Module 6 Flashcards
(207 cards)
1
Q
Mammary glands lie over the …
A
muscles of the anterior chest wall
2
Q
Where do the breast lie?
A
Horizontally over the sternum to the mid axillary line, and vertically from the 2nd to 6th Intercostal Spaces
3
Q
What determines the difference in breasts between the genders?
A
Estrogen and Progesterone
4
Q
The breasts are a _____ reproductive muscle
A
accessory reproductive muscle
5
Q
Functions of the Breast
A
Milk
Sexual Stimulation
6
Q
Types of Breast Tissue
A
Glandular
Fibrous
Adipose
7
Q
Glandular Breast Tissue
A
- Functional tissue
-Makes milk - arranged into 15-20 lobes in a circular orientation with 50-75 lobules and 10-100 acini cells producing milk
8
Q
Acini Cells
A
Cells producing milk
9
Q
Fibrous Breast Tissue
A
The cooper’s suspensory ligaments
10
Q
Cooper’s Ligaments
A
ligaments that support the shape of the breast by connecting skin and muscle throughout
11
Q
Adipose Breast Tissue
A
Subcutaneous and Retromammary Fat of the breast
Makes up the majority of the breast, determines shape and size, but does not have a functional capacity
12
Q
How are the mammary ducts constructed to bring milk to the nipples?
A
lobules, ductules, and lobes converge into a single milk duct that transports the milk
13
Q
What else is looked at during a breast exam?
A
The axilla and the lymphatics
14
Q
What are the sets of lymph nodes examined alongside the breast?
A
Axillary Lymph Nodes
Clavicular Lymph Nodes
15
Q
Important Axillary Lymph Nodes to examine in a breast exam?
A
- Lateral - drains the arm - brachial
- Central - on midaxillary line
- Pectoral - anterior axillary - drains most of the breast
- Subscapular - posterior axillary
16
Q
The Central Axillary Node…
A
gets drainage from the other nodes, and a small amount flows into the Clavicular nodes
17
Q
2 Clavicular Lymph Nodes to Exam
A
Supraclavicular and Infraclavicular
18
Q
Concerning Findings in Lymph Node Examination?
A
Enlargement
Tender or Painful Nodes
Nonpainful Enlargement
Larger than 1 cm enlargement
Nonmoving Lymph Node Mass
19
Q
Non Modifiable Associations for the Health History Breast Exam
A
- Things that cannot be changed -
Gender
Age at Menarche
Age at Menopause
Genetics (thought as highly important to risk)
Race/Ethnicity
Family History
Personal History
Previous Chest Radiation
Diethylstilbestrol Exposure
Age During Pregnancies (May be modifiable)
20
Q
Menstruation and Menopause at what ages cause a higher risk for breast cancer?
A
Menstruation pre age 12 and Menopause post age 55
21
Q
DES
A
Diethylstilbestrol
Now banned medicine for miscarriage in the 1940/50s that has been shown to cause a severely high rate of breast cancer in the daughters of the medication’s user
22
Q
Modifiable Associations for the Health History Breast Exam
A
Children
Oral contraceptives
Hormones
Medications
Breast Feeding
Alcohol
Excessive Weight Gain
Physical Activity
Night Light
23
Q
Children prior to age ____ is thought to be more protective against breast cancer
A
30
24
Q
Use of hormone therapy for estrogen and progesterone ____ risk of breast cancer, but cessation of use ____ risk after 2-3 years
A
increases; decreases
25
Medications for ____ ____ and ____ can increase breast cancer risk
Breast enlargement and Transgender (breast enlargement)
26
Breast feeding is ____ against breast cancer
protective
27
Excessive Weight and Obesity increases estrogen thus leading to ...
a higher risk of breast cancer
28
Physical activity can decrease breast cancer risk by ___%
10
29
Unclear Associations for the Health History Breast Exam
Night Work
Secondhand Smoke
Dieting and Vitamins
Medications
Environmental
30
How might night work increase breast cancer rate?
it is unclear and undergoing further study right now, but decreased melatonin levels may be linked to a higher risk of cancer
31
At the start of the Physical Exam of the Breast it is important to do/keep in mind what things?
