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98 Cards in this Set
- Front
- Back
The clavicles extend from the acromion of the scapula to the part of the sternum termed the _________________
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Manubrium
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The bony ridge located at the point where the manubrium articulates with the body of the sternum is termed the sternal
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Notch
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The spinous process termed the vertebra prominence is in which cervical vertebra?
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7th
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The apex of each lung is located at the ____________
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Area slightly above the clavicle
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The thin double layer of serous membrane that lines the chest cavity is termed _____________
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Parietal pleura
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The lining of the trachea and bronchi which serves to remove dust foreign bodies and bacteria is termed the ________
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Cilia
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Under normal circumstances the strongest stimulus in the human being to breathe is _____________
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Hypercapnia
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When assessing an adult client the client tells the nurse that she has difficulty catching her breath since yesterday the nurse should assess the client for further signs and symptoms of _____________
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Infection
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An adult client visists the clinic and tells the nurse that he has been sitting up rust colored sputum the nurse should refer the client to the physician for possible ______________
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Tuberculosis
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While assessing an adult client the nurse observes decreased chest expansion at the bases of the clients lungs the nurse should refer the client to a physician for possible _____________
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Chronic obstructive pulmonary disease
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The nurse is planning the percuss the chest of an adult male client for diaphragmatic excursion. The nurse should begin the assessment by?
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Asking the client to exhale forcefully and hold his breath.
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The nurse is preparing to auscultate the posterior thorax of and adult female client. The nurse should?
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Ask the client to breathe deeply through her mouth.
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While assessing the thoracic area of an adult client the nurse plans to auscultate for voice sounds to asses the bronchophony the nurse should ask the client to ?
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Repeat the phrase 99
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The nurse assesses an adult clients thoracic area and observes a markedly sunken sternum and adjacent cartilages. The nurse should document the clients?
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Pectus excavatum
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The nurse assess an adult client and observes that the clients breathing patteren is very labored and noisy with occasional coughing. The nurse should refer the client to a physician for possible?
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Chronic bronchitis
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While assessing and adults clients lungs during the postoperative period the nurse detects coarse crackles. The nurse should refer the client to a physician for possible?
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Pneumonia
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The nurse assesses an adults patients breath sounds and hears sonorous wheezes primarily during the clients expiration. The nurse should refer the client to a physician for possible?
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bronchitis
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The nurse has assed the respiratory pattern of an adult client. The nurse determines that the clients is exhibiting Kussmauls respirations with hyperventilation. The nurse should contact the clients physician because this type of respiratory pattern usually indicates ?
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Diabetic ketoacidosis
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High pitched short popping sounds
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Crackles (fine)
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Forward protrusion of the sternum
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Pectus carinatum
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High pitched musical sounds
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Wheeze (sibilant)
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An increased in carbon dioxide in the blood
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Promotes the strongest stimulus to breathe
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Low pitched bubbling moist sounds
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Crackles (coarse)
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Low pitched snoring or moaning sounds
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Wheeze (sonorous)
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Difficulty breathing when lying supine
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orthopnea
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Markedly sunken sternum and adjacent cartilage
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pectus excavatum
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Low pitched dry grating sound
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Pleural friction rub
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A crackling sensation
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crepitus
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___________ identifies the portion of the body extending from the base of the neck superiorly to the level of the diaphragm inferiorly.
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Thorax
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The lungs, distal portion of the trachea and the bronchi are located in the thorax and make up the ________________ system
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Lower respiratory system
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The _________ is constructed of the sternum, 12 pairs of ribs, 12 thoracic vertebrae, muscles and cartilage.
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Thoracic cage
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What is the function of the thoracic cage?
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It provides support and protection for many important organs.
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The ______________ aka breast bone lies in the center of the chest anteriorly and is divided into three parts.
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Sternum
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What are the three parts of the Sternum?
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Manubrium
Body of the sternum Xiphoid process |
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This is the U shaped indention located on the superior border of the manubrium
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Suprasternal notch
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A few centimeters below the suprasternal notch, a bony ridge can be palpated at the point where the manubrium articulates with the body of the sternum. This landmark is referred to a the __________
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Sternal angle
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The sternal angle is also known as the ________________
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Angle of louis
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The angle of Louis or sternal angle is also the location of the second pair of ribs and comes a reference point to count the spaces in-between the ribs known as_____________
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Intercostal spaces (The yummy part of BBQ ribs)
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How many pairs of ribs make up the main structure of the thoracic cage? Anterior and posterior
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10 Anterior ribs all connected to the sternum and vertebra
Posterior all 10 from front plus to more sets of floating ribs. For a total of 12 sets of ribs. |
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The first set of ribs is located?
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They curl up just under the clavicles, and only a small part can be palpable.
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The second pair of ribs is located?
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Adjacent to the sternal angle.
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Explain how to find rib sets 2-6, 7-10, and 11and 12.
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Set 2-6 located easy to count anteriorly and rib six is almost in line with the xiphoid process.
Ribs 7-10 connects to cartilages to the pair lying superior to them rather than to the sternum. Ribs 11 and 12 are floating ribs because they do not connect to either the sternum or the ribs anteriorly. |
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On the anterior chest these lines are known as ________ _______ and ___________
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Midsternal line and the right and left midclavicular lines
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The posterior thorax includes the ____________, ___________ and _________
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Vertebral or spinal line and the right and left scapular lines.
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The ___________ runs from the apex of the axillae to the level of the 12 rib.
