ACCS: Patient Assessment questions answered.

ACCS: Patient Assessment
Jugular Venous Distension
Commonly occurs in patients with congestive heart faliure
Capillary Refill
Perfusion problem
Precuts Carinatum
Anterior protrusion of the sternum
Precuts Exavatum
Depression of part of the entire sternum
Cheyene-Stokes
Gradually increasing then decreasing rate and depth in a cycle, with periods of apneas
-Caused by increased ICP, meningitis, drug overdose
Biot's
Increased RR and depth with irregular periods of apnea
Cause-CNS problem
Kussmaul's
Increased RR, increased depth, irregular rhythm, breath sounds labored
Caused by hypoxemia, metabolic acidosis, diabetic ketoacidosis
Apneustic
Prolonged gasping inspiration followed by extremely short, insufficient expiration
Caused by problem with respiratory center, trauma, or tumor
Paradoxical pulse/pulsus paradoxus
Pulse/BP varies with respiration
-Indicates severe air trapping
Tracheal Deviation:
Pulled to abnormal side
(Toward pathology)
Pulmonary Atelectasis
Pulmonary Fibrosis
* the problem is inside*
Tracheal Deviation:
Pushed to normal side
(away from pathology)
Massive pleural effusion
Tension pneumothorax
*problem is outside*
Minute Ventilation formula
Ve= (Vtxf)
Alveolar Minute Ventilation formula
VA=(Vt-Vd) x f
Deadspace to Tidal Volume Ratio formula
PaCO2-PECO2/PaCO2 x 100
**An increase in VD/VT ratio indicates a headspace producing disease (pulmonary embolus)
Oxyhemoglobin Dissociation Curve
Shift to the Left