Question Answer
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)
Question Answer
Purpose of pursed lip breathing to prevent the air trapping caused by bronchiolar airway collapse by increasing the back pressure and to aid with panic
How to do pursed lip breathing Take deep breathe in hold and then breath out with lips like blowing out a candle
Physiological effects of pursed lip breathing Will decrease patients resp rate by increasing the expiratory rate.
Diseases that are helped with pursed lip breathing COPD and emphysema
Purpose of abdominal diaphragmatic breathing exercises This 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 breathing COPD
Lateral Costal breathing unilateral or bilateral costal breathing exercises increase ventilation to the lower lobes and aid diaphragmatic breathing
What patients use lateral costal breathing post surgery, pregnancy, or ascites
What are the purposes of breathing exercises 1.promote efficient use of the diaphragm,2.decrease use of the rib cage3. improve cough, medication, and effiency of ventilation
4 phases of cough irritation, inspiration, compression, and expulsion
What are causes of irritation stage Mechanical(foreign), chemical(gases),, thermal(cold air), or inflammatory(infection, or swelling)
direct cough diliberate 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 drainage self drainage by breathing in and out bringing the mucuc up and up
incentive spirometer technique using visual feedback to encourage patients to take a slow, deep sustained inspiration
sustained maximal inspiration stain (hold) the inspirtory effort as long a possible
volume and number of performances necessary for incentive spirometer to achieve results achieve 10 cc/kg of IBW or IC greater than about 1/3 of predicted. RR less than 25
Contraindications for IS obtunded, comatose, uncooperative, neuromuscular disorder, unable to breath effectively (asthma attack)
Hazards or complications for IS hyperinvilation and resp alkalosis, paresthesia, fatiuge, and pulmonary barotrauma (pressure held to long)
Physiological changes occuring with incentive breathing and the effect on PaO2 and PaCO2 Ventilation is increased to reach blood flow which is 1. PaO2 should increase
Normal V/Q .8
What V/Q will be after incentive breathing 1
Monitoring perfomance of an IS treatment Frequency of sessions, # of breaths/session, volume/flow goals acheived, breath hold maintained, vital signs/breath sounds cough results
Indicators that IS has improve atelectasis breath hold has maintained or risen since before, normal chest x-ray, breath sounds sound betteer
Question Answer
Vesicular BS Normal; low pitch soft sounds, “whispering, rustling of leaves”; inspiration longer than expiration, heard over lung periphery
Bronchial BS Normal; 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 BS Muted sound, with pause between inspiration and expiration, both are roughly the same length; heard over sternum between scapulae and rt. apex
Tracheal BS Hard, high pitch sounds; expiration longer than inspiration
Harsh BS Normal breath sounds louder than normal
Diminished BS Normal breath sounds quieter than normal
Abnormal BS Hearing ‘normal’ breath sounds in areas, in which, are not appropriate.
Adventitious BS Crackles, wheezes, rhonchi, pleural rub, stridor
Continuous BS wheezes, rhonchi, stridor
Discontinuous BS Crackles
Wheezes High pitched, can either be monophonic (tumor, foreign object) or polyphonic (asthma)
Rhonchi Low pitched, sounds like snoring, usually because of secretions
Stridor heard over trachea durning inspiration, obstruction of trachea/larynx
Crackles Low pitched, inspiration and expiration, coarse crackles dealing with secretions in larger airways, fine crackles = atelectasis, fibrosis, pulmonary edema
Kussmal’s Breathing Deep and rapid; caused by ketoacidosis, diabetic coma
Biot’s Breathing Very irregular breathing with periods of apnea; caused be a rise in intercranial pressure
Cheyne-Stoke’s Breathing Gradual increase, gradual decrease followed with apnea; caused by CNS depression, CHF
Apneustic Breathing Prolonged inspiration, regular expiration; caused by brain injury
Paradoxical Breathing Chest depresses on inspiration, expiration chest puffs; caused by chest injury
Asthmatic Breathing Prolonged expiration, regular inspiration
Tactile Fremitus; increased Something inside the lung; secretions, tumor, pneumonia,
Tactile Fremitus; decreased Something outside the lung; pnuemothorax, pleural effusion
Question Answer
Eupnea Normal breathing
Apnea Not breathing
Platypnea Can breath better when laying down.
Orthopnea Can breath better when sitting up.
Cheyne Stokes Gradual increase of breathing followed by a gradual decrease in breathing followed by apnea.
Kussmal breathing Deep rapid respiration characteristic of diabetic or other types of acidosis.
Biot’s breathing Irregular breathing followed by apnea seen in patients with ICP.
Tachypnea Rapid breathing.
Hyperpnea Deeper and more rapid than normal breathing at rest.
Bradypnea Slow respiratory frequency.
Paroxymal Nocturnal Dyspnea Dyspnea during the night.
Exertional Dyspnea Dyspnea that occurs only durring exertion.
Kyphoscoliosis Kyphosis (hunch back) plus Scoliosis (lateral curvature)
Kyphosis Abnormal AP curvature causing a hunch back.
Scoliosis Lateral curvature
Barrel Chest A chest with increased anteroposterior diameter, seen in patients with emphysema.
Pectus Excavatum Funnel chest (concaved)
Pectus Carinatum Pigeon breast (protruding)
Jugular Venous Pressure Reflects the volume of blood and pressure to the right side of the heart. Right heart failure can increase it.
Right heart failure Corepulmonade
Paradoxical Pulse A reverse of normal pulse, durring inspiration pulse is weaker and stronger durring exhalation. Seen in Cardiac Tamponade.
Blood pressure higher than 140/90 Hypertension
Causes of Hypertension Increased ICP, Corpulmonale, hypervolemia, hypoxemia, and sympathomimetics.
Blood pressure lower than 90/60 Hypotension
Causes of Hypotension Hypovolemia, left ventricular failure, peripheral vasodilation/sepsis, beta blockers, positive pressure ventilation, and PEEP/CPAP.
past medical HX Childhood diseases and development, hospitalizations, surgeries, injuries, accidents, major illnesses, alergies, and medications.
Hemoptysis Blood in sputum or blood from the lungs.
Hematemesis Vomiting blood or blood from the gastrointestinal tract.
Hyperthermia Temp increase cuasing increase of O2 consumption and CO2 production. Also causes increase in ventilation and circulation.
Fever Temp increase caused by disease.
Pleuritic chest pain Located laterally or posteriorly worsens if patient takes a deep breath. Sharp stabbing type pain.
Nonpleuritic Located in the center of the anterior of chest and may radiate to the shoulder or back. Not affected by breathing, dull ache.
Vital signs HR 60 to 100, BP 90 to 140/60 to 90, Temp 98.6, RR 12 to 18.