...
Is the dyspnea acute? If the dyspnea is acute onset, one should ask if there is a drug history, particularly a history of mainlining narcotics. If ... DIAGNOSTIC WORKUP
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... A patient with orthopnea is able to breathe without significant subjective difficulty in the sitting or upright position but almost invariably develops shortness of breath in the recumbent position. This symptom is most characteristic of
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Is the patient an adult or a child? If the patient is a child, acute epiglottitis, acute laryngotracheitis, foreign body, congenital laryngeal ... DIAGNOSTIC WORKUP
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... Wheezing is classically due to bronchial asthma, but there is a danger in jumping to that conclusion because it occurs in a few other conditions as well. The wheezing of bronchial asthma is heard primarily on expiration, whereas... DIAGNOSTIC WORKUP
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...
Is there excessive snoring? Excessive snoring would indicate obstructive sleep apnea from large tonsils, deviated nasal septum, cleft palate, other abnormalities, and obesity.
Is there ... DIAGNOSTIC WORKUP
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...
Dyspnea is defined as an abnormally uncomfortable awareness of breathing. It is one of the cardinal symptoms of cardiac and pulmonary disease, but may also result from abnormalities of the chest wall,... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Orthopnea is defined as difficulty breathing (dyspnea) while in the recumbent position. The dyspnea is due to increased venous return to the lungs while recumbent, resulting in increased pulmonary venous and... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Paroxysmal nocturnal dyspnea is defined as severe difficulty breathing or air hunger that awakens the patient from sleep (usually 1–3 hours after lying down) and forces them to a sitting or standing position. The patient... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Tachypnea is defined as an increase in the normal respiratory rate. The normal respiratory rate varies with age (24–38 respirations per minute for children <1 year of age; 12–19 rpm for adults). Tachypnea is typically>... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Stridor is characterized by a high-pitched grating sound on inhalation or exhalation, but it is caused by narrowing or obstruction of the upper airway. Wheezing is a high-pitched musical... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Apnea is defined as the cessation of breathing; how long a pause is physiologically significant depends on age. History will often be more helpful than physical exam. Central apnea... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Dyspnea is defined as “shortness of breath,” so it is important to determine the effect of activity on breathing. Worsening when supine does not reliably differentiate... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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...
Priority of stridor evaluation is based on history and clinical presentation. A child with new stridor and respiratory distress requires immediate intervention. The most common cause of chronic stridor in infants is... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Tachypnea is defined as rapid breathing. The younger the child, the faster the average respiratory rate, and the wider the acceptable range of normal. The average newborn may breathe anywhere between 30 and 80... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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Breath sounds are made by air flow through airways. Normally they are fairly quiet and somewhat louder during inspiration as air flows toward the stethoscope. Wheezing is defined... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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By definition, 3% of normal children are short: A height 2 standard deviations (SD) below the mean for age. Dwarfism is defined as height more than 3 SD below the mean; midget is a dwarf with normal body... Differential Diagnosis ... Workup and Diagnosis ... Treatment
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... Dyspnea is the subjective feeling of rapid or difficult breathing. The patient will often say, “I can’t get my breath!” Tachypnea is the objective finding of a rapid respiratory rate and may or may not be
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... Nurses frequently become distressed and summon the intern during the night about these signs. Cheyne–Stokes respirations are a frequent source of bewilderment because they may occur at times with no
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... The differential diagnosis of sleep apnea may be arrived at by utilizing both physiology and anatomy. Normal sleep requires an unobstructed pathway from the nasopharynx to the lung and an intact central nervous system that
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... Both these symptoms are the result of the same pathophysiologic mechanism: obstruction in the upper air passages. That obstruction may be due to any one of the etiologies recalled by the mnemonic MINT.
