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Costal cartilages become calcified... - Answer- ✔✔a less mobile thorax.
Aging lung is more rigid structure... - Answer- ✔✔harder to inflate.
Changes result in an increase in small airway closure - Answer- ✔✔commonly known
as "ate________"
histiologic changes... - Answer- ✔✔-a gradual loss of intra-alveolar septa and a
decreased number of alveoli
-increase the older person's risk of postoperative pulmonary complications.
decreased number of alveoli means... - Answer- ✔✔less surface area is available for
gas exchange.
as a result of closing off of a number of airways... - Answer- ✔✔Lung bases become
less ventilated
weight changes in the last 3 months may indicate... - Answer- ✔✔pulmoary edema, 3
lbs in a short amound of time is not good.
equpitment for respiratory assessment - Answer- ✔✔-Stethoscope
-Small ruler, marked in centimeters
-Marking pen
-Alcohol wipe
how can a nurse provide respect and comfort during examination of respiratory system -
Answer- ✔✔A warm room, a warm diaphragm endpiece, and a private examination time
with no interruptions
when should you begin the respiratory examination - Answer- ✔✔just after palpating
thyroid gland when you are standing behind person.
-listen to both the front and the back of the individual
where do you perform inspection, palpation, percussion, and auscultation of the thorax -
Answer- ✔✔on posterior and lateral thorax, Then move to face person and repeat four
maneuvers on anterior chest
Anteroposterior (AP) diameter should be _____ than transverse diameter. - Answer-
✔✔less
, symmetric expansion - Answer- ✔✔-Confirm symmetric chest expansion by placing
your warmed hands on the posterolateral chest wall with thumbs at the level of T9 or
T10.
-Slide your hands medially to pinch up a small fold of skin between your thumbs Ask the
person to take a deep breath.
-Your hands serve as mechanical amplifiers; as the person inhales deeply, your thumbs
should move apart symmetrically. Note any lag in expansion.
tactile fremitus - Answer- ✔✔Palpable vibrations (normal)
-Sounds generated from larynx are transmitted through LUNG to chest wall, where you
feel them as vibrations.
how do you palpate for tactile fremitus - Answer- ✔✔Use palmar base (ball) of fingers or
ulnar edge of one hand
-touch person's chest while he or she repeats words, "ninety-nine" or "blue moon."
-Start over lung apices and palpate from one side to another
-symmetry is most important; vibrations should feel same on each side.
o-avoid palpating over scapulae because bone damps out sound transmission.
Factors affecting normal intensity of tactile fremitus - Answer- ✔✔o Thickness of chest
wall
o Pitch and intensity;
thickness of chest wall and fremitus - Answer- ✔✔-greater over thin wall
-Less over obese or muscular one-dampens vibration (may be herder to hear in athletes
due to muscle mass)
o Pitch and intensity and fremitus - Answer- ✔✔§ loud, lowpitched voice generates
more fremitus than soft, high-pitched one.
what makes a better conducting medium for sound-increase tactile fremitus. - Answer-
✔✔increase density of lung tissue
what is most important when listening to breath sounds - Answer- ✔✔Side-to-side
comparison is most important.
when listening to breath sounds, how should you instruct the batient to breathe? -
Answer- ✔✔Instruct person to breathe through mouth, a little bit deeper than usual.
what side of the stethoscope should you use for breath sounds and how do you hold it?
- Answer- ✔✔Use flat diaphragm endpiece of stethoscope and hold it firmly on person's
chest wall; listen to at least one full respiration in each location.
what extraneous noises may be confused with lung pathology if not recognized? -
Answer- ✔✔o Examiner's breathing on stethoscope tubing