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Chapter 19 - Assessing Thorax and Lungs - Questions
Health Assessment in Nursing: Chapter 19
Terms in this set (50)
If the client experiences difficulty breathing or a loss of breath what assessment should you use?
Dyspnea can indicate which health problems?
Pulmonary disorders, congestive heart failure (CHF), coronary heart disease (CHD), myocardial ischemia, and myocardial infarction (MI)
Clients who have COPD may describe their dyspnea as what?
Not being able to "breathe or take a deep breath"
Anxious clients may describe their dyspnea as feeling like they are suffocating or may have tingling in the lips due to?
A decrease in carbon dioxide level
Gradual onset of dyspnea is usually indicative of?
Lung changes such as emphysema
Sudden onset of dyspnea is associated with?
Viral or bacterial infections
What are the common symptoms of asthma?
Wheezing, frequent cough with or without mucus, shortness of breath, and chest tightness
When is dyspnea normal?
With exercise or heavy activities if it subsides with resting from activity
Why might older adults experience dyspnea with certain activities related to aging changes of the lungs?
Loss of elasticity, fewer functional capillaries, and loss of lung resiliency
Edema or angina that occurs with dyspnea may indicate?
A cardiovascular problem
Continuous coughs are associated with?
Coughs occurring only early in the morning are often associated with?
Chronic bronchial inflammation or smoking
Coughs late in the evening may be the result of?
Exposure to irritants during the day
Coughs occurring at night are often related to?
Postnasal drip or sinusitis
Why might the ability to cough effectively be decreased in the older client?
Because of weaker muscles and increased rigidity of the thoracic wall
Nonproductive coughs are often associated with?
Upper respiratory infections and early congestive heart failure (CHF)
White or mucoid sputum is often seen with?
Common colds, viral infections, or bronchitis
Yellow or green sputum is often associated with?
Hemoptysis is seen with?
More serious respiratory conditions
Rust-colored sputum is associated with?
Tuberculosis or pneumococcal pneumonia
Pink, frothy sputum may indicate?
An increase in the amount of sputum is often seen in?
An increase in exposure to irritants, chronic bronchitis, and pulmonary abscess
What does wheezing indicate?
Narrowing of the airways due to spasm or obstruction
What is wheezing associated with?
CHF, asthma (reactive airway disease), or excessive secretions
Studies have shown that up to 75% of clients with asthma have?
Gastroesophageal reflux disease (GERD) or are more susceptible to GERD
Asthma symptoms may mimic symptoms commonly associated with?
Emphysema or heart failure
Many allergic responses are manifested with respiratory symptoms such as?
Dyspnea, cough, or hoarseness
What medications are associated with the side effect of persistent cough?
Beta-adrenergic antagonists (beta blockers) and angiotensin-converting enzyme (ACE) inhibitors
What two conditions make up COPD?
Emphysema and chronic asthmatic bronchitis
Nasal flaring is seen with?
Labored respirations (especially in small children) and is indicative of hypoxia
Pursed lip breathing may be seen in what conditions to help slow down expiration and keep alveoli open longer?
Asthma, emphysema, or CHF as physiologic response
What muscles normally do most of the work when breathing?
The diaphragm and intercostal muscles
Ruddy to purple complexion may be seen in clients with?
COPD or CHF as a result of polycythemia
Cyanosis may be seen if client is?
Cold or hypoxic
Pale or cyanotic nails with clubbing may indicate?
What is kyphosis?
An increased curve of the thoracic spine
Kyphosis is common in older clients because?
It results from a loss of lung resiliency and a loss of skeletal muscle, so it may be a normal finding
Spinous processes that deviate laterally in the thoracic area may indicate?
Ribs appearing at an angle greater than 45 degrees with the spinal column are frequently the result of?
An increased ratio between the anteroposterior-transverse diameter (barrel chest)
Barrel chest is commonly the result of?
Emphysema due to hyperinflation of the lungs
Trapezius, or shoulder, muscles are used to facilitate inspiration in cases of?
Acute and chronic airway obstruction or atelectasis
What is tripod position?
When clients lean forward and use arms to support weight and lift chest to increase breathing capacity, often seen in patients with COPD
What is crepitus?
Subcutaneous emphysema, a crackling sensation that occurs when air passes through fluid or exudate
What is fremitus?
Vibrations of air in the bronchial tubes transmitted to the chest wall
Unequal chest expansion can occur with?
Severe atelectasis (collapse or incomplete expansion), pneumonia, chest trauma, or pneumothorax (air in the pleural space)
Decreased chest excursion at the base of the lungs is a characteristic of?
COPD due to decreased diaphragmatic function
What is resonance?
The percussion tone elicited over normal lung tissue
What is hyperresonance?
Elicited in cases of trapped air such as emphysema or pneumothorax
Dullness is present when?
Fluid or solid tissue replaces air in the lung or occupies the pleural space, such as in lobar pneumonia, pleural effusion, or tumor
How would you percuss for diaphragmatic excursion?
Ask the client to exhale forcefully and hold the breath. Beginning at the scapular line (T7), percuss the intercostal spaces of the right posterior chest wall.
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