chapter 16

What is the purpose of clinical assessments in healthcare?

To help physicians make decisions about initiating, changing, or discontinuing therapy based on accurate patient evaluations.

Who is responsible for clinical decision making in patient care?

The physician is primarily responsible, but respiratory therapists (RTs) participate in the process.

What is the process of obtaining information about a patient's health history called?

Interviewing the patient and taking a medical history.

What are the two key sources of patient data during clinical assessments?

Medical history and physical examination.

What is 'differential diagnosis'?

The term used when signs and symptoms are shared by many diseases, making the exact cause unclear.

What do 'signs' refer to in a clinical context?

Objective manifestations of illness.

What do 'symptoms' refer to in medicine?

The sensation or subjective experience of some aspect of an illness.

What is dyspnea?

A sensation of breathing discomfort or breathlessness experienced by the patient.

What does 'orthopnea' refer to?

Dyspnea that is triggered when the patient assumes a reclining position.

What is the term for oxygen desaturation upon assuming an upright position?

Orthodeoxia.

What is a common cough symptom associated with pulmonary disease?

Cough is the most common nonspecific symptom observed in patients with pulmonary disease.

What is considered a chronic cough?

A cough that lasts for 8 weeks or longer.

What does hemoptysis refer to?

Coughing up blood or blood-streaked sputum from the lungs.

What is the difference between pleuritic and nonpleuritic chest pain?

Pleuritic chest pain is sharp and increases with deep breathing, while nonpleuritic chest pain is located in the center of the chest and is not affected by breathing.

What indicates pedal edema in patients?

Swelling of lower extremities, most often due to heart failure.

What are the four steps of a physical examination?

Inspection, palpation, percussion, and auscultation.

What is significant about the 'level of consciousness' in a patient?

It reflects the oxygenation status of the brain and overall health.

What are the normal ranges for adult body temperature, pulse rate, and respiratory rate?

Body temperature: 98.6 F or 37.0 C; Pulse rate: 60-100 beats/min; Respiratory rate: 12-18 breaths/min.

What characterizes Kussmaul breathing?

Deep and fast respirations typically caused by metabolic acidosis.

What are abnormal lung sounds that can be categorized under adventitious lung sounds?

Discontinuous sounds, such as crackles, and continuous sounds, such as wheezes.

What does the term 'pulsus paradoxus' refer to?

A drop in systolic blood pressure of 10 mm Hg or more upon inspiration.

What physical examination finding is characterized by an inward sinking of the chest wall during inspiration?

Retractions.

What should a respiratory therapist be mindful of during the interview process with a patient?

Establishing rapport and using neutral questions.

What does the term 'pitting edema' refer to?

Indentations in the skin that remain after pressure is applied.

What can the presence of digital clubbing indicate?

Chronic conditions like congenital heart disease, bronchiectasis, or various cancers.