Diagnostic Tests for Neonatal Respiratory Distress Syndrome
Neonatal Respiratory Distress Syndrome Tests: Book Excerpts
Home Diagnostic Testing
These home medical tests may be relevant to Neonatal Respiratory Distress Syndrome:
- Child Behavior: Home Testing
- Child General Health: Home Testing
- Mental Health (Adults): Home Testing
- Lung & Respiratory Health Tests:
- Cold & Flu: Home Testing:
- Menopause: Related Home Testing:
- Vaginal Health: Home Testing:
- Breast Cancer: Related Home Tests:
- Mental Health: Home Testing:
- Brain & Neurological Disorders: Related Home Testing:
Neonatal Respiratory Distress Syndrome Diagnosis: Book Excerpts
Diagnosis of Neonatal Respiratory Distress Syndrome: medical news summaries:
The following medical news items
are relevant to diagnosis of Neonatal Respiratory Distress Syndrome:
Diagnostic Tests for Neonatal Respiratory Distress Syndrome: Online Medical Books
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Review excerpts from medical books online, free, without registration,
for more information about the diagnostic tests for Neonatal Respiratory Distress Syndrome.
Accessory muscle use:
History and physical examination
(Handbook of Signs & Symptoms (Third Edition))
If the patient’s condition allows, examine him more closely. Ask him about the onset, duration, and severity of associated signs and symptoms, such as dyspnea, chest pain, cough, or fever.
Explore his medical history, focusing on respiratory disorders, such as infection or COPD. Ask about cardiac disorders, such as heart failure, which may lead to pulmonary edema; also inquire about neuromuscular disorders, such as amyotrophic lateral sclerosis, which may affect respiratory muscle function. Note a history of allergies or asthma. Because collagen vascular diseases can cause diffuse infiltrative lung disease, ask about such conditions as rheumatoid arthritis and lupus erythematosus.
Ask about recent trauma, especially to the spine or chest. Find out if the patient has recently undergone pulmonary function tests or received respiratory therapy. Ask about smoking and occupational exposure to chemical fumes or mineral dusts such as asbestos. Explore the family history for such disorders as cystic fibrosis and neurofibromatosis, which can cause diffuse infiltrative lung disease.
Perform a detailed chest examination, noting an abnormal respiratory rate, pattern, or depth. Assess the color, temperature, and turgor of the patient’s skin, and check for clubbing.
» READ BOOK EXCERPT ONLINE »
Source: Handbook of Signs & Symptoms (Third Edition), 2006
Accessory muscle use:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
If the patient’s condition allows, examine him more closely. Ask him about the onset, duration, and severity of associated signs and symptoms, such as dyspnea, chest pain, cough, and fever.
Explore his medical history, focusing on respiratory disorders, such as infection or COPD. Ask about cardiac disorders, such as heart failure, which may lead to pulmonary edema; also inquire about neuromuscular disorders, such as amyotrophic lateral sclerosis, which may affect respiratory muscle function. Note a history of allergies or asthma. Because collagen vascular diseases can cause diffuse infiltrative lung disease, ask about such conditions as rheumatoid arthritis and lupus erythematosus.
Ask about recent trauma, especially to the spine or chest. Find out if the patient has recently undergone pulmonary function tests or received respiratory therapy. Ask about smoking and about occupational exposure to chemical fumes or mineral dusts such as asbestos. Explore the family history for such disorders as cystic fibrosis and neurofibromatosis, which can cause diffuse infiltrative lung disease.
Perform a detailed chest examination, noting abnormal respiratory rate, pattern, or depth. Assess the color, temperature, and turgor of the patient’s skin, and check for clubbing. (See Accessory muscle use: Causes and associated findings, page 30.)
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Respirations, grunting:
History and physical examination
(Professional Guide to Signs & Symptoms (Fifth Edition))
After addressing the child’s respiratory status, ask his parents when the grunting respirations began. If the patient is a premature infant, find out his gestational age. Ask the parents if anyone in the home has recently had an upper respiratory tract infection. Has the child had signs and symptoms of such an infection, such as a runny nose, cough, low-grade fever, or anorexia? Does he have a history of frequent colds or upper respiratory tract infections? Does he have a history of respiratory syncytial virus? Ask the parents to describe changes in the child’s activity level or feeding pattern to determine if the child is lethargic or less alert than usual.
Begin the physical examination by auscultating the lungs, especially the lower lobes. Note diminished or abnormal sounds, such as crackles or sibilant rhonchi, which may indicate mucus or fluid buildup. Characterize the color, amount, and consistency of any discharge or sputum. Note the characteristics of the cough, if any.