1. Always provide privacy as it may be embarrassing
2. you want to teach the patient on breast awareness and to reassure them (decreases anxiety or embarrassment)
3. May need a chaperone (especially if you are a male nurse)
32
Physical Assessment of the Breast includes what techniques?
Inspection
Palpation
33
Inspection of the breast should be done in what position(s)?
while sitting and while supine
34
Palpation of the breast includes what parts and intensity?
Light, Mid, and Deep Palpation
Breast, Axillae (tail of spence and lymph nodes), and Clavicular lymph nodes
35
Tail of Spence
the prolongation of the upper and outer breast quadrant into the axillary direction ("Axillary Tail")
36
Why do we inspect breast in a supine position too?
So the tissue spreads out to see something you may not while sitting
37
Inspection of the breast occurs in what areas?
Between the 2nd and 6th ribs
Between the sternal edge and the midaxillary line
38
Inspection of the Breast in a Sitting Position involves the patient doing what things?
Sitting with arms at side
Sitting with arms pressed into waist
Sitting with arms above head
Sitting while leaning forward
39
Inspection of the Breast in a Lying Down position involves the patient doing what?
Having their arm up next to the ear with a pillow under one side, this allows the breast tissue to spread over the chest wall
40
What should be observed for during breast inspection?
Size
Shape
Surface Characteristics
Edema
Dimpling
Retractions
Venous Patterns
Areolar and Nipple Characteristics
41
Tanner Scale
Scale that assesses breast development during puberty and starts usually around ages 8-13 in women
11 years is the average starting age of breast development
42
If nipples are seen inverted ...
ask whether they normally are inverted, if they are then it is not concerning
43
Montgomery Tubules
lubricate the nipple/areolar region
44
Peau D Orange
Dimpling of the breast caused by a blocked duct which causes congestion leading to the pitting orange like look of the breast
45
Pendulous Breasts
occurs due to gravity pulling on the cooper ligaments with age, so you have the patient lean forward to check the ligaments
46
What sort of things inspected may be concerning?
Thick Area Felt
Dimpling
Nipple Crust
Red or Hot
New Fluid
Skin Sores
Bumps
Growing Venous Patterns
New Sunken Nipple
New Size/Shape
Peel like Skin
Hard Lump
47
Breast Retractions
When the nipple caves inwards
48
Venous Patterns in the Breast
each side should generally look the same, but different congestion/venous patterns should be noted as it may indicate malignancy
49
Concerning Nipple Characteristics
Color not being dark pink to dark brown
Dry Patchiness/Eczema
New Discharge other than when breastfeeding
Green/White or Bloody/Clear Discharge
Unilateral differences rather than Bilateral
Persistent or Spontaneous differences
50
Paget's Disease
Aggressive Cancer that can be detected in the areolar and nipple region (but it may be hidden by use of creams)
51
Green and White Discharge from the Nipple May Indicate...
a cyst
52
Bloody or Clear Discharge from the Nipple may indicate...
metastasis (cancer)
53
Reasons for Nipple Discharge
Drugs like oral contraceptives, antihypertensive, and tranquilizers
Hypothyroidism
Pituitary Adenoma
Overstimulation
Benign Cancers (Intraductal papilloma, papillomatosis, duct ectasia)
Malignant Cancer
54
Supernumerary Breast or Nipple
a non concerning "extra" nipple that may have formed along the milk line
55
Gynecomastia
- more mamillary density in meds
can be from drugs, hormones, thyroid toxosis, or weight gain
56
Breast health is for ...
