inspect the chest - without clothes on; 1st assess shape and size; 2nd check for
symmetry; 3rd thoracic landmarks; 4th color of skin; 5th check for supernumerary
nipples; 6th superficial venous patterns; and 7th observ
...
inspect the chest - without clothes on; 1st assess shape and size; 2nd check for
symmetry; 3rd thoracic landmarks; 4th color of skin; 5th check for supernumerary
nipples; 6th superficial venous patterns; and 7th observe for rib prominence
thoracic landmarks - midline trachea, costal angle, angle of ribs, intercostal spaces,
suprasternal notch
symmetry of chest - thoracic expansion at costal angle, w/o use of accessory muscles
hx questions for cc of resp issue - What is the nature of your cough?; Do you produce
any sputum?; Is your cough related to activity?; What position are you most comfortable
in?; How many pillows do you sleep with at night?; Is your SOB related to activity?
normal respirations - rate between 12 to 20/min; ratio of resp to heart beats= 1:4; pt
should breathe easily, regularly w/o apparent distress; pattern should be even, not too
shallow or too deep
hypopnea - term for abnormally shallow respirations
tachypnea - term for resp rate greater than 20, but consistent and may occur during
hyperventilation; often a symptom of pain
bradypnea - term for resp rate less than 12; may indicate neurologic or electrolyte
disturbances, infection, or conscious response to protect against the pain of pleurisy or
other irritative pneumonia. Can also be 2/2 level of cardio fitness
hyperventilation - term for fast and deep, heavy respirations, can be caused by
exercise, anxiety, and CNS and metabolic diseases
hyperpnea - term for abnormally deep respirations
kussmaul respirations - deep and mostly rapid respirations, used to describe resp effort
of metabolic acidosis
cheyne stokes respirations - regular breathing with intervals of apnea by crescendo
decrescendo breathing; can be seen in sleeping pts, but mostly pts who are very ill, esp
with brain damage
biot respirations - irregular breathing that varies in depth and is interrupted irregularly by
intervals of apnea; associated with severe and persistent increased intracranial
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