Assessments and Diagnostics Flashcards
1
Q
Guaiac test
A
- Hemoccult, Fecult
- chemical test to ID blood in stool
- possible causes: cancer, hemorrhoids, GI bleed
2
Q
upper GI series
A
- series of barium X-rays (oral) of esophagus, stomach, small intestines
- used to ID problems with swallowing, stomach ulcers, twisting of small intestine
3
Q
lower GI series
A
- series of barium X-rays (enema) to show large intestine and rectum
- can ID diverticulitis/diverticulosis, tumors, etc.
4
Q
endoscopy
A
- flexible, fiberoptic instrument with camera used to visualize esophagus, stomach, large bowel
- different names used for each area explored (colonoscopy)
5
Q
colonoscopy
A
flexible, fiberoptic instrument with camera used to visualize large bowel
6
Q
ultrasonography (ultrasound)
A
- high-frequency sound waves used to visualize internal organs
- primarily for abdominal and pelvic organs
7
Q
pitting scale
A
8
Q
Braden scale
A
9
Q
delirium rating scale
A
- tool used to determine level of delirium or likelihood of pt becoming delirius
- Fundamentals Ch. 25
10
Q
blanch (capillary refill) test
A
- tests integrity of circulation by applying, then releasing pressure to a fingernail or toenail
- expected: regains color in 2-3 sec.
- > 3 sec. indicates impaired blood flow
11
Q
jugular/neck vein distension
A
- visualized with pt supine, HOB about 45°, head turned to side, tangential light
- can palpate to determine if pulsation is from vein or artery (vein easily occluded)
- sign of increased venous pressure
- used to estimate right atrial pressure
- indicates backup of blood from heart
- seen in heart failure, superior vena cava obstruction, tricuspid valve disease, and pericardial disease
12
Q
corneal light reflex
A
13
Q
accommodation
A
14
Q
red reflex
A
15
Q
red reflex
A
16
Q
accommodation
A
17
Q
corneal light reflex
A
18
Q
jugular/neck vein distension
A
- visualized with pt supine, HOB about 45°, head turned to side, tangential light
- can palpate to determine if pulsation is from vein or artery (vein easily occluded)
- sign of increased venous pressure
- used to estimate right atrial pressure
- indicates backup of blood from heart
- seen in heart failure, superior vena cava obstruction, tricuspid valve disease, and pericardial disease
19
Q
blanch (capillary refill) test
A
- tests integrity of circulation by applying, then releasing pressure to a fingernail or toenail
- expected: regains color in 2-3 sec.
- > 3 sec. indicates impaired blood flow
20
Q
delirium rating scale
A
- tool used to determine level of delirium or likelihood of pt becoming delirius
- Fundamentals Ch. 25
21
Q
Braden scale
A
22
Q
pitting scale
A
23
Q
otoscope
A
instrument with light designed to examine outer ear and tympanic membrane
uses disposible specula in 4 mm for adults and 2 mm for peds
24
Q
nares
A
- nostrils
- inspect for alignment of septum, drainage (note purulence, blood content, viscosity), coloration of nasal mucosa, edema
- occlude one at a time to check for patency
25
Q
CN I
A
- olfactory
- (assess patency of nostrils) coffee/mint smell test
- sensory
26
Q
CN II
A
- optic
- Snellen chart
- sensory
27
Q
CN III
A
- oculomotor
- draw H to test EOM, test pupillary reflex (PERRLA)
- motor
28
Q
CN IV
A
- trochlear
- draw H to test EOM, test PERRLA
- motor
29
Q
CN V
A
- trigeminal
- test
- motor: palpate temporal and masseter muscles as the person clenches the teeth
- sensory: light touch on forehead (ophthalmic), cheek (maxillary), and chin (mandibular); also corneal reflex test, which we don’t do
- both
30
Q
CN VI
A
- abducens
- draw H to test EOM, test for PERRLA
- motor
31
Q
CN VII
A
- facial
- test
- motor: smile and frown, close eyes tightly, lift eyebrows, show teeth and puff cheeks (press cheeks to check for even air escape)
- sensory: test sense of taste with lemon, salt, etc., which we don’t do
- both
32
Q
CN VIII
A
- acoustic
- test hearing: whisper test, normal conversation, Weber & Rinne tuning fork tests (which we don’t do)
- sensory
33
Q
CN IX
A
- glossopharyngeal
- test
- motor: gag reflex
- sensory: none; taste from back of tongue, sensory from sinuses, etc.
