1. Living Will
    Describes treatment patient would want if he becomes terminally ill (less than 6 mos to live)
  2. Durable Power of Attorney (for Health Care)
    Legal document that names a health care proxy responsible for making health care decisions for the patient
  3. Normal Urine Output
    40 ml/hr (1 liter/day)
  4. If fluid intake exceeds fluid output, this could result in...
    • Weight Gain
    • Electrolyte Imbalance
    • Increased Hemodynamic Pressures
    • Decreased Lung Compliance
  5. Alert/Responsive
  6. Lethargic/Somnolent
    • COPD O2 overdose
    • Sleep apnea
  7. Stuporous/Confused
    Responds inappropriately (intoxication, drug overdose)
  8. Semi-comatose
    Responds only to painful stimuli
  9. Coma
    Does not respond...even to painful stimuli
  10. Obtunded
    Drowsy state...may have decreased cough or gag reflex
  11. Activities of Daily Living (ADL)
    • Eating
    • Dressing
    • Walking
    • Bathing
    • Grooming
    • Toilet Use
  12. Assess ADL to determine
    • Nursing home admission
    • Need for home health care providers
    • Living arrangements
    • Use of hospital services
    • Insurance Coverage
    • Mortality
  13. Orthopnea
    • Difficulty breathing except in the upright position
    • (Heart problem, CHF)
  14. Dyspnea
    A feeling of shortness of breath or difficulty in breathing
  15. Five Grades of Dyspnea
    • I Normal dyspnea occurs after unusual exertion
    • II Breathless after going up hills or stairs
    • III Dyspnea while walking at normal speed
    • IV Dyspnead slowly walking short distances
    • V Dyspnea at rest, shaving, dressing, etc
  16. Dysphagia
    Difficulty swallowing
  17. Work of Breathing (WOB)
    During normal breathing inhalation is active and exhalation is passive. Forced exhalation requires work from the muscles of expiration
  18. Work of Breathing Equation
    Pressure x Volume (measured with a manometer or spirometer)
  19. Exercise Tolerance Test (ETT) or Stress Test
    A diagnostic exam used to evaluate the ability of heart and lungs to provide oxygen and remove carbon dioxide from the bloodstream
  20. Peripheral Edema
    • Presence of excessive fluid in the tissue know as "pitting edema"
    • Occurs primarily in the arms and ankles
    • Caused by CHF or renal failure
  21. Clubbing of fingers...cause?
    Chronic hypoxemia
  22. Diaphoresis
    A state of profuse, heavy sweating
  23. Skin Color
    • Normal: pink, tan, brown, black
    • Abnormal: decrease in color due to anemia or acute blood loss
    • Jaundice: increase in bilirubin in blood and tissue (face & trunk)
    • Erythema: redness of the skin (capillary congestion, inflammation)
    • Cyanosis: Blue/blue-gray discoloration of skin/mucous membranes
  24. Pectus Carinatum
    Anterior protrusion of the sternum..."pigeon chest"
  25. Pectus Excavatum
    Depression of the sternum (part or all)
  26. Kyphosis
    Convex spinal curve (hunchback)
  27. Scoliosis
    Lateral curvature of the spine
  28. Kyphoscoliosis
    A combination of both and causes a severe restrictive impairment
  29. "Barrel Chest"
    A result of air trapping in the lungs for a long period of time (COPD)
  30. Eupnea
    Normal respiratory rate, depth and rhythm
  31. Tachypnea
    • Increased respiratory rate (over 20/min)
    • Causes: fever, hypoxia, pain, CNS problem
  32. Bradypnea (Oligopnea)
    • Decreased respiratory rate (less than 8/min), variable depth and irregular rhythm
    • Causes: sleep, drugs, alcohol, and metabolic disorders
  33. Apnea
    Cessation of breathing
  34. Hyperpnea
    • Increased respiratory rate, increased depth and regular rhythm
    • Causes: Metabolic disorder/CNS disorder
  35. Cheyne-Stokes
    • Gradually increasing then decreasing rate and depth in a cycle lasting from 30-180 seconds, with periods of apnea lasting up to 60 seconds
    • Causes: Increased ICP, meningitis, and drug overdose
  36. Biots
    • Increased respiratory rate and depth with irregular periods of apnea (each breath has the same depth)
    • Causes: CNS problem
  37. Kussmaul's
    • Increased respiratory rate (usually over 20/min), increased depth, irregular rhythm, labored breathing sounds
    • Causes: Metabolic acidosis, renal failure, diabetic ketoacidosis
  38. Apneustic
    • Prolonged gasping inspiration followed by extremely short insufficient expiration
    • Causes: Respiratory center problem, trauma, or tumor
  39. Symmetrical Chest Movement
    Both sides of the chest move at the same time
  40. Causes of Unequal/Assymetrical Chest Movement
    • Chronic lung disease
    • Atelectasis
    • Pneumothorax
    • Flail Chest (paradoxical)
    • Intubated patient with ET tube in one lung
Card Set