patient assessment competencies

evaluation of the level of consciousness

exhibits slight decrease in consciousness, has slow mental responses, decreased or dulled perception, incoherent thoughts

easily agitated, irritable, experiences hallucinations

sleepy, arouses easily, responds appropriately when aroused

awakens only with difficulty, responds appropriately when aroused

does not awaken completely, has decreased mental and physical activity, responds to pain and exhibits deep tendon reflexes and responds slowly to verbal stimuli

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

no breathing

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

prolonged inhalation

part or all of the chest wall moves in with inhalation and out with exhalation

shivering to generate heat and vasoconstriction to conserve heat

vasodilation to increase perfusion

decrease of 15-20mmHg of BP during spontaneous inhalation

peak force exerted in teh arteries during contraction of the left ventricle

the force remaining in the arteries after relaxation of the left ventricle

difference between systolic and diastolic pressures with a normal range between 35-40 mmHg

interaction of the force of the left ventricle contraction, the systemic vascular resistance, and blood volume

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)

Indicates a significant drop in intrapleural pressure caused by increase work of breathing due to decreased compliance or increased airway resistance

intermittent sinking inward of the skin overlying the chest wall during inspiration. Can be intercostal, supraclavicular, subcostal or substernal

When the abdomen sinks inward during inspiration due to a fatigued diaphragm

lung sound associated with rapid airflow through obstructed upper airways

vasoconstriction to incease blood flow resistance through the pulmonary vasculature which increases pulmonary workload

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

crackling resulting from atelectasis, fibrosis, and pulmonary edema

pleural spaces filled with fluid, such as blood or water (consolidated alveolus)

air blocking due to inflammation or mucus plugging

when heard over peripheral lung regions and lung has increased tissue density

hyperinflation that can result from acute or chronic bronchial obstruction such as asthma or emphysema

shallow breathing

A breathing technique used to maintain resistance in the airway during exhalation to enhance oxygenation, used by COPDers