1. Introduction (normal, abnormal, primary,  Paradoxical Breathing 10.

adoxical Breathing 10. Vital signs aorta, causing increased pressure within the arterial
secondary) - Is present when a portion of chest wall moves in  Introduce yourself, state the purpose of the system
2. Breath sounds the opposite direction as it should during the breathing encounter and make your patient comfortable - Systole: Contraction of the heart
cycle  Get the temperature by placing the thermometer in - Diastole: Resting phase of the heart
Normal breath sounds the axilla - Note rate, rhythm, and amplitude (strength)
 Vesicular sounds - Soft “rustling” sounds heard 4. Tanner staging - is a sexual maturity rating; female  While waiting for the temperature, get the pulse - Normal : 60 to 100 beats/minute
over most lung tissue breast development is one of the things rated (5 rate of the patient using the radial pulse for 1 - Radial pulse is the most easily accessible
 Bronchovesicular sounds - Heard only over major stages) minute - In cardiovascular emergencies, palpate for femoral or
airways 5. Abdomen  After obtaining the pulse rate, do not remove your carotid pulse.
 Tracheal sounds - Hollow tubular sounds 6. Bell's palsy - condition in which the fingers on the patients pulse yet
Abnormal breath sounds  Observe the patients breathing, count the number Abnormal findings:
 Crackles (rales) muscles on one side of your face of breaths in 1 minute - Irregular pulse rhythm – Bradycardia, Tachycardia
- discontinuous ”pop-like” sounds become weak or paralyzed. It affects  Get the thermometer and record the temperature
- generally heard on inspiration but can be heard on only one side of the face at a time, reading COMMON PULSE POINTS
exhalation also  Then get the blood pressure of your patient.  Apical: at the apex of the heart (most accurate)
 Wheezes causing it to droop or become stiff on  Carotid: between midline and side of neck
- high-pitched continuous musical sounds that side. - give insight into the function of specific organs –  Temporal
- can be heard on both inspiration or exhalation 7. Romberg's test - test used in an exam of especially the heart and lungs – as well as the entire body  Facial
 Rhonchi systems  Brachial: medially in the antecubital space
- low-pitched snoring sound that is continuous neurological function for balance, and - helps observe for trends  Radial: laterally on the anterior wrist
- can be heard on inspiration or exhalation also as a test for drunken driving. - identifies physiologic problems  Femoral: in the groin fold
 Bronchial Breath Sounds 8. Physical tests/ assessment - monitors response to therapy  Popliteal: behind the knee
- same as Tracheal Sounds except heard over lung 9. How to measure blood pressure - blood pressure  Post tibial
parenchyma  It is important that you are relaxed at least a good - pulse rate  Dorsalis pedis
 Stridor - high pitched raspy sound five minutes before taking your BP rate. Sit at a - respirations
- is heard at it’s loudest over the trachea table and let the tabletop support your arm so that it - temperature RESPIRATIONS
- indicates upper airway narrowing is at a height level to your heart.  Normal : 16 to 20 breaths/minute
- heard in such conditions as;  Wrap the cuff securely around your upper arm BODY TEMPERATURE  Determine if breathing is shallow, moderate, deep
- post extubation stenosis (atleast 2 cm from the antecubital crest), make - measured and recorded in Fahrenheit (°F) or Celsius  Observe rhythm and symmetry
- croup in young children sure that it is not too tight so you can still two (°C)  Be aware of the skeletal deformity, broken ribs,
 Pleural Friction Rub fingers between the cuff and the skin. - Normal 37 +/- 0.5 degrees celsius and collapsed lung tissue can cause unequal chest
- occurs when pleural surfaces rub together  Locate the brachial artery and place over it the expansion
- seen in some pneumonias effecting pleural stethoscope, inflate the cuff until you no longer Abnormal findings:
surfaces hear a pulse. That means blood has already been Hyperthermia Abnormal findings:
 Egophony - e to a changes cut off from the blood vessels found in your upper Hypothermia  Prolonged expiration suggesting narrowing in
- first section heard is the normal e sound arm. Continue inflating the cuff a little bit more. bronchioles
- second sound heard is the example of egophony:  Slowly release the air in by turning the valve on the Routes for taking temperatures  Sounds: wheezing or stridor
letter “e” heard as “a” rubber hand bulb and listen to a swooshing or - Oral  Apnea: no breathing
pounding sound. The pressure at the time the first - Most accessible and accurate  Bradypnea: abnormally slow
3. Breathing patterns sound occurs indicates your heart’s systolic blood - Do not use if unconscious, confused, recent oral  Tachypnea: abnormally fast
 Cheyne-Stokes Breathing pressure, or the pressure it exerts when pumping or facial operation
