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Nursing 1J02 > Respiratory Assessment > Flashcards

Respiratory Assessment Flashcards

(52 cards)

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1
Q

crackles (rales)

A

popping sounds heard on auscultation of the lung when air enters diseased airways and alveoli; occurs in disorders such as bronchiectasis or atelectasis and heard likely w/ inspiration in the lower lungs

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2
Q

wheezes

A

continuous high-pitched whistling sounds produced during breathing

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3
Q

friction rub

A

a coarse, grating, adventitious lung sound heard when the pleurae are inflamed

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4
Q

apnea

A

absence of breathing

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5
Q

cyanosis

A

a bluish discolouration of the skin resulting from poor circulation or inadequate oxygenation of the blood

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6
Q

inspiration

A

breathing in

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7
Q

expiration

A

breathing out

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8
Q

hypoventilation

A

ventilation of the lungs that does not fulfill the body’s gas exchange needs

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9
Q

hyperventilation

A

increased rate and depth of breathing

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10
Q

bradypnea

A

abnormally slow breathing

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11
Q

dyspnea

A

difficult or labored breathing

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12
Q

hypoxia

A

deficiency in the amount of oxygen reaching the tissues

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13
Q

vesicular breath sounds

A

soft, fine, breezy, low-pitched sounds heard over peripheral lung tissue; inspiratory > expiratory

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14
Q

bronchial breath sounds

A

loud, high-pitched, hollow sounds normally heard over the trachea and the large bronchi

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15
Q

bronchiovesicular breath sounds

A

medium-pitched, moderately loud sounds heard over the mainstem bronchi; inspiration = expiration

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16
Q

what are the anterior thoracic landmarks?

A

suprasternal notch, sternum, sternal angle, costal angle, Angle of Louis

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17
Q

what are the posterior thoracic landmarks?

A

vertebral prominens, spinous processes, inferior border of the scapula (at 7th or 8th rib), and the 12th rib

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18
Q

what does the mediastinum contain?

A

esophagus, trachea, heart, great vessels

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19
Q

lung apices

A

above clavicle and first rib, through superior thoracic aperture

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20
Q

lobes of the lungs

A

anterior (mainly upper and middle lobe), posterior (mainly lower lobe), and lateral

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21
Q

components of the tracheal & bronchial tree

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A

trachea, bronchi, cilia and goblet cells, alveoli and alveolar ducts which create large SA for gas exchange

22
Q

what are the four functions of respiration?

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A

O2 delivery, CO2 removal, homeostasis/acid-base balance, maintaining heat exchange

23
Q

how is respiration controlled?

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A

main drive to breath is hypercapnia, inspiration is active movement (diaphragm and rib elevation) and expiration is passive recoil of lungs, abdomen and thorax

24
Q

anterior reference lines

Study These Flashcards
A

midsternal, midclavicular, anterior axillary

25
posterior reference lines
vertebral, scapular
26
lateral reference lines
posterior, andterior and midaxillary lines
27
respiratory system: developmental considerations for infants and children
surfactant produced continuously at 32 wks, vulnerability related to small size and immaturity of pulmonary system
28
respiratory system: developmental considerations for pregnant women
enlarging uterus elevates diaphragm, decreases vertical cafe, compensated by increase in horizontal diameter
29
respiratory system: developmental considerations for older adults
- lungs more rigid + harder to inflate - decrease in VC - increase in RV - decrease in # alveoli - increased shortness of breath on exertion - above changes mean increased risk for postoperative complications
30
preventable risk factors for respiratory disease
tobacco, smoke, poor air quality
31
what can prenatal tobacco lead to?
low birth weight, chronic hypoxia
32
questions to ask on a focused respiratory health history
cough, SOB, chest pain, history of resp. infections, past history of resp. disease, smoking history, environmental exposure, self-care behaviour, respiratory impact on daily living
33
addition HH questions for infants
illness (frequent colds), allergies, chronic resp. illness, safety, environmental smoke
34
additional HH questions for older adults
activity intolerance, SOB, fatigue, level of activity, lung disease (coping, energy lvls, impact on life), chest pain w/ breathing (rib fracture post-fall)
35
what to consider when preparing a pt for a respiratory physical exam?
pt is upright, gown open in back - close draping - consider timing during complete examination (anterior, posterior, lateral) - cleaning stethoscope end piece - client breathing rate (rhythm, effort, use of accessory muscles, comfort)
36
inspecting the posterior chest
straight spinous processes and symmetric scapulae, antero-posterior/transverse diameter, neck and trapezius muscles, position pt takes to breather, skin colour & condirion, location of lobes of lungs
37
palpating the posterior chest
symmetrical expansion at T9 or T10, tactile or vocal fremitus, palpate the entire chest wall
38
percussing the posterior chest
- resonance is predominant note (clear, hollow, low pitched) | - start above the scapula and percuss at 5cm intervals (comparing bilaterally)
39
auscultating the posterior chest
ask pt to breathe through mouth and slightly deeper than usual - assess for presence/absence of breath sounds, intensity, symmetry, quality - assess any adventitious sounds
40
inspecting the anterior chest
- shape & configuration of chest wall; downward sloping ribs and costal angle <90º - facial expression - LOC - skin colour & condition quality of respirations, RR, pattern - accessory muscles
41
palpating the anterior chest
symmetrical chest expansion at the costal margin, tactile fremitus at 4 locations, palpating the anterior chest wall for moisture, tenderness, lumps and masses
42
percussing the anterior chest
start in supraclavicular area, resonance is predominant, compare sounds bilaterally, borders of cardiac dullness, done at 5 locations bilaterally
43
expected percussion notes over anterior chest
flat over muscle and bone, cardiac dullness near heart, resonance in IC spaces, liver dullness and stomach tympany
44
auscultating the anterior chest
assess breath sounds while asking pt to breathe deeply through mouth, compare bilaterally at 5 locations, note presence and quality of sounds - verbalise the location and quality of the normal lung sounds (B, BV and V), any abnormal breath sounds and include the lateral chest (RML)
45
respiratory assessment: developmental considerations for infants & children
flexibility in exam sequence, thoracic cage soft & flexible, diaphragm main resp. muscle (will see abdomen move w/ respiration)s, sternal or IC retractions indicate distress, RR and pattern may be irregular, infants are nose breathers up to 3 months, localizing breath sounds are more difficult and percussion yields hyperresonance (limited use in newborns)
46
respiratory assessment: developmental considerations for pregnant women
wider thoracic cage, wider costal angle, 40% increase in TV
47
respiratory assessment: developmental considerations for older adults
round, barrel-shaped thoracic cage and kyphosis, chest expansion somewhat decrease and less mobile thorax
48
respiratory assessment: developmental considerations for acutely ill patients
second examiner needed to support pt in upright position for exam
49
Bronchial Sounds
heard over the trachea, high pitched; expiration > inspiration
50
bronchiovesicular sounds
heard over main bronchi, medium pitched insp=expir
51
vesicular
heard over tissue of the lungs, inspiration> expiration; low and soft pitched
52
stidor
loud wheezes; caused by narrowing of larger airways

Nursing 1J02 (6 decks)

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