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Questions and Answers
Which abnormal breath sound is characterized by a loud, inspiratory wheeze that is loudest over the trachea?
What is the expected range for pulse oximetry (SpOâ‚‚) values?
Which statement about flexible bronchoscopy is true?
What is NOT a component of an Arterial Blood Gas (ABG) analysis?
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Which type of abnormal breath sound is specifically described as continuous, high-pitched, and typically heard during expiration?
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Which respiratory rate is considered normal for an adolescent?
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Which symptom is NOT typically associated with respiratory disease?
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What is the respiratory rate threshold for tachypnea in adults?
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What is one of the abnormal configurations that can indicate a respiratory issue?
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Which of the following would NOT be a part of the initial respiratory assessment?
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Study Notes
Learning Outcomes
- Understand nursing assessment for the lower respiratory system.
- Identify abnormal breath sounds and their associated medical conditions.
- Recognize five main symptoms of respiratory disease.
Subjective Data
- Assess signs and symptoms of Shortness of Breath (SOB) through specific questions during patient interviews.
- Inquire about:
- Coughing (productive vs. non-productive).
- Type and amount of sputum.
- Allergies, dyspnea or SOB (rest and exertion).
- Chest pain, and history of respiratory conditions (asthma, bronchitis, emphysema, tuberculosis).
- Cyanosis and pallor.
- Exposure to environmental inhalants.
- Smoking history (amount and duration).
Initial Respiratory Survey (Inspection)
- Observe breathing pattern:
- Rate: normal vs. increased/decreased.
- Depth: shallow vs. deep.
- Effort: any accessory muscle use, inspect neck.
- Assess skin color, checking for cyanosis.
Normal Respiratory Rates
- Infant: 30-60 breaths/min
- Toddler: 24-40 breaths/min
- Preschooler: 22-34 breaths/min
- School-age child: 18-30 breaths/min
- Adolescent: 12-16 breaths/min
- Adult: 16-20 breaths/min
Inspection and Assessment of Respiration Patterns
- Look for abnormalities in chest configuration (e.g., pigeon chest, funnel chest).
- Check for rib and interspace abnormalities during breathing, which may indicate airflow obstruction.
- Assess respiration patterns:
- Tachypnea: >20 breaths/min (adults).
- Bradypnea: <10 breaths/min.
- Palpate chest areas for tenderness or bulges as needed.
Abnormal Breath Sounds
- Crackles (Rales): Commonly heard during inspiration, associated with conditions like pulmonary edema.
- Wheeze: Continuous high-pitched sound, heard mainly during expiration but can occur during inspiration.
- Rhonchi: Low-pitched, snoring sounds, a subtype of wheeze.
- Stridor: Loudest inspiratory wheeze, best heard over the trachea.
- Pleural Friction Rub: Continuous brushing sound, indicative of pleural inflammation.
Arterial Blood Gas (ABG) Components
- Key components for interpretation:
- pH
- Partial pressure of carbon dioxide (PaCOâ‚‚)
- Bicarbonate (HCO₃)
- Other components: Partial pressure of oxygen (PaOâ‚‚) and oxygen saturation (SaOâ‚‚).
Pulse Oximetry (SpOâ‚‚)
- Measure respiratory status.
- Normal SpOâ‚‚ range: 95-100%.
Bronchoscopy
- Procedure to visualize the airway and collect specimens by inserting a tube into the airway.
Flexible Bronchoscopy
- Utilizes a bronchoscope for viewing the respiratory system.
- Provides real-time images on a monitor during the procedure.
Indications for Flexible Bronchoscopy
- Minor treatments include:
- Removing blockages from airways.
- Draining an abscess or fluid from the lungs.
- Widening narrowed airways.
Indications for Rigid Bronchoscopy
- Primarily used for foreign object removal from the airway.
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Description
This quiz covers the nursing assessment of the respiratory system, focusing on diagnostic studies and abnormal breath sounds. Students will explore key symptoms and medical conditions related to respiratory diseases. Prepare to test your knowledge on the essential aspects of respiratory health in nursing.
