What is the first step in preparing a patient for a clinical physical examination?
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Explain the procedure to the patient and obtain consent.
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What is the first step in preparing a patient for a clinical physical examination?
Explain the procedure to the patient and obtain consent.
What position should the patient be in to enhance lung volumes during examination?
Upright position, if possible.
What should you do if SpO2 is 95% or below on two occasions?
Seek medical attention ASAP.
What can be evaluated through a CXR?
Lung zones and anatomical structures.
What technique should be used during chest auscultation?
Listen to all lung fields during full inspiration and expiration.
How should privacy and dignity be maintained during a physical examination?
By covering areas not being assessed.
What is the significance of the shape of the thoracic cage?
The shape of the thoracic cage is important for protecting vital organs and facilitating respiratory mechanics.
What technology does a CT scan use to create images?
X-rays that pass through body organs at a 360-degree angle.
What are the primary shapes of the thoracic cage?
The thoracic cage can be classified into two primary shapes: conical and cylindrical.
What does CXR stand for?
Chest X-Ray.
What is an important technique to use during a respiratory assessment?
Auscultation of lung sounds.
What should be checked for chest symmetry during inspection?
Both sides should expand equally; asymmetry may indicate underlying respiratory issues.
What is injected intravenously during a CT scan?
Iodine-containing contrast dye.
How is tactile fremitus assessed?
By placing the flat palm of the hand on the chest and asking the patient to say '99' repeatedly while palpating both sides of the posterior chest.
What signs of respiratory distress should be looked for on the face?
Grimacing, gasping, nasal flaring, and lip puckering.
How does smoking or vaping history affect post-operative risks?
It increases the risk of respiratory complications.
What should be observed during a respiratory assessment?
Respiratory rate, rhythm, and effort.
What is the purpose of auscultation of the chest?
To evaluate the presence and quality of normal breath sounds and identify respiratory problems.
What type of pain is a concern after surgery?
Surgical pain.
What is the primary purpose of respiratory investigations?
To assess lung function and diagnose respiratory conditions.
What are common procedures performed using a CT scan?
CT brain, chest, abdomen/pelvis, extremities, and spine.
What is assessed to determine the depth of chest movement?
Whether the chest expands fully to the bottom of the lungs; inadequate expansion may indicate impaired ventilation.
How can motor neuron disease affect respiratory function?
It can lead to a weak cough.
What indicates normal findings during chest expansion assessment?
Thumbs symmetrically spread apart.
What type of sample is used to detect respiratory infections?
Sputum.
How can medical histories be evaluated in relation to respiratory symptoms?
To identify potential causes and determine nursing interventions.
What is the significance of CXR in respiratory assessment?
It shows important anatomy and lung zones.
What do nurses need to understand for effective respiratory assessment?
The anatomy and physiology of the respiratory system.
What are important indicators of respiratory function?
Heart rate and blood pressure.
Where should hands be placed to assess chest expansion?
On the chest wall at the 10th rib.
What are the three key stages in respiratory assessment?
Clinical examination (Objective), Patient questioning (Subjective), and checking the medical notes.
What does the Culture & Sensitivity (C/ST) test for a throat swab determine?
The appropriate antibiotic treatment if needed.
What are crackles (rales) and when are they heard?
Coarse, low-pitched sounds heard during inspiration and expiration, associated with serous secretions; clinical examples include pulmonary edema and pneumonia.
What is an important aspect of patient questioning?
Encouraging patient expression.
What is the purpose of the Modified Early Warning Score (MEWS)?
To assess illness severity and risk of deterioration for timely management of deteriorating patients.
What is paroxysmal nocturnal dyspnea (PND)?
Sudden, acute dyspnea during sleep, common in patients with congestive heart failure.
What is thoracentesis?
A medical procedure to remove fluid or air from the pleural space.
What do classifications 1 and 2 on the Bronkotest chart represent?
White to light yellow sputum color.
What is the normal range for pulse oximetry (SpO2)?
95% or above.
What action is required if pulse oximetry readings are consistently 92% or below?
Go to the Accident & Emergency Department.
What is the normal range for chest expansion?
~ 2 - 4 cm.
What is sputum?
Mucoid discharge from the respiratory tract.
What should be compared during auscultation?
Left and right lung fields.
What is the significance of having the lowest risk of causing a transfusion reaction?
To ensure patient safety during surgery.
What is the recommended patient positioning for auscultation?
Sitting position if possible.
What does cyanosis around the lips and mouth indicate?
A low O2 level requiring immediate oxygen therapy.
What does an increase in fremitus suggest?
Fluid in the lungs.
What does the Bronkotest 5-point chart assess?
Sputum characteristics and inflammation.
What does asymmetric expansion during the assessment indicate?
A possible chest wall deformity or pneumonia.
What should be completed to score physiological measurements in MEWS?
The MEWS 2 chart.
What is the normal range of Hemoglobin (Hb) for females?
12.0 – 15.0 g/dL.
What does it indicate if the AP diameter equals the transverse diameter?
It indicates a 'barrel chest'.
