rt pt assessment
Terms
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- 4 critical life funtions
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1. ventilation - brething air in & out of lungs
2. oxygentaion - getting oxygen into the blood
3. circulation - moving the blood through the body
4. perfustion - getting blood & oxygen into the tissue - calculate pack years
- # of packs/day X # of years smoked
- If intake exceeds output, what could result
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1. weight gain
2. electrolyte imbalance
3. increase hemodynamic pressures
4. decreased lung compliance - peripheral edema
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1. caused by CHF & renal failure.
2. rated +1,+2,+3; the higher the number the greater the swelling - clubbing fo fingers
- caused by chronic hypoxemia
- kyphosis
- hunchback or conves spinal curve
- scoliosis
- lateral curvature of the spine
- kyphoscoliosis
- is a combination fo baotha & causes a severe restrictive impairment
- barrel chest
- a result of air trapping in the lings for a long period of time due to: COPD
- cheyne-stokes
- gradually increasing then decreasing rate & depth in a cycle lasting from 30-180 second, with periods of apnea lasting up to 60 seconds
- biots
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increased respiratory rate & depth with irregular periods of apnea - Each breath has the same depth.
cause: CNS problem - kussmaul's
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increased respiratory rate (usually over 20 breaths/min),increase depth, irregular rhythm, breathing sounds labored
Cause: metabolic acidosis, renal failure, diabetic ketoacidosis - apneustic
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prolonged gasping inspiration followed by extremely short insufficient expiration
Cause: problem with respiratory center, trauma or tumor - retractions
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when the chest moves inward during inspiratory efforts instead of outward
Due to: blocked obstructed airway
Sign of: respiratory distress - resonance
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normal air filled lung
this gives a hollow sound - flatness
- areas over the sternum, muscle or areas of atelectasis - give a full sound
- dullness
- areas over fluid-filled organs such as the heart or liver. Pleural effusion or pheumonia will give this thudding sound
- tympany
- areas over air fill stomach. This is a drum-like sound & when heard over the lungs indicates increased volume
- hyperresonance
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fournd in areas of the lung where pneumothorax or emphysema re present.
This is a booming sound - rales (crackles) secretion/fluid
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a. coarse rales(ronchi)- large airway sectretions - pt need suctioning
b. medium rales - middle airway sectretions. pt needs chest physical therapy
c fine rale (moist crepitant rales) -alveoli, fluid
pt has CHF/pulmonary edema
pt needs IPPB, heart drugs, diuretics & O2 - wheeze
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due to bronchospasm
pt needs brochodilator
unilateral wheeze indicative of foreign body obstruction - stridor
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due to upper airway obstruction
1) supraglottic swelling (epiglottitis)
2) subglottic swelling (croup, post extubation)
3) foreign body aspiration(solids or fluids)
Treatment - topical decongestant (racemic epi) for swelling & edema
suctioning or bronchoscopy for secretions
intubation for severe swelling - pleural friction rub
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a. A coarse grating or cruching sound
b.Due to inflamed surface of the visceral and partiatal pleura rubbing together
c.May be associated with pleurisy, TB, pneumonia
D. Drugs such as steroids and antibiotics are indicated - blood pressure
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normal 120/80
increased indicates cardiac stress - hypoxemia
decreased indicated poor perfusion - shock