Observation

Question 1

What are you observing during an objective assessment?

Answer 1

General appearance 
Position 
Chest 
Skin colour 
Abdomen 
Use of accessory muscles 
Nasal flaring 
Lines, drains etc 
Oxygen therapy 
Quality of voice

Question 2

What are you looking for in general appearance?

Answer 2

Eyes
Hands
Mouth
Oedema

Question 3

What are you looking for when observing the chest?

Answer 3

Shape
Work of breathing
Breathing pattern

Question 4

What are you observing for skin colour?

Answer 4

Pale
Ruddy
Cyanosed

Question 5

When observing the eyes in general appearance what type of thing are you looking for?

Answer 5

Pallor
Plethora
Jaundice
Oedema

Question 6

What causes pallor?

Answer 6

Anaemia

Question 7

What caused plethora?

Answer 7

High Hb

Question 8

What causes jaundice?

Answer 8

Liver or blood disorders

Question 9

What causes oedema?

Answer 9

Fluid retention

Question 10

What are you looking for when observing the hands?

Answer 10

Flapping tremor 
Fine tremor 
Wastage 
Clubbing 
Nicotine stains 
Cyanosis 
Temperature

Question 11

What are the causes of clubbing?

Answer 11

Cardiac - congenital heart disease and bacterial endocarditis
Lung disease - infective, fibrotic and malignant

Question 12

What are you observing for when looking at the mouth?

Answer 12

Dry/dehydrated
Hydrated
Cyanosis
Purse lip breathing

Question 13

What positions are you observing for?

Answer 13

Slumped
Position of ease
Fixing

Question 14

What are you observing for when looking at chest shape?

Answer 14

Scoliosis 
Kyphosis 
Kyphoscoliosis 
Funnel chest 
Pigeon chest 
Hyperinflated

Question 15

What are you looking for when observing the chest for work of breathing and shortness of breath?

Answer 15

Needing to pause between sentences 
Able to talk in full sentences 
Position 
Purse lip breathing 
Accessory muscle use

Question 16

What are you looking for when observing the chest wall movement?

Answer 16

Symmetrical
Pump handle
Bucket handle

Question 17

What are you looking for when observing breathing pattern?

Answer 17

Depth
Indrawing/recession of intercostal space
Tracheal tug
Asymmetry

Question 18

What does pale skin colour mean?

Answer 18

Anaemic

Low BP

Question 19

What does ruddy skin potentially mean?

Answer 19

Retaining CO2

Increased red blood cells

Question 20

What does cyanosed skin mean?

Answer 20

Lack of O2
Central
Peripheral

Question 21

How do you palpate the abdomen?

Answer 21

Recline posture
Apply a flat hand
Gently palpate the abdomen just below the rib cage?

Question 22

What are the muscles of inspiration?

Answer 22

Diaphragm

External intercostals

Question 23

What are the accessory muscles of inspiration?

Answer 23

Scalenes 
Sternocleidomastoid 
Pectoralis minor and major 
Serratus anterior 
Latissimus Dorsi

Question 24

What are the muscles of expiration?

Answer 24

Passive elastic recoil of lungs

Question 25

What are the accessory muscles of expiration?

Answer 25

``` Rectus Abdominis External obliques Internal obliques Transverse Abdominis Longissimus Quadratus Lumborum Serratus posterior inferior Lowest fibres of Iliocostalis ```

Question 26

What is nasal flaring?

Answer 26

Dilation of the nostrils

Question 27

What does nasal flaring do?

Answer 27

Attempt to decrease airway resistance

Question 28

What do you listen for in someone’s voice?

Answer 28

Volume Audible sounds Wet sounding Talking in full sentences

Question 29

What can you palpate/notice on palpation?

Answer 29

``` Abdomen Chest expansion Trachea Body temperature Scars Response to touch Surgical emphysema ```

Question 30

What does a distended abdomen limit?

Answer 30

Diaphragmatic movement

Question 31

How does limited diaphragmatic movement effect breathing?

Answer 31

Restricts lung volume | Increases work of breathing

Question 32

What is tactile fremitus?

Answer 32

Transmission of crackles felt on the outside of the chest wall?

Question 33

What does vocal fremitus measure?

Answer 33

Speech vibrations

Question 34

What is surgical emphysema a sign of?

Answer 34

Pneumothorax

Question 35

What are the exercise tolerance tests?

Answer 35

``` 6 min walk test Endurance shuttle walk test Stair climbing test Chair-stand test 3 minute SWT ```

Question 36

What is on a chart?

Answer 36

``` Blood pressure Heart rate Temperature Oxygen saturations Oxygen requirements Respiratory rate Weight AVPU Fluid balance Urine output Medications ```

Question 37

What are additional things of a critical care chart?

Answer 37

``` Mode of ventilation FiO2 Heart rhythm Pressure support/volume control Airway pressure Tidal volume PEEP CVP GCS ABG’s Blood chemistry ```