sleepy, arouses easily, responds appropriately when aroused
describes sensorium rating: obtunded
awakens only with difficulty, responds appropriately when aroused
describes sensorium rating: stuporous
does not awaken completely, has decreased mental and physical activity, responds to pain and exhibits deep tendon reflexes and responds slowly to verbal stimuli
describes sensorium rating: comatose
unconscious, does not respond to stimuli or move voluntarily, exhibits possible signs of upper motor neuron dysfunction such as Babinski's reflex or hyperreflexia and loses reflxes with deep or prolonged coma
irregular breathing with long periods of apnea
irregular type of breathing - breaths increase and decrease in depth and rate with periods of apnea
deep and fast respirations
part or all of the chest wall moves in with inhalation and out with exhalation
what is the physiologic response to hypothermia?
shivering to generate heat and vasoconstriction to conserve heat
what is the physiologic response to hypoxia?
vasodilation to increase perfusion
define pulsus paradoxus
decrease of 15-20mmHg of BP during spontaneous inhalation
define systolic pressure
peak force exerted in teh arteries during contraction of the left ventricle
define diastolic pressure
the force remaining in the arteries after relaxation of the left ventricle
define pulse pressure
difference between systolic and diastolic pressures with a normal range between 35-40 mmHg
what are the 3 physical factors of blood pressure
interaction of the force of the left ventricle contraction, the systemic vascular resistance, and blood volume
what is the physiologic response to a fever?
increase of the metabolic rate, thereby increasing both oxygen consumptiong and carbon dioxide production. the increase in metabolic rate must be accompanied by an increase iun both circulation and ventilation to maintain homeostatis (increased heart and respiratory rates)
what causes pulsus paradoxus?
Indicates a significant drop in intrapleural pressure caused by increase work of breathing due to decreased compliance or increased airway resistance
what are retractions in respect to the lungs?
intermittent sinking inward of the skin overlying the chest wall during inspiration. Can be intercostal, supraclavicular, subcostal or substernal
what is abdominal paradoxus?
When the abdomen sinks inward during inspiration due to a fatigued diaphragm
lung sound associated with rapid airflow through obstructed upper airways
what is the physiological response to hypoxemia?
vasoconstriction to incease blood flow resistance through the pulmonary vasculature which increases pulmonary workload
what is the physiologic process of JVD
hypoxemia that causes vasoconstriction to increase blood flow resistance which causes increased pulmonary workload which increase right ventricular workload and if persistent, can cause cor pulmonale and JVD
what is bubbling and the lung base?
crackling resulting from atelectasis, fibrosis, and pulmonary edema
what could cause decreased resonance to precussion?
pleural spaces filled with fluid, such as blood or water (consolidated alveolus)
what can cause diminished or absent breath sounds?
air blocking due to inflammation or mucus plugging
when are bronchial sounds abnormal?
when heard over peripheral lung regions and lung has increased tissue density
what can cause hyperresonance?
hyperinflation that can result from acute or chronic bronchial obstruction such as asthma or emphysema
what breathing pattern will COPDers adopt?
Pursed lip breathing
A breathing technique used to maintain resistance in the airway during exhalation to enhance oxygenation, used by COPDers