CRT/RRT (NBRC)
accumulation of fluid in the abdomen caused by LIVER FAILURE - ANS- Ascites
-occurs with CHF
-seen with obstructive patients (seen in exhalation phase) - ANS- Venous distention
-indication of peripheral circulation
-Normal < 3 seconds - ANS- Capillary refill
-increase in bilirubin.
-mostly in face and trunk - ANS- Jaundice skin color
-decreased respiratory rate (<12bpm) variable depth and irregular rhythm - ANS-
Bradypnea (oligopnea)
-increased rate, depth, with regular rhythm - ANS- Hyperpnea
-gradually increasing then decreasing rate and depth in a cycle lasting from 30 - 180
secs, with apnea up to 60 secs
-increased ICP, meningitis, overdose - ANS- Cheyne-Stokes
-increased rate and depth with irregular periods of apnea
-CNS problem, head/brain injury - ANS- Biots
-increased rate, depth, irregular rhythm, breathing sounds labored
-Raspy voice - ANS- Kussmaul's
prolonged gasping inspiration followed by extremely short, insufficient expiration
-respiratory center problems, trauma, tumor - ANS- Apneustic
muscle atrophy/loss of muscle tone - ANS- cachectic
-chest moves inward during inspiratory efforts instead of outward
-blocked airway in adults = INTUBATE
-RDS in infants - ANS- retractions
-dry, non-productive cough may indicate tumor in the lungs or asthma
-productive cough may indicate infection - ANS- Character of cough
,-short receding mandible (chin)
-enlarged tongue (macroglossia)
-bull neck
-limited neck range-of-motion - ANS- evidence of difficult airway
-pulse/blood pressure varies with respiration. may indicate severe air trapping (status
asthmaticus or cardiac tamponade) - ANS- pulsus paradoxus
-vibrations felt by hand on chest wall
-vocal fremitus: voice vibrations on the chest wall
-pleural rub fremitus: grating sensation due to roughened pleural spaces
-Rhonchial fremitus(palpable rhonchi): secretions in airways - ANS- tactile fremitus
-bubbles of air under skin that can be palpated and indicates subcutaneous emphysema -
ANS- Crepitus
-hollow sound
-normal lungs - ANS- Resonant percussion
-heard over sternum, muscles, or areas of atelectasis - ANS- Flat percussion
-heard over fluid-filled organs such as heart or liver (thudding)
-pleural effusion or pneumonia - ANS- Dull percussion
-heard over air-filled stomach.
-drum-like sound and when heard over lung = increased volume - ANS- Tympanic
percussion
-found where pneumothorax or emphysema is present.
-booming sound - ANS- Hyperresonant
normal sounds in lungs - ANS- vesicular breath sounds
-normal sounds over airways.
-breath sounds over lungs indicate LUNG CONSOLIDATION - ANS- bronchial breath
sounds
-patient instructed to say E and sounds like A.
-lung consolidation - ANS- Egophony
-increased intensity or transmission of the spoken voice and indicate CONSOLIDATION
or PNEUMONIA
-increase in spoken voice = consolidation
,-decrease in spoken voice = obstructon, pneumo, emphysema - ANS- Bronchophony /
whisphered pectoriloquy
-crackles
-secretions/fluid - ANS- Rales
-rhonchi
-LARGE airway secretions
-needs suctioning - ANS- Coarse rales
-middle airway secretions
-needs CPT - ANS- medium rales
-fluid in alveoli
-CHF, pulmonary edema
-IPPB, heart drugs, diuretics and O2 - ANS- Fine rales
-due to bronchospasm
-bronchodilator Tx
-unilateral wheeze indicative of a foreign body obstruction - ANS- Wheeze
-upper airway obstruction
-supraglottic swelling (epiglottitis) (thumb sign)
-subglottic swelling (croup, postextubation) (steeple sign)
-foreign body aspiration
-Racemic epinephrine
-intubation if MARKED stridor
-Lateral neck Xray for confirmation - ANS- stridor
-coarse grating or crunching sound
-visceral and parietal pleura rubbing together
-associated with TB, pneumonia, pulmonary infarction, cancer
-steroids and antibiotics - ANS- Pleural friction rub
-closure of the mitral and tricuspid valves at the beginning of ventricular contraction -
ANS- Heart Sound S₁
-closure of pulmonic and aortic valves
-occurs when systole ends; ventricles relax - ANS- Heart Sound S₂
-abnormal and may suggest CHF - ANS- Heart Sound S₃
-abnormal and indicative of cardiac abnormality such as myocardial infarction or
cardiomegaly - ANS- Heart Sound S₄
, -sounds caused by turbulent blood flow
-heart valve defects or congenital heart abnormalities
-can occur when blood is pushed through an abnormal opening (ASD, PDA) - ANS- Heart
murmurs
-sounds made in an artery or vein when blood flow becomes turbulent or flows at an
abnormal speed.
