Apnea?Complete absence of breathing
Eupnea?Normal breathing
Biot’s Breathing?Short episodes of rapid, uniformly deep inspirations, followed by 10-30 sec. of apnea. Often seen in patients with meningitis.
Hyperpenea?Increased depth (volume) of breathing with or without an increased frequency
Hyperventilation?increased rate or depth of breathing that causes an increase in CO2
Tachypnea? (Tak-kip-nee-a)A rapid rate of breathing RR>24
Cheyne-Stokes Breathing?Graduate increase and the decrease of rate and volume of breathing then 5-10 seconds of apnea. Often occurs in patients with cerebral disorders and CHF
Kussmaul Breathing?Both an increased depth (hypernea) and rate of breathing. CO2 decreases, O2 increases.
Orthopnea?A condition in which an individual is able to breathe most comfortably only in an upright position
Dyspnea?Difficulty in breathing, of which the individual is aware. (SHORTNESS OF BREATH)
Purpose of pursed lip breathingto prevent the air trapping caused by bronchiolar airway collapse by increasing the back pressure and to aid with panic
How to do pursed lip breathingTake deep breathe in hold and then breath out with lips like blowing out a candle
Physiological effects of pursed lip breathingWill decrease patients resp rate by increasing the expiratory rate.
Diseases that are helped with pursed lip breathingCOPD and emphysema
Purpose of abdominal diaphragmatic breathing exercisesThis promotes greater use of the diaphragm, decrease the work of breathing by slowing your breathing rate, Decrease oxygen demand, use less effort and energy to breathe, to prevent atelectasis
disease that will benefit from diaphragmatic breathingCOPD
Lateral Costal breathingunilateral or bilateral costal breathing exercises increase ventilation to the lower lobes and aid diaphragmatic breathing
What patients use lateral costal breathingpost surgery, pregnancy, or ascites
What are the purposes of breathing exercises1.promote efficient use of the diaphragm,2.decrease use of the rib cage3. improve cough, medication, and effiency of ventilation
4 phases of coughirritation, inspiration, compression, and expulsion
What are causes of irritation stageMechanical(foreign), chemical(gases),, thermal(cold air), or inflammatory(infection, or swelling)
direct coughdiliberate maneuver that is taught, supervised, and monitored
forced expiratory techinique (huff cough)deep breath in and huff huff out, vibration will get mucuc out
Active cylcleof breathing (ACB)diaphragmatic breathing, thoracic breathig, and FET
Autogenic drainageself drainage by breathing in and out bringing the mucuc up and up
incentive spirometertechnique using visual feedback to encourage patients to take a slow, deep sustained inspiration
sustained maximal inspirationstain (hold) the inspirtory effort as long a possible
volume and number of performances necessary for incentive spirometer to achieve resultsachieve 10 cc/kg of IBW or IC greater than about 1/3 of predicted. RR less than 25
Contraindications for ISobtunded, comatose, uncooperative, neuromuscular disorder, unable to breath effectively (asthma attack)
Hazards or complications for IShyperinvilation and resp alkalosis, paresthesia, fatiuge, and pulmonary barotrauma (pressure held to long)
Physiological changes occuring with incentive breathing and the effect on PaO2 and PaCO2Ventilation is increased to reach blood flow which is 1. PaO2 should increase
Normal V/Q.8
What V/Q will be after incentive breathing1
Monitoring perfomance of an IS treatmentFrequency of sessions, # of breaths/session, volume/flow goals acheived, breath hold maintained, vital signs/breath sounds cough results
Indicators that IS has improve atelectasisbreath hold has maintained or risen since before, normal chest x-ray, breath sounds sound betteer
Vesicular BSNormal; low pitch soft sounds, “whispering, rustling of leaves”; inspiration longer than expiration, heard over lung periphery
Bronchial BSNormal; loud, high pitch, hollowing sounding; Expiration longer than inspiration w/ short pause; heard over upper sternum (monubrium) bc of the right/left main stem
Bronchovesicular BSMuted sound, with pause between inspiration and expiration, both are roughly the same length; heard over sternum between scapulae and rt. apex
Tracheal BSHard, high pitch sounds; expiration longer than inspiration
Harsh BSNormal breath sounds louder than normal
Diminished BSNormal breath sounds quieter than normal
Abnormal BSHearing ‘normal’ breath sounds in areas, in which, are not appropriate.