What is the purpose of the blood type and screen test?
To determine the patient's blood type, screen for antibodies, and check the Rhesus factor.
What is the purpose of testing respiratory samples?
To identify evidence of bacterial infection.
How do X-rays interact with different tissues and organs?
They penetrate tissues and organs differently according to tissue density.
Why is social and family history important in post-operative care?
It helps assess potential risks and complications.
What should be assessed if contrast is used in radiographic studies?
Allergy history.
What is the purpose of a Type & Screen in blood banking?
To check blood grouping, Rhesus factor, and antibody identification.
What must be removed before conducting a radiographic test?
Metallic objects.
Who should collect the blood specimen for ABG?
Doctors.
What should be evaluated regarding breathing rhythm?
Whether the breathing pattern is regular; irregular patterns can signal distress or deterioration.
What does the Culture & Sensitivity (C/ST) test for sputum determine?
The appropriate antibiotic treatment if needed.
Who is not suitable for an MRI?
Patients who are pregnant or breastfeeding.
What is a key question to ask a patient about their current state?
What is troubling you most at the moment?
What indicates hypercapnia in hypoventilation?
Elevated PaCO2 (> 44 mmHg or 5.9 kPa).
What is the normal anteroposterior (AP) to transverse diameter ratio in adults?
0.7 to 0.75.
What is the purpose of respiratory assessment?
To identify changes to respiratory functions through a systemic analysis of breathing.
Why is pregnancy contraindicated for all X-ray studies?
To avoid potential harm to the developing fetus.
What should be reviewed in the history of presenting conditions?
Details of the current physical conditions and past medical history.
What type of sample is collected to identify bacteria or fungi causing infection?
Throat swab.
What color do bones appear on radiographs and why?
Bones appear white because X-rays cannot penetrate bone to reach the film.
What does a decrease or lack of fremitus indicate?
Excess air in the pleural space, such as in pneumothorax.
What is the purpose of analyzing the respiratory system's anatomy and physiology?
To detect changes in function during assessments.
What should be reviewed to understand the progression of a disease?
Previous hospital admissions.
What substances can cause toxic ingestion leading to respiratory symptoms?
Fentanyl, Ketamine, and Cocaine.
What complications should be assessed for after a bronchoscopy?
Laryngeal edema, bronchospasm, pneumothorax, cardiac dysrhythmias, and bleeding.
What are the common sources of pain in pulmonary disorders?
Pain arises from pleurae, airways, or chest wall.
What device is used in pulse oximetry?
Oximeter.
What role does arterial blood gas analysis play in respiratory investigations?
It assesses the gas exchange function of the lungs.
What does the Rhesus factor indicate?
Whether blood is Positive or Negative.
What should be done if a patient has a clotting problem?
Inform the doctor.
What should the patient be instructed to do before the thoracentesis?
Keep fast as prescribed.
What type of needle and syringe should be used for ABG collection?
A heparinized needle and syringe.
What type of anesthesia is used during thoracentesis?
Local anesthesia.
What approach should be taken to build a shared understanding of ongoing care?
A collaborative approach.
What is hypoventilation?
Decreased rate and depth of breathing, leading to increased carbon dioxide levels.
Why are clinical signs alone limited in differentiating pneumonia types?
Because they have limited value in distinguishing between viral and bacterial infections.
Why is it important to differentiate central chest pain from cardiac pain?
To rule out cardiac problems.
What is the limit for fluid removal during thoracentesis?
1000 mL – 1500 mL at one time.
What should be assessed before a Pulmonary Angiography?
Hypersensitivity to iodine or seafood.
What is spirometry used for?
To conduct pulmonary function tests.
How does a Chest X-ray work?
An x-ray beam is passed through the body, with some x-rays absorbed or scattered by internal structures.
What is the significance of observing breathing patterns?
It can provide important clues about a patient's respiratory and overall health.
What imaging should be performed after thoracentesis?
A chest X-ray (CXR) as prescribed to assess for complications.
What should be inspected in the thoracic cage?
Shape and configuration of the chest wall.
What skeletal deformities may limit thoracic cage excursion?
Scoliosis and kyphosis.
What is the first step in carrying out a respiratory assessment?
Gathering patient history and symptoms.
Why is effective communication important during a physical examination?
To ensure the patient understands the procedure and feels comfortable.
What muscles should be observed during thoracic cage inspection?
Neck and trapezius muscles.
What is a post-operative risk related to anesthesia?
Increased risk of respiratory complications.
What type of view does a CT scan provide?
A three-dimensional, cross-sectional view of body structures.
What does a change in sound vibrations in the chest wall indicate?
Abnormalities of lung tissues.
What are the three types of normal breath sounds?
Bronchial, Bronchovesicular, and Vesicular breath sounds.
What can the doctor do once the blood type and screen results are available?
Reserve the appropriate blood product that is compatible with the patient's blood type.
What does a discrepancy between chest and abdominal movement suggest?
It may suggest respiratory distress.
What is a characteristic of Bronchial breath sounds?
