COMPLETE RESPIRATORY CARE CONCEPTS
AND PRACTICE QUESTIONS
◉ What action should be recommended if the APGAR score is 8?
Answer: Monitor routine care
◉ Orthopnea Answer: Difficult breathing except in the upright
position (CHF)
◉ General malise Answer: Run down feeling, nausea, weakness.
fatigue. headache (check electrolyte imbalance)
◉ Dyspnea Answer: A feeling of shortness of breath or difficulty
breathing
◉ Dysphagia Answer: Difficulty swallowing and hoarseness are
common symptoms
◉ Peripheral Edema Answer: Fluid in the arms and legs
Recommend a Diuretic
Pathology: Presence of excessive fluid in the tissue as pitting edema
caused by CHF and renal failure
,◉ Ascites Answer: Accumulation of fluid in the abdomen generally
caused by liver failure.
Pathology: Abdominal infection
◉ Clubbing of fingers Answer: Caused by chronic hypoxemia
Pathology: Pulmonary disease COPD, CHF
The thumb and first fingers are affected.
◉ Venous Distention Answer: Increased venous distention, jugular
distention (JVD) temporal veins popping out
Pathology: occurs with CHF, seen during exhalation in patients with
COPD.
◉ Capillary refill Answer: Indication of peripheral circulation
Pathology: blanching the hand and watch for color return
Color should return within 3 seconds
◉ Diaphoresis Answer: A state of profuse/heavy sweating, heart
failure recommend diuretics. positive inotropic agents.
Pathology: fever infection (recommend antibiotics), anxiety
nervousness (recommend sedatives), tuberculosis/night sweats
(recommend antitubular gram stain)
,◉ Ashen/pallor Answer: Abnormal
Indicates: anemia, blood loss, (vasoconstriction will cause color
change by reducing blood)
◉ Erythema Answer: Redness of the skin
Indicates: due to capillary congestion, inflammation or infection
◉ Cyanosis Answer: Blue or blue-gray dusky discoloration of the
skin and mucous membranes.
Indicates: hypoxia from increased amount of reduced hemoglobin
◉ Chest configuration Kyphosiscoliosis Answer: Convex curvature of
the spine with a lateral curvature of the skin
- causes a restrictive pattern and reduced lung volumes.
◉ Describe symmetrical chest movement Answer: When both sides
of the chest are moving equally at the same time
◉ List five underlying pathologies that can contribute to a patient
displaying asymmetrical chest movement Answer: Post lung
resection, post pneumonectomy
Atelectasis (hyperinflation recruitment maneuver
, Flail chest
Pneumothorax
Endotracheal tube inserted in right or left mainstem bronchi
◉ Eupnea Answer: Normal respiratory rate, depth and rhythm
Condition: normal respiratory rate for an adult 12-20bpm
◉ Tachypnea Answer: Increased respiratory rate >20bpm
Condition: hypoxia, fever, pain, CNS problem
◉ Bradypnea Answer: Decreased respiratory rate <12bpm
Condition: sleep, drugs, alcohol, metabolic disorder
◉ Cheyne-Stokes Answer: Gradually increasing then decreasing rate
and depth in a cycle lasting from 30-180 secs with periods of apnea
up to 60 secs.
Condition: increased intracranial pressures, brainstem injury, drug
overdose
◉ Biot's Answer: Increased respiratory rate and depth with
irregular periods of apnea
Condition: CNS depression