-usually heard via stethoscope over the identified vessel (carotid artery) - ANS- Bruits
-systolic and diastolic pressures
-sphygmomanometer to measure cuff pressures
-↑BP = cardiac stress = hypoxemia
-↓BP = poor perfusion = hypovolemia, CHF - ANS- Blood pressure
-angle made by the outer curve of the diaphragm and the chest wall
-obliterated by pleural effusions and pneumonia - ANS- Costophrenic Angle
-dome shaped normally
-flattened with COPD
-hemidiaphragms may shift downward with pneumothorax
-right hemidiaphragm is level of 6th anterior rib and slightly higher than the left
-right lung: 55% and appear larger than left lung - ANS- Diaphragm
-patient lying on affected side
-detecting small pleural effusions - ANS- Lateral decubitus CXR
-taken when patient is at end-exhalation
-detecting small pneumothorax/foreign body aspiration (FBA) - ANS- End expiratory film
-tip should be positioned below the vocal chords and no closer than 2 cm or 1 inch above
the carina.
-approx same level of the aortic knob/arch
-observation and auscultation will quickly determine adequate ventilation before CXR is
taken
-cuff should not extend over the end of the ET or tracheostomy tube - ANS- Position of
ET/Tracheostomy tube
-pacemaker should be positioned in the right ventricle
-PAC should appear in right lower lung field
-central venous catheters are placed in the right or left subclavian or jugular vein and
should rest in the vena cava or right atrium
-chest tubes should be located in the pleural space surrounding the lung
accumulation of fluid in the abdomen caused by LIVER FAILURE - ANS- Ascites
-occurs with CHF
-seen with obstructive patients (seen in exhalation phase) - ANS- Venous distention
-indication of peripheral circulation
-Normal < 3 seconds - ANS- Capillary refill
-increase in bilirubin.
-mostly in face and trunk - ANS- Jaundice skin color
-decreased respiratory rate (<12bpm) variable depth and irregular rhythm - ANS-
Bradypnea (oligopnea)
-increased rate, depth, with regular rhythm - ANS- Hyperpnea
-gradually increasing then decreasing rate and depth in a cycle lasting from 30 - 180
secs, with apnea up to 60 secs
-increased ICP, meningitis, overdose - ANS- Cheyne-Stokes
-increased rate and depth with irregular periods of apnea
-CNS problem, head/brain injury - ANS- Biots
-increased rate, depth, irregular rhythm, breathing sounds labored
-Raspy voice - ANS- Kussmaul's
prolonged gasping inspiration followed by extremely short, insufficient expiration
-respiratory center problems, trauma, tumor - ANS- Apneustic
muscle atrophy/loss of muscle tone - ANS- cachectic
-chest moves inward during inspiratory efforts instead of outward
-blocked airway in adults = INTUBATE
-RDS in infants - ANS- retractions
-dry, non-productive cough may indicate tumor in the lungs or asthma
-productive cough may indicate infection - ANS- Character of cough
,-short receding mandible (chin)
-enlarged tongue (macroglossia)
-bull neck
-limited neck range-of-motion - ANS- evidence of difficult airway
-pulse/blood pressure varies with respiration. may indicate severe air trapping (status
asthmaticus or cardiac tamponade) - ANS- pulsus paradoxus
-vibrations felt by hand on chest wall
-vocal fremitus: voice vibrations on the chest wall
-pleural rub fremitus: grating sensation due to roughened pleural spaces
-Rhonchial fremitus(palpable rhonchi): secretions in airways - ANS- tactile fremitus
-bubbles of air under skin that can be palpated and indicates subcutaneous emphysema -
ANS- Crepitus
-hollow sound
-normal lungs - ANS- Resonant percussion
-heard over sternum, muscles, or areas of atelectasis - ANS- Flat percussion
-heard over fluid-filled organs such as heart or liver (thudding)
-pleural effusion or pneumonia - ANS- Dull percussion
-heard over air-filled stomach.
