Title NCM 112 REVIEWER ✅

several breaths with gradually decreasing tidal volume; cycle repeats itself ● Biot’s Respirations ○ Repeated sequences of deep gasps and apnea THE ASSESSMENT HISTORY (interview) ● Reasons for seeking care ● Present Illness ● Previous Illness ● Family History ● Social History PAST HISTORY ● Smoking history(#1 cause of respiratory problems) ● Environmental or occupational exposure to dusts, fumes, or gases ● Allergic, asthma sinusitis, upper respiratory tract infection CHIEF COMPLAINT A. COUGH ● Sudden, often repetitive, spasmodic contraction of the thoracic cavity, resulting in violent release of air from the lungs ● Usually accompanied by a distinctive sound. ● Action the body takes to get rid of substances that are irritating the air passages CHARACTERISTICS OF COUGH ● DRY AND HACKING - doesn’t produce phlegm ● LOUD AND HARSH ● WHEEZING- constricting the airway ● SEVERE OR CHANGING IN CHARACTER OR W/ POSITION ● LOOSE ● PAINFUL ● CHRONIC, PRODUCTIVE Relationship of cough to time, patient’s position, and to environmental exposure ● Gradually progressive over a period of weeks or months (TB or Bronchogenic CA) ● Worsens when patient is supine (postnasal drip from sinusitis, bronchiectasis) ● Most noticeable on awakening (suppurative lung disease, bronchitis) ● Recent onset of cough (hours/days) (cold, flu, or sinus infection) B. SPUTUM/ PHLEGM ● Secretions that is transferred from the tracheobronchial tree into the oropharynx, from where it may be expelled by coughing or expectoration ● This aqueous solution is produced by the goblet cells and submucosal glands lining the respiratory tract CHARACTERIZE SPUTUM ACCORDING TO: ● Volume ● Color ● Presence of blood (hemoptysis) ● Odor ● Consistency ○ Mucoid sputum- whitish, thin and elastic ○ Purulent more yellowish, viscous and less elastic ○ Mucopurulent sputum- both C. CHEST PAIN ● Use PQRST to assess. HEMOPTYSIS ● Coughing-up or expectoration of blood from the respiratory tract. ● Includes blood clotting or blood streaking of sputum to the bringing-up of massive amounts of frank blood. CONSIDER THE FOLLOWING DETAILS: ● Timing and duration of hemoptysis ● Triggers and pattern ○ Time of day ○ Associated with eating, playing, exercise, or bouts of coughing