8.29 Systems Review 3

Question 1

changes in mentation

Answer 1

• onset of confusion, disorientation, or worsening of these symptoms
• can be a manifestation of multiple disorders

Question 2

Most important things to consider with changes in mentation?

Answer 2

• memory loss
• impulsivity (different, out of character, mood swings?)
• chronic HA or head injuries?

Question 3

Other questions to ask with changes in mentation

Answer 3

• attention loss?
• more confused than normal?
• Any activities harder than they should be?

Question 4

If patient has a head injury or stroke and these symptoms haven’t worsened since they have last seen the physician, then this becomes a

Answer 4

yellow flag

Question 5

Follow up questions if symptoms of mentation change have worsened

Answer 5

• When did you notice changes?
• Has it gradually gotten worse?
• Are you taking medications?
• Any changes in medications?

Question 6

FUPs for a report of nausea

Answer 6

• describe the nausea (constant, intermittent, frequency)
• How long?
• Any new/unusual symptoms?
• Do you know why you’re nauseated?
• Is your doctor aware?
• Is there vomiting?
• Any vomiting without nausea
• How are you treating?

Question 7

If the doctor is aware of the nausea, what should you also ask?

Answer 7

Has it gotten worse since you saw them?

Question 8

Red flags: nausea/vomiting

Answer 8

• may be related to medication use

- Rx meds

Question 9

red flags: OTC drugs and nausea/vomiting

Answer 9

may mix with Rx drugs

Question 10

Red flags: medications and nausea/vomiting

Answer 10

• Ask why they are taking the meds, how long, and if their doc knows
• supplements

Question 11

problem with supplements

Answer 11

not regulated by FDA

Question 12

Questions to ask about Rx meds

Answer 12

• do you need more of them to feel comfortable compared to a few weeks/months ago?
• may reveal a serious condition that is worsening

Question 13

s/s of heart and vascular problems

Answer 13

• dyspnea
• blue, cold
• nail clubbing
• palpitations

Question 14

palpitations

Answer 14

less than 30 seconds of heart pounding

Question 15

v-tac

Answer 15

heart pounding more than a minute

Question 16

pulmonary red flags

Answer 16

• SOB
• positional dyspnea
• wheezing
• coughing
• stridor

Question 17

positional dyspnea is also known as

Answer 17

3 pillow orthopnea

Question 18

orthopnea

Answer 18

having trouble breathing when lying down flat

Question 19

orthopnea often occurs when there is

Answer 19

fluid in the lungs

Question 20

3+ pillow orthopnea

Answer 20

• terminology used with smokers or COPD

- 2+ pillows is usu indicative of a lung problem

Question 21

wheezing

Answer 21

airway is plugged

Question 22

stridor involves both

Answer 22

• larynx

- trachea

Question 23

Janeway lesions and Osler nodes are pathognomonic to

Answer 23

bacterial endocarditis

Question 24

Janeway lesions look like

Answer 24

subcutaneous hemorrhages

Question 25

Janeway lesions are caused by

Answer 25

capillary breakdown

Question 26

Pts with Janeway lesions are generally on these meds

Answer 26

blood thinners

Question 27

What do Osler nodes look like?

Answer 27

• blanched center

- looks like a bug bite

Question 28

Where are Osler nodes commonly located

Answer 28

• palms of hands

- soles of feet