Part 1 Flashcards

Terms Definitions
Sound with drum like, loud, empty quality heard over gas-filled stomach or intestine, or pneumothorax
Low pitched sound heard over normal lungs
Loud, lower-pitched sound than normal resonance heard over hyperinflated lungs, such as in copd and acute asthma
Low-pitched sound heard over normal lungs
Sound with medium intensity-intensity pitch and duration heard over areas of "mixed" solid and lung tissue, such as over top area of liver, partially consolidated lung tissue (pneumonia) or fluid filled pleural space
Soft, hi-pitched sound of short duration heard over very dense tissue where air is not present, such as posterior chest below level of diaphragm
Vq scan interventions
Same as chest X-ray. (remove Any metal, undress and put on gown), no precautions needed afterwards because the gas and isotope transmit radioactivity for only brief interval.
Biopsy bronchoscope monitor for
Hemorrhage and pneumothorax
Thoracentesis post assessment
Listen to their lung sounds, feel the site for crepitus, observe for s/s of hypoxia and pneumothorax. Encourage deep breathing to expand the lungs.
Pre-procedure pleurodesis
Inform consent, position pt upright with elbow on overbed table and feet supported, premedicate pt.
Post-procedure pleurodesis
Position pt per rotation schedule with clamped chest tube, monitor frequent vs and respiratory status, medicate for comfort
Pleural space is artificially obliterated. It involves the adhesion of the two pleurae.
Genetic predisposition to develop an allergy (immunoglobulin E). Major risk factor for asthma.
What's 2 major factors in the development & possibly the severity of asthma?
Respiratory syncytial virus (RSV) & rhinovirus
Asthma triad
Polyps, asthma, sensitivity to aspirin and NSAIDs
Asthma and aspirin/NSAIDs
May cause wheezing to occur within 2 hrs
Symptoms of asthma triad
Profound rhinorrhea, congestion, tearing, facial flushing, GI symptoms, angioedema
Meds that trigger bronchospasm
B-Adrenergic blockers (metoprolol), topical eyedrops (timolol)
Other Meds that make asthma worse
Angiotensin-converting enzyme (ACE) inhibitors (eg. Lisinopril [prinivil]) - may produce cough in susceptible individuals
Continuous bubbling in the water seal chamber
Indiates an air leak -Call MD
Acute asthma attack med
Albuterol (proventil)
What provides the highest level of oxygen via a low-flow system?
Non rebreather mask
Vesicular sounds
are relatively soft, low-pitched, gentle, rustling sounds.
• heard over all lung areas except the major bronchi.
• 3:1 ratio, with inspiration 3 times longer than expiration
normal breath sounds
vesicular, bronchovesicular, and bronchial
Bronchovesicular sounds
medium pitch and intensity
•heard anteriorly over the mainstem bronchi on either side of the sternum and posteriorly between the scapulae
•1:1 ratio, with inspiration equal to expiration.
Bronchial sounds
louder and higher pitched and resemble air blowing through a hollow pipe.
• 2:3 ratio with a gap between inspiration and expiration. This reflects the short pause between the respiratory cycles.
• To hear the likeness of bronchial breath sounds, place the stethoscope alongside the trachea in the neck.
Fine crackles sounds
Series of short-duration, discontinuous, high-pitched sounds heard just before the end of inspiration; result of rapid equalization of gas pressure when collapsed alveoli or terminal bronchioles suddenly snap open; similar sound to that made by rolling hair between fingers just behind ear
Fine crackles findings
Idiopathic pulmonary fibrosis, interstitial edema (early pulmonary edema), alveolar filling (pneumonia), loss of lung volume (atelectasis), early phase of heart failure
coarse crackles sounds
Series of long-duration, discontinuous, low-pitched sounds caused by air passing through airway intermittently occluded by mucus, unstable bronchial wall, or fold of mucosa; evident on inspiration and, at times, expiration; similar sound to blowing through straw under water; increase in bubbling quality with more fluid
coarse crackles findings
Heart failure, pulmonary edema, pneumonia with severe congestion, COPD
rhonchi sound
Continuous rumbling, snoring, or rattling sounds from obstruction of large airways with secretions; most prominent on expiration; change often evident after coughing or suctioning
rhonchi findings
COPD, cystic fibrosis, pneumonia, bronchiectasis
wheezes sounds
Continuous high-pitched squeaking or musical sound caused by rapid vibration of bronchial walls; first evident on expiration but possibly evident on inspiration as obstruction of airway increases; possibly audible without stethoscope
wheezes findings
Bronchospasm (caused by asthma), airway obstruction (caused by foreign body, tumor), COPD
stridor sounds
Continuous musical or crowing sound of constant pitch; result of partial obstruction of larynx or trachea
stridor findings
Croup, epiglottitis, vocal cord edema after extubation, foreign body
absent breath sounds
No sound evident over entire lung or area of lung
findings in absent breath sounds
Pleural effusion, mainstem bronchi obstruction, large atelectasis, pneumonectomy, lobectomy
pleural friction rub sounds
Creaking or grating sound from roughened, inflamed pleural surfaces rubbing together; evident during inspiration, expiration, or both and no change with coughing; usually uncomfortable, especially on deep inspiration
pleural friction rub findings
Pleurisy, pneumonia, pulmonary infarct
Forced vital capacity (FVC)
Amount of air that can be quickly and forcefully exhaled after maximum inspiration
Forced expiratory volume in first second of expiration (FEV1)
Amount of air exhaled in first second of FVC; grades severity of airway obstruction
FEV1/FVC ratio
Dividing of value for FEV1 by value for FVC; useful in differentiating obstructive and restrictive pulmonary dysfunction
Forced midexpiratory flow rate (FEF25%-75%)
Measurement of airflow rate in middle half of forced expiration; early indicator of disease of small airways
Maximal voluntary ventilation (MVV)
Deep breathing as rapidly as possible for specified period; fairly nonspecific test that gives information about exercise capacity; used in conjunction with exercise stress test
Peak expiratory flow rate (PEFR)
Maximum airflow rate during forced expiration; aids in monitoring bronchoconstriction in asthma; can be measured with peak flow meter
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