Breath sounds

[ryze21]

I received my patient flat on bed without pillow. She has difficulty of breathing but no adventitious breath sounds. What is the rationale for this? Please help me!! and Many thanks.

[obicurn]

Do you have any lab results? Hemoglobin levels?

[obicurn]

Just had another thought.....maybe something going on that makes breathing painful?

No clue on the laying flat though.....I've always thought keeping the bed elevated at least 30 degrees was supposed to make respiration easier. Seems like flat would make breathing difficulties worse because the lungs don't have as much room to inflate. Please post if you find the answer...I'm curious now.

[ryze21]

The patient is a casarean section. This is a post operative. In all lab results, Red blood cells are only low. Thanks

[ryze21]

Is this mean that if there is DOB there is a abnormal breath sounds????.:icon_roll

[Daytonite, BSN, RN]

the question is asking you the pathophysiology of the dyspnea in a woman who has just given birth by caesarean section, is lying flat, and has a respiratory assessment of clear lungs but is having difficulty breathing. after someone else asked, you revealed there were low rbcs. make sure you review all the information you have on this patient and not just individual bits or pieces. diagnosing is like putting together a jigsaw puzzle--every piece of information links with another piece of information to form the entire picture. leave something out and your picture (and conclusions) has holes in it.

problem solve this using the nursing process to help you.

first step: assess (gather information). the scenario says the patient is having difficulty breathing. let me get to basics. . .do you know what "difficulty of breathing" means and what the clinical signs and symptoms of it are? there are also other words that can be substituted for "difficulty breathing" and there is a medical term for it--dyspnea. check the indexes of the all nursing books you have for the word "dyspnea" and read what information is there. look in a medical dictionary, a nclex review book if you have one, an anatomy book, a pathophysiology book. one of these resources is bound to lead you to some of the causes (and remedies) for shortness of breath. do the same for post-op caesarian sections. what are the post-op complications of childbirth? do you have a lab reference? in what conditions are rbcs low? and, what are the clinical signs and symptoms of those conditions? is shortness of breath among them? always ask why and try to find the answer. i suspect that once you do all this and put a few things together (post-op c-section, low rbcs, sob, flat in bed) that something is going to light up in your brain.

• here are websites where you can find lab information:
  • medicine net procedures & tests a to z index http://www.medicinenet.com/procedures_and_tests/article.htm
    
  • web md index list of tests http://www.webmd.com/a_to_z_guide/medical_tests.htm
    
  • lab tests online http://www.labtestsonline.org/
    

second step: determine the problem. consider the information you have collected. where do many of the signs seem to be pointing? did some symptoms (like the dyspnea) show up in the complications of childbirth and a low rbc count? this is not a coincidence. welcome to the wonderful world of critical thinking!