» READ BOOK EXCERPT ONLINE »
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
Epigastric Distress:
Physical examination
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
A. General assessment. Obtain vital signs. Is the patient febrile—indicating an infectious cause? Tachycardia and hypotension can indicate dehydration or GI bleed. Is the patient in acute distress? Jaundiced?
B. Cardiopulmonary assessment. Evaluate the heart and lungs to rule out any cardiac or pulmonic process that could present with epigastric distress. Is there evidence of an arrhythmia, myocardial infarction, or congestive heart failure? Are there crackles or rales suggesting a pneumonia?
C. Abdominal examination. Are bowel sounds present? Decreased or absent bowel sounds can indicate a small bowel obstruction, acute surgical abdomen (appendicitis, perforated ulcer), or pancreatitis. Rebound tenderness should prompt consideration of an acute surgical abdomen. The right upper quadrant (RUQ) should be palpated. A palpable liver warrants evaluation for other signs of liver disease—jaundice, ascites, skin changes. Murphy’s sign—sudden cessation of the patient’s inspiratory effort during deep palpation of the RUQ—is suggestive of acute cholecystitis (3). Tenderness to palpation of the left upper quadrant can indicate splenic infarct such as seen with sickle cell disease. Tenderness of the midepigastric area can represent peptic ulcer disease, dyspepsia, “nonclassical” presentation of acute appendicitis, or any other of the above-mentioned conditions. A rectal examination with testing for occult blood should be a part of the examination, particularly with any concern about GI bleeding (Chapter 9.7).
Testing
A. Clinical laboratory tests. Laboratory tests should be directed by the history and physical examination. A complete blood count is indicated if signs are seen of infection or bleeding. An elevated white blood cell count is consistent with appendicitis or pneumonia. A decreased hemoglobin or hematocrit warrants further evaluation for GI bleed. Other laboratory tests that might be indicated by the history and physical examination include liver function tests (hepatitis, gallbladder disease), amylase and lipase (pancreatitis—although no single laboratory test is diagnostic for pancreatitis), creatine kinase-MB (CK-MB), and/or troponin (cardiac pathology). Laboratory testing for Helicobacter pylori is controversial except for those with documented PUD. Keep in mind that of patients who have PUD, 90% are infected with H. pylori and only 10% to 20% of patients infected with H. pylori develop PUD (4).
B. Diagnostic imaging. Plain film x-ray studies are helpful only if bowel obstruction or perforation is suspected. RUQ ultrasound is warranted if gallbladder disease or pancreatitis is suspected. Computed tomography scan of the abdomen could be considered in cases of difficulty in differentiating acute abdominal pain or when needed to evaluate for possible complications. Barium studies are not indicated in the acute setting, but can be helpful in the diagnostic workup for gastric ulcer, GERD, and esophagitis.
C. Endoscopy. Esophagogastrodoudenoscopy in the setting of an upper GI bleed may help to identify the source of the bleeding, assuming the patient is sufficiently stable to tolerate the procedure (Chapter 9.7). The diagnoses of PUD, gastritis, and esophagitis are best made using endoscopy, which also allows evaluation for the presence of H. pylori (5).
D. Other tests. Other tests useful in the evaluation of epigastric distress include an electrocardiogram to assess for possible cardiac disease and chest radiographs and a pulmonary function test to evaluate for possible pulmonary disease.
Diagnostic assessment
The key to the successful approach to a patient presenting with epigastric distress begins with a careful history. If the distress is of acute onset, a more urgent and directed evaluation is needed. Vital signs and physical examination should be directed to evaluate for fever (infection), hypotension (GI bleed), and non-GI causes (MI, ruptured aneurysm). Epigastric distress of a chronic nature can be evaluated using history, directed laboratory testing, and diagnostic imaging.
References
1. Scott M, Gelhot AR. Gastroesophageal reflux disease: diagnosis and management. Am Fam Physician 1999;59(5):1161–1169.
2. Isselbacher KJ, Podolsky DK. Approach to the patient with gastrointestinal disease. In: Fauci AS, ed. Harrison’s principles of internal medicine. New York: McGraw-Hill, 1998:1579–1583.
3. Swartz MH. Textbook of physical diagnosis, history and examination. Philadelphia: WB Saunders, 1994:324.
4. NIH Consensus Conference. Helicobacter pylori in peptic ulcer disease. JAMA 1994;
272(1):65–69.