-drum-like sound and when heard over lung = increased volume - ANS- Tympanic
percussion
-found where pneumothorax or emphysema is present.
-booming sound - ANS- Hyperresonant
normal sounds in lungs - ANS- vesicular breath sounds
-normal sounds over airways.
-breath sounds over lungs indicate LUNG CONSOLIDATION - ANS- bronchial breath
sounds
-patient instructed to say E and sounds like A.
-lung consolidation - ANS- Egophony
-increased intensity or transmission of the spoken voice and indicate CONSOLIDATION
or PNEUMONIA
-increase in spoken voice = consolidation
,-decrease in spoken voice = obstructon, pneumo, emphysema - ANS- Bronchophony /
whisphered pectoriloquy
-crackles
-secretions/fluid - ANS- Rales
-rhonchi
-LARGE airway secretions
-needs suctioning - ANS- Coarse rales
-middle airway secretions
-needs CPT - ANS- medium rales
-fluid in alveoli
-CHF, pulmonary edema
-IPPB, heart drugs, diuretics and O2 - ANS- Fine rales
-due to bronchospasm
-bronchodilator Tx
-unilateral wheeze indicative of a foreign body obstruction - ANS- Wheeze
-upper airway obstruction
-supraglottic swelling (epiglottitis) (thumb sign)
-subglottic swelling (croup, postextubation) (steeple sign)
-foreign body aspiration
-Racemic epinephrine
-intubation if MARKED stridor
-Lateral neck Xray for confirmation - ANS- stridor
-coarse grating or crunching sound
-visceral and parietal pleura rubbing together
-associated with TB, pneumonia, pulmonary infarction, cancer
-steroids and antibiotics - ANS- Pleural friction rub
-closure of the mitral and tricuspid valves at the beginning of ventricular contraction -
ANS- Heart Sound S₁
-closure of pulmonic and aortic valves
-occurs when systole ends; ventricles relax - ANS- Heart Sound S₂
-abnormal and may suggest CHF - ANS- Heart Sound S₃
-abnormal and indicative of cardiac abnormality such as myocardial infarction or
cardiomegaly - ANS- Heart Sound S₄
, -sounds caused by turbulent blood flow
-heart valve defects or congenital heart abnormalities
-can occur when blood is pushed through an abnormal opening (ASD, PDA) - ANS- Heart
murmurs
-sounds made in an artery or vein when blood flow becomes turbulent or flows at an
abnormal speed.
-usually heard via stethoscope over the identified vessel (carotid artery) - ANS- Bruits
-systolic and diastolic pressures
-sphygmomanometer to measure cuff pressures
-↑BP = cardiac stress = hypoxemia
-↓BP = poor perfusion = hypovolemia, CHF - ANS- Blood pressure
-angle made by the outer curve of the diaphragm and the chest wall
-obliterated by pleural effusions and pneumonia - ANS- Costophrenic Angle
-dome shaped normally
-flattened with COPD
-hemidiaphragms may shift downward with pneumothorax
-right hemidiaphragm is level of 6th anterior rib and slightly higher than the left
-right lung: 55% and appear larger than left lung - ANS- Diaphragm
-patient lying on affected side
-detecting small pleural effusions - ANS- Lateral decubitus CXR
-taken when patient is at end-exhalation
-detecting small pneumothorax/foreign body aspiration (FBA) - ANS- End expiratory film
-tip should be positioned below the vocal chords and no closer than 2 cm or 1 inch above
the carina.
-approx same level of the aortic knob/arch
-observation and auscultation will quickly determine adequate ventilation before CXR is
taken
-cuff should not extend over the end of the ET or tracheostomy tube - ANS- Position of
ET/Tracheostomy tube
-pacemaker should be positioned in the right ventricle
-PAC should appear in right lower lung field
-central venous catheters are placed in the right or left subclavian or jugular vein and
should rest in the vena cava or right atrium
-chest tubes should be located in the pleural space surrounding the lung
