BRTP01 Flashcards

1
Q

Normal Heart rate

A

60-100 beats per minute

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2
Q

Normal range of respiratory rate

A

12-20 breaths per minute

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3
Q

Normal range of blood pressure

A

90/60 to 140/90

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4
Q

Average temperature

A

98.7 degrees F or 36.4- 37.2 degrees C

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5
Q

Apnea

A

Absence of breathing

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6
Q

Hyperpnea

A

Increased depth of breathing or air flow

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7
Q

Hypopnea

A

Decreased depth of breathing and air flow

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8
Q

Eupnea

A

Normal breathing

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9
Q

Hyperventilation

A

Increased ventilation that results in an abnormally low CO2 levels (less than 35)

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10
Q

Hypoventilation

A

Decreased ventilation that results in an abnormally high CO2 level ( greater than 45)

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11
Q

Bradypnea

A

Decrease in respiratory rate ( less than 12 breaths per minute)

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12
Q

Tachypnea

A

Increase in respiratory rate ( RR higher than 20 breaths per minute)

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13
Q

Capillary refill

A

Pressing nails and watching for color to return.

Color should return in less than 3 seconds

If greater than 3 seconds it indicates poor perfusion.

Common causes are low BP and decreased cardio output.

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14
Q

Sensorium

A

Mental status

Oriented to time, place, person

(Oriented x 3)

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15
Q

Alert

A

Awake, coherent, responsive

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16
Q

Lethargic

A

Awake but drowsy

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17
Q

Obtunded

A

How to stimulate to get response or to show eyes

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18
Q

Stuporous

A

Withdraw from pain

Ex: if you pinch hand they will pull hand back

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19
Q

Comatose

A

No response, nothing.

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20
Q

Tachycardia

A

Increase in HR (greater than 100 beats per minute)

Causes:
Hypoxia 
Infection and fever 
Shock
Anxiety, stress, fear
Medications
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21
Q

Cheyne-Stokes respiration

A

Waxing and waning tidal volumes with periods of apnea. Usually a neuro issue or Congestive Heart Failure (CHF)

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22
Q

Kussmaul’s respiration

A

Rapid, deep breaths. Typically related to diabetic Keto acidosis. (Patient will be panting)

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23
Q

Biot’s respiration

A

Variable rate and depth of breaths with periods of apnea. Can be caused by meningitis, head injury, increase ICP, brain tumor. (Neurological issue) (panting w apnea)

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24
Q

Systolic pressure

A

Pressure when heart is contracting

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25
Q

Diastolic pressure

A

Pressure when heart is resting

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26
Q

Hypotension

A

Low blood pressure less than 90/60

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27
Q

Hypertension

A

High blood pressure above 140/90

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28
Q

Hypertension causes

A
Fear and anxiety 
Tachycardia, vasoconstriction 
Hypoxia (lack of O2 at tissues) 
Kidney disease 
Medications 
Poor lifestyle habits 
Heredity
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29
Q

Hypotension causes

A
Bradycardia 
Cardiac failure, vasodilation, or shock
Hypovolemia/ dehydration 
Postural (orthostatic) hypotension 
Hypothermia
Medications 
Tension pneumothorax
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30
Q

Pulsus paradoxus

A

Pulse that is weaker during inspiration

Air trapping, pneumothorax, pericardial effusion[cardiac tamponade], pericarditis

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31
Q

Pulsus alternans

A

Alternating weak and strong pulses

Associate this with cardiac arrhythmia
Also left ventricle failure

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32
Q

Fever (Pyrexia)

A

Elevated body temperature secondary to disease such as infection

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33
Q

Febrile

A

Body temperature above normal

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34
Q

Afebrile

A

Body temperature that is within normal limits

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35
Q

Hypothermia

A

Potentially dangerous drop in body temperature

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36
Q

Hyperthermia

A

Potentially dangerous increase in body temperature

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37
Q

Effects of hypothermia

A

Decreased metabolism
Decreased oxygen consumption and CO2 production
Bradypnea and hypoventilation
Bradycardia

(Lower temp lowers everything else)

