Physical Assessment ch 11 (GA) lungs and respiratory system

What is the difference between atelectasis and pneumothorax?
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What is the difference between atelectasis and pneumothorax?
atelectasis is partial lung collapse and pneumothorax is fulllung collapse
The right lung has ______lobes, while the left has ______
right-3, left-2
What's the formula for cigarette usage?(pack-year)
# of packs of cigarettes smoked daily X the # of yrs the pt smoked
How can dyspnea be assessed?
counting how many words can be spoken by the pt.
(normally a person can say 10-14 b4 taking a breath)
Normal respiration rate in an adult
12-20 breaths per minute
Sign of respiratory distress
restlessness, nasal flaring, supraclavicular and intercostal retractions.
What kind of findings are these: (describe)
bradypnea, tachypnea, hyperventilation, Kussmaul, cheyne stokes, and biot.
abnormal breathing patterns
slow breathing<12,
rapid/shallow breathing,
breathing very fast decreasing Co2 in the body, labored, deeper breath, fruity acetone
near death breathing
irregular
apnea
absence of breathing
Only able to breathe comfortable in upright position (such as sitting in chair), unable to breath laying down
Orthopnea
Dyspnea:
Subjective sensation related by patient as to breathing difficulty
attacks of severe shortness of breath that wakes a person from sleep, such that they have to sit up to catch their breath (e.g pt with congestive heart failure.)Paroxysmal nocturnal dyspneaHyperpnea:Increased depth of breathingLow oxygen in tissue.Hypoxia:Crackles may be heard in pt withpneumonia, heart failure and restrictive pulmonary diseaseWheezing may be heard in pt withasthmatic ptRhonci may be heard in pts withheard in disorders causing obstruction of the trachea or bronchus (e.g bronchitis or COPDPleural friction rubheard in pt with pleurisy (inflammation of the pleural surfaces) orwith pericarditisIf the nurse is assess breathing sound and adventitious sound is heard, what should the nurse ask the pt to do to confirm the nurses initial finding?ask the pt to cough, repeat the auscultation to determine if sound has changed or disappeared.chronic inflammatory disorder and hyperactivity airway disease, that causes reversible airway constriction due to bronchial hyperreactivityAsthmaName some common triggers for asthmaAllergens, exposure to chemicals, tobacco, viral infections, circadian rhythm changes, and or exerciseIf asthma is related to allergies, what are some objective findings?chronic rhinitis: nasal edema, nasal polyps, rhinorrhea and oropharyngeal erythemaWhat test is used to diagnosed asthma?PFT ( forced expiratory volume at 1 second/forced vital capacity)Atelectasispartial collapsed lungDecreased breath sounds on auscultation are consistent with_______ and ____emphysema and atelectasisPurulent sputum and inflammation of the pleura may occur in what condition_________pneumoniaNormal or abnormal Muffled sounds heard when a pt says "e-e-e" on vocal resonancenormalHigh pitched whistling or sighing sound during expirationwheezingan instrument used to examine the ear canalotoscopeResonancethe normal sound percussed over lung tissueName the pneumothorax: occurs in people with a wide variety of lung diseases (ie emphysema, TB, sarcoidosis, cystic fibrosis, malignancy, and idiopathic pulmonary fibrosis)Secondary Spontaneous Pneumothoraxtactile fremituspalpable vibration in the lungs, detected by the palmsCrackles are normally heard in___________and _________.pneumonia and pulmonary edemaPercussion of dull sound is heard consolidated areas of ____________ or __________.lung tissue or pleural fluid (pg 499)Asthma is characterized by (S&S)dyspnea, cough, chest tightness, wheezingName the pneumothorax occurs in people without underlying lung disease and in the absence of an inciting event. Common in tall, young men ages 10-30 ie: Marfan SyndromePrimary Spontaneous pneumothorax (PSP)exacerbationincrease in the severity of a disease or its symptomsTrue or False Emphysema and COPD can be cured.False, but treatments can help relieve symptoms and slow the progression of the diseaseWhat disease is characterized by a combination of chronic bronchitis, emphysema, and hyperreactive airway disease.Chronic Obstructive Pulmonary Disease (COPD)True or False COPD is the 3rd leading cause of death in the USTrueTrue or False The major cause of COPD, is a genetic predisposition of AAT deficiencyFalse, 90% of pts are smokersHypersecretion of mucus