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Scenario > Assessment Signs, Triads, ect > Flashcards

Assessment Signs, Triads, ect Flashcards

1
Q

URQ major organs:
ULQ major organs:
LLQ major organs:
LRQ major organs:

A

= Liver, Gallbladder
= Spleen, Pancreas, Stomach
= Colon
= Appendix

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2
Q

Skin tugor test:
Norm/ skin=
Poor turgor (tenting)=
Decreased mobility=

A

= pulling skin fold over bony prominence then releasing it.
= immediately returns to its original state.
= results from dehydration
= suggests edema or scleroderma, a progressive skin disease

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3
Q

Cheyenne Stokes B pattern:
Biots B pattern:
Both mean possible:

A

= series of increasing & decreasing breaths followed w/ period of apnea
= short, gasping, irregular breaths ”random” & “fish out of water”
= brainstem injury or +ICP

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4
Q

Endotracheal intubation 4 indications: 1.
2. =
3.=
4.=

A

=1. in or going into Resp/ arrest
=2. Resp/ failure (hypoxic or hypercapnic)
=3. in or going into Cardiac arrest
=4. Airway swelling (anaphylaxis; airway burns)

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5
Q

Oxygenation 3 needs=

A

intact airway, adequate vent & respiration

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6
Q

Set up for intubation needs:

A

Adjunct airway, Suctioning, Stylet/Bougee, 1 size below & above size of ETT & Laryngoscope Blade, Capnography, BVM w/ oxy/, Stethoscope, C-Collar

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7
Q

colorimetric changes color after how many breathes:

A

6 ventalations

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8
Q

~SBP site numbers: -Carotid:
Femoral:
Radial:

A

= 80
= 70
= 60

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9
Q

Shock 5 catagories:

A

= Hypovolemic, Cardiogenic, Distributive, Obstructive, Respiratory/ metabolic,

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10
Q

Compensated Shock:

Decompensating Shock:

A

= HR: Elevated or normal BP: Norm or slightly decreased, RR: Increased, Skin: Not warm, pale, possibly sweaty
= HR: lowering, BP: Lowering, RR: none or irregular, Skin: Cool, pale, clammy, or cyanotic

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11
Q

Stroke Assess:

A

= FAST Face Arms Speech Time> drooping, drifting/weakness, slurred,

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12
Q

How do you use the AVPU scale?
GCS- E points:
M points:

S Points:

A

= Alert, Verbal, Pain, Unresponsive
= 4 Alert, 3 Verbal, 2 Pain, 1 Unresponsive
= 5 Oriented, 4 Confused, 3 inappropriate words, 2 sounds, 1 no audiation
= 6 Obeys comands, 5 localizes to pain, 4 withdraws w/ pain, 3 flextion, 2 extension, 1 no response

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13
Q

Pressure in the jugular veins approximate:
Elevated jugular venous pressure can indicate:

A

= central venous pressure (CVP)indicator of body’s overall blood volume & venous return
= L-side ventricle failure or fluid overload.

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14
Q

adventitious lung sounds:

A

= crackles/rales, wheezes, rhonchi, stridor, & pleural rubs

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15
Q

S1 Sounds auscultate @:
S2 Sounds (aortic) auscultate @:
S2 Sounds (Pulmonic) auscultate @:

A

= 5th ICS at Left Sternal border “TRI BI”
= 2nd ICS at Right Sternal border “aoRtic Right”
= 2nd ICS at Left Sternal “puLmonic L”

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16
Q

Aortic Valve auscultate @:
Pulmonic Valve auscultate @:
Erb’s Point auscultate @:
Tricuspid Valve auscultate @:
Mitral Valve (Apex) auscultate @:

A

= 2nd ICS, Right Sternal border.
= 2nd ICS, Left Sternal border
= 3rd ICS Left sternal border.
= 4th ICS Left Sternal border
= 5th ICS, Left Midclavicular line

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17
Q

What is Kehr’s sign/meaning:
PT w/ Murphy’s sign means?

Where/what is McBurney’s Point?