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38
Q

Effects of hyperthermia

A
Increased metabolism 
Increased oxygen consumption 
Tachypnea and increased ventilation 
Tachycardia 
Coma, seizures, renal failure
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39
Q

Normal oxygen saturation (SpO2)

A

Normal is mid to upper 90’s

(96-99)

(Less than 90% indicates a level of hypoxemia typically in need of supplemental oxygen)

40
Q

Palpation

A

Using hands to take pulses

41
Q

Percussion

A

Using hands to tap and listen to body

42
Q

Auscultation

A

Using a stethoscope to observe body

43
Q

Tripod breathing

A

Leaning forward while bracing elbows on a table or furniture. Makes it easier to use accessory muscles

44
Q

Orthopnea

A

Dyspnea (difficulty breathing) in the reclining position

45
Q

Accessory muscles used when in respiratory distress

A

Intercostal ( between ribs)
Subcostal (below ribs)
Supraclavicular (above clavicles)
Suprasternal (above sternum)

46
Q

Retractions

A

Inward depression of skin on inspiration caused by ventilatory muscles contracting to cause a decrease in intrathoracic pressure

47
Q

Pursed lip breathing

A

Breathing through pursed lips to create a slight back pressure in airways to keep them from collapsing

48
Q

Nasal flaring

A

Nares widen during inspiration and return to normal on expiration

49
Q

Grunting

A

High pitched sound made by partially closing the glottis over trachea
(Helps keep alveoli open on exhalation)
(An attempt to maintain lung volume)

50
Q

Diaphoresis

A

Profuse sweating

51
Q

Cyanosis

A

A visible bluish tinge is the skin and mucous membranes
(Can be a sign of hypoxia)
(Can be hypoxia but not cyanotic)

52
Q

Central cyanosis

A

Associated with hypoxia and mucous membranes

Lips and tongue will be blue

53
Q

Acrocyanosis

A

Hands and feet are blue

Due to poor circulation and poor perfusion

54
Q

Barrel chest

A

Increase in A-P diameter of chest

55
Q

Pectus carinatum

A

Sternal protrusion

56
Q

Pectus excavatum

A

Depression of part or all of sternum

57
Q

Kyphosis

A

Abnormal A-P spinal curvature

58
Q

Scoliosis

A

Abnormal lateral curvature

59
Q

Digital clubbing

A

Progressive, painless enlargement of ends of fingers and toes ( usually linked to hypoxia, not always)

60
Q

Jugular venous pressure (JVP)
Or
Jugular venous distention (JVD)

A

Large elevated vein in right side of neck

Usually caused by :
right heart failure (cor pulmonale) 
Tension pneumothorax 
Lung disease 
Cardiac tamponade
61
Q

Trachea shifts AWAY from affected side

A

Tension pneumothorax
Pleural effusion
Hemothorax

(All occur outside of lung)

62
Q

Trachea shifts towards the affected side

A

Atelectasis
Pulmonary fibrosis

Occur inside lung

63
Q

Subcutaneous emphysema

A

Sometimes called “sub q” or “crepitus”

Air leaks into subcutaneous layer of tissue

Fine air bubbles create crackling sensation

Classic sign of: 
Barotrauma 
Pneumothorax
Trauma 
Surgeries (heart, thoracic, tracheostomies)
64
Q

Tactile fremitus

A

Vibrations through chest wall when patient speaks

Vibrations decrease with extra air inside lungs, or fluid, or air in the plural space

Vibrations increase as lung tissue becomes more dense

65
Q

Increased fremitus is found in?

A

Unilateral:

Pneumonia
Atelectasis
Consolidation

Bilateral:

Pulmonary edema (fluid in lungs equally)
Acute respiratory distress syndrome (ARDS)
66
Q

Decreased fremitus is found:

A

Unilateral:
Pneumothorax
Pleural effusion
Bronchial obstruction

Bilateral:
Thick chest walls (high amounts of fat or muscle)

Chronic obstructive pulmonary disease (COPD)

67
Q

Resonant sound

A

Indicates good aeration, will be moderately low pitched

68
Q

Dull sound

A

Indicates poor aeration/ solid tissue/ fluid-filled

69
Q

Hyperresonant

A

Hyperinflated or excessive air

Increased resonance

Louder and lower than normal sound

70
Q

Tympany

A

Drum-like sound

Increased resonance

Interchangeable with hyperresonance

71
Q

What causes DULL sounds? (Decreased resonance)

