Respiratory Distress in Adults

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What term describes deep, rumbling, continuing breath sounds that are more pronounced on expiration?

Coarse crackles

Expiratory wheezing

Vesicular sounds

Rhonchi (correct)

What condition does hyperresonant percussion notes indicate in the context provided?

Air trapping (correct)

Pleural effusion

Pulmonary edema

Consolidation

What is the term for the decrease in pulse strength during inspiration observed in acute asthma exacerbation?

Tachycardia

Orthostatic hypotension

Pulsus paradoxus (correct)

Bradycardia

What is required from the patient to ensure understanding of their care options?

Informed consent Signup and view all the answers

What does pursed lip breathing often indicate?

Chronic obstructive pulmonary disease (COPD) Signup and view all the answers

What is the normal range for Peak Expiratory Flow Rate (PEFR) in a healthy adult?

300-500 L/min Signup and view all the answers

What is a common characteristic of cough associated with a respiratory infection?

Weak but produces thick secretions Signup and view all the answers

Learning occurs in which of the following domains?

Cognitive, affective, and psychomotor Signup and view all the answers

What heart sound is produced by the closure of the mitral and tricuspid valves?

S1 Signup and view all the answers

Which factors may cause an increase in intensity of S1?

Fever Signup and view all the answers

Which of the following may cause an increase in intensity of S2?

Pulmonary embolism Signup and view all the answers

In which area on the precordium can the aortic valve best be auscultated?

2nd right intercostal space Signup and view all the answers

Where is the Point of Maximal Impulse (PMI) typically located?

5th intercostal space, medial to mid-clavicular line Signup and view all the answers

What is the second heart sound also known as?

S2 Signup and view all the answers

Which condition is NOT commonly associated with an increase in the drive to breathe?

Hypocapnia Signup and view all the answers

Which of the following is of right ventricular origin?

Pulmonary hypertension Signup and view all the answers

What heart sound occurs late in diastole just before S1?

S4 Signup and view all the answers

What term describes the chest pain associated with blockage of the coronary arteries?

Angina Signup and view all the answers

Which heart sounds may show decreased intensity due to cardiac reasons?

S1 and S2 Signup and view all the answers

What causes the S1 sound during cardiac auscultation?

Closure of atrioventricular valves Signup and view all the answers

Where is the apical pulse palpated most strongly?

5th intercostal space Signup and view all the answers

What is the most common cause of pedal edema?

Heart failure Signup and view all the answers

What causes an increase in intensity of S1?

Hyperdynamic circulation Signup and view all the answers

How is auscultation to determine the rate and rhythm of the heart performed?

With a stethoscope at the apex Signup and view all the answers

What learning domain is demonstrated when a patient adjusts the flow meter on an oxygen concentrator?

Psychomotor Signup and view all the answers

Which approach is most effective in encouraging patients to take responsibility for their health?

Patient education Signup and view all the answers

Which learning domain has been addressed if a patient understands that oxygen therapy is for those with breathing difficulties?

Cognitive Signup and view all the answers

What symptoms indicate Mr. Carney may be experiencing respiratory distress?

Fine crackles in lung bases Signup and view all the answers

If a patient's total respiratory time remains the same but expiratory time is increased, what happens to inspiratory time?

It decreases Signup and view all the answers

Which of the following would be associated with left ventricular origin diseases?

Pulmonary edema Signup and view all the answers

What auscultation finding might indicate a problem in the lungs?

Wheezing Signup and view all the answers

What does a respiratory rate of 25 breaths per minute indicate?

Respiratory distress Signup and view all the answers

Study Notes

Breath Sounds and Respiratory Distress

Rhonchi (coarse crackles): Deep, rumbling, continuous sounds, more pronounced during expiration.
66-year-old patient: Presented with respiratory distress, fixed arms, accessory muscle use, pursed lip breathing, and chest tightness.
Symptoms/Observations: Heart rate 123 bpm, Blood Pressure 157/110, Respiratory Rate 30 shallow breaths per minute. Hyperresonant notes on left percussion, dull on right lower lung field (RLL). Expiratory wheezing and coarse crackles bilaterally, more diminished in RLL. Large amount of thick yellow secretions. ABG: 7.27, PaCO2 64, HCO3 25, PaO2 48 on room air.
Chest X-ray Findings: Severely depressed diaphragm and consolidation in RLL. Peak expiratory flow 165 L/min.
Diagnosis/Possible Concerns: Air trapping, possibly COPD. Pulsus paradoxus (marked decrease in pulse strength during inspiration).
Informed Consent: Essential for patients to understand their care plan.

Identifying Learning Domains

Psychomotor: Adjusting oxygen concentrator flow, using oxygen cannula.
Cognitive: Understanding oxygen therapy's purpose in treating breathing difficulties.
Important Patient Responsibility: Patient education essential to assuming responsibility for health.

Case Study: Mr. Carney - Post-Surgical Respiratory Issues

Patient Presentation: 35-year-old male, one day post abdominal surgery. Reported difficulty breathing ("just so hard to breathe"). Temp 37.3°C, BP 145/95 mmHg, HR 120 bpm, RR 25, SpO2 92% on 1 LPM nasal cannula. Painful cough, no sputum production.
Physical Exam Findings: Fine crackles bilaterally in lower lung areas, decreased thoracic expansion, lateral spinal curvature, indented sternum, increased vibrations with palpation in lower lung bases, neck and shoulder muscle use with breathing, ap diameter 1:2, capillary refill 2 seconds, cool extremities with blue tint on nail beds, midline trachea.
Lab Values: pH 7.53, PaCO2 28, PaO2 62, HCO3 20.
Possible Diagnoses (considerations): Possible reasons for respiratory distress, likely related to surgery. Note hypocarbia (low carbon dioxide). Possible issues include pulmonary edema, aspiration, or other complications from surgery.

Heart Sounds and Underlying Causes

S1: Closure of atrioventricular valves (mitral and tricuspid).
S2: Closure of semilunar valves (aortic and pulmonary).
Increased S1 Intensity: Fever, tachycardia, anemia, exercise.
Increased S2 Intensity: Possible causes include pulmonary embolism, chronic left ventricular dysfunction, primary pulmonary hypertension.
PMI (Point of Maximal Impulse): Located in the 5th intercostal space at the mid-clavicular line. May shift laterally with left ventricular hypertrophy.
Common Causes for Increased Breathing Effort (Dyspnea): Hypocarbia.

Other Medical Findings

Pulsus paradoxus: Drop in pulse strength during inspiration. Important diagnostic finding needing immediate evaluation.
Pedal Edema: Right ventricular failure suggested as possible cause.

General Medical Considerations

Informed Consent: Patient must be given adequate information about their condition to make decisions for care.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

This quiz covers key aspects of respiratory distress, focusing on lung sounds, patient symptoms, and diagnostic findings. It is tailored for medical students and healthcare professionals seeking to enhance their understanding of respiratory conditions like COPD. Test your knowledge on the interpretation of breath sounds and related clinical signs.