They are typically loud and high-pitched, heard over the trachea.
What do the characteristics of sputum vary by?
Underlying conditions.
What is the first step in patient questioning?
Identify the main problem.
How can a decrease in consciousness affect respiratory function?
It can impair respiratory drive and function, requiring escalation of care.
What is pulse oximetry?
A simple, non-invasive method of measuring oxygen levels.
What is a common marker of bacterial infection in sputum?
A high presence of neutrophils.
What condition is the patient admitted for?
Lung cancer.
What indicates the use of accessory muscles during breathing?
The use of neck muscles to lift the shoulder girdle and ribs; increased effort suggests respiratory compromise.
How should a patient position their arms for posterior auscultation?
Move their arms forward to clear the scapulae.
What distinguishes Vesicular breath sounds?
They are soft, low-pitched sounds heard over the lung fields.
What are clubbed fingers or toes a sign of?
Hypoxia from respiratory or cardiovascular disease.
What should healthcare providers allow patients to do during consultations?
Share their concerns and expectations.
What should be assessed in the patient's medication history before ABG collection?
Use of anticoagulants or aspirin.
Why is confirming a patient’s ABO group important?
An incompatible transfusion can be fatal.
Describe wheeze and its clinical example.
High-pitched, musical squeaking sounds that predominate in expiration but may occur in both expiration and inspiration; commonly associated with acute asthma.
What is the normal respiratory rate for adults?
Typically between 12 to 20 breaths per minute.
What should be identified and corrected for angiography?
Bleeding disorders.
What approach should be used for acute deterioration in respiratory assessment?
The ABCDE approach.
What does pulse oximetry measure?
Blood O2 saturation.
Why is blood taken from the patient before surgery?
To perform a type and screen test for compatibility with blood products.
What is crucial for nurses to do in respiratory assessment?
Timely assessment and intervention to alleviate breathing difficulties and prevent deterioration.
What does pyrexia (fever) indicate in relation to respiratory health?
It may indicate a respiratory infection, necessitating further investigation and management.
What are the characteristics of severe dyspnea?
Flaring of nostrils, use of accessory respiratory muscles, and retraction of muscles between or above the ribs.
Name a common type of respiratory investigation.
Pulmonary function tests (PFTs).
What color do lungs or bowels appear on X-ray films?
They appear black or very dark.
What do pulmonary function tests measure?
Lung volumes, capacities, and airflow rates.
In what settings is pulse oximetry useful?
For continuous or intermittent monitoring of oxygenation.
What is required for invasive procedures in radiographic studies?
Informed written consent.
What patient preferences should be consulted regarding post-operative care?
Resuscitation and escalation of care preferences.
What is thoracentesis?
An invasive procedure to insert a large-bore needle through the chest wall into the pleural space.
How should the assessment of chest expansion be performed?
Systematically, anteriorly and posteriorly, from apex to bases of lungs.
How does an oximeter measure oxygen saturation?
It emits red and infrared light to measure oxygen saturation in the blood.
What is a common imaging technique used to visualize the chest?
Chest X-ray.
What vital signs should be regularly monitored in respiratory investigations?
Temperature, blood pressure, pulse, respiratory rate, and conscious level.
What types of investigations are important for interpreting respiratory health?
Blood gases, spirometry, and imaging.
What is the purpose of the Modified Early Warning Score (MEWS)?
To identify patients at risk of clinical deterioration.
What is sneezing a reflex response to?
Irritation in the upper respiratory tract.
What is the purpose of a Pulmonary Angiography?
To identify pulmonary emboli, tumors, aneurysms, and vascular changes.
What does spirometry measure?
Lung capacity and how easily and quickly air can be exhaled.
What question can help explore a patient's beliefs about their health?
What are your beliefs about your condition?
What type of heart valves can affect MRI suitability?
Prosthetic (artificial) metal heart valves.
What is the purpose of a Ventilation-perfusion scan (VQ scan)?
To assess airflow and blood flow in the lungs.
What does 'E' stand for in the ABCDE approach?
Exposure.
Why is there a limit on fluid removal during thoracentesis?
To reduce the risk of cardiovascular collapse from rapid removal of too much fluid.
What should patients avoid before a CT Scan if contrast dye is used?
Oral food or fluids for 4 hours before the test.
What sound might be heard when percussing over an area with excess air?
Hyperresonant sound.
What can pink sputum indicate?
Can indicate pulmonary edema from a condition such as congestive heart failure.
What is recorded for later evaluation in a Chest X-ray?
An image of the internal structures.
What is the normal respiratory rate (RR) for adults?
10 to 18 breaths per minute, regular and effortless.
What is essential to check for all female patients before radiographic studies?
The last menstrual period (LMP).
What are potential causes of respiratory symptoms?
Heart failure, neuromuscular disorders, toxic ingestion, central nervous system disorders, obesity, and cardiac conditions.
What should the patient do during the chest expansion assessment?
Take a deep breath.
Where are Bronchovesicular breath sounds normally heard?
Over the major bronchi.
What should be monitored post-bronchoscopy as ordered?