A

= Referred shoulder pain from spleen or liver
= Suspected gall bladder infection→ cupping under rib w/ breath causes pain
= LRQ pain w/ rebound tenderness ⅔ of way from umbilicus to illicac; pos/ appendicitis

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18
Q

“Coffee grounds” in mouth suggests:
Pink sputum indicates:
Green/Yellow phlegm suggests:

A

= upper gastrointestinal (GI) bleed.
= acute pulmonary edema
= a respiratory infection

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19
Q

Chronically ill=
frail=
feeble=
robust=
vigorous=

A

= Can’t do basic human necessities
= sick soreness
= lack of strength
= energetic
= VERY energetic

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20
Q

Aaron’s signs:
Rovsing’s sign:
Psoas sign:

A

= Epigastric pain during palpation to McBurney’s point
= RLQ pain w/ palpation to LLQ
= RLQ pain when PT tries to raise R-leg against resistance

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21
Q

shock index:
quick & easy way to assess shock index:

A

= ratio of HR-SBP. #s over 0.9 suggest impending hypotension.
= if HR>SBP, shock index must be over 1 & should anticipate peri-intubation hypotension.

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22
Q

Comfortable space:
Intimate space:
Personal Space:
Public Space:

A

= 4-12 ft
= 0-1.5 ft
= 1.5-4ft
= 12 or more ft

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23
Q

Never ask “why did you” b/c?

A

can be perceived as blame

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24
Q

SPED & challenging PTs interview

A

use same techniques as would on any other patient, but in a slightly different way.
EX start interview in usual manner. If PT doesn’t respond to your questions, take time to develop rapport by reviewing the reason dispatch gave for the call.

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25
Q

Interviewing Children PTs

A

down to their eye level. Children pick up on anxiety easily and often take cues from what they observe

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26
Q

Elderly PT interviews

A

Always use a formal means of address, such as “Mr.” and “Mrs.” or “Ms.” Speak slowly and clearly

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27
Q

Angry PT interviews

A

Avoid confrontation, but keep trying until. Use same questioning techniques usually used. Sometimes PTs open up if you clearly explain benefits & advantages of cooperation.
Could obtain info from: observing scene, questioning PT’s family, bystanders, or law enforcement officers.

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28
Q

Transferring care

A

“Are you the person who will be listening to my hand-off report?” If so, follow up w/ “Are you ready to listen, or would you rather wait a moment?” Also, be sure to introduce the PT by name & say bye to PT

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29
Q

CAGE alcoholic questionnaire: C:
A:
G:
E

A

=Cut down- drinking “Have you ever felt need to cut down on drinking?”
=Annoyed- by criticism “Annoyed by people criticizing your drinking?”
=Guilty feelings- “Have you ever felt guilty about drinking?”
=Eye-opener- “You ever felt needing a drink 1st in the morning (eye-opener) to steady your nerves or to get rid of a hangover?

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30
Q

Vehicle airbags are designed to do

A

Cushion chest of large adults, deploy during front-end collisions, deflate automatically after deployment

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31
Q

When arriving on the scene of an emergency, determining if your patient is a medical or trauma patient is most likely performed

A

When you approach the PT and make your GI

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32
Q

Ventilations Qs?:

A

Rate, Quality, Pattern, IE 1:2, Positioning/ Accessory M. use?

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33
Q

GCS:

A

E4, M5 (orient, confused, words, sounds, none), S6 (obey, local/withdraw, normal flex, abnorm flex decorb, exten/ decer, none)

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34
Q

Pupils: Direct response:
Indirect response:
Accommodation:
Ocular motor movement:

A

= same pupil in light responds
= pupil opposite of light responds
= eyes cross when finger to nose
= eye movement in “H”

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35
Q

Chest 3 phases: phase 1:
phase 2:
phase 3:

A

=Chest wall:
=Pulmonic: bronchial, tracheal, bronchovesicular (rhonci), vesicular
=Cardiac: S3: CHF maybe, S4: in CHF (Aortic, Pulmonic, Erb’s point (3rd ICS), Tricuspid)

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36
Q

ABDMN examine:

A

Scaphoid abdomen, hemoptysis, hematochezia, Murphy’s sing, McBurny’s point, Aaron’s signs, Rovsing’s sign, Psoas sign