EVERY patient, not just female
57
When palpating the breast...
it is best if they enter the supine position now
use a systematic method
use light and then deep palpation
58
Most Registered nurses do not...
give breast exams - but it is technically within the scope of practice
59
Areas to Make Sure you Palpate on a Breast Exam
Tail of Spence
Glandular Area
Areola Area
Nipple Compression (check for discharge, may be advised against at times)
60
Systemic Methods of Palpating Breasts
Concentric Circles
Spokes of Wheel
Grid Top to Bottom
Compass inward and outward
61
When discussing a finding on the breast, refer to it in terms of...
a clock face
62
Abnormal Breast Palpation Findings
Mastitis
Benign and Malignant Masses (Fibroids, Growths, Etc)
63
Mastitis
Milk duct infection
caused usually by a blocked duct (due to blockage or cancer)
important to know if they are lactating currently, because if not it can indicate cancer
64
Why should mastitis be treated quickly?
because it can lead to systemic problems
Teach the new mom if they have flu like symptoms like malaise or that they are not lactating to immediately see a provider
65
Fibrocystic Breasts
Catch all term for many benign breast growth conditions
Swollen, painful, tender, "lumpy bumpy"
often due to hormones or a high caffeine and fat diet
if these are painful, tender, or lumpy they should still be checked for a rare inflammatory breast cancer just in case
66
Fibroadenomas
Benign Solid Breast Tumors
Oval Shape
rubbery
Mobile
5 mm to 5 cm (huge spectrum)
Rare post-menopause
can grow "overnight"/quickly
large and uncomfortable for the patient
can occur even in younger people
67
Malignant Mass in Breasts
Hard
Sharp Edges / Irregular Shape
Non-Mobile
Non-Tender (Could be tender sometimes though, see Fibrocystic final point)
Nipple Erosion, Retraction, or Blood Discharge may occur
Enlarged, shrunken, or dimpled breasts may occur with no pain present
68
51% of Breast Cancers occur in what region?
the upper outer breast region (near the axillary area)
69
Cancer in the breasts are ...
very widespread (many different areas can occur)
70
Invasive (Infiltrating) Ductile Carcinoma
most common breast cancer
71
When documenting breast exam findings what things should be included?
Location (in terms of clock face and how far from nipple)
Size (terms of actual measurements)
Shape
Consistency
Mobility of Mass
Tenderness
Erythema
Dimpling over the mass
Depth of the Mass
Ex: 1 cm hard, circular, non-moveable, painless mas noted at 2 O clock, 2 cm from areola in right breast, no erythema or edema noted
72
Diagnostic Breast Tests
Mammograms
Ultrasounds
Needle Aspirations
Surgical Biopsy
73
Usually diagnostic breast tests occur between...
patient and provider
74
Recommended Mammogram Age?
baseline at 35/36 with yearly ones starting at 40, or 10 years prior to a family members diagnosis of breast cancer
75
Ultrasound
often used in addition to the mammogram to help visualize dense breasts
76
Needle Aspiration and breast cancer diagnosis
Determines fluid contents of the mass
used depending on lesion type seen and potential risks of this test
77
Surgical Biopsy and breast cancer diagnosis
Determines whether a mass is malignant
used depending on lesion type seen and potential risks of this test
78
Breast Awareness should be taught in the patient's...
early 20s
79
Most important thing nurses do in regard to breast health?
Patient Teaching of Awareness and Examinations
80
When should self breast exams be done?
If they no longer menstruate.. choose a day of the month for the exam
If they still menstruate... do shortly after the time of menstruations for a better baseline and less pain
81
How should the self breast exam be done?