Vital signs.
What are the four main blood groups?
A, B, O, AB.
How do muscles, blood, and organs appear on radiographs?
They appear as various shades of grey.
Why are imaging studies important in respiratory investigations?
They help visualize the structure of the lungs and detect abnormalities.
What is the first nursing intervention before a thoracentesis procedure?
Obtain written consent.
What are radiographs used for?
They are used in many types of examinations and procedures.
What lab test results should be checked before the ABG procedure?
Blood coagulants lab test results.
What is stridor and when is it most pronounced?
High-pitched, monophonic, inspiratory crowing sound that is louder in the neck than over the chest wall; associated with croup and acute epiglottitis in children, and may indicate a life-threatening obstructed airway.
What is another name for Magnetic Resonance Imaging (MRI)?
Nuclear magnetic resonance imaging.
Where can thoracentesis be performed?
At the bedside or in a procedure room.
What type of imaging technique is MRI?
Non-invasive.
What is percussion in a clinical context?
A technique used to assess the condition of the lungs and other organs by tapping on the body.
What should be reported to the doctor after a bronchoscopy?
Any bleeding, pain, and respiratory difficulty.
What surgical materials can make a patient unsuitable for MRI?
Metal plates, wires, screws, or rods used during surgery for bone fractures.
What blood tests are commonly performed in respiratory investigations?
Complete blood count, type & screen.
What is involved in the procedure of Pulmonary Angiography?
Catheter insertion into the brachial or femoral artery, threaded to the pulmonary artery for dye injection.
What may a persistent cough indicate?
Respiratory disease or chronic irritation.
Which parts of the body can MRI examine?
Almost any part, including the brain, spinal cord, bones, joints, breasts, heart, blood vessels, and internal organs.
What sound indicates the presence of fluid in the lungs during percussion?
Dull sound.
Can MRI be used to examine internal organs?
Yes, including the liver, prostate gland, and uterus.
What is a possible complication of thoracentesis?
Pneumothorax if the visceral pleura is punctured.
What does a Pulmonary Ventilation Scan (V/Q Scan) measure?
Ventilation and perfusion in the lungs using nuclear scans.
How does age influence specimen choice in respiratory viral studies?
Children typically have higher viral loads and detection rates, while patients over 65 may have reduced specimen quality.
What occurs during hyperventilation?
Alveolar ventilation exceeds metabolic demands, leading to decreased PaCO2.
What are the main components of the thoracic cage?
The ribs, sternum, and thoracic vertebrae.
What should be encouraged to help expand the lungs post-thoracentesis?
Encourage deep breaths.
What is orthopnea?
Dyspnea experienced while lying down, relieved by raising the upper body with pillows.
What type of questions should be used to allow patients to express their concerns?
Open-ended questions.
What is a pleural friction rub and its clinical significance?
Coarse, low-pitched sounds heard during inspiration, accompanied by pain with breathing; associated with pleuritis.
What is the purpose of the initial assessment in respiratory care?
To determine the severity of the respiratory problem and the need for immediate treatment.
What is hypoventilation?
Inadequate alveolar ventilation due to pulmonary or neurologic issues.
What is a key technique for gathering comprehensive respiratory information from patients?
Applying effective communication techniques.
What is collateral history?
Information gathered from family or caregivers when communication is difficult.
What is bradypnea?
Abnormally slow breathing, usually less than 12 breaths per minute.
What question can help understand a patient's perspective on their condition?
What should I understand about your condition?
What is blood banking?
The process to ensure donated blood or blood products are safe for transfusions and medical procedures.
What should patients be educated about regarding post-bronchoscopy symptoms?
It is normal to have some blood-tinged sputum, hoarseness, and sore throat.
What can exudates from the upper respiratory tract be used for?
Microbiology and viral studies.
What symptoms are associated with hypoventilation?
Somnolence and disorientation.
What type of pain occurs after coughing in individuals with tracheitis?
Central chest pain.
What does an occasional cough indicate?
It is normal in healthy individuals.
What type of images does MRI produce?
Cross-sectional, multiplanar, and clearer images.
How should the patient be positioned during the thoracentesis?
Upright with elbows on an overbed table and feet supported.
What can be assessed using a Chest X-ray?
Disease, foreign objects, and structural damage or anomalies.
What vital signs should be assessed before bronchoscopy?
Vital signs of the patient.
What do culture and sensitivity tests identify?
They only identify bacteria, not viruses.
What does haematology refer to?
The study of blood cells.
What types of specimens are considered for upper respiratory tract infections (URTIs)?
Nasopharyngeal swabs, nasal swabs, throat swabs, and bronchoalveolar lavage fluids.
What monitoring is needed for at-risk patients with hypoventilation?
Regular monitoring of arterial blood gases.
What is the primary function of the thoracic cage?
To protect the organs in the thoracic cavity, including the heart and lungs.
When did your wheeze start?
This question helps determine the onset of the symptom.
What are common sites for ABG puncture?
Radial artery and femoral artery.
How many pairs of ribs are typically found in the human thoracic cage?