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... When breathing requires extra effort, the accessory muscles — the sternocleidomastoid, scalene, pectoralis major, trapezius, internal intercostals, and abdominal muscles ... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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Apnea
(Handbook of Signs & Symptoms (Third Edition))
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... Apnea, the cessation of spontaneous respiration, is occasionally temporary and self-limiting, as occurs during Cheyne-Stokes and Biot’s respirations. More commonly, however, it’s a life-threatening emergency that... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of fewer than 10 breaths/minute. This sign results from neurologic and metabolic... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Asymmetrical chest expansion is the uneven extension of portions of the chest wall during inspiration. During normal respiration, the thorax uniformly expands upward and outward, and then... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... The most common pattern of periodic breathing, Cheyne-Stokes respirations are characterized by a waxing and waning period of hyperpnea that alternates with a shorter period of apnea. This pattern can occur normally in patients... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations
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... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It's usually reported as shortness of breath. Its severity... Other causes ... Special considerations ... Pictures
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... Hyperpnea indicates increased respiratory effort for a sustained period — a normal rate (at least 12 breaths/minute) with increased depth (a tidal volume greater than 7.5 ml/kg), an increased... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pictures
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... Orthopnea — difficulty breathing in the supine position — is a common symptom of cardiopulmonary disorders that produce dyspnea. It’s usually a subtle symptom; the patient may complain that he can’t catch his... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Typically dramatic and terrifying to the patient, this sign refers to an attack of dyspnea that abruptly awakens the patient. Common findings include diaphoresis, coughing, wheezing, and chest... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Respirations are shallow when a diminished volume of air enters the lungs during inspiration. In an effort to obtain enough air, the patient with shallow respirations usually breathes at an... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... A cardinal sign of respiratory distress in infants and children, retractions are visible indentations of the soft tissue covering the chest wall. They may be suprasternal (directly above the sternum and clavicles... Emergency interventions
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... A loud, harsh, musical respiratory sound, stridor results from an obstruction in the trachea or larynx. Usually heard during inspiration, this sign may also occur during... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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... A common sign of cardiopulmonary disorders, tachypnea is an abnormally fast respiratory rate — 20 or more breaths/minute. Tachypnea may reflect the need to increase minute volume — the amount of air breathed... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. They are caused by air flowing at a high velocity through a narrowed airway.... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Pictures
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... A late and ominous sign of neurologic deterioration, Biot's respirations are characterized by an irregular and unpredictable rate, rhythm, and depth. This rare breathing pattern may appear abruptly and may reflect increased... Emergency interventions ... Medical causes ... Special considerations ... Pictures
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... Acute
Pleuropulmonary causes
Obstructive lung disease
Asthma
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... Asthma
Extrinsic
Intrinsic
Exercise- or cold-induced
Drug-induced
Aspirin
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... Signs and Symptoms Rapid, shallow breathing; dyspnea, crackles, rhonchi; hypoxemia; bilateral infiltrates on chest X-ray
Treatment (Tx) Treatment of... Pictures
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... Infant respiratory distress syndrome (IRDS), also called hyaline membrane disease, is the most common cause of neonatal mortality. In the United States alone, it kills 40,000 neonates every year. IRDS occurs in premature... Causes and incidence ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... When breathing requires extra effort, the accessory muscles—the sternocleidomastoid, scalene, pectoralis major, trapezius, internal intercostals, and abdominal muscles—stabilize the thorax during respiration. Some accessory... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Apnea
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Apnea, the cessation of spontaneous respiration, is occasionally temporary and self-limiting, as in Cheyne-Stokes and Biot’s respirations. In most cases, though, it’s a life-threatening emergency that requires immediate... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Bradypnea
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of fewer than 10 breaths/minute. This sign may result from neurologic or metabolic disorders or a drug overdose... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Asymmetrical chest expansion is the uneven extension of portions of the chest wall during inspiration. During normal respiration, the thorax uniformly expands upward and outward,... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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... The most common pattern of periodic breathing, Cheyne-Stokes respirations are characterized by a waxing and waning period of hyperpnea that alternates with a shorter period of apnea. This pattern can occur normally in patients with heart or... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Dyspnea
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It’s usually described as shortness of breath. Its severity varies greatly and is usually unrelated to the severity of... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Hyperpnea
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Hyperpnea indicates increased respiratory effort for a sustained period—a normal rate (at least 12 breaths/minute) with increased depth (a tidal volume greater than 7.5 ml/kg), an... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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Orthopnea