- both
34
Q
CN X
A
- vagus
- test
- motor: say “ah” to check for midline soft palate rise and fall; listen for smooth, unstrained voice and speech
- sensory: none
- both
35
Q
CN XI
A
- spinal accessory
- test sternomastoid and trapezius muscle strength and symmetry with hand pushing against each cheek and down on shoulders
- motor
36
Q
CN XII
A
- hypoglossal
- stick out tongue, should be midline with no tremor; say “light, tight, dynamite”
- motor
37
Q
pulse deficit
A
difference between peripheral and apical pulses
38
Q
pulse pressure
A
difference between systolic and diastolic blood pressures
39
Q
tragus
A
- projection in front of the ear
- used to block hearing in one ear for testing
40
Q
tympanic membrane
A
- eardrum
- expected: shiny and pearly gray with reflected cone of light
41
Q
hyperthyroidism
A
- ultrasound of thyroid gland
- thyroid scan
- serum levels of free and total T4, T3, and calcitonin
42
Q
AKI
A
acute kidney injury
43
Q
ADR
A
adverse drug reaction
44
Q
GCS (Glasgow Coma Scale)
A
- indications: LOC changes in encephalitis, cerebral lesions and infarctions, head injuries
- eye-opening response
- 4 - spontaneous
- 3 - to voice
- 2 - to pain
- 1 - none
- verbal response
- 5 - oriented
- 4 - confused
- 3 - inappropriate words
- 2 - incomprehensible sounds
- 1 - none
- motor response
- 6 - obeys commands
- 5 - localizes pain
- 4 - withdraws
- 3 - flexion
- 2 - extension
- 1 - none
45
Q
AVPU
A
- Alert
- responsive to Voice
- responsive to Pain
- Unresponsive
46
Q
common causes of pulseless electrical activity
A
- 5 Hs
- hypovolemia
- hypoxia
- H+ accumulation → acidosis
- hypothermia
- 5 Ts
- toxins (accidental or deliberate drug OD)
- tamponade (cardiac)
- tension pneumothorax
- thrombosis (coronary)
- thrombosis (pulmonary)
47
Q
OLDCARTS
A
- onset
- location: site/radiation
- duration
- character
- alleviating/aggravating factors
- time
- severity
48
Q
Alzheimer’s dz stages
A
- stage 1: no apparent manifestation
- stage 2: forgetfulness, esp. of everyday objects; looks like normal age-related change
- stage 3: mild cognitive decline
- losing important things
- short-term memory loss noticeable to close relatives
- ↓ ability to plan
- ↓ attention span
- diffculty remembering names, words
- difficulty in social/work situations
- can get lost while driving
- stage 4: mild to moderate decline
- personality changes
- obvious memory loss
- ↓ knowledge and memory or recent events
- difficulty with tasks that need planning/organizing
- difficulty with complex math
- depression/social withdrawal
- stage 5: moderate decline
- ↑ cognitive deficits
- inability to recall important details
- memory of info about self and family remains intact
- assistance with ADLs necessary
- disorientation/confusion about time and place
- stage 6: moderate to severe decline
- memory problems ↑
- recalls name, but not personal Hx
- significant personality changes: hallucinations, delusions, compulsion)
- wandering
- assistance with ADLs, personal care
- sleep/wake cycle disrupted
- ↑ urinary/fecal incontinence episodes
- stage 7: severe decline
- no ability to respond, speak, control movement
- urinary incontinence
- impaired swallowing
- requires help eating
- gradual loss of ability to move extremeties (ataxia)
49
Q
MS labs and diagnostic procedures
A
- labs
- CSF: ↑ protein
- slight ↑ WBC count
- diagnostic procedures
- MRI: plaques of brain and spine
50
Q
cerebral angiography
A
- visualization of cerebral blood vessels
- tracks blood flow to and within brain
- indications
- aneurysms
- surgical planning for tumors
- inject meds for Tx of blood clots
- inject chemo
