Week 4: Respiratory Assessment
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What are the symptoms of respiratory failure type 1?
• hypoxaemia • low inspired O2 • alveolar hypoventilation • diffusion impairment • shunt
What are the causes of respiratory failure type 1?
• pulmonary oedema • pneumonia • asthma • COPD • pulmonary embolism • acute respiratory distress syndrome
What are the symptoms of respiratory failure type 2?
• hypercapnia • central neurological injury • neuromuscular dysfunction • abnormalities of the chest wall, airway or lungs
What are potential causes of respiratory failure type 2?
• COPD • severe asthma • muscle weakness e.g. Gillian barre syndrome • respiratory centre depression
What is a pulmonary oedema?
A pathophysiological condition where there is fluid in and around alveoli, interfering with gas exchange, increasing the work of breathing
What are the two types of pulmonary oedema?
• cardiogenic (high pressure) • non-cardiogenic (high permeability)
Define what a clinical assessment is
Clinical assessment is a way of diagnosing and planning treatment for a patient that involves evaluating someone in order to figure out what is wrong
What is the structure of a respiratory assessment?
• introduction • clinical history • general impression • examination of hands • examination of the thorax • palpation • percussion • auscultation
What are you looking for when examining the hands?
• temperature • palpate radial pulse • assess respiratory rate • fine tremor • flapping tremor • cap refill
What are you looking for when examining the face?
• central cyanosis • plethoric complexion • eyes • pursed lip in expiration • signs of dehydration
What are you looking at when inspecting the thorax?
• scars, small mid-axillary • horizontal lateral scars • skin changes • asymmetry • deformities • hyper expansion (barrel chest)
What are you looking for when performing percussion?
• resonant normal findings • hypo resonant-consolidation • hyper resonant pnuemothorax
What are you looking for when palpitating?
• tracheal position • chest expansion • expansion
What are you assessing the quality of in auscultation?
• vesicular (normal) • bronchial (harsh sounding associated with consolidation) • the volume of sounds • quiet breath sounds- reduced air entry/consolidation
What can a wheeze usually suggest?
asthma/COPD
What can course crackles usually suggest?
Pneumonia/bronchiectasis/fluids overload
What do fine crackles usually suggest?
Pulmonary fibrosis
How would you assess for oedema and DVT?
• examine the sacrum for oedema • examine leg for pitting oedema and assess the calves for signs of DVT