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... Orthopnea—difficulty breathing in the supine position—is a common symptom of cardiopulmonary disorders that produce dyspnea. It’s often a subtle symptom; the patient may complain that he... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling
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... Typically dramatic and terrifying to the patient, this sign refers to an attack of dyspnea that abruptly awakens the patient. Common findings include diaphoresis, coughing, wheezing, and chest discomfort. The attack abates after the... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers
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... Characterized by a deep, low-pitched grunting sound at the end of each breath, grunting respirations are a chief sign of respiratory distress in infants and children. They may be... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pictures
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... Respirations are shallow when a diminished volume of air enters the lungs during inspiration. In an effort to obtain enough air, the patient with shallow respirations usually breathes at an... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... A cardinal sign of respiratory distress in infants and children, retractions are visible indentations of the soft tissue covering the chest wall. They may be suprasternal (directly above the... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Pictures
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Stridor
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... A loud, harsh, musical respiratory sound, stridor results from an obstruction in the trachea or larynx. Usually heard during inspiration, this sign may also occur during expiration in... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Pictures
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Tachypnea
(Professional Guide to Signs & Symptoms (Fifth Edition))
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... A common sign of cardiopulmonary disorders, tachypnea is an abnormally fast respiratory rate—20 or more breaths/minute. Tachypnea may reflect the need to increase minute volume—the amount of air... Emergency interventions ... History and physical examination ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. They’re caused by air flowing at a high velocity through a narrowed airway.... Emergency interventions ... History and physical examination ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Stridor
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Alexandra Duke and Tahany Maurice-Habashy
Stridor is a common type of wheezing (Chapter 8.9). It is characterized by a harsh, raspy, medium-pitched sound produced as air flows through a partially blocked... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Wheezing
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Thomas C. Bent
Wheezing is one of the most common respiratory complaints to present to primary care physicians. Although most often caused by asthma or chronic obstructive pulmonary disease, there are... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Shortness of Breath
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Robert M. Theal
Shortness of breath, or dyspnea, accounts for 3.7% of all visits to medical clinics (1).
Approach The initial history, physical examination, and chest x-ray ... History ... Physical examination ... Testing ... Diagnostic assessment ... Pictures
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Epigastric Distress
(The 10-Minute Diagnosis Manual: Symptoms and Signs in the Time-Limited Encounter)
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... Cindy Barter
Epigastric distress is a very common presenting complaint in both the emergency room setting and the outpatient setting. Of the multitude of... Approach ... History ... Physical examination ... Testing ... Diagnostic assessment
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... Differential Overview
Wheezing
❑ Asthma
❑ Reactive airways disease
❑ Pulmonary edema ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Asthma
❑ COPD exacerbation
❑ Left heart failure
❑ Pneumonia ... Diagnostic Approach ... Clinical Findings ... Pictures
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... Differential Overview
❑ Chronic obstructive pulmonary disease
❑ Congestive heart failure
❑ Asthma
❑ Recurrent... Diagnostic Approach ... Clinical Findings
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... Differential Overview
❑ Tachypnea
❑ Paroxysmal nocturnal dyspnea
❑ Sleep apnea
❑ Cheyne-Stokes ... Clinical Findings
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... Also called hyaline membrane disease and infant respiratory distress syndrome, respiratory distress syndrome is the most common cause of neonatal mortality.
Respiratory... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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... A form of pulmonary edema that causes acute respiratory failure, acute respiratory distress syndrome (ARDS, shock lung, stiff lung) results from increased permeability of the alveolocapillary membrane. Fluid... Causes ... Signs and symptoms ... Diagnosis ... Treatment ... Special considerations
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Apnea
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Apnea is the cessation of spontaneous respiration and is usually a life-threatening emergency that requires immediate intervention to prevent death. It may occur as a temporary and self-limiting event, such as Cheyne-Stokes and... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Bradypnea
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of less than 10 breaths/minute. This sign results from neurologic and metabolic disorders and drug... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Asymmetrical chest expansion is the uneven extension of portions of the chest wall during inspiration. During normal respiration, the thorax uniformly expands upward and outward, and then contracts downward and... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Cheyne-Stokes respirations are characterized by a waxing and waning period of hyperpnea that alternates with a shorter period of apnea. It’s the most common pattern of periodic breathing. This pattern can occur normally in patients... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Dyspnea
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It’s usually reported as shortness of breath. Its severity varies greatly and is... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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Hyperpnea