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Midaxillary line
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What does the thoracic cavity consist of?
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Mediastinum and the lungs
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The _______ of each lungs extends slightly above the clavical
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Apex
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The base of the lungs are at the level of the _____________
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Diaphragm
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Lines that divide the lungs into lobes called ___________
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Fissures
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The right lung is made up ____________ lobes where as the left lung contains _____________ lobes.
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Right 3 lobes Left 2 lobes
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The thoracic cavity is lined by a thin double layered serous membrane collectively referred to as the _________
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Pleura
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The __________ pleura lines the chest cavity and the _______ pleura cover the external surface of the lungs.
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Parietal pleura and the visceral pleura
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The space between the two layers is known as __________
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Pleural space
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The pleural space is fluid with this lubricating fluid
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Serous fluid
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This is the flexible structure that lies anterior to the esophagus begins a the level of the cricoid cartilage in the neck. In adults it is around 10 to 12 cm long.
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Trachea
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These are C shaped rings that make up the cartilage of the trachea.
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Hyaline cartilage
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What is the function fo Hyaline cartilage?
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To help maintain shape and prevent the trachea from collapsing during respiration.
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At this level of the sternal angle the trachea divides into the left and right main _____________
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Bronchi
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The __________ main bronchus is shorter and more vertical than the __________ main bronchus
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Right is shorter than the left
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The trachea and the bronchi are lined with a mucous membrane containing _____________
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Cilia
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What is the function of cilia?
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Hair like projections that help sweep dust and foreign bodies and bacteria that have been trapped by the mucus toward the mouth for removal.
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Bronchi divided into smaller passage ways known as ___________
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Bronchioles
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Bronchioles split into break further down into this __________
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Alveolar ducts
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These are the little sacs located a the end of the alveolar ducts
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Alveolar sacs
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What is the function of alveolar sacs?
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Serve it increase surface area available for gas exchange
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When the alveolar sacs have collapsed it is known as ___________.
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Atelectasis
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____________ is difficulty breathing and can indicate a number of health problems most of which are related to the respiratory system
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Dyspnea
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Periods of breathing cessation during sleep
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Sleep apnea
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True or false
Pain sensitive nerve ending are located int eh parietal pleura thoracic muscles and tracheobronchial tree but not in the lungs. |
True
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True or false
Chest pain related to pleuritis may be absent in older adults due to age related alteration of pain perception. |
True
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____________ coughs are usually associated with acute infections.
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Continuous
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Early morning coughing is associated with ________________
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Chronic bronchial inflammation or smoking.
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Late evening coughing may be due to ____________
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exposure of irritants during the day.
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Night coughing is related to ____________ most of the time
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postnasal drip or sinusitis
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True or false
The ability to cough effectively may be decreased in the older client because of weaker muscles and increased rigidity of the thoracic wall |
True
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True or false
Nonproductive coughs are often associated with upper respiratory irritations and early congestive heart failure. |
True
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White or __________ sputum is often seen with common colds viral infections or bronchitis
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Mucoid
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Yellow or green sputum indicates?
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Bacterial infections
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Blood in the sputum is known as ___________
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hemophtysis
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Rust colored sputum indicates?
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Tuberculosis or pneumococcal pneumonia
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____________ indicates narrowing of the airways due to spasm or obstruction of the air way and is associated with CHF asthma,or excessive secretions
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Wheezing
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True or false
Asthma symptoms may mimic symptoms commonly associated with emphysema or heart failure. |
True
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What is SARS and who is at higher risk for it
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Severe Acute Respiratory Syndrome. Anyone traveling to mainland China, Hong Kong, Hanoi, Vietnam, Singapore, or Toronto Canada.
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This is caused by histoplasmosis a systemic fungal disease that is common in the rural midwestern US
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Histoplasma capsulatum
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Can SOB be manifested by stress?
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Yes
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_____________ is seen when labored respiration and is indicative of hypoxia
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Nasal flaring
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________ lip breathing may be seen in asthma and emphysema or CHF as a physiologic response to help slow down expiration and keep the alveoli open longer.
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Pursed lip breathing
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_____________ is a increased curve of the thoracic spine and is common in older adults
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Kyphosis
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True or false
Pale or cyanotic nails may indicate hypoxia |
True
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The ____________ muscles are used to facilitate inspiration increases of acute and chronic airway obstruction.
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Trapezius or shoulder
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When a client leans forward and uses arms to support weight and lift chest to increase breathing capacity this is known as _____________
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Tripod position often seen in COPD patients
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12 to 20 Respirations per min.
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Normal breathing pattern
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Patient is running a fever of 102, is anxious, and respirations are 24 breaths per min what kind of breathing pattern is this?
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Tachypnea
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Patient enters the ER and is supected of an drug over dose. Respirations are 10 breaths per min. What Breathing pattern is this?
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Bradypnea
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What are Kussmauls respirations?
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Hyperventilation associated with diabetic ketoacidosis, or CNS problems, or drug overdose.
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These respirations are at a decreased rate, depth, and of irregular pattern
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Hyporventilation. Usually the result of a narcotics or anesthetics overdose.
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This breathing pattern is regular caharacterized by alternating period of deep rapid breathing followed by periods of apnea. (typically see this when someone is about to code)
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Cheyne stokes respirations
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Irregular breathing pattern characterized by varying depth and rate of respirations followed by periods of apnea. Seen with meningitis or severe brain damage
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Biots respirations.
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