5. Rank JM, Vennes JA. Gastrointestinal endoscopy. In: Bennet JC, Plum F, eds. Cecil textbook of medicine. Philadelphia: WB Saunders, 1996:636–642.
» READ BOOK EXCERPT ONLINE »
Source: The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter, 2000
Accessory muscle use:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Perform a detailed chest assessment, noting abnormal respiratory rate, pattern, or depth. Assess the color, temperature, and turgor of the patient’s skin, and check for clubbing.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Respirations, grunting:
Physical assessment
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Begin the physical examination by auscultating the lungs, especially the lower lobes. Note diminished or abnormal sounds, such as crackles or sibilant rhonchi, which may indicate mucus or fluid buildup. Also, characterize the color, amount, and consistency of any discharge or sputum. Note the characteristics of the cough, if any.
» READ BOOK EXCERPT ONLINE »
Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007
Respiratory Distress and Apnea:
Diagnostic Approach: Respiratory Distress
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
In preterminfants, most common cause of respiratory distress is respiratorydistress syndrome. In term infants, transient tachypnea, meconiumaspiration, pneumonia, and pneumothorax are most common lower respiratorytract disorders causing respiratory distress. Other nonpulmonarycauses of respiratory distress in neonates are congenital heartdisease, persistent fetal circulation, and septicemia. In infancyand childhood, most common causes of respiratory distress are bronchiolitis,croup, asthma, pneumonia, foreign body aspiration, and congenitalor acquired heart disease with cardiac failure.History and physical exam suggest mostlikely cause for respiratory distress. Oxygen saturation in roomair indicates degree of hypoxemia. Certain tests should be considereddepending on clinical circumstances:Airway radiography or endoscopy for upperairway obstructionChest radiography for lower respiratorydisorders or cardiac diseaseCBC for anemiaSerum electrolytes and creatinine;blood urea nitrogen; and venous/capillary pH for metabolicacidosisECG and 2-D echocardiography for cardiacfailureChest CT for any airway, lung, or mediastinal mass
» READ BOOK EXCERPT ONLINE »
Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006
Accessory muscle use:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
If the patient's condition allows, examine him more closely. Ask him about the onset, duration, and severity of associated signs and symptoms, such as dyspnea, chest pain, cough, sputum production, or fever.
Explore his medical history, focusing on respiratory disorders, such as infection or COPD. Ask about cardiac disorders, such as heart failure, which may lead to pulmonary edema; inquire about neuromuscular disorders, such as amyotrophic lateral sclerosis, which may affect respiratory muscle function. Note a history of allergies or asthma. Because collagen vascular diseases can cause diffuse infiltrative lung disease, ask about such conditions as rheumatoid arthritis and lupus erythematosus.
Ask about recent trauma, especially to the spine or chest. Find out if the patient has recently undergone pulmonary function tests or received respiratory therapy. Ask about smoking and occupational exposure to chemical fumes or mineral dusts such as asbestos. Explore the family history for such disorders as cystic fibrosis and neurofibromatosis, which can cause diffuse infiltrative lung disease.
Perform a detailed chest examination, noting an abnormal respiratory rate, pattern, or depth. Assess the patient's chest for equal expansion during inspiration. Check the trachea for midline position. Assess the color, temperature, and turgor of the patient's skin, and check for clubbing. Auscultate the lungs for adventitious breath sounds.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
Respirations, grunting:
History and physical examination
(Nursing: Interpreting Signs and Symptoms)
After addressing the child's respiratory status, ask his parents when the grunting respirations began. If the patient is a premature infant, find out his gestational age. Ask the parents if anyone in the home has recently had an upper respiratory tract infection. Has the child had signs and symptoms of such an infection, such as a runny nose, cough, low-grade fever, or anorexia? Does he have a history of frequent colds or upper respiratory tract infections? Does he have a history of respiratory syncytial virus? Ask the parents to describe changes in the child's activity level or feeding pattern to determine if the child is lethargic or less alert than usual.
Begin the physical examination by auscultating the lungs, especially the lower lobes. Note diminished or abnormal sounds, such as crackles or sibilant rhonchi, which may indicate mucus or fluid buildup. Characterize the color, amount, and consistency of any discharge or sputum. Note the characteristics of the cough, if any. Note the respiratory rate. Assess accessory muscle use for breathing and cyanosis.
» READ BOOK EXCERPT ONLINE »
Source: Nursing: Interpreting Signs and Symptoms, 2007
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