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37
Q

!!! Murphy’s signs:

A

= Suspected gall bladder infection→ cupping under rib w/ pressure with breath causing pain

38
Q

!!! McBurny’s point:

A

= RLQ pain w/ rebound tenderness ⅔ of way from umbilicus to illicac

39
Q

Aaroon’s sign:

A

= Epigastric pain during palpation to McBurney’s point

40
Q

Rovsing’s sign:

A

= RLQ pain w/ palpation to LLQ

41
Q

Psoas sing:

A

=Pain to RLQ when patient tries to reaise R leg against resistance

42
Q

Back: Lordosis:
Scoliosis:
Kyphosis:

A

=swayback
=Lateral curve
=humpback

43
Q

Sniffing position:

A

=pillow under head ear aligned with sternum (called sniffing bc/ way head recoils when you shift)

44
Q

Ramped position:

A

for obese PTs, <LOTS>prepare a proper ramp (head and shoulder support) before transferring them to the ambulance.</LOTS>

45
Q

3 types of abdomen pain:

A

= Visceral: (dull) distension, ischemia, inflammation
Referred: kehrs should pain w/ abdomen b/c phriadam nerve
= Somatic> (sharp pinpoint) appendinixsitis

46
Q

Scaphoid abdomen

A

A severely sunken in & flat abdomen

47
Q

Percussion 5 sounds:

A

Tympany, Hyperresonance, Resonance, Dull, Flat
“Thunderous Hammers Rattle Doors Flatly”

48
Q

Tympany percussion sound:

A

= “drumlike” , loud intensity, High pitched, Medium duration, located in stomach

49
Q

Hyperresonance percussion sound:

A

= “Booming” , loud intensity, Low pitched, long duration, located in Hyperinflated-Lung

50
Q

Resonance percussion sound:

A

= “Hallow” , loud intensity, low pitched, long duration, located in a normal lung

51
Q

Dull percussion sound:

A

= “thud” , Medium intensity, medium pitched, medium duration, located in solid organs

52
Q

Flat percussion sound:

A

= “Extremely dull” , Soft intensity , High pitched, short duration, located in muscle & atelectasis

53
Q

Direct Percussion:
Technique:
Commonly used for:

A

= tapping directly on PTt’s skin w/ your fingertip.
= tap sharply & release immediately.
= used w/ percussing PT’s frontal & maxillary sinuses

54
Q

Indirect percussion:
Technique:

Commonly used for:

A

=indirectly percussing PT;
= Place 1 hand on area you wish to percuss. Use finger of that hand (usually middle finger) as striking surface. Sharply tap (simply from snapping wrist) distal knuckle of finger w/ tip of other middle finger. Snap the finger back quickly to avoid dampening sound.
= Percussing chest (make sure finger lies in ICS)

55
Q

Blunt percussion:
technique:

Commonly used for:

A

= “Blunt weapon” best used for detecting pain/ inflammation.
= Simply strike PT’s skin w/ ulnar side of your fist w/ just enough force to elicit tenderness but not cause undue pain.
= in costovertebral angle when examining a PT for a kidney infection

56
Q

AVPU:

A

Alert, responds to Verbal stimuli, Only Painful stimuli, & Unresponsive

57
Q

Dysarthria:
Dysphonia:
Aphasia:

A

= defective speech caused by motor deficits
= voice changes caused by vocal cord problems
= defective language caused by neurologic damage to the brain

58
Q

Expressive aphasia:
Receptive aphasia:

A

= words will be garbled &/or expressed
= words will be clear but unrelated to your questions
(PT w/ receptive aphasia can have such difficulty talking that you could mistakenly suspect a psych disorder)

59
Q

Assessing PT’s ability to concentrate w/ 3 exercises:

A

= 1st: digit span
= 2nd: serial sevens
= 3rd: spelling backwards

60
Q

1st exercise for assessing PT’s concentration:

2nd exercise for assessing PT’s concentration:

3rd exercise for assessing PT’s concentration:

