8976 Lecture Notes - Lecture 9: Bronchoconstriction, Hyperinflation, Edema
2 Jul 2018
School
Department
Course
Professor
Physical Assessment
POMS – problem orientated medical system
- Initial data
- Subjective
-Objective/physical
Obs Chart = observation chart
- HR
- Bp
- Temp
- Respiratory Rate
- SpO2 + O2
HR
- Normal 60-100 b/min
-Tachycardia = > 100b/min = high, normal after exercise
-Bradycardia = <60b/min = low, normal when resting, or athletic
BP
-Hypertension = >145/95 mmHg
-Hypotension = <90/60 mmHg
-Postural/orthostatic hypotension = drop in blood pressure of more than 5mmHg.
From lying to sitting or standing.
Temperature
- Normal 37 degrees Celsius (36.5 – 37.5)
-Fever/pyrexia
ohigh temp about 37.5
oFebrile = fever
oAfebrile = no fever
oFever can be associated with infection (don’t know where), or following
invasive procedures.
oEver 0.6 degree rise = 10% ^^ in O2 consumption ( if have a fever = ^^ temp =
require more O2)
Respiratory Rate
- Normal 12 – 20 breaths/min (bpm)
-Tachypnoae = rate > 25 bpm
-Bradypnoea = rate < 10 bpm
- Can be voluntarily altered
-Count rate while pretending to count the pulse.
ASSESSMENT = OBSERVATION PALPATION AUSCULTATION COUGH
find more resources at oneclass.com
find more resources at oneclass.com
Observation:
- Physical location
- Monitoring + attachments
oOxygen, lines, catheters, drains
- General appearance
Level Of Consciousness (LOC)
- Reduced level = risk of aspiration and retention of pulmonary secretions
-Unconscious
-Semiconscious
-Obtunded (reduced sensitivity)
- Caused by:
oCO2 narcosis
oMedications
oBrain injury
- Scale = Glasgow Coma Scale (GCS)
oEye opening
oVerbal response
oMotor response
General Appearance:
-Cachexia vs obesity cachexia deformity
- Deformity
- Scars
find more resources at oneclass.com
find more resources at oneclass.com
Barrel shaped chest:
-Hyperinflation = ^^ AP diameter of chest
- AP = anterioposterior
- Hyperinflation = too much air trapped in the lungs
- Causes diaphragm to flattens = less efficient = not optimal
Pectus Excavatum Pectus Carinatum
- Often evident from birth
- Does not effect breathing to much
- Deformity of sternum or rib shape
Terminology
Patterns of Breathing
- Chest expansion = a symmetrical increase in:
oAP
oVertical
oTransverse diameters
find more resources at oneclass.com
find more resources at oneclass.com
Document Summary
Tachycardia = > 100b/min = high, normal after exercise. Bradycardia = <60b/min = low, normal when resting, or athletic. Postural/orthostatic hypotension = drop in blood pressure of more than 5mmhg. Normal 37 degrees celsius (36. 5 37. 5) Count rate while pretending to count the pulse. Monitoring + attachments: oxygen, lines, catheters, drains. Reduced level = risk of aspiration and retention of pulmonary secretions. Caused by: co2 narcosis, medications, brain injury. Scale = glasgow coma scale (gcs: eye opening, verbal response, motor response. Hyperinflation = ^^ ap diameter of chest. Hyperinflation = too much air trapped in the lungs. Causes diaphragm to flattens = less efficient = not optimal. Chest expansion = a symmetrical increase in: ap, vertical, transverse diameters. Accessory muscle recruitment: pectorals, scalenes, sternocleidomastoid, trapezius, abdominals. Paradoxical respiration eg. diaphragm paralysis: where the diaphragm moves in the opposite manner to normal, caused by: paralyzed diaphragm, respiratory failure, or fatigue during an exacerbation of copd.