- Irregular patterns of deep breathing followed by out blood to the arteries. - Rectal MECHANICS OF VENTILATION
periods of shallow breathing; usually ending with a  Continue releasing the air from the cuff. When the - 99 F - Inspiration
period of apnea sound stops, the pressure indicates your heart’s - Accurate but uncomfortable - Drawing air into the lung
 Biot’s Breathing diastolic pressure, or the pressure it exerts in - Avoid if patient has problems with GI - Involves the ribs, diaphragm
- Irregular patterns of breathing; usually very between heartbeats. This is the lowest blood - Axillary - Creates negative pressure-allows air into lung
disorganzied. May be periods of apnea pressure level your heart exerts. - 97 F—least accurate, most safe - Expiration
 Kussmaul’s Breathing - Rapid & deep breathing  Repeat the process and measure your blood - Tympanic - Relaxation of the thoracic muscles and diaphragm
 Apneustic Pattern pressure two more times, with a rest time of two - 98 F—avoid with infection, after exercise, with causing air to be expelled
- Prolonged inspirations; serial inspirations w/o minutes in between each. This ensures that you hearing aid
exhalation after each followed by “summative” have a more or less accurate reading. If the BLOOD PRESSURE
exhalation differences in the readings are more than 5mmHg, PULSE - Evaluates cardiac output, fluid and circulatory status,
 Asthmatic Pattern - Excessively long expiratory you should take the average of the three readings. - Reflects amount of blood ejected with each heartbeat and arterial resistance
periods - Each contraction forces blood into the already filled - Normal systolic pressure & diastolic pressure
  SH - Social History
Abnormal findings:  FH - Family history
- Hypertension: may be caused by anxiety  ROS - review of systems
- Cardiac disease: difference of 15 mm Hg or more  PE - physical examination
between arms  SOAP - Subjective, objective, assessment, plan
- Orthostatic hypotension: drop of 20 mm Hg or more  ABCDE - asymmetry, irregular borders, more than
from sitting to standing position one or uneven distribution of color, a large
- Venous congestion or hypertension: silent period diameter, evolution of your moles
(auscultatory gap) between systolic and diastolic sounds  ICS - Intercostal spaces
 PMI - Point of maximal impulse
11. Percussion lungs  AST, Aspartate aminotransferase;
12. Consolidated lungs  CK-MB, creatine kinase containing M and B
13. Matching type: subunits;
a) Lab test  LDH-1, lactate dehydrogenase.
b) Diagnostic tests  CRP - C-reactive protein
c) Gram staining  TG - triglycerides
14. ABO typing - The antigenic properties of blood are  ECG - Electrocardiogram
analyzed to avoid potentially lethal transfusion  VMA - Vanillylmandelic acid
reactions. Blood types include A, B, AB, and O.  GTT - glucose tolerance test
15. Clotting factors  TRH - Thyrotropin-releasing hormone
16. CBC (Complete blood count) - consists of the  T3U - Triiodothyronine uptake
hemoglobin, hematocrit, RBC count, WBC count,  PT - prothrombin time
mean cell volume, mean corpuscular hemoglobin,  aPTT - activated partial thromboplastin time
and mean corpuscular hemoglobin concentration.  ALT - Alanine aminotransferase
17. Crossmatching - determines compatibility between  AST - Aspartate aminotransferase
donor and recipient blood. Agglutination between  CEA - carcinoembryonic antigen
the donor’s RBCs and the recipient’s serum  BUN - Blood urea nitrogen
indicates incompatibility.  ABG - arterial blood gas
18. Hematocrit  PEF, PEFR - Peak expiratory flow rate
- the percentage of the volume of blood occupied by  RV- Residual volume
RBCs. Reference ranges vary with age, gender, and  ESR - Erythrocyte sedimentation rate
elevation above sea level.  MRI - Magnetic resonance imaging
- increased in vitamin B12 and folic acid deficiencies
and is decreased in iron deficiency. 25. CT scan (computed tomography) - uses a
19. Hemoglobin - the oxygen-carrying RBC protein. computerized x-ray system to produce detailed
Reference ranges vary with age, gender, and sectional x-ray images. The system is very
elevation above sea level. Hemoglobin is decreased sensitive to differences in tissue density and
in blood loss and iron deficiency anemia. produces detailed two-dimensional planar images;
20. Acid staining the use of contrast agents increases attenuation. In
21. Cold agglutinins - are antibodies that bind to the spiral or helical CT scanning pictures are taken
surface of RBCs and agglutinate (clump) when the continuously, which decreases the time needed to
blood sample is cooled. About 50% of patients obtain images.
with Mycoplasma pneumoniae infections have
high cold agglutinin titers.
22. Culture and sensitivity - Cultures of body fluids
and tissues identify specific infecting organisms. In
vitro testing is used to determine antibiotic
susceptibilities.
23. Sensory motor function

24. abbreviations (MCM)