in the large and small airways, hypoxia and cyanosisChronic bronchitisName the condition Excessive mucus creates obstruction to inspiratory airflow that inhibits optimal oxygenation.chronic bronchitisHow is chronic bronchitis diagnosed?a cough for 3 months out of a yr, for 2 consecutive yrsName the condition characteristic finding is overdistention of alveoli with trapped air, creating obstruction to expiratory airflow, loss of elastic recoil of the alveoli, and high residual volume of carbon dioxide in the lung.emphysemaClubbing of fingers indicates chronic ________.hypoxia.What condition is referred to "blue bloaters" ?Individual with chronic bronchitis (blue because of hypoxia and cyanosis, and bloater because of the edema that occurs as a result of right ventricular failure.)What condition is referred to pink puffers?People with emphysema (pink because they remain well-oxygenated until late in their disease, and puffer because they have a characteristic manner of exhalation using pursed-lip breathing.)What causes a collapsed lung?when air enters the pleural space, the area between the lung and the chest wall.What is a pneumothorax?Full collapsed lungWhat are the 5 types of pneumothorax?1. Primary spontaneous pneumothorax (PSP) 2. Secondary spontaneous pneumothorax (SSP) 3. Traumatic pneumothorax 4. Tension pneumothorax 5. Iatrogenic pneumothoraxTrue or False Air can enter the pleural cavity due to chest trauma or rupture of alveoli.TrueName the emphysema: commonly caused by a penetrating wound of the thoracic cage and underlying pleural membrane, (ie: a rib fracture that punctures the pleural membrane pulling air into the opening of the wound from the atmosphere)Traumatic PneumothoraxName that pneumothorax: occurs when there is an escalating buildup of air within the pleural cavity that compresses the lung, bronchioles, cardiac structures, and vena cava **allows air into the pleural cavity but will not allow air out.Tension PneumothoraxName that pneumothorax: Caused by a complication of medical or surgical procedures. (e.g transthoracic needle aspiration, therapeutic thoracentesis, pleural biopsy, central venous catheter insertion, transbronchial biopsy, positive pressure mechanical ventilation, and inadvertent intubation of the right mainstem bronchus.)Iatrogenic PneumothoraxClinical signs and symptoms of a pneumothorax include: auscultation/percussion/ inspectionchest pain, dyspnea, and increased respiratory rate. lack of breath sounds on the affected side./chest hyperresonance/may be an obvious asymmetry of the chest and intercostal muscle retractions.What is used to confirm pneumothorax?CT scan and Chest X-rayTrue or False Oxygen administration is not necessary for all patients with a pneumothoraxFalse, it is necessary for all.Treatment of an open traumatic pneumothorax would require________a chest tube with suction on the affected sideTrue or False An Iatrogenic Pneumothorax is an emergency situation that requires a large-bore needle inserted into the affected side to pull the air out of the chest to relieve the accumulated pressure oFalse, tension pneumothoraxIn some cases, a procedure called pleurodesis is performed to prevent recurrence of which pneumothorax (visceral and parietal pleural membrane layers to adhere to each other and close off the pleural space)spontaneous pneumothorax.an abnormal collection of fluid within the pleural cavity that compresses lung tissue and inhibits lung inflationPleural EffusionWhat are some reasons behind edematous fluid accumulating within the pleural space?heart failure, severe pulmonary infection, or neoplasm.What are the most common signs of a pleural effusion areDyspnea, tachypnea, sharp pleuritic chest pain, dullness to percussion, and diminished breath sounds on the affected sideWhat are clinical findings of a nurse percusses and palpates someone with pleural effusion ?a flat, dull sound that indicates fluid blocking the normally resonant lung tissue. tactile fremitus is decreased over a pleural effusion.True or false? Chest x-ray, CT scan, and ultrasound can all detect the presence of a pleural effusion.trueTrue or False Suction and drainage of a pleural effusion are hardly necessaryFalse, usually necessaryThoracotomy is the treatment forpleural effusion.Presence of blood in the pleural spacehemothoraxCauses of hemothoraxPenetrating injuries of the lungs, heart, great vessels, or chest wall are obvious causes of hemothorax; they may be accidental, deliberate, or iatrogenic in origin