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800 > Week 8 (CR Assessment and Auscultation) > Flashcards

Week 8 (CR Assessment and Auscultation) Flashcards

1
Q

Normal values for Spo2

A

95-100%

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2
Q

Normal values for HR

A

60-100bpm

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3
Q

Normal values for BP

A

100-140/60-90

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4
Q

Normal values for RR

A

12-16breaths/min

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5
Q

Normal values for temperature

A

36.5-37.4 (afebrile)

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6
Q

Temperature of 37.5-38.2 degrees represents

A

Low grade fever (febrile)

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7
Q

Temperature of > 38.2 represents

A

High grade fever (febrile)

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8
Q

What are the 3 main parts of a CR assessment

A
  1. pre-interview
  2. subjective examination
  3. objective examination
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9
Q

Define sign

A

A physical manifestation of a disease or an objective measurement

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10
Q

Define symptom

A

Something the patient experiences, complains or feels of - subjective measurement

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11
Q

What are the basic CR objective assessment and the other parts

A

Basic: Ventilatory support and Sao2, observation, palpation, auscultation, cough assessment
Other: CXR, spirometry, ABG

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12
Q

What does the oxygen dissociation curve show?

A

Relationship between partial pressure of oxygen and oxygen saturation

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13
Q

PaO2 (80-100mHg) = SaO2 (?)

A

Normal: 95-100%

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14
Q

PaO2 (<80mmHg) = SaO2 (?)

A

Low (hypoxemia): <95%

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15
Q

PaO2 (<60mmHg) = SaO2 (?)

A

Respiratory failure: <90%

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16
Q

CR assessment: Ventilatory support and SaO2 consists of

A

Measured to assess need for oxygen therapy, define respiratory impairments

  • Level of oxygen, sort of oxygen therapy
  • Oxygen saturation
  • Oxygen dissociation
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17
Q

CR assessment: observation

A

Externally
Face
Body

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18
Q

Observation: externally

A

Bed charts/monitors

Current vital signs

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19
Q

Observation: face

A

Level of consciousness
Facial expression
Colour (face and lips)

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20
Q

Observation: body

A 
Posture/position
Weight/size
Chest wall shape
Breathing pattern and rate
Signs of increased effort to breathe
Fingers: peripheral cyanosis
Fingers: clubbing
Peripheral oedema
Scars/incisions
Attachments
21
Q

CR assessment: palpation

A

Common: LBE, AP, abdominal movement
Other: trachea, accessory muscle use, secretions vibrating through chest wall

22
Q

Bronchial breath sounds are normal when heard over… and abnormal when heard over…

A

Tracheal area

Chest wall

23
Q

Mechanism: decreased breath sounds

A

Less gas flow causing less sound OR an increased sound attenuation in the periphery

24
Q

Interpretation: decreased breath sounds

A
  • Shallow breathing
  • Incomplete blockage of an airway
  • Atelectasis/partial lung collapse
  • Hyperinflation
  • Reduction in transmission of the BS e.g. obesity, pleural abnormalities such as effusion, thickening, pneumothorax
25
Mechanism: no breath sounds
- Localised accumulation of air or fluid in the pleural space blocking transmission from large airways - If the bronchus supplying an area of the lung is obstructred
26
Interpretation: no breath sounds
- Segmental or total lung collapse - Pleural abnormalities e.g. large pleural effusion or pneumothorax - Carcinoma or large sputum plug
27
Mechanism: bronchial breath sounds
Tissues between central airways and the chest wall are altered so that they conduct sound very well
28
Interpretation: bronchial breath sounds
- Consolidation (most common) - Large cavity communicating with a bronchus - UL collapse (with bronchus open or obstructed) - LL collapse (only when the bronchus is still open to transmit the sound)
29
Mechanism: wheeze
Oscillation or vibration of airflow through narrowed opposing airway walls i.e. airways narrowing
30
Interpretation: wheeze
- Secretions - Bronchospasm - Oedema (inflammation) - Tumour/foreign bodies
31
Mechanism: fine crackles
Sudden opening of closed small airway and alveoli on inspiration, after collapsing due to fluid or lack of aeration during expiration
32
Mechanism: coarse crackles
Movement of air bubbles through secretion
33
Interpretation: fine crackles
Atelectasis, fibrosis, interstitial pulmonary oedema
34
Interpretation: coarse crackles
Presence of secretions in the airways, resolving pneumonia, pulmonary oedema
35
Mechanism: stridor
Obstructed trachea or larynx
36
Interpretation: stridor
Medical emergency - upper airway obstruction
37
Decreased secretion movement:
- Patient subjective report - Wheeze - Obstructive spirometry - Cough: moist and/or productive - Ausc: coarse crackles, URTN - Palp: feel secretions - Obvs: see sputum - History of smoking and respiratory disease
38
Decreased gas movement
- ABG: decreased Pao2, increased paco2, decreased spo2 - CXR changes - Spirometry results - Palp: feel decreased LBE - Ausc: fine crackles, decreased BS, no BS - Obvs: see cyanosis, altered pattern of breathing
39
Clin Sim: What to routinely observe on patient in a photo?
Level of consciousness/alertness Patient position (in bed/chair) Oxygen therapy (FiO2/ or L/min and mode) Oxygen saturation (SpO2) RR (+ other vital signs and CXR if available) Attachments e.g. drips, drains, catheters
40
What can cause unilateral decreased LBE
Collapse, consolidation, pleural effusion Accessory muscle use Secretions through chest wall
41
Lung anatomy: ant seg UL
1-4
42
Lung anatomy: ant RML
5
43
Lung anatomy: ant lingula seg LL
6
44
Lung anatomy: ant seg LL
7 and 8
45
Lung anatomy: post seg UL
1 and 2
46
Lung anatomy: apical seg LL
3 and 4
47
Lung anatomy: post seg LL
5 and 6
48
Lung anatomy: lat seg LL
7 and 8

800 (12 decks)

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