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Uncategorized > PD Exam 2 > Flashcards

PD Exam 2 Flashcards

1
Q

What are described as normal bronchial sounds?

A

coarse, loud, and long expirations, heard over the trachea, high pitched, expirations somewhat longer than inspirations

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2
Q

What are normal bronchovesicular breathing patterns?

A

combination of bronchial and vesicular; heard over main bronchus area and over upper right posterior lung field; medium pitch; expirations equal to inspirations

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3
Q

What is are normal vesicular breath sounds?

A

low pitch, soft and short expirations; heard over most lung fields; accentuated in a thin person or child; diminished in overweight or very mascular individuals

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4
Q

Sonorous Rhonchi

A

Loud, low coarse sounds like a snore; often heard continuously during inspiration or expiration; cough may clear it

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5
Q

What is a Wheeze?

A

Musical noise sounding like a whistle; most often heard continuously during inspiration or expiration; usually louder during expiration

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6
Q

What are crackles?

A

Loud, high-pitched bubbly or crackling noise heard during inspiration; not cleared by cough

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7
Q

What is a pleural friction rub?

A

Dry rubbing or grating sound, usually caused by inflammation of pleural surfaces; heard during inspiration or expiration

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8
Q

Chest Exam Inspection

A

1) Inspect size, shape and symmetry (front and back)
2) thoracic landmarks (costal angle, angle of the ribs, and intercostal spaces
3) color of skin (cyanosis or pallor)
4) supernumerary nipples
5) superficial venous patterns
6) prominence of the ribs
7) use of accessory muscles, pursing of the lips, nasal flaring, pallor

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9
Q

Assessing Respirations

A

1) RespiratoryRate (12-20 beats/min=normal)
2) note pattern or rhythm of breathing (should breath easily and without distress) and chest expansion should be bilaterally symmetric

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10
Q

Tachypnea

A

persistent respiratory rate approaching 25 breaths per minute

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11
Q

bradypnea

A

rate slower than 12 beats/min

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12
Q

hyperpnea

A

deep breathing

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13
Q

Kussmaul Breathing

A

deep, rapid breathing associated with metabolic acidosis

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14
Q

Hypopnea

A

abnormally shallow respiration

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15
Q

Cheyne-Stokes Respiration

A

regular respiration with intervals of apnea followed by a crescendo-decrescendo breathing

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16
Q

Biot Respiration

A

irregular breathing that varies in depth and is interrupted irregularly by intervals of apnea

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17
Q

What do you observe chest wall movement for?

A

Symmetry in expansion, use of accessory muscles, and bulging or retractions

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18
Q

What are the four peripheral areas to look for clues to respiratory problems?

A

Inspect lips and nails for cyanosis
Observe the lips for pursing
check the fingertips for clubbing
inspect alae nasi for flaring

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19
Q

How do you palpate the chest and lungs?

A

Palpate thoracic muscles and skeleton feeling for pulsations, tenderness, bulges, depressions, masses and unusual movement or positions

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20
Q

What are expected findings on palpation of the chest and lungs?

A

bilateral symmetry, some rib cage elasticity, relative inflexibility of the sternum and xiphoid, and rigid thoracic spine

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21
Q

What are unexpected findings when palpating the chest and lungs?

A

Crepitus (crackly or crinkly sensation) and pleural friction rub (palpable, grating vibration)

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22
Q

What is thoracic expansion?

A

place thumbs at the tenth rib and watch them diverge during quiet and deep breathing, thumbs should move symmetrical

23
Q

What is Tactile Fremitus?

A

Palpate with a light, firm touch the front, side and back while patient repeats “99” to feel for chest wall vibration

24
Q

How do you percuss the chest?

A

Directly/Indirectly
5 times bilaterally in the front
4 times bilaterally on the sides (might want patient to raise arms)
5 times bilaterally in the back
Should hear resonance over all lung fields

25
Q

Diaphragmatic Excursion

A

1)Inhale deeply 2)percuss down scapular line to the lower border where resonance turns to dullness and mark that point 3)patient needs to take a few breaths and exhale fully 4) percuss up from the first point and mark where tone changes from dullness to resonance (be sure to tell patient to start breathing 5) repeat on other side 6)measure the distances between the marks on each side (usual excursion is 3-5cm)

26
Q

How do you auscultate the chest?

A

5 bilaterally anteriorly
4 bilaterally laterally
5 bilaterally posteriorly
Have patient take a breath in each time you place the diaphragm of the stethoscope of their chest

27
Q

What are you listening for when you auscultate the chest?

A

intensity, pitch, quality, and inspiratory and expiratory duration

28
Q

What are the two types of crackles you can hear?

A

high-pitched and sibilant
or
low-pitched and sonorous

29
Q

What is a mediastinal crunch?

A

variety of noises (loud crackles, clicks, and gurgles) that are synchronous with the heartbeat

30
Q

How will you auscultate for vocal resonance?

A

Patient repeating numbers or words

31
Q

What is bronchophony?

A

repeating 99 while auscultating

sound should be clearer and louder

32
Q

What is whispered pectorilquy?

A

whisper that can be heard clearly during auscultation

33
Q

What is egophony?

A

voice intensity increases and has a nasal quality

patient will repeat “eeeeeee” as you auscultate

34
Q

How would you describe a cough?

A

moisture, onset, frequency, regularity, pitch, loudness, postural influences, and quality

35
Q

If cough produces sputum, what would you document?

A

color, clarity, consistency, amount, timing, and the presence of blood or pus

36
Q

What is the peak expiratory flow rate and how is it measured?

A

maximum airflow achieved during forced expiration and you use a peak flow meter

37
Q

Areas of hyperresonance are percussed over the lung fields in what condition?

A

Emphysema

38
Q

Areas of friction rub are percussed over the lung fields in what condition?

A

Pleurisy

39
Q

Areas of dullness are percussed over the lung fields in what condition?

A

pneumonia and pleural effusion

40
Q

Which breath sounds, heard in the posterior bases, suggests atelectasis?

A

Diminished breath sounds due to collapse of alveoli

41
Q

What does a crowing sound with upper airway obstruction indicate?

A

stridor breath sounds

42
Q

Which finding on the patient history is suspicious for pulmonary tuberculosis?

A

night sweats

43
Q

What symptoms are associated with pulmonary tuberculosis?

A

night sweats, fever, weight loss, and blood-tinged sputum

44
Q

What is an abnormal assessment finding of the respiratory system in a 2-month old infant?

A

Grunting

45
Q

What assessment finding suggest a child has epiglottitis?

A

Difficulty Swallowing

46
Q

Adult patient’s and the AP versus Lateral diameter of the cheat

A

AP is less than Lateral with a value of .7-.75

47
Q

What sign is associated with asthma?

A

Wheezing

48
Q

What does a harsh barking cough represent?

A

Acute Laryngotracheitis or croup

49
Q

What type of breathing would a patient demonstrate if they had metabolic acidosis?

A

rapid deep regular breathing

50
Q

In which condition is fluid present in the pleural space?

A

Pleural effusion

51
Q

What is crepitus?

A

crunchy/crinkling sound

air in the subcutaneous tissues leaking from the lung area

52
Q

What is pneumonia?

A

consolidation of alveoli with debris caused by infection

53
Q

What is a pneumothorax?

A

air present in the pleural space

54
Q

What are normal heart sounds?

A

Bronchial, Bonchiovesicular, and vesicular

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