Respiratory Flashcards
Pulsus paradoxicus - indicates?
- Late sign of cardiac tamponade
- Severe acute asthma
- Severe exacerbation of COPD
Respiratory causes of raised JVP?
- Pulmonary hypertension
Normal cricosternal distance?
3-4 fingers
Bronchial breath sounds?
Harsh-sounding, inspiration and expiration are equal and there is a pause between
Associated with consolidation
Further assessments and investigations at the end of a respiratory exam?
- Check O2 sats
- Vital signs such as temperature and BP
- Sputum sample
- Peak flow assessment
- Chest x-ray
- ABG
- Full cardiovascular exam
Things to do before using an inhaler?
- Device test (if haven’t been used for 5 days or more, test the devise first)
- Dose counter
- Expiry date
Procedural steps of using an inhaler
- Preparation
- Inhalation
- Final steps
- Multiple doses
Preparation steps of inhaler technique?
- Hold the inhaler upright
- Remove the cap from the inhaler and inspect to ensure nothing in mouthpiece
- Shake the inhaler well
Inhalation steps of inhaler technique?
- Sit or strand straight
- Breathe out gently
- Put lips around mouthpiece and make tight seal
- Start to breath in slowly and steadily whilst pressing inhaler
- Continue to breathe in slowly
- Remove inhaler and seal lips, holding breath for 10 seconds
Final steps of inhaler technique?
Once you have finished, replace the cap and if it contained steroids rinse your mouth with water
Multiple doses - inhaler technique?
If you have prescribed a second puff, wait 30 seconds to a minute for repeating steps
How to use a spacer?
- Prepare inhaler as explained
- Attach inhaler to the spacer device
- Breath out gently
- Place lips around spacer and make an effective seal
- Release one dose of the inhaler into the spacer
- Breathe deeply in and out through the spacer several times
- administer a second dose if required
Spacer device care?
Spacer device should be washed with detergent (washing up liquid is fine) once a month and left to air-dry
It should never be wiped dry - causes static
Spacers replaced at least once a year
How to measure PEFR?
- Check peak flow meter is at zero
- Position standing up or sitting straight
- Take the deepest breath possible
- Hold the peak flow parallel to the floor and create a tight seal around mouth piece
- Exhale as forcefully as you can
- Note the reading
- Repeat 2x more
- Record the highest of the three attempts
Causes of Interstitial lung disease?
Primary - idiopathic, acute interstitial pneumonia
Secondary - Sarcoidosis, rheumatoid arthritis, SLE, Mycoplasma, asbestosis, drugs