Move in a grid like manner into the axilla
Do it lying down or in the mirror
They may do it themselves or need help from a provider
82
The overall newer consensus on self breast exams are...
they may not be all that useful, and awareness may be better to teachq
83
Example Nursing Diagnoses from the Breast Examination
Anxiety
Breast Feeding (effective, ineffective, interrupted)
Body image disturbance
Fear
Health Seeking Behaviors
Knowledge Deficit
Pain (acute, chronic)
Risk for infection
84
Purpose of the Respiratory system
the lungs, in conjunction with the circulatory system, deliver oxygen to and expel carbon dioxide from the cells of the body
To maintain adequate O2 levels in the blood to maintain cellular life
85
Purpose of the upper respiratory system
warms, humidify, filter inhaled air
make sound
send air to lower airways
86
The lungs/lower respiratory system...
accomplishes gas exchange
87
What does the respiratory system include?
Airways
lungs
bony thorax
respiratory muscles
central nervous system
upper and lower respiratory systems
88
Structures of the Upper Respiratory Tract
Nose
Sinuses and Nasal Passages
Pharynx (naso, oro, largynogo)
Tonsils and Adenoids
Larynx: Epiglottis, Glottis, Vocal Cords, Cartilages
89
Thorax
base of the neck to the area superior of the diaphragm
90
Epiglottis
flap of tissue that covers the top of the larynx when the patient swallows.
Protects the person from aspirating food or fluid into the lower airways
91
The larynx is on top of ...
the trachea, and houses the trachea
92
Structures of the Lower Respiratory System
Trachea
Lungs
Pleura
Mediastinum
Lobes of the Lungs
Bronchi and Bronchioles
Alveoli
93
Carina
area where the trachea divides into two bronchi
94
Amount of Lobes per Lung
Right - 3 - upper middle lower
Left - 2 - upper lower
95
Apex of the Lungs
Located at the top'
sit slightly above the clavicle
96
Base of the Lungs
located at the bottom
sit slightly superior to the diaphragm
97
Visceral Pleura
pleura wrapping each lung
98
Parietal Pleura
lines the chest/thoracic cage wall
has nerve endings
99
Between the Visceral and Parietal pleura, there is ...
pleural fluid
100
____ is where gas exchange occurs
Alveoli
101
How many alveoli are in the adult lung?
300 million
102
2 Important Structures of the Respiratory System
Thorax / Thoracic Cage
Respiratory Muscles
103
Thoracic Cage
Everything under the thorax:
Clavicles
Sternum
Scapulae
12 Sets of ribs
12 Thoracic Vertebrae
104
Respiratory Muscles
Diaphragm
External Intercostal Muscles
Accessory inspiratory muscles (Trapezius, Sternocleidomastoid, Scalenes)
105
Respiration
the process of gas exchange between atmospheric air and the blood at the alveoli and between the blood and the cells of the body
106
exchange of gases occurs because...
of differences in partial pressures
107
Pulmonary Ventilation
Inspiration + Expiration
it is the movement of air in and out of the airways
108
Inspiration
active phase of ventilation
involves the movement of muscles and thorax to bring air into the lungs
109
Expiration
the passive phase of ventilation (normally)
movement of air out of the lungs
110
What occurs in the thoracic cavity during Inspiration?
contraction of the diaphragm (downwards/flattening) and contraction of the external intercostal muscles increases thoracic space
The lowered pressure causes air to enter through the airways to inflate lungs
111
The thoracic cavity is a ___ chamber
airtight
112
The floor of the thoracic cavity is the ...
diaphragm muscle
113
What occurs in the thoracic cavity during expiration?
