Chapter13 Patient Assessment Flashcards
Identified by no chest wall movement and no sensation or sound of air moving in/out of the nose or mouth.
Apnea
breathing of fluids into the lungs
Aspiration
What is the mnemonic for Assessment of Mental Alertness?
AVPU A= Alert V = Responds to verbal stimulus P= Responds to pain stimulus U= Unresponsive
Trauma that is caused by a force that impacts or is applied to the body but is not sharp enough to penetrate.
blunt trauma
trauma that is a force that pierces the skin and body tissues, i.e knives, gunshots, tools, etc.
Penetrating trauma
what is it when brain tissue, cerebrospinal fluid, and blood vessels are moved or pressed away from their usual position inside the skull?
brain herniation
What is a clear fluid that surrounds the brain and provides the organ with protection and support?
cerebrospinal fluid
When a patient answer the question “ Why did you call EMS today”
chief complaint
Difficult or labored breathing; shortness of breath is called?
dyspnea
involuntary flexion or extension of the arms and legs, indicating severe brain injury that is associated with compression of the lower brain stem is known as?
extension posturing (decerebrate posturing)
indicating severe brain injury that is associated with compression of the upper brain stem and causes patient to arches the back and flexes the arms inward toward the chest is known as?
flexion posturing (decorticate posturing)
the patient (or trauma professional) is restrained from moving the cervical spine.
in-line stabilization
an exam focused on a specific injury site
modified secondary assessment
To cause to become closed; obstruct: occlude an artery. 2. To prevent the passage of: occlude
occluded
What is dyspnea (shortness of breath) that occurs while lying down.
It is often a sign of heart failure
orthopnea
a type of breathing in which all or part of a lung inflates during inspiration and balloons out during expiration; the opposite of normal chest motion
paradoxical movement
open, unobstructed, or not closed.
patent
a rapid, initial examination of a patient to recognize and manage all immediate life-threatening conditions
primary assessment
rapid head-to-toe exam
rapid secondary assessment
what is known as conduct that follows the secondary assessment
reassessment
a continuation of the primary assessment, where the medical professional obtains vital signs, reassesses changes in the patient’s condition, and performs appropriate physical examinations.
secondary assessment
what is the mnemonic for pain assessment.
.Onset – Did the pain start suddenly or gradually get worse and worse?
Provokes/Palliates – Does anything make the pain better or worse?
Quality – What does the pain feel like?
Radiates – Point to where it hurts the most. Does the pain go anywhere from there?
Severity – How would you rate your pain on a scale of 0 to 10?
Time – How long have you had the pain?
what is the mnemonic to remember specific soft tissue injuries to look for during a person’s assessment after a traumatic injury.
DCAPBTLS
D-Deformity C-Contusion A-Abrasion P-Puncture/Penetrating B-Burns T-Tenderness L-Laceration & S-Swelling
what is the mnemonic to remember key questions for a person’s assessment.
S-Signs & symptoms A-Allergies M-Medications P- Past medical history L-Last oral intake E-Events leading to this episode
What the components of forming a general impression?
Estimate the patients age.
Note the patients sex.
Determine if the patient is a trauma or medical patient.
Obtain the patients chief complaint.
Identify (& mange) immediate life threats.
What life threats require immediate attention if found while forming a general impression.
- An airway compromised by vomitus, blood, secretion, tongue, teeth or any other objects.
- Obvious open wounds to the chest.
- Paradoxical movement of a segment of the chest.
- Major bleeding
- Unresponsive with no breathing or no normal breathing.
Pinch that extends from along the base of the neck to the shoulders
Trapezius Pinch
Pressure applied with finger under the upper ridge of the eye socket
Supraorbital pressure
hard downward pressure to the center of the sternum with knuckles
Sternal rub
pinch of the soft tissue of the earlobe
Earlobe pinch
Pinch of the skin & underlying tissue along the margin of the arm pit
Armpit pinch
Example of peripheral pain stimuli
Nail bed pressure, pinch between the web of thumb/index figure, and pinch figure, toe, hand, or foot
What do you watch for when applying painful stimulus?
facial grimace, purposeful/non-purposeful movement
What is purposeful movement?
