Chapter 10-Assess Breathing

Question 1

A patient’s breathing status is directly related to

Answer 1

The adequacy of the patient’s airway

Question 2

A patient who is breathing without assistance is said to have:

Answer 2

Spontaneous Breathing

Question 3

As you assess the patients breathing, what three questions should you ask yourself?

Answer 3

Is the patient breathing?
Is the patient breathing adequately ?
Is the patient hypoxic?

Question 4

________ ventilations should be performed for patients who are not breathing or whose breathing is too slow or shallow

Answer 4

Positive pressure

Question 5

The goal for oxygenation for most patients is an oxygen saturation of greater than _____

Answer 5

94%

Question 6

When respirations exceed ___ breaths/min with signs of distress or fewer than ___ breaths/min, or are too shallow for air exchange, what should you do

Answer 6

28 breaths/min
8 breaths/min
provide positive pressure ventilations and an airway adjunct

Question 7

Remember number of breaths is not the critical issue, but rather______

Answer 7

Air exchange

Question 9

Normal breathing is an effortless process that does not affect _____, ______, or ______

Answer 9

Speech, posture, positioning

Question 10

______ is a good indicator of whether a conscious patient is having difficulty breathing

Answer 10

Speech

Question 11

A patient who can speak normally without unusual extra pauses is breathing normally

Answer 11

True.

Question 12

What would speech look like in a person who is having difficulty breathing?

Answer 12

Only one word at a time
Must stop every two to three words to catch a breath
Having significant difficulty breathing

Question 13

Normal respirations are not ____ or excessively _______

Answer 13

shallow
deep

Question 14

How are shallow respirations identified?

Answer 14

little movement of the chest wall, reduced tidal volume (amount of air in and out the lungs in one breath), or poor chest excursion

Question 15

Deep respirations, on the other hand, cause ______

Answer 15

significant rise and fall of the chest wall

Question 16

During retractions, where do indentations occur?

Answer 16

Above the clavicles
In the spaces between the ribs

Question 17

Use of ________ muscles during during respirations is a sign of inadequate breathing

Answer 17

accessory

Question 18

Name the accessory muscles

Answer 18

Neck muscles (sternocleidomastoid)

Chest pectoralis major muscles

Abdominal muscles

Question 19

In pediatric patients, ________ and ________ indicate inadequate breathing

Answer 19

Nasal flaring
Seasaw breathing

Question 20

A patient who can only speak two or three words without pausing to take a breath has a condition known as:

Answer 20

two-to-three word dyspnea

Question 21

What are the two common postures that indicate the patient is trying to increase air flow:

Answer 21

Tripod position
Sniffing position

Question 22

Describe the tripod position.

Answer 22

The patient is sitting and leaning forward on outstretched arms with head and chest thrust slightly forward

Question 23

Define sniffing position

Answer 23

This is most commonly seen in children
The patient sits upright with head and chin thrust slightly forward , appearing to be sniffing

Question 24

When you can see the effort in the breathing, the patients breathing is described as:

Answer 24

labored breathing

Question 25

Labored breathing is characterized by what 3 categories:

Answer 25

The patient’s position Concentration on breathing Increased effort and depth of each breath

Question 27

As breathing becomes more labored, accessory muscles in the _____ and _____ are used and the patient may make ______ sounds

Answer 27

Neck and Chest Grunting

Question 28

In infants _______ and _________ and ________ are associated with labored breathing

Answer 28

nasal flaring supreclavicular and intercoastal retractions gasping

Question 29

In infants and small children, ______ is generally caused by respirator arrest

Answer 29

Cardiac arrest

Question 30

What is respiratory distress?

Answer 30

When a person has difficulty breathing, therefore the work of breathing is increased.

Question 31

What is respiratory failure and when does it occur?

Answer 31

Occurs when the blood is inadequately oxygenated or ventilation is inadequate to meet the oxygen demand of the body

Question 32

What is the result of uncorrected respiratory failure?

Answer 32

Respiratory arrest

Question 33

Signs of respiratory distress

Answer 33

Agitation, Anxiety, Restlessness Stridor (high-pitched, whistling sound when air flows through an obstructed airway) Wheezing Accessory muscles used, intercostal retractions, neck muscle use (sternomastoid) Tachypnea Mild tachycardia Nasal flaring, seasaw breathing, head bobbing

Question 34

Signs of respiratory failure

Answer 34

Lethargy, difficult to rouse Tachypnea with periods of bradypnea or agonal respirations Inadequate chest rise/poor excursion inadequate respiratory rate and effort Bradycardia diminished muscle tone

Question 35

Typically a person in respiratory distress has an increase in ________

Answer 35

Respiratory effort and rate