Dealing with the Patient

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  1. What are the two types of chest pain?
    • Pleuritic
    • Nonpleurtic
  2. Pleurtic
    • Type if chest pain
    • Made worse by breathing
    • Sharp in nature
    • Located laterally and posteriorly on chest wall
    • Associated with diseases that affect lining of the lung ( pheumothorax, pulmonary embolism, pneumonia)
  3. Nonpleuratic
    • Type of chest pain
    • Not affected by respiratory efforts
    • Radiates
    • Dull pressure sensation
    • Located centrally in chest
    • Assiciated with ischemic heart disease
  4. Sputum
    • Noticible production is a sign of disease of airway
    • Most common cause is smoking (also caused by asthma and pheumonia)
  5. How is sputum described?
    • Mucoid- clear/thick (airway diseases without infection
    • Fetid- foul smell
    • Purulent- pus (bacterial infection)
    • Copious- large amounts (most often seen in bronchiectasis)
    • Color
  6. Cough
    • Most frequent symptom (caused by stimulation of cough receptors from mechanical, chemical, inflammatory and thermal sources)
    • Usually associated with airway disease (found in acute upper respiratory infection, asthma, bronchitis)
  7. What should you ask about a cough?
    • When and how often
    • Productive
    • How severe
  8. What are the most common symptoms of patients with cardiopulmonary disease?
    • Dyspnea
    • Cough
    • Sputum production
    • Chest pain
    • Hemoptysis
    • Fever
    • Wheeze
  9. What to ask about dyspnea?
    • When, where and why?
    • Rate 1 to 10
    • History of disease
    • Stable or worsening
  10. What to ask about sputum?
    Recent changes in color and amount
  11. Hemoptysis
    • Caused by infections disease
    • 20-30% of the time cause is undetermined
    • Chronic hemoptysis can be caused by chronic disease
    • When associated with bronchitis- harmeless
    • When associated with carcinoma-life threatening
  12. Fever
    • Abnormal rise in body temperature due to disease (usually due to an infection)
    • Common respiratory problem associated with fever (viral infection, bacterial bronchitis, bacterial pneumonia, fungal infections, tuberculosis)
  13. Wheeze
    • Caused by narrow airways due to constriction or obstruction
    • Associated with SOB, cough, sputum
    • Commonly found in asthmatics, congestive heart failure, bronchitis
  14. What are the four basic vital signs?
    • Heart rate
    • Respiratory rate
    • Blood pressure
    • Body temperature
  15. What is considered the fifth vital sign?
    Pulse oximetry
  16. What are different breathing patterns?
    • Abdominal paradox due to diaphragm fatigue
    • Biot's respiration due to increased intracranial pressure
    • Cheyne-Stokes due to CHF or CNS disorder
    • Kussmal's due to metabolic acidosis
    • Apneustic due to brain damage
    • Paradoxical respirations due to chest trauma, diaphragm paralysis, muscle fatigue
    • Asthmatic due to obstruction of airflow out of lungs
  17. Chest inspection
    Degree of symmetrical expansion
  18. Chest percussion
    • Resonant
    • Hyperresonance
    • Dull
    • Flat
  19. Other things to look for when assessing the patient
    • jugular venous distention
    • digital clubbing
    • cyanosis
    • abdomen
    • pursed lip breathing
  20. CBC
    • Complete blood count:
    • leukocytosis (increased WBC)
    • leukopenia (decreases WBC)
    • anemia
    • polycythmia
  21. Serum electorlytes
    • sodium
    • potassium
    • cholide
    • total bicarb
  22. Data collected via a lab
    • Sputum
    • cardiac enzymes
    • ABG (arteriole blood gas)
    • pulmonary function testing
  23. types of patient records
    • traditional chart
    • problem oriented medical record (POMR)
    • computer documentation
  24. what do traditional chars include?
    • admission sheet
    • physician's order sheet
    • progress notes
    • history and physical examination data
    • medication sheet
    • respiratory care sheet
    • nurses' admission info
    • nursing care plans
  25. Most common POMR
    SOAP note
  26. What does SOAP mean?
    • Subjective (feeling by the patient/nonmeasurable)
    • Objective (measureable tests like bp, rr, temp etc.)
    • Assessment
    • Plan
  27. What does IER mean in SOAPIER note?
    • Implementation
    • Evaluation
    • Revision
  28. Health care associated infections
    • HAIs
    • infection that patients aquire during a course of recieving medical treatment
  29. PPE for Concact
    Gloves and gown
  30. PPE for Droplet
    Gloves, gown, mask
  31. PPE for airborne
    Gloves, gown, goggles, n95
Card Set:
Dealing with the Patient
2012-09-26 21:59:22
Health Disease

Patient assessment, Patient Interview, Infection control
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