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Hyperpnea indicates increased respiratory effort for a sustained period — a normal rate (at least 12 breaths/minute) with increased depth (a tidal volume greater than 7.5 ml/kg), an... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Characterized by a deep, low-pitched grunting sound at the end of each breath, grunting respirations are a chief sign of respiratory distress in infants and children. They may be soft and heard only on auscultation, or loud and clearly... Assessment ... History ... Physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... Respirations are shallow when a diminished volume of air enters the lungs during inspiration. In an effort to obtain enough air, the patient with shallow respirations usually breathes at an accelerated rate. However, as he tires or... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... A cardinal sign of respiratory distress in infants and in children, retractions are visible indentations of the soft tissue covering the chest wall. They may be suprasternal (directly... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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Stridor
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... A loud, harsh, musical respiratory sound, stridor results from an obstruction in the trachea or larynx. Other causes include foreign-body aspiration, croup syndrome, laryngeal diphtheria, pertussis, retropharyngeal abscess, and congenital... Assessment ... History ... Physical assessment ... Pediatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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Tachypnea
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... A common sign of cardiopulmonary disorders, tachypnea is an abnormally fast respiratory rate — 20 or more breaths/minute. Tachypnea may reflect the need to increase minute volume ... Assessment ... History ... Physical examination ... Pediatric pointers ... Geriatric pointers ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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Wheezing
(Alarming Signs and Symptoms: Lippincott Manual of Nursing Practice Series)
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. They’re caused by air flowing at a high velocity through a narrowed airway. When they originate in... Assessment ... History ... Physical examination ... Pediatric pointers ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... When breathing requires extra effort, the accessory muscles — the sternocleidomastoid, scalene, pectoralis major, trapezius, internal intercostal, and abdominal muscles — stabilize the thorax during... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of less than 10 breaths/minute. This sign results from neurologic and metabolic disorders and... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Asymmetrical chest expansion is the uneven extension of portions of the chest wall during inspiration. During normal respiration, the thorax uniformly expands upward and outward, then contracts downward and... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Dyspnea
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It’s usually reported as shortness of breath. Its severity varies greatly and is usually unrelated... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... The typical patient with hyperpnea breathes at a normal or increased rate and inhales deeply, displaying marked chest expansion. He may complain of shortness of breath if a respiratory disorder is... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... Orthopnea — difficulty breathing in the supine position — is a common symptom of cardiopulmonary disorders that produce dyspnea. In many patients, it’s a subtle symptom; the patient may complain that he can... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Characterized by a deep, low-pitched grunting sound at the end of each breath, grunting respirations are a chief sign of respiratory distress in infants and children. They may be soft and heard... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Patient counseling ... Pictures
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... Respirations are shallow when a diminished volume of air enters the lungs during inspiration. In an effort to obtain enough air, the patient with shallow respirations usually breathes at an accelerated rate. However, as he tires or as his... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... A cardinal sign of respiratory distress in infants and children, retractions are visible indentations of the soft tissue covering the chest wall. They may be suprasternal (directly above the sternum and... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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Stridor
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
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... A loud, harsh, musical respiratory sound, stridor results from an obstruction in the trachea or larynx. Usually heard during inspiration, this sign may also occur during expiration... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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... A common sign of cardiopulmonary disorders, tachypnea is an abnormally fast respiratory rate — 20 or more breaths/minute. Tachypnea may reflect the need to increase minute volume ... Emergency Actions ... History ... Physical assessment ... Medical causes ... Other causes ... Special considerations ... Pediatric pointers ... Geriatric pointers ... Patient counseling ... Pictures
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. Also known as sibilant rhonchi, they’re caused by air flowing at a high velocity through a narrowed airway.... Emergency Actions ... History ... Physical assessment ... Medical causes ... Special considerations ... Pediatric pointers ... Patient counseling ... Pictures
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Wheezing
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)
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...Wheezing is a high-pitched musical soundthat is usually produced by narrowing of the segmental bronchi andbronchioles. May be heard during inspiration, expiration, or both. Principal ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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...Signs of respiratory distress include tachypnea,dyspnea, nasal flaring, grunting, retractions, and cyanosis. Apneais an extreme form of respiratory distress. Respiratory distress(neonatal and... Principal Causes of Respiratory Distress (Neonatal) ... Clinical Features and Diagnosis: Respiratory Distress (Neonatal) ... Principal Causes of Respiratory Distress (Postneonatal) ... Clinical Features and Diagnosis: Respiratory Distress (Postneonatal) ... Diagnostic Approach: Respiratory Distress ... Principal Causes of Apnea ... Clinical Features and Diagnosis: Apnea ... Diagnostic Approach: Apnea ... References