The diaphragm relaxes (bowl shape upward) and intrathoracic pressure increases
Increased pressure means air is pushed out of the lungs as the lungs deflate
Expiration as a passive process requires the elastic recoil of the lungs to occur
114
Inspiration is normally X/3rd of the Respiratory Cycle, and Expiration is X/3rds
Inspiration is 1/3
Expiration is 2/3
115
Pressure in the thoracic cavity on inspiration
lowered
116
Pressure in the thoracic cavity on expiration
increased
117
Ventilation Perfusion (V/Q Ratio)
Ventilation is the movement of air in and out of the lungs, while perfusion is the blood that reaches the alveoli
So an adequate V/Q ratio determines adequate gas exchange as air must reach the alveoli to be available for gas exchange
118
___ occurs when there is an imbalance of ventilation and perfusion which results in ____
Shunting; Hypoxia
119
Tidal Volume (TV)
air volume of each breathe
measure several breaths since it can vary form breath the breath
120
Inspiratory Reserve Volume (IRV)
maximum amount that can be inhaled AFTER a normal inhalation
121
Expiratory Reserve Volume (ERV)
maximum volume that can be exhaled AFTER a normal exhalation
122
Vital Capacity (VC)
the maximum volume of air exhaled from a maximal inspiration
VC = TV + IRV + ERV
123
Forced Expiratory Volume (FEV)
volume exhaled forcefully over time in seconds. Time is indicated as a subscript, usually 1 second
124
Who usually does measurement of volume and inspiratory forces?
a respiratory therapist (but we need to be able to teach use, like how we teach COPD patients the spirometer for use at home)
125
Spirometer
measures volumes of air exhaled and is used to assess lung capacities
126
Pulmonary Function Tests
assess respiratory function and determine the extent of dysfunction
127
Peak Flow Rate
reflects maximal expiratory flow and is frequently done by patients using a home spirometer
128
Diagnostic Procedures and Tests for the Respiratory System
ABGs
Sputum collection and Analysis
CXR, CT, MRI
PFT - measure inspiration and expiration rates and ratios
O2 Sat
129
Sputum is best collected...
in the morning while noting color and density
130
White Sputum indicates...
normal function or a viral/cold infection
131
Green Sputum indicates ...
bacteria
132
Rust color Sputum may indicate ...
Pneumonia or Tuberculosis
133
Pink Frothy Sputum may indicate..
pulmonary edem
134
Bright Red Sputum indicates
blood
135
Brown/Black Sputum indicates
blood or hemoptysis
136
Arterial Blood Gases (ABGs)
measurement of arterial oxygenation and CO2 levels
Used to assess adequacy of alveolar ventilation, ability of the lungs to provide O2 and remove CO2, and acid base level
137
Pulse Oximetry
Non invasive method of monitoring oxygen saturation of the blood
DOES NOT REPLACE ABGs
may be unreliable if they smoke, have nail poliush, etc
138
Normal Pulse OX level is...
95-100%
139
What information to glean from the Subjective health history portion of the respiratory exam?
-present symptoms
-past and family history
-onset of symptoms (COLDSPA)
-Precipitating Factors (QRST/COLDSPA)
-aggravating and alleviating factors
-treatments and self care interventions
-immunizations - pneumovax, influenza annually, etc
140
Listen and Learn what things during the health history respiratory assessment?
SOB
Cough - productive, chronic, etc
Sputum Production
Wheezing
Chest Pain
History of Smoking
What is their normal posture or breathing style
Recent Chest Trauma
General health
Work
Asthma
141
Make sure to get specific information on attempts to quit smoking because...
they could say they quit but only started a day ago
make sure to be non judgmental and not preachy
142
5 As to advising smokers
Ask, Advice, Assess, Assist, Arrange
143
____ patients who move toward quitting smoking
praise
144
Important Landmarks for the Physical Respiratory Assessment
Anterior: Midsternal, Midclavicular, Anterior Axillary Lines
Posterior Chest: C7, T1, T4, T7, T10, Vertebral Line, Scapular Line, Posterior Axillary line
Lateral Chest: Midaxillary line, T9, T5
145
Suprasternal Notch
Notch in anterior neck above the manubrium and angle of louis - great starting point
146
Angle of Louis
Notch distal to the suprasternal notch indicating the 2nd Intercostal
147
Positioning of client for Physical Respiratory Assessment
Sitting for Posterior and Lateral and Anterior, or Supine for Anterior Assessment
148
You can hear lung sounds from what side?