an attempt made by the patient to stop painful stimulus (pushes away, grabs hands, etc)
What is non-purposeful movement?
movement made by patients with severe spinal or head injuries, i.e. flexion posturing and extension posturing
low oxygen levels causes a patient to become agitated and anxious this is known as
hypoxia
high carbon dioxide levels cause a patient to become confused and sleepy this is known as
hypercapnia
What sounds indicate an airway obstruction
Snoring - rough, snoring-type sound on inspiration/exhalation
Gurgling - a sound similar to rushing water on inspiration/exhalation
crowing- a sound like cawing crow on inspiration
Stridor - harsh, high-pitched sounds on inspiration
What is the best method to assess breathing?
looking, listening, & feeling
inadequate rate or inadequate tidal volume = ?
inadequate breathing
adequate rate and adequate tidal volume = ?
adequate breathing
Poor movement (rise) chest wall, indicating not air is being breathed in with each inspiration
inadequate tidal volume
breathing that is to fast or to slow (outside the range of 8-24 adults and 15-30 child, 25-50 infant)
abnormal respiratory rate
condition of reduced rate of breathing. It indicates the person is not taking sufficient amounts of oxygen while breathing. If the breathing rate is below 12 breaths for one minute
bradypena
Because the brain cells require a constant supply of oxygen an altered metal status may be an early sign of ?
Hypoxia
When the respiratory rate is greater than 40 per minute in the adult, the time for the lungs to fil is so short that the tidal volume will become in adequate and the patient will become ?
Hypoxic
on average an elderly person respiratory rate is ? per minute
20
cool, pale, clammy (moist) skin is an early sign of
hypoxia
a late sign of hypoxia is
cyanosis
respiratory rate that is to fast
tacyhpnea
Chemorecptors constantly monitor the amount of ________and_______in arterial blood.
the body increase respiratory rate in attempt to eliminate___________?
carbon dioxide and oxygen
carbon dioxide
Asymmetrical movement of the chest wall is AN IDICATION OF WHAT
SIGNIFICANT CHEST INJURY
the uncomfortable sensation of breathing difficulty is produced when the oxygen demands of the cell are not being met by the respiratory or circulation system is known as
dyspnea
when must you apply positive pressure ventilation supplemented with oxygen
if a patient is apneic (not breathing) or is inadequately breathing
the method that pushes air and oxygen into the lungs is known as
positive pressure ventilation
positive ventilation can be achieved by
mouth-to-mask, bag-valve-mask, or flow restricted, oxygen-powered device
In patients that are breathing adequately, when is oxygen therapy recommended ?
signs of
hypoxia, hypoxemia, poor perfusion, heart failure, respiratory distress, patient complaining of dyspnea and with SpO2 reading lower than 94%
how is oxygen therapy usually delivered
nasal cannula 2 to 4 Ipm
a patient with an SpO2 of <94% should be considered___________and given________
hypoxic supplemental oxygen
elderly patients commonly have a irregularly irregular heart rhythms that is
an irregular or abnormal rhythm that has no regular pattern
Bradycardia an ominous sign of hypoxia in
infants and children
tachycardia is a heart rate of greater than
100per min
a heart rate of greater than 100 per min is a sign of
anxiety, blood loss, shock, abnormal heart rhythms, heart attack, early hypoxia, fever, medical or traumatic conditions
patients perfusion can be checked by checking
skin color, temperature, and condition
pale and mottled skin
indicates a decrease in perfusion and the on set of shock
patient is losing blood
Cyanotic skin
bluish grey skin
may indicate patient has chest injury, blood loss or has pneumonia or pulmonary edema
why does the skin of hypoxic patients appear blue
hemoglobin in red blood cells changes color when starve of oxygen
red skin
increase in amount of blood circulating in the blood vessels of the skin
indicator of anaphylactic shock, saogenic shock, poisoning, overdose, alcohol ingestion, inflammation cold exposure and heat stroke
yellow skin
liver dysfunction
treat shock patients with positive pressure ventilation with supplement oxygen at _______ with a _____________mask.
15 Ipm non-rebreather
what is the mnemonic to remember
OPQRST O-Onset P-Provocation/Palliation Q-Quality R Radiation/region S-Severity T-timing