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... Stertoris noisy, snoring-type breathing that results from airway obstructionin the nose, nasopharynx, or oropharynx. The sounds are heard onlyduring inspiration. Stridor is a low- to... Principal Causes of Airway Obstruction ... Clinical Features and Diagnosis ... Diagnostic Approach ... References
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... Impairedverbal communication affects normal development, social relationships, andlearning in school. Basic components of verbal communicationare language, speech, and voice. On each well-child... Principal Causes of Verbal Communication Difficulty ... Clinical Features and Diagnosis ... Diagnostic Approach ... Table 72.1. Indications of the Normal Sequence of Language Development ... Table 72.2. Clinical Indications of Suspected Abnormal Verbal Communication ... References
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... When breathing requires extra effort, the accessory muscles—the sternocleidomastoid, scalene, pectoralis major, trapezius, internal intercostals, and abdominal muscles—stabilize the thorax during respiration. Some accessory... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Apnea, the cessation of spontaneous respiration, is occasionally temporary and self-limiting, as occurs during Cheyne-Stokes and Biot's respirations. More commonly, it's a life-threatening... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Commonly preceding life-threatening apnea or respiratory arrest, bradypnea is a pattern of regular respirations with a rate of fewer than 10 breaths/minute. This sign results from... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Asymmetrical chest expansion is the uneven extension of portions of the chest wall during inspiration. During normal respiration, the thorax uniformly expands upward and outward, and then contracts downward and inward. When... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... The most common pattern of periodic breathing, Cheyne-Stokes respirations are characterized by a waxing and waning period of hyperpnea that alternates with a shorter period of... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Typically a symptom of cardiopulmonary dysfunction, dyspnea is the sensation of difficult or uncomfortable breathing. It's usually reported as shortness of breath. Its severity varies greatly and is usually unrelated to the... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... Hyperpnea indicates increased respiratory effort for a sustained period—a normal rate (at least 12 breaths/minute) with increased depth (a tidal volume greater than 7.5 ml/kg), an increased rate (more than 20... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... Orthopnea—difficulty breathing in the supine position—is a common symptom of cardiopulmonary disorders that produce dyspnea. It's usually a subtle symptom; the... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... Typically dramatic and terrifying to the patient, this sign refers to an attack of dyspnea that abruptly awakens the patient. Common findings include diaphoresis, coughing,... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... Characterized by a deep, low-pitched grunting sound at the end of each breath, grunting respirations are a chief sign of respiratory distress in infants and children. They may be soft and heard only on auscultation, or loud and clearly... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching
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... Respirations are shallow when a diminished volume of air enters the lungs during inspiration. In an effort to obtain enough air, the patient with shallow respirations usually breathes at an... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... A cardinal sign of respiratory distress in infants and children, retractions are visible indentations of the soft tissue covering the chest wall. They may be suprasternal (directly above the sternum and clavicles),... History and physical examination ... Medical causes ... Nursing considerations ... Patient teaching ... Pictures
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... A loud, harsh, musical respiratory sound, stridor results from a partial to near complete obstruction of the trachea or larynx. Usually heard during inspiration, this sign may also occur during expiration in severe upper airway obstruction.... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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... A common sign of cardiopulmonary disorders, tachypnea is an abnormally fast respiratory rate—greater than 20 breaths/minute. Tachypnea may reflect the need to increase minute volume—the amount of air... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching
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... Wheezes are adventitious breath sounds with a high-pitched, musical, squealing, creaking, or groaning quality. They're caused by air flowing at a high velocity through a narrowed airway. When... History and physical examination ... Medical causes ... Other causes ... Nursing considerations ... Patient teaching ... Pictures
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...
Dyspnea is the subjective feeling of rapid or difficult
breathing. The patient will often say, “I can’t get my breath!”
Tachypnea is the objective finding of a... Pictures
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...
Nurses frequently become distressed and summon the intern during the
night about these signs. Cheyne–Stokes respirations are a frequent source
of bewilderment because they may occur at times... Pictures
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...
The differential diagnosis of sleep apnea may be arrived at by
utilizing both physiology and anatomy. Normal sleep
requires an unobstructed pathway... Pictures
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...
Both these symptoms are the result of the same pathophysiologic
mechanism: obstruction in the upper air passages. That obstruction may be
due to any one of the etiologies recalled by the mnemonic MINT.... Pictures
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... Author:
Renée Roberts, MD
What to Do - Gather Appropriate Data
Mild hypoxemia, airway obstruction, hypercapnia, atelectasis, and bronchospasm are so... Suggested Readings
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