The posterior sides
149
Techniques and order used for Physical Respiratory Assessment
Inspection --> Palpation --> Percussion --> Auscultation
150
It is important to look at ____ for comparison in the physical respiratory assessment
symmetry
151
Inspection during the Physical Respiratory Assessment
-Hallway Assessment
-Introduction
-Use good lighting
-check LOC
-measure and assess respiration pattern and retractions
-assess skin, color, condition, lesions, cyanosis potential (nail beds and lips), signs of respiratory distress
-thoracic configuration, symmetry, AP diameter
-abnormalities like barrel chest, kyphosis, scoliosis, funnel and pigeon chest
-assess neck muscles
-assess bilateral symmetric chest expansion (Thoracic Expanse)
152
Signs of Respiratory Distress
SOB
Diaphoresis
Grunting
Nasal Flaring
Audible Wheezing
Intercostal Retractions
153
LOC
level of consciousness
hypoxic patients may be disoriented or confused or agitated so be aware and do not assume that it is their typical personality
154
Respiratory rate in adults should not go above..
24 maximum (typically 12-20)
155
Infant Respiration Rate
20-40
156
AP Diameter
Ratio of lateral and anterior/posterior thorax - should be a 2:1 ratio normally
157
Kyphosis
curvature in the spine/back
158
Barrel Chest
AP diameter of 1:1 - seen often chronic bronchitis/ COPD patients (due to trouble expiring)
159
It is very to important to do what during palpation, percussion, and auscultation of the chest?
Do a bilateral comparison !!!
160
Pattern of Anterior Chest Physical Examination (Palp/Perc/Ausc)
1. Anterior neck
2. Bilateral ICS 2 (angle of louis)
3. Bilateral ICS 4
4. Bilateral ICS 6
5. Bilateral Lateral ICS 6
161
Pattern of Posterior Chest Physical Examination (Palp/Perc/Ausc)
1. Anterior neck
2.Bilateral T1
3. Bilateral T4
4. Bilateral T7
5 Bilateral T10
6. Bilateral Lateral 9
7. Bilateral lateral 5
162
When Palpating the Chest what should you keep in mind?
1. perform with one hand or two
2. feel thoracic muscles and skeleton for pulsations, tenderness, depressions, masses, unsual movement or positions
3. Crepitus
4. Location of trachea
5. Thoracic Expansion
6. Vocal or Tactile Fremitus
163
Crepitus
snap crackle pop sound/feeling during palpation indicating an air pocket
164
Fremitus
vibrations recognized in the upper lungs and decreasing in intensity as you move away from the vocal cords while the patient says "99"
absence is concerning
165
Palms of the hand can indicate patient ___
pain (palms used in resp exam)
166
Percussion used in a respiratory assessment?
Indirect (tap on your own fingers)
compare bilaterally for sounds
167
Lots of air does what to fremitus
less fremitus occurs
168
Lots of fluid accumulation does what to fremitus
more fremitus occurs
169
Resonant Percussion (loud, low, long, hollow) indicates what?
Normal Lung Tissue
Bronchitis
170
Flat Percussion (soft, high, short, very dull) indicates what?
Consolidations
Bones
171
Dull Percussion (medium, med to high duration, medium dull thud) indicates what?
A solid area like in pneumonia
The heart
172
Tympanic Percussion (loud, high, medium, drum like) indicates what?
Air collection
Emphysema
Pneumothorax
(not as common as Hyperresonant)
173
Hyperresonant Percussion (very loud, very low, longer, booming, abnormal air trapped sounds) indicates what?
Large Pneumothorax
174
What lung sounds are heard through auscultation?
Bronchial/tubular, Bronchovesicular, Vesicular
175
Breath smells can be indicative of ...
illness
176
Bronchial / Tubular Sounds
Blowing, hollow sounds
over the trachea, above the clavicles on each side of the sternum
loud, high pitched
Inspiration < Expiration
177
Bronchovesicular Sounds
Medium pitched
found in 2nd intercostal space and T4 (posterior)
Next to the sternum between the scapulae
Inspiration = Expiration
178
Vesicular Sounds
soft low pitched
over the lung periphery
Inspiration > Expiration
179
Abnormal Breath Sounds in Auscultation?