Adventitious BSCrackles, wheezes, rhonchi, pleural rub, stridor
Continuous BSwheezes, rhonchi, stridor
Discontinuous BSCrackles
WheezesHigh pitched, can either be monophonic (tumor, foreign object) or polyphonic (asthma)
RhonchiLow pitched, sounds like snoring, usually because of secretions
Stridorheard over trachea durning inspiration, obstruction of trachea/larynx
CracklesLow pitched, inspiration and expiration, coarse crackles dealing with secretions in larger airways, fine crackles = atelectasis, fibrosis, pulmonary edema
Kussmal’s BreathingDeep and rapid; caused by ketoacidosis, diabetic coma
Biot’s BreathingVery irregular breathing with periods of apnea; caused be a rise in intercranial pressure
Cheyne-Stoke’s BreathingGradual increase, gradual decrease followed with apnea; caused by CNS depression, CHF
Apneustic BreathingProlonged inspiration, regular expiration; caused by brain injury
Paradoxical BreathingChest depresses on inspiration, expiration chest puffs; caused by chest injury
Asthmatic BreathingProlonged expiration, regular inspiration
Tactile Fremitus; increasedSomething inside the lung; secretions, tumor, pneumonia,
Tactile Fremitus; decreasedSomething outside the lung; pnuemothorax, pleural effusion
EupneaNormal breathing
ApneaNot breathing
PlatypneaCan breath better when laying down.
OrthopneaCan breath better when sitting up.
Cheyne StokesGradual increase of breathing followed by a gradual decrease in breathing followed by apnea.
Kussmal breathingDeep rapid respiration characteristic of diabetic or other types of acidosis.
Biot’s breathingIrregular breathing followed by apnea seen in patients with ICP.
TachypneaRapid breathing.
HyperpneaDeeper and more rapid than normal breathing at rest.
BradypneaSlow respiratory frequency.
Paroxymal Nocturnal DyspneaDyspnea during the night.
Exertional DyspneaDyspnea that occurs only durring exertion.
KyphoscoliosisKyphosis (hunch back) plus Scoliosis (lateral curvature)
KyphosisAbnormal AP curvature causing a hunch back.
ScoliosisLateral curvature
Barrel ChestA chest with increased anteroposterior diameter, seen in patients with emphysema.
Pectus ExcavatumFunnel chest (concaved)
Pectus CarinatumPigeon breast (protruding)
Jugular Venous PressureReflects the volume of blood and pressure to the right side of the heart. Right heart failure can increase it.
Right heart failureCorepulmonade
Paradoxical PulseA reverse of normal pulse, durring inspiration pulse is weaker and stronger durring exhalation. Seen in Cardiac Tamponade.
Blood pressure higher than 140/90Hypertension
Causes of HypertensionIncreased ICP, Corpulmonale, hypervolemia, hypoxemia, and sympathomimetics.
Blood pressure lower than 90/60Hypotension
Causes of HypotensionHypovolemia, left ventricular failure, peripheral vasodilation/sepsis, beta blockers, positive pressure ventilation, and PEEP/CPAP.
past medical HXChildhood diseases and development, hospitalizations, surgeries, injuries, accidents, major illnesses, alergies, and medications.
HemoptysisBlood in sputum or blood from the lungs.
HematemesisVomiting blood or blood from the gastrointestinal tract.
HyperthermiaTemp increase cuasing increase of O2 consumption and CO2 production. Also causes increase in ventilation and circulation.
FeverTemp increase caused by disease.
Pleuritic chest painLocated laterally or posteriorly worsens if patient takes a deep breath. Sharp stabbing type pain.
NonpleuriticLocated in the center of the anterior of chest and may radiate to the shoulder or back. Not affected by breathing, dull ache.
Vital signsHR 60 to 100, BP 90 to 140/60 to 90, Temp 98.6, RR 12 to 18.