12 pairs.
What is bronchoscopy?
A procedure for direct visualization of the larynx, trachea, and bronchi using a bronchoscope.
When did your night sweats start?
This question helps assess the duration of the symptom.
What is haemoglobin concentration (Hgb)?
The amount of oxygen-carrying protein in red blood cells.
What tools may be used during bronchoscopy to collect samples?
Catheter brush or biopsy forceps.
When should closed questions be utilized?
When breathlessness hinders communication for key aspects.
How does obesity affect respiratory health?
It causes mechanical compression and restrictive pulmonary damage.
What signs and symptoms should be monitored post-bronchoscopy?
Dyspnea, decreased breath sounds, decreased SpO2, and hemoptysis.
What do classifications 3, 4, and 5 on the Bronkotest chart indicate?
Increasingly purulent sputum.
How can dyspnea present itself?
As breathlessness or shortness of breath, occurring with exertion or at rest.
What is an example of a metal implant that makes a patient unsuitable for MRI?
A pacemaker.
What does 'B' represent in the ABCDE approach?
Breathing.
What is spirometry?
A common type of pulmonary function test (PFT) that measures lung capacity and airflow.
How should the ABG sample be handled after collection?
Place the sample on an ice water bag and transport immediately to the lab.
What does percussion help to determine?
The presence of fluid, air, or solid masses in the lungs.
What is the primary purpose of a Chest X-ray (CXR)?
To diagnose or treat patients by imaging internal body structures.
What does 'D' indicate in the ABCDE approach?
Disability.
How does hypoventilation affect carbon dioxide levels?
It leads to CO2 buildup and detectable hypercapnia.
What is a critical MEWS score that indicates the need for immediate intervention?
A score of 5 or higher.
What characterizes a dry (unproductive) cough?
It lacks mucus production and can disrupt sleep.
What should be done with labeled specimens after thoracentesis?
Send them to the laboratory promptly for analysis.
What can delayed treatment of hypoventilation lead to?
Worsening of the condition.
What methods are used to assess breathing changes?
Inspection, palpation, percussion, and auscultation.
What does red sputum signify?
Can be a sign of an internal injury, lung cancer, or a pulmonary embolism.
What does an Arterial Blood Gas (ABG) analysis measure?
Acidity (pH), oxygen (O2), and carbon dioxide (CO2) levels from an artery.
What is the normal range of Hemoglobin (Hb) for males?
14.0 – 16.5 g/dL.
What should be checked regarding pregnancy before performing an MRI?
Check if the patient is pregnant; the test is not performed if so.
What conditions are indicated by Kussmaul respirations?
Acidosis or post-exercise.
What is particularly difficult to expel in elderly or debilitated patients?
Cough with thick secretions.
What is the normal PaCO2 level?
Approximately 40 mmHg (5.3 kPa).
What sounds may indicate small airway obstruction?
Audible wheezing (whistling sounds on expiration).
What does HCO3 represent in an ABG analysis?
The calculated concentration of bicarbonate in arterial blood.
Do you have pain when you cough?
Understanding pain associated with coughing can aid diagnosis.
When might a cough be worse?
Is it worse at night?
What symptoms are associated with paroxysmal nocturnal dyspnea?
Waking up gasping for air and coughing, along with a subjective feeling of discomfort due to an inability to inhale.
What is the most common type of pulmonary pain?
Pleural pain.
What should be checked for before performing a thoracentesis?
Hypersensitivity to anesthetics and antibiotics.
What does 'A' stand for in the ABCDE approach?
Airway.
What should be checked regarding the patient before bronchoscopy?
Hypersensitivity to anesthetics and antibiotics.
What does the blood banking process include?
Typing the blood for transfusion and testing for infectious diseases.
What does a CT scan provide in respiratory investigations?
Detailed cross-sectional images of the chest.
What parameters are typically included in the MEWS?
Respiratory rate, heart rate, blood pressure, temperature, and level of consciousness.
What is the normal PaCO2 level?
Approximately 40 mmHg (5.3 kPa).
What post-collection care should be provided at the puncture site?
Apply pressure for at least 5 minutes.
What sound is produced when percussing over normal lung tissue?
Resonant sound.
What are the absolute contraindications for MRI?
Pregnancy, breastfeeding, and having metal implants or fragments in the body.
What should the patient be instructed not to do during the thoracentesis?
Not to talk or cough (if possible).
What nursing intervention is required post-Pulmonary Angiography?
Apply pressure to the injection site until bleeding stops, for 5-10 minutes.
What dietary recommendations are given before a spirometry test?
Eat a light meal and avoid too much fluid.
What happens to the x-ray pattern after it passes through the body?
The remaining x-ray pattern is transmitted to a detector.
What is a fine needle aspiration used for in respiratory investigations?
To collect cells for cytological analysis.
What does decreased uptake during a perfusion scan indicate?
Blood flow problems.
What should be done regarding transdermal medication patches before an MRI?
Remove them unless otherwise prescribed.
Who can collect non-NPS upper respiratory sources?