Crackles
Rhonchi
Wheezing
Pleural Friction rub
Silence
180
Crackles
FINE high pitched, discrete (crackling on inspiration)
heard at the end of inspiration
medium lower more moist sounding in the mid stage of inspiration with coarse loud bubbly sounds heard in inspiration
All are not cleared by coughing
mostly found in the base of the lungs usually
181
Rhonchi
Sonorous Wheeze (low snore like during inhale and exhale)
low, low course sound, snore like
continuous during inspiration or expiration
may clear with cough accompanied by mucus accumulated in the trachea or large bronchi
182
Wheeze
Sibilant Wheeze (musical during inhale and exhale)
musical sound squeak
louder on expiration
183
Pleural Friction Rub
dry rubbing grating inflammation of the pleural surfaces (rubbing heard on inhale and exhale)
loudest at the anterior lateral surface
184
Silence (During Auscultation)
Diminished sound indicative of things like emphysema, atelectasis, and bronchospasm
185
Atelectasis
complete or partial collapse of the entire long or an area (lobe) because alveoli deflated or filled with fluid
common complication following surgery
"Collapse in Alveoli"
186
Crackles late on inspiration may indicate ...
Pneumonia, Congestive Heart Failure, or Edema
187
During Auscultation the patient should...
breathe deeply through the mouth
188
Physiological Changes of the Respiratory System With Age?
Decrease in:
-Stretching and compliance of chest wall
-rib motility and tone
-strength and function of respiratory muscles
-depth and oxygenation
-ability to cough and expectorate
Increase in:
-risk for accumulation of secretions leading to pneumonia
-potential increase in respiration rate
189
Interventions to improve the airway?
1. Administer Oxygen when ordered
2. Sit them at the head of the bed upright (high fowlers 90deg)
3. Encourage coughing and deep breathing (10 times at least every hour)
4. Lots of fluid intakes, but restrictions (dont want to overhydrate and cause edema)
190
Hyperventilation
an increase in rate and depth of rbeathing
191
Kussmaul
rapid deep labored breathing often seen during diabetic ketoacidosis
192
Tachypnea
respiration greater than 24 per minute
193
Bradypnea
respiration lower than 10 per minute
194
Hypoventilation
decreased depth and rate of breathing, and an abnormal pattern
195
Chain Stokes
alternating periods of rapid breathing along with periods of apnea
196
Ataxic
significant disorganization of varying irregular and regular types of respirations (disorganized respiration)
197
Air Trapping
in COPD / obstructive respiratory disorders
increased difficulty getting air out
198
normal adult chest sounds should be ..
resonant
199
When auscultating the chest make sure to be touching?
the patients skin directly with the diaphragm
200
Right way to use an Incentive Spirometer
Set goal with yellow marker --> Sit up and exhale completely --> seal mouth around device --> inhale slowly to keep side indicator within normal range --> keep inhaling until impossible then hold breath for 6 seconds --> exhale slowly allowing the piston to fall completely --> do 10 times every hour or two while patient is awake
201
Atmospheric Oxygen is ___%
21
202
Flow Meter
device that goes into the wall to regulate oxygen output in L/Min
203
Nasal Canular
delivers lower flow rate of oxygen to a higher rate (1-6 L) and are often called nasal prongs
may need to get humidified at higher rates
204
Simple Face Mask
Step up in flow rate from nasal canula
205
Rebreather
step up in flow rate from simple face mask
206
Non-rebreather/Modified Rebreather
step up in flow rate from rebreather (largest flow rate)
207
Oxy Mask
Good for claustrophobia due to more holes
can deliver flow rate of any other device (1-15 L with 24-90% FiO2)
