Week 6: Lung and Breasts Flashcards
bronchodialators
i.e. albuterol, dialates the airways so we can breathe easier
glucocorticoids
help reduce inflammation
some drugs such as NSAIDs and motrin can have what impact on asthma patients?
can cause wheezing and exacerbate bronchoconstriction
bulging
Trapped air in forced expiration associated with asthma or emphysema
bradypnea vs hypoventilation
bradypnea (slow and deep RR,
tachypnea vs hyperventilation
tachypnea (fast and shallow, >20 bpm)
hyperventilation (fast and deep RR)
Cheyne-stokes breathing is normal in what populations?
children and elderly, or PTs with heart or kidney failure, or increased intracranial pressure.
biot’s breathing pattern
quick, shallow inspiration followed by regular and irregular periods of apnea, usually seen in PTs w/ brain damage or overdose of opiates
hyperresonance heard on lungs
too much air is present (emphysema or pneumothorax)
dullness heard on lungs
abnormal lung density such as in lobar pneumonia, pleural effusion, atelectasis, or tumor
where are bronchial lung sounds typically heard?
over trachea and larynx
high pitch, loud amplitude, inspiration
where are broncho-vesicular lung sounds typically heard
over major bronchi
They have a moderate pitch and 1:1 expiratory -versus-inspiratory ratio
where are vesicular lung sounds typically heard
over the peripheral lung fields
low pitch, soft amplitude, inspiration>expiration
what’s the recommended age to start doing mammograms?
40 years
Why not earlier? Risk of false positives (breast tissue is very firm when we’re younger and can give false positives)
what is the leading cause of cancer in women?
breast cancer
who is at a higher risk for breast cancer?
- African-American women have highest death risk for any age
- White women OVER age 45
- African american women UNDER age 45
What are the non-modifiable risk factors for breast cancer?
Female gender Age > 50 years Mutation of BRCA1 and BRCA2 genes – (women w/ BRCA2, the risk is 45% of developing breast cancer. Increased ovarian cancer risk is also associated with these genes.) First-degree relative w/ breast cancer Early menarche ( 55 years) High breast tissue density
What are the modifiable risk factors for breast cancer?
Nulliparity (no kids) or first child after age 30 years
Never breastfed
Recent oral contraceptive use
Recent and long-term estrogen and progestin use
Alcohol intake of ≥ 1 drink daily
Obesity (especially after menopause) and high fat diet
Physical inactivity
What is Cheyne-stokes breathing?
regular irregular rhythm that cycles from deep and fast to shallow and slow, with some periods of apnea
Agonal breathing
found in PTs at end of life.
Irregular pattern with changing rate and depth
apnea
no breaths
kussmaul breathing
seen in PTs with DKA bc body is attempting to remove CO2 to normalize pH
Crackles (coarse and fine)
discontinuous sounds cause by fluid in the airways or alveoli, or that result from the opening of collapsed airways and alveoli as they reinflate during deep breathing (hairs rubbing or velcro)
Wheezes
continuous, high-pitched, musical sounds caused by air squeezing through narrowed airways (seen in ASTHMA, bronchitis, emphysema) generally on expiration)
Rhonchi
continuous, low-pitched, snoring sounds resulting from secretions moving around in airways (may CLEAR with coughing, seen in PTs with chronic bronchitis or pneumonia)
pleural friction rub
loud, coarse and low-pitched grating or creaking sound (squeaky door). Seen in pleuritis
stridor
loud, high-pitched, crowing or honking sound louder in upper airway
seen in croup, obstructed airway, epiglottis
A 92-year-old woman with a history of COPD presents with increasing shortness of breath, decreased lung sounds in the bases, increased ankle edema, and 5-lb weight gain in 1 week. What is the most likely problem?
excess fluid volume
COPD PTs often retain fluid because of the increased workload of the heart that the disease imposes
What is the most common cause of COPD?
smoking!
When the nurse assesses the client with respiratory symptoms, which of the following complaints should be evaluated first?
a. chest pain
b. dyspnea
c. cough
d. sputum
dyspnea
tactile fremitus
a vibration felt on the patient’s chest during low frequency vocalization.
what are the various patterns recommended for breast exams
vertical patter, circular patter, wedge pattern
Gynecomastia
enlargement of man’s breasts
when is the best time to palpate the breasts?
4-7 days after the menstrual cycle begins
The breasts are least congested and smallest right after the menstrual period (or days 4 to 7 of the menstrual cycle).
Paget’s disease
an inflammation of the nipple associated with breast cancer.
In older women, secretion of estrogen and progesterone decreases, leading to
atrophy of the glandular tissue and its replacement with fibrous connective tissue. This tissue feels granular
It is important to examine the upper outer quadrant of the breast because it is
where most tumors develop (called the tail of spence)
fibroadenoma
a tumor formed of mixed fibrous and glandular tissue, typically occurring as a benign growth in the breast.
Peau d’orange (orange peel skin) appearance is highly suggestive of which of the following?
breast cancer
The correct position in which to place the patient to palpate the breasts is
supine with arm over head.
stridor is a high-pitched, inspiratory crowing sound commonly associated with
upper airway obstruction
where does the nurse expect to auscultate bronchovesicular lung sounds in a healthy adult?
near the sternal border
a nurse hears inspiratory and expiratory wheezes bilaterally. What is the meaning of this?
narrowed airways
a known risk factor for breast cancer includes:
early menarche or late menopause
which woman in the US has the highest incidence for development of breast cancer?
a. african american
b. american indian
c. white
d. asian
white
