Chapter 16 Egan's objectives

Patient interviews

Essential for understanding patient conditions and needs.

Social space

Distance of 4-12 feet, used for casual interactions.

Personal space

Distance of 1.5-4 feet, used for personal conversations.

Communication factors

Influences include environment, emotional state, and cultural background.

Signs

Objective evidence of disease observed by the clinician.

Symptoms

Subjective experiences reported by the patient.

Neutral questions

Five questions to gather patient symptom information.

Dyspnea

Subjective feeling of difficulty in breathing.

Breathlessness

Objective measure of respiratory distress.

Breathing perception factors

Includes lung mechanics, neural input, and psychological factors.

Cough effectiveness factors

Requires airway patency, respiratory muscle strength, and coordination.

Cough characteristics

Five traits monitored: frequency, intensity, duration, sound, and sputum.

Infected sputum

Contains pathogens, often purulent or colored.

Noninfected sputum

Clear or mucoid, indicating no infection.

Massive hemoptysis

Coughing up over 600 mL of blood.

Nonmassive hemoptysis

Coughing up less than 600 mL of blood.

Pleuritic chest pain

Sharp pain worsened by breathing or coughing.

Non-pleuritic chest pain

Dull, persistent pain not affected by breathing.

Fever threshold

Temperature above 100.4°F (38°C) indicates fever.

Pedal edema

Swelling in feet, linked to heart or kidney disease.

Medical record review

Provides comprehensive patient history for assessment.

Patient information categories

Includes demographics, medical history, medications, allergies, and lab results.

Smoking history calculation

Pack-years = (packs per day) x (years smoked).

Physical examination steps

Inspection, palpation, percussion, and auscultation.

Sensorium

State of consciousness; assessed by four criteria.

Vital signs elements

Includes temperature, pulse, respiration, blood pressure, and oxygen saturation.

Pulse pressure sites

Seven sites include radial, femoral, and carotid arteries.

Hypertension definition

Blood pressure consistently above 130/80 mmHg.

Hypotension

Blood pressure below 90/60 mmHg; differs from shock.

Blood pressure measurement

Use cuff and stethoscope to assess arterial pressure.

Head and neck examination

Reveals signs of COPD and CHF.

Increased work of breathing signs

Includes accessory muscle use and nasal flaring.

Restrictive lung disease pattern

Characterized by reduced lung volume and rapid breathing.

Obstructive lung disease pattern

Characterized by prolonged expiration and wheezing.

Abnormal breathing patterns

Five patterns linked to neurological conditions.

Lung hyperinflation assessment

Evaluated through chest examination and breath sounds.

Normal breath sounds

Includes vesicular, bronchial, and bronchovesicular sounds.

Adventitious breath sounds

Includes wheezes and crackles, indicating pulmonary disease.

Point of maximal impulse (PMI)

Location where heart's contraction is felt; varies in disease.

Heart sounds

Four common sounds linked to cardiac mechanisms.

Abdominal dysfunction impact

Can hinder breathing efficiency and worsen lung disease.

Extremity signs of disease

Four signs include cyanosis, clubbing, edema, and temperature changes.