Pulmonary Flashcards
(46 cards)
Why should you check for lung dz?
Super common and undiagnosed
Why should you check for lung dz?
Super common and undiagnosed
What drugs exacerbate lung conditions?
Beta blockers
Aspirin and NSAIDs
Antihistamines
Narcotics
How much do beta blockers reduce lung function in healthy patients?
10%
What effect do Beta blockers have on lung function?
Bronchospasm
Cheap and used in many combos
What timeframe can bronchospasms occur with use of beta blockers?
Within 24 hours
What does aspirin and NSAIDs do to respiration?
Asthma Attack
What do antihistamines do to respiration?
Changes lung secretions
How do narcotics affect respiration
Decreases respiratory rate
What should you ask a patient about to determine their lung function?
Coughing
Onset - pattern - productive?
SOB
Onset - pattern
Can also occur in heart dz
Chest pain
Onset - patterns - assoc symptoms
Rare in lung dz - more often in heart dz
Previous lung problems
Asthma, TB, Allergies
Ever use O2 tank?
Personal and social history
Tobacco - Particulates - Exercise toleranceWhat would you observe about a pt’s breathing to evaluate lung function?
Labored - distressed - wheezing
Use of accessory muscles
Pt ability to speak (no? Asthma attack, fool)
What would you observe about pt’s appearance to determine lung function?
Posture
Upright - tripodding - upper body posture
Pursed lips
Color of nail beds and lips
Nail beds only? Heart problem
Nails and lips weird? LungsWhat order should you auscultate a patient?
Posterior Lowers then up
Anterior lower, side lower
Anterior middle an dup
Why do you listen to lowers first?
Tend to develop problems first
Would normal sounds be harsher lower or higher when listening to lungs?
Harsher Higher
How would you approach listening to posterior lung?
Pt does chicken wing arm to loosen shirt
Lower: Have pt find bottom of breast bone and trace around to back
Place steth right over that line in middle of side
Middle: Find “L” of scapula and put steth on angle - have pt hug self to move scapula out of way
Upper: Draw line from shoulders around, put steth right below
How would you approach listening to anterior lung?
Pt places steth and you hold it
Lower: Bottom of bone until middle
Can do side by moving over to bottom of arm
Middle: Bottom of breast bone, hand width up
Upper: Collar bone + 4 cm down
Normal breath sounds
Bronchovesicular
Will sound harsh
Vesicular
Louder on inspiration
Adventitious sounds
Rhonchi
Dry, low snores heard in normal people
Caused by secretions - clear with cough
Wheeze
Musical whistle from forced air
Louder with expiration
Can hear either
Rub
Mechanical rubbing sound from inflam
Inhale and Exhale
Crackles (AKA Rales)
Bubblefroth noise - spaces filled with fluid
Pulmonary edema, pneumonia, CHF
Comes and goes
Fine or coarse not cleared with cough
Inhale
How do you measure forced expiratory flow?
Have pt blow in meter 3x and and choose the best number to record.
Blow fast and hard
Mouthpiece into biohazard
What does forced expiratory flow measure?
Ease of air through bronchii
How would you evaluate result of forced expiratory flow
Using table of norms
Measured in L/min
> is high
80% to expected is normal
What could cause decreased forced expiratory flow?
Emphysema, asthma, COPD, etc
When would you beware when Rxing beta blockers?
