Block 1 Objectives part 2

Question 1

Purpose of taking heart rate (pulse)

Answer 1

Number of cardiac cycles/minute may give clues to cardiovascular or neurologic status, psychogenic factors, or drug use

Question 2

Adult average pulse

Answer 2

60-90 bmp

Question 3

How to take pulse

Answer 3

Most common site: radial pulse. Palpate lateral flexor surface of wrist with pads of 2nd & 3rd fingers. Count pulsations over 15 seconds then multiply x 4

Question 4

Purpose of taking temperature

Answer 4

Used to assess severity of illness

Question 5

Standard “normal” temperature range for adults

Answer 5

97.3 - ~99.5 (oral)

Question 6

Most average (oral) temperature

Answer 6

98.6F/37C (decreases with age)

Question 7

Average rectal temperature

Answer 7

99.6

Question 8

Average axillary temperature

Answer 8

97.6

Question 9

Average tympanic membrane temperature

Answer 9

99.6

Question 10

Most accurate temperature measurement method

Answer 10

rectal

Question 11

How to take respiratory rate

Answer 11

Without patient’s knowledge, observe rise and fall of chest for 15 seconds. Multiply x 4. May be performed while still holding wrist after taking pulse.

Question 12

Normal respiratory rate range for adults

Answer 12

12-20 respirations/minute

Question 13

4 parameters to assess for respiration

Answer 13

(1) respiratory rate (2) respiratory pattern (3) respiratory depth (4) signs of distress

Question 14

Signs of distress in respiration

Answer 14

nasal flaring, cyanosis, labored breathing, tensed accessory muscles, wheezing, tachypnea or bradypnea

Question 15

Purpose of taking blood pressure

Answer 15

Measure of cardiovascular function

Represents force of blood against arterial walls

Question 16

Adult blood pressure range

Answer 16

<90

Question 17

Systole

Answer 17

Maximal ventricular contraction (top number)

Question 18

Diastole

Answer 18

Maximal ventricular relaxation (bottom number)

Question 19

Cardiac outout

Answer 19

Stroke volume x heart rate

Question 20

Stroke volume

Answer 20

Blood pumped by left ventricle in 1 contraction

Question 21

How to measure cuff size for BP

Answer 21

Bladder length must cover 80% circumference of upper arm, width should be ⅓ - ½ circumference

Question 22

How to take BP

Answer 22

Locate brachial artery and center cuff (arrow toward) artery
While palpating radial pulse, inflate cuff until pulse disappears, deflate cuff
Re-inflate cuff to 20-30 mm Hg above reading when pulse disappeared (this is the auscultatory gap)
Deflate cuff slowly, note mm Hg when Korotkoff sounds start and stop
Repeat in other arm (right tends to be higher)

Question 23

What can affect BP?

Answer 23

Anxiety, hyper/hypotension, vascular resistance, pain, fever, weight, lifestyle, caffeine, alcohol, drugs

Question 24

BMI formula

Answer 24

weight (kg) / height (m^2)

Question 25

Describe the auscultatory gap, method for obtaining it, and the clinical usefulness of it

Answer 25

The auscultatory gap is the period of silence between the Korotkoff sounds Phase 1 and Phase 2. It’s obtained by palpating the blood pressure and adding 20-30 mm Hg to the systolic number. This is useful because it prevents providers from being misled into underestimating the systolic or overestimating the diastolic

Question 26

What is the most appropriate time in the female menstrual cycle to perform a breast exam?

Answer 26

The week after menses. hormonal changes are least noticeable during this time (breast enlargement, tenderness, increased nodularity)

Question 27

Korotkoff sounds

Answer 27

Low-pitched sounds produced by turbulence of blood flow in the artery

Question 28

T/F: Korotkoff sounds are best heard with the bell of a stethoscope.

Answer 28

True, they are LOW-pitched (light pressure with “tunable” stethoscope)

Question 29

Stated Age vs. Apparent Age

Answer 29

Stated age is the patient’s chronological age.

Apparent age is based off appearance, may be older, younger or equal to stated age.

Question 30

Level of toxicity

Answer 30

Most important in assessing an ill patient. Only mention if the patient is ill; not mentioned if patient is not ill. How sick does the patient appears to you; toxic vs nontoxic appearing.

Question 31

Acutely ill vs. chronically ill

Answer 31

Acute: sudden, temporary onset of symptoms.
Chronic: longer, more generalized pain.

Question 32

Affect appropriate for situation

Answer 32

Assessing a patient’s mood and behavior. Behavior should usually be cooperative and friendly.

Question 33

Level of alertness

Answer 33

Patient’s ability to interact and respond to you.

Question 34

Orientation

Answer 34

Patient’s ability to recognize where the pt is, who the pt is and what time it is.

Question 35

Tanner Stage

Answer 35

Stages of sexual development in males and females beginning with the adolescent stage through adult stage. Breast development is measured from M1-M5. Pubic Hair development in both males and females is measured from P1-P6. Testes/Scrotum development is measured from G1-G5.

Question 36

What BMI is considered obese?

Answer 36

30-39.9

Question 37

What does cachectic mean?

Answer 37

Looks like pt is at the end of his/her lifetime; physical wasting

Question 38

Ethnic/racial background

Answer 38

Not generally appropriate. Only include if there is a clear clinical connection and can be accurate when identifying ethnicity/race.