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Checkout 1 Flashcards

1
Q

Stethoscope Diaphragm

A

-high frequency sounds

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2
Q

Stethoscope Bell

A

-low frequency sounds

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3
Q

S1

A

-first heart sound (higher frequency)
-closure of M1 and T1
-best heard in Mitral Area

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4
Q

S2

A

-second heart sound (lower frequency)
-closure of semilunar valves valves
-best heard in Aortic Area

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5
Q

Aortic Area

A

-right sternal border
-2nd intercostal space
-S2 best heard

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6
Q

Pulmonic Area

A

-left sternal border
-2nd intercostal space

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7
Q

Tricuspid Area

A

-left sternal border
-4th intercostal space

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8
Q

Mitral Area

A

-left side under nipple
-apex of heart
-5th intercostal space
-S1, S3, S4 best heard

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9
Q

Apical Pulse

A

Listen to apex of heart for 1 min

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10
Q

S3

A

-could be abnormal (heart failure, late diastole) or normal (pregnancy/children)
-extra heart sound after S2
-“kenTUCKy”
-caused by rapid filling of ventricle
-listen with bell @ apex

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11
Q

S4

A

-always abnormal (HTN, MI, atrial kick of blood into stiff ventricle diastolic bad)
-right before S1
-gallop

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12
Q

Respiratory Cycle

A

Inspiration: 1/3, faster and louder

Expiration: 2/3, slower and softer

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13
Q

Vesicular Breath Sounds

A

-most of lung area
-inspiratory longer than expiatory
-soft

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14
Q

Brocho-Vesicular Breath Sounds

A

-near midline around upper spine and sternum
-inspiratory equal expiatory

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15
Q

Bronchial Breath Sounds

A

-above manubrium
-loud
-inspiratory shorter than expiatory

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16
Q

Lung Auscultation Areas

A

2 for each lobe

-anterior right (apical, upper,middle,lower(basal)),
-anterior left (apical, upper, lingua, lower(basal)

-posterior: apical, upper, superior lower, basal

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17
Q

Lung Ascultation Checkout Steps

A
  1. Explain (I’m going to be usuing this stethescope to listen to your lungs and see how well they are working)
  2. Position them properly
  3. Drapes for modesty
  4. Listen to front and back
18
Q

Heart Ascultation Checkout

A
  1. Explain (I’m going to be usuing this stethescope to listen to your heart and see how well it’s working)
  2. Position them properly
  3. Drapes for modesty
  4. Listen to A, P, T, M switching stethiscope to bell for apical, S3 and S4
19
Q

Patient Position

A

-feet on floor
-back support
-measured in both arms
-remove shirt/sleeve
-arm level with RA
-sleeve an inch above cubital fossa

20
Q

BP Steps

A
  1. Explain procedure
  2. Determine cuff size
  3. Drape appropriately
  4. Positions Patient Properly
  5. take radial pulse for 60s (deflate at 2mmHg/sec if >60 or 2mmHg/bear if <60bpm)
  6. Palpate radial pulse and inflate cuff until pulse disappears
  7. re-inflate cuff 30mmHg above previous pressure
  8. deflate at 2mmHg/sec if >60 or 2mmHg/beat if <60bpm
21
Q

Patient Postition Options

A

Standing:

Supine:

Sitting: Arm at right atria

22
Q

Pulses to Find

A

-Brachial: medial elbow crease
-Radial: under thumb
-Abdominal Aorta: left of belly button
-Femoral: Crease of leg
-Popliteal: behind knee
-Posterior Tibial: Behind med malleolus
-Dorsalis pedis: midfoot, btwn big and 2nd toe

23
Q

Pulse Grading

A

0: absent
1+: faint
2+: dimished
3+: normal
4+: Bounding

24
Q

Bruit Check

A

-check for swishiing sound from vascular pathology
-Check: Carotid, bachial, ab aorta, femoral

25
Pulses Assessment Checkout
1. Explain (I will be checking your pulses today to see how hard your heart is working) 2. Drape (I will be using this cover to maintain your privacy while i check your pulses 3. Palpate and grade 4. Asculate large arteries
26
Venous Insufficinecy S/S
-moist skin, swelling, discoloration -allieviated with elevation -aggrevated when legs down
27
Signs of Deep Vein Thombosis
-Unilateral cramping, unilateral signs of inflammation (red, heat, pain, swelling)
28
Phlebitis Examination
-meauring thigh or calf for a bilateral increase in size, heat, pain, redness, -feet standing a foot apart -significant if measuring 1.5 (male) or 1.2 (female) difference in size
29
Lowenberg Cuff Test
-wrap cuff around uppe calf below knee -inflate grradually to 80mmHg and ask about discomfort -discomfort with <40 is abnormal (do both)
30
Venous Filling Time
-use a pen to mark superficial veins of foot -elevate feet and do ankle pumps at 60 degrees for 1-2 mins -sit patient up and time venous refilling -12-20s
31
Arterial Insufficiency S/S
-cyanosis, paleness, coldness, lack of hair -alleiviated with feet down -agrrevated with feet elevated
32
Buerger's Test
-elevate ONE leg to 45 degrees for 3 minutes -return to sitting and watch as the skin turns blue and then red -should take 1-2 minutes forr the color to be equal
33
Capillary Nail Refill test
-have patients hold hand above heart -apply pressure to nail bed until white -release until redness returns -2 seconds ->2s sign of dehydration, shock, peripheral artery disease
34
Performance Test Checkoff
1. Explain Procedure 2. Take vitals (HR, lung, heart) 3. Put gait belt on patient 4. Set up test 5. Demonstrate test to patient 6. Stay near Pt 7. Do post test vitals 8. Interpret test
35
Timed Up and Go
-balance assessment, fall risk -time it takes from standing to sitting -Take vitals (HR, lung, heart) -patient stands from chair without using the arms -walks to the cone 3m away -comes back and sits down 2x -12s or more
36
10m Walking Test
-detect frailty and speed -cones 10m apart and 2m and 8m -Take vitals (HR, lung, heart) -have Pt walk and only measure 6m -can do fastest possible w/o running -find m/s and average each score 3x
37
6min Walk Test
-endurance, vo2, speed -30 meters (20m if not possible) -Take vitals (HR, lung, heart) -place cones and count laps for 6 minutes (measure the distance from cone for last)
38
5 Times Sit to Stand
-Take vitals (HR, lung, heart) -sit in chair and cross arms over chest -stand and sit 5 times as quickly as possible ->15s bad
39
30 Second Sit to Stand
-leg endurance, fall risk -Take vitals (HR, lung, heart) -sit in chair and cross arms over chest -stand and sit as quickly as possible in 30s -<13.6 disability, 15 cutoff for falling
40
2 Minute Walk Test
-endurance, speed, post surgical -10-15 meters -Take vitals (HR, lung, heart) -place cones and count laps for 2 minutes (measure the distance from cone for last)
41
2 Minute Step Test
-functional abilities, stairs -Take vitals (HR, lung, heart) -Pt facing wall -measure iliac crest to patella and put it against the wall -go halfway and instruct Pt to step with both legs as fast as possible for 2 minutes -measure how often the right knee passes line -can use chair for balance -<65 steps lower functional ability
42
Chair Step Test
-endurance, if standing is a barrier -measure resting HR -tape 6 (2.3 MET), 12 (2.9MET, and 18 (3.5) inches of tape on a wall -have patient in chair full extension away from wall -have them tap to the beat of of 60bpm for 3 min each round -take HR each round

Cardiopulmonary (23 decks)

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