ch 16 pt 2 RCP Flashcards
(23 cards)
what causes an abnormal increase in AP diameter (barrel chest) what type if patient does this happen to?
Patients w/ emphysema, COPD
chronic lung problems
hyper-inflated lungs
explain 5 different thoracic configurations
1.PECTUS CARINATUM: protrusion of sternum
2.PECTUS EXCAVATUM: depression of part/entire sternum
3.KYPHOSIS: spinal deformity in which the spine has abnormal horizontal ap curvature
4.SCOLIOSIS: spinal deformity, the spine has lateral curvature
5.KYPHOSISCOLIOSIS: produce severe restrictive lung defect as a result of poor lung expansion a mixture of scoliosis and kyphosis.
explain tracheal deviation
Normal: trachea midline
shift toward pathology:
*atelectasis
*diaphragmatic paralysis
shift away from pathology
*plural effusion
*pnemothorax
*neck or thyroid tumors
what do retractions indicate in a patient?
severe increase of WOB
Inward sining of the chest wall during inspirtation
explain the following breathing pattern:
Apnea
no respirations
emergency situtation
explain the following breathing pattern: agonal
intermittent prolonged gasps
patient is not breathing adequately cardiac arrest
explain the following breathing pattern:Kussmaul
increased rate & depth, fast/deep
diabetic crisis
explain the following breathing pattern: cheyne-stokes
respiratory rate & tidal volume increase in intensity then decrease into apnea for several seconds
neurological problem
wheezes. how do we fix it?
albuterol
*consistent w/airway obstruction
*monophonic- one airway affected
* polyphonic- many airways are involved
explain the following breathing pattern: biot
chaotic breathing w/ irregularity in rate & tidal volume which becomes agonal breathing
astma
stridor: how do we fix it
cool aerosol
*upper airway compromised
*chronic stridor- laryngomalacia
*acute-stridor-croup
*heard on inspirtation
crackles
course: suction or humidification/ PT coughs
*airflow move secretion or fluid in airways
Fine: lasixs diuretic
*sudden opening of small airways in lung deep breathing
*heard w/pulmonary fibrosis & atelectasis
what causes murmurs
- back flow of blood through an incompetent valve
*forward flow of blood through a narrowed valve
*rapid blood flow through a normal valve
heart sounds
S1. closure of the mitral valve & tricuspid valves
ventricular contraction
S2. closure of the pulmonary & aortic valves
ventricular relax
explain the difference between vocal and tactile fremitus
vocal:heard by speech
tactile: felt on chest
describe the difference between fremitus in emphysema in pneumonia
emphysema: increase resonance more air than normal
pneumonia: decrease resonance- solid fluid in lungs
how does subcutaneous empysema form?
what is the feeling of air under the skin called?
air leaks into the subcutaneaous tissues, “crepitus”
percusion notes:
emphysema
atelectasis
pleural effusion
pneumothorax
pneumonia
emplysema: hyperresonance
atelectasis: dull or flat, decrease resonance
pleural effusion: decrease resonance dull or flat
pneumothorax: increase resonance, tympanic,hyper
Pneumonia: decrease resonance, dull or flat
breath sounds/pitch/intensity/location
vesicular
bronchial
bronchovesicular
Vesicular: low/soft/ plural lungs
bronichial: high/loud/over trachea
bronchovesicular: moderate/moderate/upper half of sternum
how do you test for capillary refill, what is normal refill time
push down on nail bed, turn pink in 2 seconds
where should you check for edema caused by heart failure? why?
lower extremities feet, legs, fluid sets down due to gavity
specific cause of cyanosis
main cause of and what is peripheral cyanosis?
low oxygen,
bluish discolor found in hands, fingers toes due to lack of oxygen. Poor circulation