A

Pneumonia
Atelectasis
Tumors
Pleural fluid

72
Q

What causes HYPERRESONANT sounds? (Increased resonance)

A

Unilateral- Pneumothorax or bleb

Bilateral- hyperinflated lungs as in an asthma exacerbation or emphysema

(Also referred to as tympany)

73
Q

Diaphragmatic excursion

A

Comparing the level of the diaphragm on inspiration and expiration

Should be 3-5 cm

74
Q

Abnormal diaphragmatic excursion can be caused by what?

A
Phrenic nerve injury 
Paralysis 
Pneumonia 
Neuromuscular diseases 
Tension pneumothorax 
Hepatomegaly
75
Q

Best position for lung auscultation?

A

Fowlers position (sitting upright)

76
Q

Normal breath sounds: BRONCHIAL

A

Over the trachea
High in pitch
Loud in intensity

77
Q

Normal breath sounds: BRONCHOVESICULAR

A

Around upper part of the sternum (main stem bronchi) and between scapulae

Moderate in pitch and intensity

78
Q

Normal breath sounds: VESICULAR

A

Over parenchyma/ periphery (most of lung)

Low in pitch and soft in intensity

79
Q

Adventitious breath sounds

A

Abnormal breath sounds

Foreign, acquired; occurring in unusual places

80
Q

Adventitious breath sound example to know:

A

Example:

Bronchial breath sounds heard in a lung base (in the parenchyma) is abnormal and suggests pneumonia or consolidation.

81
Q

Fine crackles

A

Also known as “rales” or just “crackles”

Heard on inspiration

Sounds like rubbing hair between fingers

Doesn’t clear with cough

Indicates alveolar secretions/ fluids or opening of alveoli on inspiration

82
Q

Fine crackles are associated with which diseases and disorders?

A

Atelectasis

Pulmonary edema

Fibrosis

(Think inside of lungs)

83
Q

Coarse crackles

A

Also known as “rhonchi”

Low in pitch, continuous sound

More common on expiration but can be heard on inspiration

Sounds like rumbling or snoring

Can clear with cough

Indicates secretions moving in airways

84
Q

Course crackles are associated with which disease?

A

Bronchitis

Severe pneumonia

85
Q

Wheezes

A

Usually heard on expiration but can be inspiratory

High pitch, musical, and continuous

Doesn’t clear with cough

Caused by increased airflow through narrowed airway

86
Q

Wheezing is related to why disease?

A
Asthma
Bronchitis 
Congestive heart failure (CHF)
Pulmonary edema 
Foreign body (more likely to have monophonic wheeze)
87
Q

Diminished or decreased breath sounds causes?

A
Shallow breathing 
Severe obesity
Chronic lung disease 
Pleural effusion/ fluid (may be completely absent) 
Pneumothorax (may be completely absent)
88
Q

Pleural friction rub

A

Creaking or grating sound

Caused by rubbing or inflamed, rough pleural surfaces

Can sound like coarse crackles but will NOT clear with cough

Localized to one area and can be painful

89
Q

Pleural friction rub is caused by?

A

Pleurisy, pneumonia, pulmonary embolus (PE)

90
Q

Stridor

A

High pitched monophonic sound CROWING sound

Caused by rapid airflow through upper airway

Most commonly acute but could be chronic

Indicates upper airway construction or partial obstruction

91
Q

Stridor is related to what disease

A

Partial upper airway obstruction caused by croup

Epiglottis

Postextubation laryngeal edema

Foreign body

92
Q

Atelectasis

A

Complete or partial collapse of lung or live of lung.

Collapses at alveolar level (from inside the lung)

93
Q

Pneumothorax

A

Collapsed lung from outside pressure

Air leaks into pleural space

94
Q

Pleural effusion

A

Abnormal amount of fluid around lungs

Fluid between pleural space

95
Q

Blunted costophrenic angle

A

Pointed angle in base of lung collapses or is obliterated due to pleural effusion