They can be collected by various personnel or self-collected.
What are the absolute contraindications for MRI related to Pulmonary Angiography?
Pregnant individuals.
What does the platelet count measure?
The number of platelets in the blood.
What are the purposes of bronchoscopy?
To identify lesions, remove foreign bodies and secretions, obtain tissue for biopsy, and improve tracheobronchial drainage.
What is the role of the sternum in the thoracic cage?
It serves as an attachment point for ribs and protects the heart.
What is the normal percentage range for Basophils in WBC count?
0% – 2%.
What monitoring is required for patients with hyperventilation?
Monitoring is required for patients with anxiety or head injuries.
Do you use any mobility aids?
Understanding mobility aids can indicate the level of fatigue.
What techniques might help with breathlessness?
Do you use any breathing exercise, relaxation, or positions of ease to help with your breathlessness?
What should be observed on the face during a respiratory assessment?
Signs of respiratory distress and any abnormal features like cyanosis.
What can affect metal implants during an MRI scan?
The strong magnet used during the scan.
What is the primary purpose of performing a thoracentesis?
To relieve pressure on the lungs or to obtain fluid for diagnostic purposes.
What are the characteristics of pleural pain?
Sharp or stabbing in nature, increases during inspiration, localized, associated with pleural friction rub, worsens with laughing or coughing.
What are common indications for thoracentesis?
Pleural effusion, pneumothorax, or to obtain pleural fluid for analysis.
What can pleural pain indicate?
It may indicate pulmonary embolism.
What items should be removed from the patient before the procedure?
Dentures, contact lenses, and jewelry.
What technology does MRI use to create images?
A huge magnet, radio waves, and a computer.
What vital signs should be assessed before the thoracentesis?
Vital signs should be assessed.
What is the purpose of percussion in respiratory assessment?
To determine lung expansion and check for the presence of air and fluid.
What items should be removed from the patient before the procedure?
Dentures, contact lenses, and jewelry.
How often should percussion be performed over the intercostal spaces?
Every 4 to 5 centimeters, or 1.5 to 2 inches.
Can dental fillings affect MRI scans?
Yes, dental fillings and bridges can affect MRI suitability.
Why is arterial blood gas analysis important in hypoventilation?
It is essential for detecting hypercapnia and critical for early intervention.
What is the first step in ensuring safety during the initial assessment?
Start with an airway assessment to check for obstructions.
What treatments may be required for a dry cough?
Cough suppressants like codeine or dextromethorphan.
What information does haematology provide?
Type, number, and appearance of cells in the blood.
What is the primary use of MRI in thoracic diagnostics?
To diagnose alterations in lung tissue not easily visualized by CT.
What is a key consideration when collecting specimens for respiratory viral studies?
Balancing timeliness, specimen quality, and sensitivity.
What triggers a cough from aspiration?
Food or fluid entering the airway.
What is the purpose of measuring red blood cell count (RBC)?
To assess the number of red blood cells in the blood.
What is the purpose of an ABG analysis?
To assess lung function and gas exchange, and to help rule out acid-base imbalance.
What are some symptoms of hyperventilation?
Dizziness, tingling, and lightheadedness.
When did you notice you had started to lose weight?
Determining the timeline of weight loss is crucial for evaluation.
What does PaCO2 measure in an ABG analysis?
The partial pressure of carbon dioxide in arterial blood.
Do you have any central chest pains, pain on inspiration, or muscular pain?
This question helps differentiate the type of chest pain.
What conditions can a CBC help diagnose?
Anaemia, certain cancers of the blood, inflammatory diseases, and to monitor blood loss and infection.
What is your normal walking distance?
This helps evaluate the level of fatigue and mobility.
What factors might contribute to breathlessness?
What makes you breathless?
What are the main purposes of thoracentesis?
To obtain specimens for diagnostic evaluation, to remove pleural fluid, or to instill medication.
What should be assessed before allowing a patient to have food or fluids post-bronchoscopy?
Gag reflex.
What does the oximeter calculate to determine peripheral oxygen saturation?
The ratio of red to infrared light.
Which imaging technique uses sound waves to create images of the chest?
Ultrasound.
What type of device is an implantable cardioverter-defibrillator?
A metal implant that can be affected by MRI.
What are potential complications of thoracentesis?
Infection, bleeding, or pneumothorax.
Why is it important to establish a patient baseline?
To differentiate between typical changes and signs of decline.
What methods may be used to locate the effusion and needle insertion site?
Physical exam and ultrasonography.
What is the purpose of a CT Scan of the Thorax?
To differentiate pathologic conditions like tumors, abscesses, and aortic aneurysms, and to identify pleural effusion and enlarged lymph nodes.
What is Cheyne-Stokes respiration?
A pattern of breathing characterized by a gradual increase in depth followed by a decrease, and then a period of apnea.
What can dark yellow or green sputum indicate?
Can indicate a bacterial or viral infection, such as pneumonia, or cystic fibrosis.
What should be avoided for 12 hours before a spirometry test?
Smoking and vaping.
