uscultation
o Crackles
Fluid
1. Fine: higher pitch, narrow/smaller airway
2. Course: lower pitch, larger airways
o Wheezes
Expiratory, inspiratory, or both
1. Sonorous: low pitched, sounds like snoring,
...
uscultation
o Crackles
Fluid
1. Fine: higher pitch, narrow/smaller airway
2. Course: lower pitch, larger airways
o Wheezes
Expiratory, inspiratory, or both
1. Sonorous: low pitched, sounds like snoring, narrowing of larger airways
2. Sibilant: higher pitched, more narrow airways
o Rhonchi
o Stridor
Crowing sounds, may mean obstruction
o Pleural friction rub
Inflammation causes this
o Distant or muffled
Barrel chest
Spinal curvature
Obese
o Absent
Indicates a removed lung
Lung Capacity
o Tidal Volume
expected to be higher in athletes and those with great capacity
o Inspiratory Reserve
o Expiratory Reserve
decrease with restrictive conditions, increased with obstructive disease
o Vital Capacity
decreased with neuromuscular disease, generalized fatigue, atelectasis, pulmonary edema, COPD,
obesity
o Forced Expiratory volume
always more with COPD, less with ARDS Arterial Blood Gases
o Measurement of arterial oxygenation and carbon dioxide levels.
o Used to assess the adequacy of alveolar ventilation and the ability of the lungs to provide oxygen and
remove carbon dioxide.
o Also assesses acid-base balance
Pulse Oximetry
o A noninvasive method to monitor the oxygen saturation of the blood.
o Does not replace ABGs
o Normal level is 95-100%
o Acceptable level is generally =/> 92%
o ―O2 sats‖
o May be unreliable- poor perfusion
If hemoglobin saturated w co2 (carbon monoxide poisoning)
How well hemoglobin saturated, not necessarily how well sat w o2
edema
Finger nail polish
Sputum Studies
o To identify the causative agent
o Expectoration
Need a nice cough w sputum not saliva
May need to suction specimen if unable to produce
o Suctioning
o Early morning***
Best time to acquire sputum sample
o Deliver to lab within 2 hours
Imaging Studies
o Chest X-Ray
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