Class notes
Respiratory Exam Health Assessment
- Institution
- Denver School Of Nursing
Respiratory Exam Study Notes based off lecture notes.
[Show more]
Seller
Follow
Content preview
Respiratory Chapter 19Lung Lobes
-Left: 2 lobes/ more narrow -Right: 3 lobes/larger but shorter -RUL: supraclavicular down to the 4th rib -LUL: supraclavicular to the 5th rib -RML: 4th and 5th ICS anteriorly/laterally -RLL/LLL: T3 (scapular area)-T10
Sternal angle: continuous with 2nd rib, trachea bifurcates here (angle of louis)
-Between manubrium and sternal body Costal angle: 90 degrees
Suprasternal Notch: top of sternum, between clavicles Lung Boarders
-Anteriorly: supraclavicular (apices) down to 5th ICS
-Posteriorly: C7(apices) down to T10
Breathing Patterns
-Tachypnea: Fast and Shallow: pain, fever, hypoxemia
-Bradypnea: Slow and Regular: sleep, CNS depressants, increased ICP
-Hypoventilation: Irregular, Slow & Shallow: CNS depressants, DKA
-Hyperventilation: Fast and Deep: panic DKA
Acute/Chronic Respiratory Disease
-Acute olabored breathing (retractions, accessory muscle use, tripod)
oAcute hypoxemia – changes in LOC (restlessness, anxiety), cyanosis
-Chronic: oAP = or > T (barrel chest)
ocostal angle widened.
onail clubbing (angle of nail base >180°)
ohypertrophy of accessory muscles
Sputum
-Frothy: pulmonary edema (HF, ARDS)
-Clear/white: viral or chronic bronchitis
-Purulent: acute infection
Adventitious breath sounds
-Crackles (rales): discontinuous, high pitched popping sounds (fluid-filled alveoli)
-Rhonchi: continuous, low-pitched snoring (secretions in bronchi, COPD)
-Wheeze: continuous, expiratory, high-pitched squeak (air moving through narrowed airways)
-Pleural Friction rub: grating, low-pitched and pain w/ breathing (pleural inflammation)
-Stridor: high pitched crowing sounds, louder in neck (upper airway obstruction)
Voice Sounds (perform if you suspect consolidation)
-Bronchophony: “99 or 1-2-3” Normal: muffled Abnormal: clear
-Whispered Pectoriloquy: whisper 1-2-3 Normal: faint & indistinct Abnormal: clear & distinct. -Egophony: “eeee” Normal: “eeee” Abnormal: “aaaaa” Palpation
-Crepitus: subcutaneous emphysema (air under skin) -Tactile fremitus
oConsolidation increases fremitus. (replacement of alveolar air with fluid, blood, pus)
oStronger near clavicles/between shoulder blades Percussion -Resonance = Normal finding over lungs -Dullness = abnormal density (fluid, mass) *Liver
-Hyperresonance = abnormal air (pneumothorax, COPD) *Muscle or Bone
Auscultation: -Appropriate technique: diaphragm, side-to-side, mouth breathing (not nose), listen from apices to bases, can moisten chest hair.
-Bronchial vs bronchovesicular vs. vesicular lung sounds: what do they sound like and where do you normally hear them?
-
Respiratory Disorders
-Asthma oBronchoconstriction, inflammation, mucus production
oTriggers: allergy, exercise, pollutants, upper/lower resp
oS/S: cough, dyspnea, chest tightness, wheezing and accessory muscle use
-ARDS
oResults from trauma or shock, rapid onset, increased capillary permeability leads to significant pulmonary edema
oS/S: rapid onset, restlessness, severe dyspnea, persistent hypoxemia, frothy sputum -Atelectasis
oSmall airways collapse due to hypo-inflation.
oCaused: tumor, fluid, foreign body, general surgery oS/S: dyspnea, hypoxia, diminished breath sounds, mediastinal shift towards unaffected side
-Pneumothorax
oPartial or complete lung collapse, resulting in air in pleural spaces. oSpontaneous: no trauma but pressure changed (at risk: tall people)
oTraumatic: trauma or chest or lungs
•S/S: dyspnea, anxiety, decreased breath sounds, tracheal displacement,
absent lung sounds.
-Pleural effusion
oFluid in pleural space (not air) commonly caused by HF or cancer. •S/S: dyspnea, sharp pain when cough or breathing, decreased fremitus,
dullness, decreased breath sounds.
-Pleuritis oPleura becomes inflamed
oS/S: Pain in chest, persistent cough, dyspnea, fatigue and fever
-COPD
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller lealopus53. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $15.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
67474 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now