What sound is expected in normal lungs during percussion?
Resonance.
Why is early identification of deterioration important in healthcare?
It can lead to timely interventions and potentially save lives.
What does hyperresonance indicate during percussion?
Pneumothorax.
What is a productive cough beneficial for?
Clearing airways by expelling secretions or inflammatory exudate.
What equipment is used during a spirometry test?
A mouthpiece connected to a spirometer, often with a nose clip applied.
What does bright red, rust-colored, or bloody streaked sputum indicate?
May indicate bronchiectasis, chronic obstructive pulmonary disease, lung cancer, lung injury, tuberculosis, pulmonary embolism, cystic fibrosis, or a bleeding disorder.
What characterizes Kussmaul respirations?
Slightly increased ventilatory rate, very large tidal volume, and no expiratory pause.
Do you use inhalers? If so, how often? Do they help?
Understanding inhaler use can indicate the severity of wheezing.
What does the pH component of ABG indicate?
The acid-base balance of the blood.
What are the different types of rib classifications in the thoracic cage?
True ribs, false ribs, and floating ribs.
What is the purpose of a differential white blood count?
To evaluate the different types of white blood cells present.
What is the reference range for base excess/deficit in arterial blood?
-2 to +2.
What does SaO2 measure in an ABG analysis?
The calculated arterial oxygen saturation.
What is the normal percentage range for Neutrophils in WBC count?
47% – 63%.
What should you ask about blood in sputum?
Is there any blood in the sputum?
Which clinical examination skills are important for assessing respiratory health?
Inspection, palpation, percussion, and auscultation.
What should be done for deteriorating patients?
Proceed directly to patient examination.
What are the consequences of hypoventilation?
Respiratory acidosis and impaired tissue function.
What common respiratory symptoms should be assessed?
Onset, timing, exacerbating or relieving factors, and severity.
What does hyperventilation refer to?
Increased rate and depth of breathing, often leading to decreased carbon dioxide levels.
What is the primary aim of respiratory viral studies?
To develop diagnostics, treatments, and vaccines for viral infections.
How long should a patient fast before a bronchoscopy?
8 to 12 hours.
Which imaging technique uses magnetic fields to create images of the chest?
Magnetic Resonance Imaging (MRI).
How does the MEWS help in patient care?
It provides a systematic approach to monitor and respond to changes in a patient's condition.
What is the purpose of an arterial blood gas test?
To assess gas exchange and acid-base balance.
What should be monitored post-thoracentesis?
Vital signs as ordered.
What is Kussmaul breathing?
Deep, labored breathing often associated with metabolic acidosis.
What does brown sputum often occur in?
Often occurs in people who smoke.
What should be administered as part of the pre-procedure care?
Ordered premedication.
What nursing intervention is necessary regarding allergies before a CT Scan?
Assess for allergies to iodine and notify the physician if present.
What does dullness indicate during percussion?
Atelectasis or mass.
What can help with a productive cough?
Increased fluid intake and expectorants like guaifenesin.
What does the white blood cell count (WBC) measure?
The number of white blood cells in the blood.
What are some indications for performing an Arterial Blood Gas (ABG) analysis?
Acute respiratory distress syndrome (ARDS), acute respiratory failure, asthma, diabetic ketoacidosis, renal tubular acidosis, inborn errors of metabolism, severe sepsis, septic shock, and hypovolemic shock.
What shape does the thoracic cage resemble?
A conical or barrel shape.
What is haematocrit (HCT)?
The volume percentage of red blood cells in blood.
What does PaO2 measure in an ABG analysis?
The partial pressure of oxygen in arterial blood.
What is the reference range for PaCO2 in arterial blood?
4.67 - 6.00 kPa (35 - 45 mm Hg).
What is the reference range for HCO3 in arterial blood?
21 - 28 mEq/L.
Why is early recognition of hyperventilation important?
It can prevent complications.
How long should you inquire about a cough?
How long have you had a cough?
How can you assess the quantity of sputum?
How much are you clearing?
Is your problem affecting your sleep?
Understanding sleep impact can provide insights into fatigue.
What does the normal appearance of sputum indicate?
What does your sputum normally look like? (Colour, consistency, viscosity)
When should you assess breathlessness during activities?
Are you breathless at rest or during activity?
What is the first nursing intervention before a bronchoscopy procedure?
Obtain written consent.
What is tachypnea?
Abnormally rapid breathing, usually more than 20 breaths per minute.
How can healthcare providers acknowledge a patient's role in their care?
By recognizing patients’ experience in managing their condition.
What is the term for peripheral oxygen saturation measured by an oximeter?
SpO2.
What is assessed under 'C' in the ABCDE approach?
Circulation.
What position is typically recommended for a patient undergoing thoracentesis?
Sitting upright and leaning forward.
What does thin, clear, white, or gray sputum usually indicate?
Usually indicates healthy lungs, but a lot of sputum may indicate lung disease, allergy, or viral infection.
What conditions can spirometry help diagnose?
Asthma, chronic obstructive pulmonary disease (COPD), and pulmonary fibrosis.
