Egan's Chapter 16 Questions and Answers well Explained Latest 2024/2025 Update 100% Correct.

soft tissue sucking in around ribs and neck when a patient has severe distress - ️️retractions Describe the significance of the findings of general appearance of sitting up, leaning with arms on table - ️️typical position for patients with obstructive lung diseases who are having trouble breathing What is the difference between mucus and sputum? - ️️Mucus is normally produced by healthy airways. When the amount of mucus is increased and expectorated, it is called sputum. What information would you gather before entering the patient's room? - ️️read the patient's medical record to determine history of present illness, chief complaint, past medical history, family/environmental history and systems review difficulty breathing when lying supine - ️️orthopnea shape of thorax associated with emphysema - ️️barrel chest chest pain typical of acute coronary syndromes - ️️angina physical wasting associated with chronic lung disease - ️️cachexia blood pressure that is too low - ️️shock the sitting position that emphysema patients use when they are in trouble - ️️tripoding drop in blood pressure on inhalation associated with asthma and hyperinflation - ️️pulsus paradoxus inspiratory sound associated with atelectasis, pneumonia, and fibrosis - ️️crackles upper airway sound that may indicate life-threatening obstruction - ️️stridor dizziness associated with drop in blood pressure - ️️syncope a rapid heart rate that may include a low blood oxygen level - ️️tachycardiapresence of a fever - ️️febrile difference between systolic and diastolic blood pressure - ️️pulse pressure a slow heart rate that may result in poor perfusion of tissues - ️️bradycardia bluish discoloration of skin often associated with hypoxemia - ️️cyanosis heart rate auscultated in chest is different than pulse rate felt in arm - ️️pulse deficit difficulty breathing - ️️dyspnea sensation of suffocation - ️️breathlessness describe how to start the ideal interview. Be sure to discuss space, privacy, and instructions. - ️️Space: 4-12 ft to start, move closer, and try to get eye level Privacy: use curtain if it is not a private room Introductions: identify self, your purpose and identify patient Which is the best approach? A1. "Hi, Bob, good morning". A2. "Good morning, Mr. Johnson." - ️️A2. "good morning, Mr. Johnson." Which is the best approach? B1. Stand at the food of the bed B2. Sit in a chair at the bedside - ️️B2. Sit in a chair at the bedside Which is the best approach? C1. Make room for your notes on the bedside table C2. Keep your clipboard on your lap - ️️C2. Keep your clipboard on your lap Which is the best approach? D1. "Do you need anything right now?" D2. "I'll tell your nurse to check on you." - ️️D2. "I'll tell your nurse to check on you." Which is the best approach? E1. "I'll be back to see you in one hour."E2. "I'll return in a while to check on you." - ️️E1. "i'll be back to see you in one hour." Which is the best approach? F1. "what are you coughing up?" F2. "You didn't cough up blood, did you?" - ️️F1. "what are you coughing up?" Which is the best approach? G1. "I understand you don't like your breathing treatments." G2. "Why don't you like your breathing treatments?" - ️️G1. "I understand you don't like your breathing treatments." Which is the best approach? H1. "How is your breathing today?" H2. "Is your breathing better today?" - ️️H1. "how is your breathing today?" When are "closed" questions most useful? Give an example. - ️️Closed questions are best when you want specific information or want to clarify something "How much did you cough up?" Describe the dyspnea (Borg) scale. List several reasons why this scale would be useful. - ️️The Borg scale is useful because it quantifies the level of dyspnea. The scale asks the patient to rate his/her dyspnea from 1 (least) - 10 (worst). Because this is subjective symptom, the scale allows us to get valuable information and compare how a person responds to therapists. Patient perception of difficulty breathing is valid and useful. How else can you identify the degree of dyspnea a patient feels? Explain the different between dyspnea and breathlessness. - ️️Identify the level of exertion (activity) associated with dyspnea. Dyspnea is the sensation of difficulty breathing, whereas, breathlessness means you feel like you are not getting enough air. Musical inspiratory and expiratory sound associated with asthma - ️️wheezes What are the possible causes of a dry cough? - ️️restrictive: CHF, fibrosis What are the possible causes of a loose, productive cough? - ️️Inflammation: astma, COPD What is the possible cause of an acute, self-limiting cough? - ️️viral respiratory infectionWhat are the possible causes for a chronic cough? - ️️gastroesophageal reflux disease, nasal drip, asthma, medication What are the three characteristics of sputum that should be documented and reported to the physician and other member of the health care team? - ️️Color, viscosity (thick, thin, sticky ,etc.) Quantity (small, copious, or by volume) What is the most serious kind of nonpleuritic chest pain? - ️️Angina, may be a symptom of heart disease or acute coronary syndrome, is the most serious kind of nonpleuritic chest pain. Esophageal issues are the number two cause of cheese pain the in emergency department and the most confused with myocardial infarction. How does pleuritic chest pain differ from nonpleuritic pain? - ️️Pleuritic pain is usually located laterally or posterior. It is a sharp, stabbing pain associated with pneumonia, pulmonary embolism and pleural disease that worsens on inspiration. Non pleuritic (angina) chest pain is usually located in the center of the chest and may radiate. Chest wall pain, gallbladder disease, reflux and esophageal spasms are causes other than acrid disease. Angina does no vary with inspiration. Significant elevation of temperature will have what result on metabolic rate, oxygen consumption, carbon dioxide production, and breathing pattern? - ️️significant temperature elevations will elevate all of these Along with fever, what are two signs that are highly suggestive of respiratory infection? - ️️cough, purulent sputum What do the initials "CC" and "HPI" stand for? List at least five important areas described in the HPI. - ️️CC= Chief complaint HPI= History of present illness 1. onset, frequency, and duration of symptoms 2. location of pain 3. quality of pain 4. aggravating and alleviating factors 5. associated manifestations What do the initials "PMH" stand for? List at lease five important areas described in the PMH. - ️️PMH= Past medical history 1. Childhood diseases 2. Hospitalizations (injuries, major illness) 3. Medication allergies 4. Surgeries 5. Drugs/medicationsDescribe the significance of the findings of general appearance for weak, emaciated, and diaphoretic - ️️general ill health and malnutrition; fever, stress, acute anxiety Describe the significance of the findings of general appearance of appearing anxious - ️️severity of problem; level of cooperation What does the phrase "oriented X 3" mean? - ️️an alert, well-oriented person who knows who they are, where they are and the time or day Compare and contrast the terms "lethargic" and "obtunded" - ️️Lethargic refers to sleepy patients who are easily aroused and respond appropriately when aroused. Obtunded patients are difficult to arouse but still respond appropriately once aroused.