Assessment of Respiratory Function

Practice flashcards covering the key concepts, diagnostic procedures, physical assessment techniques, and clinical findings from the Assessment of Respiratory Function lecture.

What are the six major signs and symptoms of respiratory disease?

Dyspnea, cough, sputum production, chest pain, wheezing, and hemoptysis.

What condition should be suspected when a patient with recent lung trauma or shock presents with dyspnea, tachypnea, and progressive hypoxemia?

Acute Respiratory Distress Syndrome (ARDS).

What underlying causes are suggested by coughing at night, coughing in the morning with sputum, coughing when supine, and coughing after eating?

Coughing at night suggests left-sided heart failure or bronchial asthma; coughing in the morning with sputum suggests bronchitis; coughing when supine suggests postnasal drip (rhinosinusitis); coughing after food intake suggests aspiration or reflux.

What respiratory clinical conditions are associated with profuse frothy pink sputum versus foul-smelling sputum?

Profuse frothy pink material suggests pulmonary edema. Foul-smelling sputum indicates a lung abscess, bronchiectasis, or an infection caused by fusospirochetal or other anaerobic organisms.

How do the physical characteristics and pH of blood from hemoptysis differ from blood from hematemesis?

Blood from the lung (hemoptysis) is bright red, frothy, mixed with sputum, and has an alkaline pH ($pH > 7$). Blood from the stomach (hematemesis) is dark or coffee-ground in appearance, vomited, mixed with food, and has an acid pH ($pH < 7$).

What visual physical finding is shown in this image, and what features define it?

Clubbing of the finger, characterized by a rounded and bulbous distal phalanx, an increased angle between the nail plate and proximal nail fold ($180^\circ$ or more), and a spongy or floating feel upon palpating the proximal nail fold.

How many generations of family history should be assessed when evaluating genetic respiratory disorders?

Three generations.

What chest configuration deformity is shown in this diagram, and what condition is it a hallmark sign of?

Barrel chest, which results from lung overinflation that increases the anteroposterior diameter; it is a hallmark sign of emphysema and COPD.

What is the core difference between Cheyne–Stokes and Biot's breathing patterns?

Cheyne–Stokes respirations feature a regular cycle where the rate and depth of breathing increase and then decrease until a period of apnea ($\approx 20\,s$) occurs. Biot's respiration features irregularly cycled periods of apnea ($10\text{--}60\,s$) interspersed with cycles of normal rate and depth.

Which rib articulates at the sternum at the Angle of Louis?

The second rib.

What is the normal range of diaphragmatic excursion for most individuals during breathing assessment?

$5\text{--}7\,cm$ ($2\text{--}2.75\,\text{inches}$), although it may reach $8\text{--}10\,cm$ ($3\text{--}4\,\text{inches}$) in healthy, tall young men.

What percussion note is expected over normal lung tissue versus lungs affected by emphysema or pneumothorax?

Resonance is expected over normal lung tissue, whereas hyperresonance is produced over hyperinflated lungs in emphysema or pneumothorax.

How do fine crackles differ from coarse crackles in terms of pitch, timing, and site of origin?

Fine crackles are soft, high-pitched popping sounds heard in mid-to-late inspiration originating in the alveoli (sounding like hair rubbing together). Coarse crackles are harsh, moist popping sounds heard in early inspiration and throughout expiration originating in the large bronchi.

What adventitious breath sound is described as a continuous, high-pitched, musical sound heard over the neck that requires immediate clinical attention?

Stridor, caused by narrowing of the upper respiratory tract.

What are the definitions of bronchophony, egophony, and whispered pectoriloquy?

Bronchophony is vocal resonance that is clearer and more intense than normal. Egophony is distorted vocal resonance where spoken 'E' sounds like 'A'. Whispered pectoriloquy is the abnormal ability to clearly hear whispered words through the stethoscope.

What vital capacity threshold indicates that a patient cannot maintain spontaneous ventilation without mechanical support?

A vital capacity less than $10\,mL/kg$.

How is minute ventilation calculated, and what happens to $PaCO_2$ when minute ventilation decreases?

Minute ventilation is calculated by multiplying tidal volume by the respiratory rate. When minute ventilation falls, alveolar ventilation decreases and $PaCO_2$ increases.

What is normal inspiratory pressure, and at what threshold is mechanical ventilation required?

Normal inspiratory pressure is approximately $100\,cm\,H_2O$. If negative pressure after $15\,s$ of occluding the airway is less than about $25\,cm\,H_2O$, mechanical ventilation is usually required.

What instructions regarding food, fluid, and substance intake must a nurse provide to a patient preparing for a PET scan?

Instruct the patient to avoid caffeine, alcohol, and tobacco for $24\,h$ prior to the PET scan and abstain from food and fluids for $4\,h$ prior to the scan.

Why must food and fluids be withheld for 4 to 8 hours before a bronchoscopy procedure?

To reduce the risk of aspiration when the cough reflex is suppressed by local anesthesia or sedation.

What critical safety risk is associated with administering sedation to a patient with respiratory insufficiency?

Sedation given to patients with respiratory insufficiency may precipitate respiratory arrest.