What is a limitation of imaging in respiratory infections?
Imaging is not specific for viral and bacterial infections.
What is typically the cause of chest wall pain?
Muscle or rib pain, commonly due to rib fractures or excessive coughing.
What does Positron Emission Tomography (PET) help to detect?
Metabolic activity in tissues, including tumors.
Are tattoos generally safe in an MRI scanner?
Most tattoos are safe, but some tattoo ink contains traces of metal.
What is bronchoscopy used for?
To visualize the airways and collect tissue samples.
What should patients do regarding bronchodilators before the test?
Hold bronchodilators as prescribed.
What is a Complete Blood Count (CBC)?
A group of tests that evaluate the cells circulating in blood, including red blood cells, white blood cells, and platelets.
What signs and symptoms should be monitored post-thoracentesis?
Decreased BP/P, dyspnea, decreased breath sounds, decreased SpO2, and hemoptysis.
What is the PaCO2 level indicating hypocapnia?
PaCO2 < 36 mmHg or < 4.8 kPa.
What should be reported to the doctor after thoracentesis?
Any bleeding, pain, and respiratory difficulty.
What is labored breathing often associated with?
Airway obstruction.
What sounds may indicate large airway obstruction?
Stridor (high-pitched sounds during inspiration).
How is a fibreoptic bronchoscope introduced into the body?
It is passed through the nose or mouth into the trachea.
How much weight have you lost?
Quantifying weight loss can indicate the severity of the issue.
What are red blood cell indices?
Measurements that provide information about the size and hemoglobin content of red blood cells.
What is the reference range for SaO2 in arterial blood?
95%.
What is the normal percentage range for Monocytes in WBC count?
4% – 9%.
What question helps evaluate sputum thickness?
How thick is your sputum?
What is a key question regarding breathlessness?
Are you normally breathless?
What is the maximum volume for therapeutic thoracentesis in a day?
Limit to 1500 mL per day.
What procedure involves the removal of fluid from the pleural space?
Thoracentesis.
What should patients do before a Pulmonary Ventilation Scan?
Remove all jewelry from the neck and chest.
What is sputum?
Mucoid discharge from the respiratory tract; characteristics vary by underlying conditions.
What causes an irritant-induced cough?
Inhaled irritants such as tobacco smoke.
What is the normal RBC count range for males?
4.2 – 5.4 × 10^6/mm³.
What is the normal RBC count range for females?
3.6 – 5.0 × 10^6/mm³.
What are the characteristics of Cheyne-Stokes respirations?
Alternating periods of deep and shallow breathing with apnea lasting 15 to 60 seconds.
What is one question to assess a cough?
Are you able to cough up sputum?
What are the types of acid-base imbalances that can be identified through ABG analysis?
Respiratory acidosis, respiratory alkalosis, metabolic acidosis, and metabolic alkalosis.
What is your normal level of function (activity of daily living)?
This assesses how fatigue affects daily activities.
What instructions are given to patients during the spirometry test?
To breathe with deep inspiration and forceful continuous expiration into the mouthpiece.
Is there anything that makes your wheeze worse?
Identifying triggers can help in managing the symptom.
What acid-base disturbance is caused by hyperventilation?
Respiratory alkalosis.
What is the reference range for pH in arterial blood?
7.35 - 7.45.
What is the reference range for PaO2 in arterial blood?
10.67 - 13.33 kPa (80 - 100 mm Hg).
What can low CO2 levels disrupt?
Acid-base balance.
What conditions are often associated with hyperventilation?
Severe anxiety, acute head injury, or inadequate oxygenation.
What does base excess/deficit indicate in an ABG analysis?
The relative excess or deficit of base in arterial blood.
What is the normal percentage range for Lymphocytes in WBC count?
24% – 40%.
What are the absolute contraindications for MRI related to Pulmonary Ventilation Scan?
Pregnant or breastfeeding individuals, and those with metal implants or fragments in the body.
What is the significance of the shape of the thoracic cage?
It allows for expansion during breathing.
What is the normal platelet count range?
150 – 400 × 10^3/μL.
What is the normal WBC count range?
4.8 – 10.8 × 10^3/μL.
What conditions may lead to Cheyne-Stokes respirations?
Conditions that slow blood flow to the brainstem or neurological impairment above the brainstem.
Are you taking any pain relief? If so, is it effective?
Assessing pain management can provide insights into the condition.
Do coughing or huffing cause incontinence?
This question helps assess the relationship between coughing and incontinence.
How often should breathlessness be evaluated?
How often are you breathless?
How does the thoracic cage contribute to respiration?
It facilitates the movement of air in and out of the lungs.
What is the normal percentage range for Eosinophils in WBC count?
0% – 3%.
What is an important question regarding sputum color?
What colour is your sputum?
Do you need help with activities of daily living?
Identifying the need for assistance can indicate severity.
What emotional state might accompany breathlessness?
Do you feel anxious or low in mood?
What question assesses walking ability related to breathlessness?
How far can you normally walk? Has this changed recently?
