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800 > Week 8 (CR Assessment and Auscultation) > Flashcards

Week 8 (CR Assessment and Auscultation) Flashcards

1
Q

Normal values for Spo2

A

95-100%

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2
Q

Normal values for HR

A

60-100bpm

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3
Q

Normal values for BP

A

100-140/60-90

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4
Q

Normal values for RR

A

12-16breaths/min

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5
Q

Normal values for temperature

A

36.5-37.4 (afebrile)

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6
Q

Temperature of 37.5-38.2 degrees represents

A

Low grade fever (febrile)

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7
Q

Temperature of > 38.2 represents

A

High grade fever (febrile)

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8
Q

What are the 3 main parts of a CR assessment

A
  1. pre-interview
  2. subjective examination
  3. objective examination
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9
Q

Define sign

A

A physical manifestation of a disease or an objective measurement

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10
Q

Define symptom

A

Something the patient experiences, complains or feels of - subjective measurement

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11
Q

What are the basic CR objective assessment and the other parts

A

Basic: Ventilatory support and Sao2, observation, palpation, auscultation, cough assessment
Other: CXR, spirometry, ABG

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12
Q

What does the oxygen dissociation curve show?

A

Relationship between partial pressure of oxygen and oxygen saturation

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13
Q

PaO2 (80-100mHg) = SaO2 (?)

A

Normal: 95-100%

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14
Q

PaO2 (<80mmHg) = SaO2 (?)

A

Low (hypoxemia): <95%

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15
Q

PaO2 (<60mmHg) = SaO2 (?)

A

Respiratory failure: <90%

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16
Q

CR assessment: Ventilatory support and SaO2 consists of

A

Measured to assess need for oxygen therapy, define respiratory impairments

  • Level of oxygen, sort of oxygen therapy
  • Oxygen saturation
  • Oxygen dissociation
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17
Q

CR assessment: observation

A

Externally
Face
Body

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18
Q

Observation: externally

A

Bed charts/monitors

Current vital signs

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19
Q

Observation: face

A

Level of consciousness
Facial expression
Colour (face and lips)

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20
Q

Observation: body

A 
Posture/position
Weight/size
Chest wall shape
Breathing pattern and rate
Signs of increased effort to breathe
Fingers: peripheral cyanosis
Fingers: clubbing
Peripheral oedema
Scars/incisions
Attachments
21
Q

CR assessment: palpation

A

Common: LBE, AP, abdominal movement
Other: trachea, accessory muscle use, secretions vibrating through chest wall

22
Q

Bronchial breath sounds are normal when heard over… and abnormal when heard over…

A

Tracheal area

Chest wall

23
Q

Mechanism: decreased breath sounds

A

Less gas flow causing less sound OR an increased sound attenuation in the periphery

24
Q

Interpretation: decreased breath sounds

A
  • Shallow breathing
  • Incomplete blockage of an airway
  • Atelectasis/partial lung collapse
  • Hyperinflation
  • Reduction in transmission of the BS e.g. obesity, pleural abnormalities such as effusion, thickening, pneumothorax
25
Q

Mechanism: no breath sounds

A
  • Localised accumulation of air or fluid in the pleural space blocking transmission from large airways
  • If the bronchus supplying an area of the lung is obstructred
26
Q

Interpretation: no breath sounds

A
  • Segmental or total lung collapse
  • Pleural abnormalities e.g. large pleural effusion or pneumothorax
  • Carcinoma or large sputum plug
27
Q

Mechanism: bronchial breath sounds

A

Tissues between central airways and the chest wall are altered so that they conduct sound very well

28
Q

Interpretation: bronchial breath sounds

A
  • Consolidation (most common)
  • Large cavity communicating with a bronchus
  • UL collapse (with bronchus open or obstructed)
  • LL collapse (only when the bronchus is still open to transmit the sound)
29
Q

Mechanism: wheeze

A

Oscillation or vibration of airflow through narrowed opposing airway walls i.e. airways narrowing

30
Q

Interpretation: wheeze

A
  • Secretions
  • Bronchospasm
  • Oedema (inflammation)
  • Tumour/foreign bodies
31
Q

Mechanism: fine crackles

A

Sudden opening of closed small airway and alveoli on inspiration, after collapsing due to fluid or lack of aeration during expiration

32
Q

Mechanism: coarse crackles

A

Movement of air bubbles through secretion

33
Q

Interpretation: fine crackles

A

Atelectasis, fibrosis, interstitial pulmonary oedema

34
Q

Interpretation: coarse crackles

A

Presence of secretions in the airways, resolving pneumonia, pulmonary oedema

35
Q

Mechanism: stridor

A

Obstructed trachea or larynx

36
Q

Interpretation: stridor

A

Medical emergency - upper airway obstruction

37
Q

Decreased secretion movement:

A
  • Patient subjective report
  • Wheeze
  • Obstructive spirometry
  • Cough: moist and/or productive
  • Ausc: coarse crackles, URTN
  • Palp: feel secretions
  • Obvs: see sputum
  • History of smoking and respiratory disease
38
Q

Decreased gas movement

A
  • ABG: decreased Pao2, increased paco2, decreased spo2
  • CXR changes
  • Spirometry results
  • Palp: feel decreased LBE
  • Ausc: fine crackles, decreased BS, no BS
  • Obvs: see cyanosis, altered pattern of breathing
39
Q

Clin Sim: What to routinely observe on patient in a photo?

A

Level of consciousness/alertness
Patient position (in bed/chair)
Oxygen therapy (FiO2/ or L/min and mode)
Oxygen saturation (SpO2)
RR (+ other vital signs and CXR if available)
Attachments e.g. drips, drains, catheters

40
Q

What can cause unilateral decreased LBE

A

Collapse, consolidation, pleural effusion
Accessory muscle use
Secretions through chest wall

41
Q

Lung anatomy: ant seg UL

A

1-4

42
Q

Lung anatomy: ant RML

A

5

43
Q

Lung anatomy: ant lingula seg LL

A

6

44
Q

Lung anatomy: ant seg LL

A

7 and 8

45
Q

Lung anatomy: post seg UL

A

1 and 2

46
Q

Lung anatomy: apical seg LL

A

3 and 4

47
Q

Lung anatomy: post seg LL

A

5 and 6

48
Q

Lung anatomy: lat seg LL

A

7 and 8

800 (12 decks)

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