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Cardiopulmonary Symptoms

Cardiopulmonary Symptoms. Chapter 3. Cardiopulmonary Symptoms. As a Respiratory Therapist you will encounter patients with a variety of symptoms. It is necessary to become familiar with these symptoms and their characteristics in order to ask relevant questions and provide optimal care.

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Cardiopulmonary Symptoms

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  1. Cardiopulmonary Symptoms Chapter 3

  2. Cardiopulmonary Symptoms • As a Respiratory Therapist you will encounter patients with a variety of symptoms. • It is necessary to become familiar with these symptoms and their characteristics in order to ask relevant questions and provide optimal care.

  3. Interviewing the Patient • “connect” with the patient • Social space • Personal space • No two interviews are the same

  4. Guidelines for Effective Patient Interviewing • Project a sense of undivided interest in the patient • Establish your professional role during the introduction • Show your respect for the patient’s beliefs, attitudes, and rights • Use a relaxed, conversational style

  5. Identify and Characterize Symptoms • When did it start? • How severe is it? • Where on the body is it? • What seems to make it better or worse? • Has it occurred before? • Evaluating the symptom over the course of therapy/hospitalization – Has this symptom changed in any way since admission? Does the therapy seem to make a difference?

  6. Cardiopulmonary Symptoms • COUGH • SPUTUM • HEMOPTYSIS • DYSPNEA • CHEST PAIN • SYNCOPE • DEPENDENT EDEMA • FEVER, CHILLS, NIGHT SWEATS • HEADACHE, ALTERED MENTAL STATUS • SNORING

  7. Cough Produced by: Three phases Inspiratory Compression expiratory • Inflammatory • Mechanical • Chemical • Thermal • Tactile (ear canal) stimulation

  8. Effectiveness of a Cough • Effectiveness is determined by: • The depth of inspiration • Amount of pressure that can be generated in the airways • Effectiveness is reduces when: • Weakness of either the inspiratory or expiratory muscles • Inability of the glottis to open or close • Obstruction, collapsibility or alteration in shape or contours of the airway • Decrease in lung recoil (emphysema) • Abnormal quantity or quality of mucus production

  9. Cough • Acute • Chronic • Paroxysmal • Effective • Inadequate • Productive • Dry • Barking • Brassy/hoarse • Inspiratory stridor • Wheezy • Chronic productive • Hacking

  10. Sputum • Substance expelled from the tracheobronchial tree, pharynx, mouth, sinuses, and nose • Phlegm strictly refers to the substances expelled from the lungs and tracheobronchial tree

  11. Sputum Description Consistency Sputum Analysis Clear Black Brown Frothy white or pink Sand or small stone Purulent Mucoid Mucopurulent • Thick • Thin • Viscous • Tenacious • frothy

  12. Hemoptysis • Frequent causes • Infrequent causes • Pulmonary • Cardiopumonary • Systemic • Pseudohemoptysis • Streaky hemoptysis • Massive hemoptysis • hematemesis

  13. Dyspnea • Most distressing symptom of respiratory disease • Cardinal symptom of cardiac disease • Subjective experience

  14. Dyspnea Scoring Systems • Visual analog scales • Modified Borg scale • ATS shortness of breath scale • UCSD Shortness of Breath questionnaire

  15. Dyspnea Clinical Types Acute Chronic Progressive Recurrent Paroxysmal Episodic • Physiologic • Restrictive • Obstructive • Cardiac • Circulatory • Chemical • Central • Psychogenic

  16. Paroxysmal nocturnal dyspnea • Orthopnea • Treopnea • Platypnea • Orthodeoxia • Inspiratory • Expiratory

  17. Chest Pain • Cardinal symptom of heart disease • Can also result from musculoskeletal disorders, trauma, drug therapy, indigestion, anxiety • Pulmonary causes involve the chest wall or parietal pleura

  18. Syncope • Vasovagal syncope • Orthostatic hypotension • Carotid sinus syncope • Tussive syncope

  19. Dependent Edema • Peripheral • Bilateral • Unilateral • Pitting

  20. Fever, Chills, and Night Sweats • Fever • Sustained • Remittent • Intermittent • Relapsing • Unknown origin • Chills • rigors • Diaphoresis • Night sweats

  21. Headache • Inadequate oxygenation • Cerebral hypoxia • hypercapnea

  22. Snoring • Concern when accompanied by apnea • Habitual • Occasional

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