Kettering Respiratory Flashcards

Life Functions

• Four essential life functions: Ventilation, Oxygenation, Circulation, Perfusion.

Objective vs Subjective Information

• Objective information refers to signs.
• Subjective information refers to symptoms.

Tobacco Use Assessment

• Tobacco exposure calculated using the formula: pack/day x years smoked.

Advance Directives

• Types include: Do Not Resuscitate (DNR), Do Not Intubate (DNI), Living Will, Durable Power of Attorney.

Respiratory Orders

• Key components needed: type of treatment, frequency, dose + route, physician signature.

Urine Output and Measurements

• Normal urine output is 40 mL/hour.
• Normal Central Venous Pressure (CVP) range is 2-6 mmHg.
• Low CVP indicates hypovolemia; increased CVP suggests hypervolemia.

Medication Reconciliation

• Conducted within 24 hours of hospital admission.

Terms and States

• Obtunded is synonymous with lethargic.
• General malaise refers to feelings of exhaustion due to electrolyte imbalance.

Dyspnea Classification

• Grade I: Unusual exertion.
• Grade II: Difficulty with uphill or stair activities.
• Grade III: Trouble walking at a normal pace.
• Grade IV: Difficulty walking short distances.
• Grade V: Dyspnea occurs at rest.

Swallowing and Communication

• Dysphagia indicates difficulty swallowing.
• KISS (Keep It Simple, Stupid) refers to using simple language for communication.

Fluid Accumulation Conditions

• Peripheral edema is caused by conditions like CHF and renal failure.
• Diuretics are recommended for managing peripheral edema.
• Ascites results from fluid accumulation in the abdomen, commonly due to liver failure.

Physical Signs of Conditions

• Clubbing of fingers indicates chronic hypoxemia, typically from COPD.
• Jugular venous distention (JVD) occurs in congestive heart failure (CHF).
• Diaphoresis describes excessive sweating.
• Ashen skin or pallor indicates anemia or blood loss.
• Jaundice indicates elevated bilirubin levels.
• Erythema refers to redness of the skin, usually from infection.

Chest and Spine Deformities

• Pectus Carinatum refers to protrusion of the sternum.
• Pectus Excavatum refers to depression of the sternum.
• Kyphosis is a convex curvature of the spine; Scoliosis is lateral curvature.
• Kyphoscoliosis leads to reduced lung volumes.
• Barrel chest results from air trapping.

Breathing and Pulmonary Terms

• Eupnea means normal breathing; hypertrophy refers to increased muscle size from COPD; atrophy is muscle wasting due to paralysis.
• Nasal flaring in infants indicates respiratory distress.

Mallampati Classification

• Class I shows soft palate, uvula, fauces, and pillars.
• Classes II to IV progressively reduce visibility; classes III and IV may require fiber optic bronchoscopy.

Heart Rate and Cardiac Recommendations

• Normal heart rate ranges from 60-100 bpm.
• Oxygen is recommended for tachycardia; Atropine is suggested for bradycardia.

Respiratory and Cardiac Sounds

• Normal heart sounds are S1 and S2.
• Abnormal sounds include S3 (suggesting heart failure) and S4 (indicating hypertension or stenosis).
• Echocardiogram is recommended for abnormal heart sounds.

Blood Pressure and Its Implications

• Normal blood pressure is 120/80 mmHg.
• Hypertension indicates cardiac stress, while hypotension suggests hypovolemia.

Tracheal Deviation Causes

• Deviations toward pathology: pneumonectomy, atelectasis, diaphragmatic paralysis.
• Deviations away from pathology: pleural effusion, tension pneumothorax, neck tumors, large mediastinal masses.

Breath Sounds and Their Meanings

• Resonant sound in normal lungs; flat in cases of atelectasis; hyperresonant in pneumothorax/emphysema; dull over fluid-filled organs.
• Egophony occurs when a patient saying "E" sounds like "A".
• Crackles indicate fluid presence in lungs; stridor suggests upper airway obstruction; wheezes result from bronchospasm.

Imaging and Diagnostic Techniques

• Croup shows a steeple sign on X-ray; enlarged epiglottis shows a thumb sign.
• Pulmonary edema presents as a butterfly pattern; atelectasis shows patchy infiltrates.
• Honeycomb patterns indicate ARDS; wedge-shaped infiltrates suggest pulmonary embolism.
• A normal ventilation scan with abnormal perfusion indicates a pulmonary embolism.

Invasive Procedures and Monitoring

• Normal Intracranial Pressure (ICP) is 5-10 mmHg; treatment initiated above 20 mmHg.
• Normal Cerebral Perfusion Pressure (CPP) is 70-90 mmHg.
• Exhaled nitric oxide (FEno) monitors corticosteroid treatment; exhaled carbon monoxide (FEco) assesses smoking status.

Blood Component Values

• Normal red blood cell (RBC) count is 4-6 mill/m3.
• Normal hemoglobin (Hb) levels range from 12-16 g/100 mL.
• Normal hematocrit (Hct) values are 40-50%.