are we listening for when using a stethoscope?
the quality of the breath sounds
the intensity of the breath sounds
the presence of any added sounds