A

= Digital Span PT repeat a series of numbers back to you. (Norm/= repeat at least 5 numbers forward & backward)
= Serial Sevens= PT start @ 100 & subtract 7 each time(Norm/= complete once in 90 Secs w/ <4 errors.)
= Spelling Backwards: PT spell a common five-letter word backward

61
Q

Tachypnea possible causes:
Bradypnea possible causes:

A

= hypoxia, shock, head injury, DKA, or anxiety.
= drug OD, severe hypoxia, or CNS insult

62
Q

Exhalation process:
Inhalation process:

A

= Passive use→ of respiratory muscles’ elastic recoil.
= Active use requiring ATP→ of respiratory muscles (diaphragm & intercostals) to increase the chest’s inner diameter.

63
Q

Eupnea:
Hyperpnea:
Cheyene-Stokes:

A

= Normal breathing
= Deep breathing
= Gradual increases & decreases in respirations w/ periods of apnea; caused by increasing ICP & brainstem injury

64
Q

Orthostatic Vital sign Test:

Healthy PTs vitals w/ test:
Positive test:

A

= Take PT’s pulse & BP while they’re supine & have PT sit up, dangle feet, & then stand. In 30- 60 secs retake vital signs.
=Healthy PT vitals should not change;
= HR increases 10- 20 BPM or if SBP drops 10- 20 mmHg indicating possible hypovolemia

65
Q

Macule:
Plaque:
Wheal:
Patch:
Papule:
Nodule:
Tumor:
Pustule:
Vesicle:
Cyst:
Bulla:
Telangiectasia:

A

= flat spot; color varying w/ white-brown or red-purple less than 1cm
= Superficial papule w/ diameter > than 1cm & rough texture
= Pink friction “burn”
= irregular flat spot w/ diameter > 1cm
= Elevated firm spot color white-brown /blue-purple w/ diameter <1cm
= elevated firm spot 1-2cm
= elevated solid >2cm
= elevated spot <1cm purulent liquid
=elevated area <1cm w/ serous fluid
= elevated palpable area w/ liquid or viscous matter
= vesicle w/ diameter >1cm
= Red threads

66
Q

Secondary skin lesions:

A

= Fissure “Frightening
= Scar Scars
= Erosion Etch
= Keloid Killer
= Ulcer Ulcers
= Excoriation Exposing
= Scale Scaly
= Lichenification Layers
= Crust: Crumbling
= Atrophy: Atrophy”

67
Q

Abnormal Nail Findings:

A

Clubbing, Paronychia, Onycholysis,Terry’s nails, Transverse lines, Psoriasis, Beau’s Lines,

68
Q

Beau’s lines in finger nails:

Estimating the timing or length of an illness by:

Why lines form:

A

= Transverse depressions in nails & associated w/ severe illness.
Like transverse lines, they form under nail fold & grow out w/ nail.
= Location of the line. (lines on >1 nail often indicates PT had serious systemic illness during past 2-3Mns)
During severe illness, the nails grow slowly, thus forming the lines.

69
Q

Traverse Lines in finger nails:
Can appear w/ or with:

A

= White lines parallel w/ lunula vs cuticle &
= Severe illness; shows under proximal nail folds & grow out w/ nail

70
Q

Terry’s nails:
Seen in:

A

= mostly whitish nail w/ band of reddish-brown at distal nail tip
= Aging, liver cirrhosis/failure, CHF, & diabetes

71
Q

Onycholysis in finger nails:

A

= nail bed separates from the nail plate. It begins distally & enlarges the free edge of the nail. There are many causes including hyperthyroidism

72
Q

Paronychia in finger nails:

A

=inflammation of proximal & lateral nail folds & can be acute or chronic. The folds appear red, swollen, & tender. The cuticle cannot be visible. People who frequently immerse their hands in water are susceptible

73
Q

Clubbing fingernails:

A

= “finger clubs” distal phalanx of each finger is rounded and bulbous. The proximal nail feels spongy. This is caused by the chronic hypoxia found in cardiopulmonary diseases and lung cancer.

74
Q

A boggy (soft & pliable) nail suggests:

A

= the clubbing seen in systemic cardiorespiratory diseases.

