Discussion Board

Question 1

!!!!!!!!!!!!! MOST IMPORTANT !!!!!!!!!!!!

Before you start assessment (6)

Answer 1

Wash hands and PPE

Introduce self/title and describe what you will do

Ask for Permission

ID verbally X2

Check Wrist band

Orientate 4x: Name, Date, Location, How many quarters in a dollar

Question 2

Measure chest length with hands

Compare to Chest Width

You are looking for the length to be 2x

A 2:1 ratio of side to side / back to front

Describes this Assessment

Answer 2

Inspect Thorax for AP diameter

Question 3

Bronchophony

Normal Findings

When listening via stethoscope over lung area, paitents voice sounds muffled

Abnormal…….

Disease state for abnormal findings

Answer 3

The sound is louder or clearer when listened to through a stethoscope

Lung consolidation: pneumonia, pulmonary edema, cancer.

Question 4

Accessing Nails for Clubbing

Normal: opposing fingers placed together back to back, a small diamond shapped space is visible between where the nail beds meet.

Nail base angle 160 degrees

Abnormal findings ………..

Abnormal findings suggest which disease

Answer 4

No space observed between fingers, nail beds angle away from one another.

Base of nail enlarged and curved.

Exceeds 180°

Diseases: COPD, cardiovascular disease, cystic fibrosis

Question 5

Procedure:

Visually examine nails laterally view angle of nail beds

Palpation for fluntuance of nail bed

Place opposing fingers together (nail to nail) to visualize space between them

Describes…

Answer 5

Assessing for nail clubbing

Question 6

Egophony

Normal: The paitent speaking the vowel “e” sounds as it should

Abnormal:…..

Diseases associated

Answer 6

The vowel “e” changes to an “ay” sound

Lung consolidation, where the lung tissue becomes denser

Pneumonia or atelectasis.

Question 7

Fluctuance

Answer 7

a tense area of skin with a wave-like or boggy feeling upon palpation;

Question 8

Measuring chest for AP diameter a barrell Chest is associated with these diseases

Answer 8

COPD or chronic air trapping conditions

Question 9

______ the buildup of pleural fluid in the pleural cavity.

______ the presence of air or gas in the pleural cavity

Answer 9

Pleural effusion

Pneumothorax

Question 10

In thoracic chest expansion Unilateral or unequal movement of the thumbs indicates which dieases

Answer 10

Fractured Ribs, chest wall injury, Pneumonia, Collapsed Lung

Question 11

Decreased fremitus is associated with which diseases

Answer 11

COPD / Asthma

Question 12

Increased fremitus is associated with which diseases

Answer 12

Congested or consolidation (Pneumonial)

Question 13

Assess palpation of temporal and carotid arteries:

Normal Findings:

Abnormal findings:

Answer 13

Norm:

Temporal, smooth and non-tender with pulsation noted

Carotid: smooth with rapid upstroke and slower down stroke

Abnormal

Temporal: Tender, Edematous, Hardened or Redness around Artery

Carotid: Alternations in Amplitude of pulse peak, distortion of upstroke or downstroke.

Question 14

Non cardiac causes of this symptom include: Anemia, bone fractures, a tight cast, Raynaud’s disease, dehydration, hypothermia

Answer 14

Delayed Capillary Refill

Question 15

How long does it take for a finger to return to normal color after capillary refill

Answer 15

< 2 sec

Question 16

Pain associated with this test maybe from the following diseases:

Pyelonephritis urinary tract infection (UTI)
Glomerulonephritis
Nephrolithiasis (Kidney Stones)

Answer 16

Percussion of the Costovertebral Angle

Question 17

Pitting Edema test

Press for 5 seconds

1+ = 2mm depth
2+ = 4mm depth
3+ = 6mm depth
4+ = 8mm depth

Name disease associated with abnormal findings

Answer 17

DTV, Venous Insufficiency, CHF, Kidney Disease

Question 18

Access for appendicitis at this point

When is the pain felt the most during this test

Answer 18

McBurneys point

It’s located 1.5–2 inches (3.8–5.1 cm) to the right of the navel, midway between the belly button and the right anterior superior iliac spine

More pain is felt on the release of pressure than during the pressure

Question 19

Abnormal findings of the Allen’s test:

Capillary refill of the palm takes more than 6 seconds.

Causes of Abnormal findings

Answer 19

PAD Perifial Artery Disease
Raynaud’s disease
Compression subclavian artery / vein

Question 20

Palpate the Gallbladder area Medial to the midclavicular line.

Instruct take deep breath and Provider palpates Gallbladder

What is a positive for this test? AKA Murphy’s sign

Causes of a positive for this test

Answer 20

Sudden stopping of breathing caused by sharp pain

Cholecystitis
Cholelithias (Gallbladder Stone)

Question 21

If able to palpate the Gallbladder but it is not tender what maybe the cause?

Answer 21

Common Bile Duct Obstruction

Question 22

No response or diminished response to evaluation deep tendon reflexes (Bi & Triceps)

Causes

Answer 22

No response: Calcium or Magnesium excesses, Hypothyroidism, Spina bifida or Gullain-Barre Syndrome

Question 23

Hyperactive response to evaluation deep tendon reflexes (Bi & Triceps)

Causes

Answer 23

Calcium/ Magnesium Deficits, Hyperthyroidism, Spinal Cord Injury

Question 24

Aortic Stenosis, hypovolemia, Hypertension
Atrial Fibrillation
Atherosclerosis
Heart Failure

Are associated with this pulse finding

Answer 24

Abnormal carotid pulse

Question 25

Murphy’s sign is associated with this organ

What is Murphy’s sign

Answer 25

Gallbladder

Sudden stop of Inspiration with palpation of URQ