75
Q

Ocular Muscles:
Innervated by 3 cranial nerves:

A

= control eye movement
= Oculomotor (CN-III), trochlear (CN-IV),& abducens (CN-VI)

76
Q

Sluggish pupil suggests=
Bilateral eye sluggishness can indicate= Global Hypoxia to the brain tissue or an adverse drug reaction.
Constricted pupils= Opiate OD
Fixed & dilated pupils usually= brain death.
Nystagmus= fine jerking of the eyes
When shining light laterally of eye look for:

Shadow could suggest=

A

= pressure on Oculomotor Nerve CN-III) from increased ICP.
=Global Hypoxia to the brain tissue or an adverse drug reaction.
= Opiate OD
= Brain death
= fine jerking of eyes
= Crescent-shaped shadow on medial side of iris B/c iris is flat & cast no shadow.
= Glaucoma→ caused by blockage that restricts aqueous humor fluid from leaving anterior chamber thus increasing intraocular pressure & threatens PT’s eyesight.

77
Q

Otorrhea:

A

= discharge from ear

78
Q

“Coffee grounds” in mouth:
Pink-tinged sputum indicates:
Green/Yellow phlegm suggests: a respiratory infection.

A

= suggests an upper gastrointestinal (GI) bleed
= acute pulmonary edema
= a respiratory infection.

79
Q

Midline neck structures:
Neck houses many life-sustaining structures:

A

= thyroid, trachea, esophagus, & S-column
= SC,Carotid Art/s & Jugular V.s delivering from/to brain, Air passage (lar/x/trac/), food passage (esoph/) into stomach (Major disruption to structures can= rapid deterioration/ death)

80
Q

Chest bone cage comprises:
Chest’s 3 cavities:
Lungs’ Lobe #s:
Mediastinum contains:

A

= 3 bones of sternum, 12 pairs of ribs & cartilage, & S-column
= mediastinum, right & left pleural cavity
= 3 R lobes & 2 L lobes to make room for heart
= heart, great vessels (vena cava, aorta, & pulmonic vessels), Trachea, & Esophagus

81
Q

pectus excavatum:
Pectus carinatum:

A

=condition where sternum is depressed
= condition where sternum curves outward

82
Q

Consolidated lung tissue:
Egophony:

Bronchophony:

Whispered pectoriloquy:

A

= pus/ tumor replaces air-filled lung
= change in voice sound through stethoscope; PT’s “ee” sound is heard as “ay,” suggesting lung consolidation/ pleural effusion.
= PT’s spoken voice sounds louder & clearer than normal when auscultated w/ stethoscope, often indicating lung consolidation
= sign where PT’s whispered voice heard clearly through stethoscope, often indicating lung consolidation.

83
Q

Tactile fremitus:

A

= When the PT speaks, you can feel vibrations on their chest wall.

84
Q

hyperresonant percussion sound in right chest can indicate:
Dull percussion sound in right chest can indicate:

A

= Pneumothorax
= Hemothorax

85
Q

Splitting heart sounds:

A

= mitral & aortic valves close slightly before the tricuspid & pulmonic valves thus hear two sets of sounds instead of one

86
Q

NAVEL meds for NG/OG tube

A

Narcan, Atropine, Vasopressin, Epi, Lidocaine

87
Q

Lavine’s sign:
Trousseau’s sign:

A

= clenching chest
= Ca binding too much and flexing in in hands “gay hand penguin”

88
Q

Paper bag syndrome:

Marfan:

A

= inhaling before wrecking thus lung pops from hitting steering wheel w/ full of air
= stretched weak spots of tissues/skins

89
Q

Caudally:

A

= towards tail

90
Q

SLUGEM

A

Salvation
Lacrimation
Uremia
GI upset
Emesis (vomiting)
Miosis / Muscle twitching

91
Q

Eupnea=
Hyperpnea=
Biots-respirations:
Cheyne-Stokes=

A

= normal/equal breathing
= deep breathes
= Completely random breathing pattern
= Gradual increases & decreases in respirations w/ periods of apnea by increasing ICP & brainstem injury

Scenario (6 decks)

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