Exam 1 Flashcards
What is the normal (oral) temperature range for adults?
36.7-37 C
98-98.6 F
What is the normal (oral) temperature range for the geriatric population?
35-36 C
95-96.8
What is the normal pulse rate for all adults?
60-100 bpm
What is the normal respiratory rate for adults?
12-20
What is the normal blood pressure for adults?
<120 mmHg systolic / <80 mmHg diastolic
What is the normal blood pressure for older adults?
120/80 up to 160/95
What is the normal range for pulse ox (SpO2)?
> 95% if its 94 or less need to follow up/ intervene
What are some normal variations in geriatric skin?
Dry skin & mucous membranes
Skin tags
Lentigines (liver spots)
Senile purpura
Thinning hair
What are the 5 levels of consciousness?
Alert
Lethargic
Obtunded - alert to verbal stimuli
Stuporous - alert to painful stimuli
Comatose
Key points of neurological assessment
Level of consciousness (AVPU)
Orientation (person, place, time, event)
Pupillary response
Motor response and strength
Sensation
What to assess for in the musculoskeletal system
Symmetry (of face/ arms)
Strength
ROM
Pain
What to assess the ears for?
Tenderness/pain
Hearing loss
Hearing aids
What are the words used to describe different types of speech?
Clear
Slurred
Garbled
Dysarthria - difficulty speaking
Aphasia (Expressive or receptive)
What is a CMS check?
Checking for circulation, motor control, and sensation in one or more extremities
And asking if the patient has any numbness or tingling
How to take orthostatic blood pressure and what is a positive result?
Measure blood pressure lying, sitting, and standing 2-5 minutes in between readings.
A positive result is a drop of 20 mmHg or more systolic or a drop of 10 mmHg or more diastolic
What is the significance of a positive orthostatic blood pressure?
Could indicate dehydration or blood loss
Indicates a risk of loss of consciousness or falling
What is the proper sizing of a blood pressure cuff? What are the results if it is the wrong size?
The width is 2/3 the length of the upper arm, and the bladder length is 80% the circumference of the limb.
If its too small it will have a higher reading
If its too large it will have a lower reading
When to avoid taking blood pressure on a limb?
Mastectomy of lymph tissue, hemodialysis grafts or fistulas, picc lines or IVs in the arm.
What is the Glasgow coma scale for eye opening response?
Spontaneously 4
To speech 3
To pain 2
No response 1
What is the Glasgow coma scale for motor response?
Obeys verbal command 6
Reacts purposefully to pain 5
Flexion - withdrawal 4
Flexion - abnormal (decorticate) 3
Extension - abnormal (decerebrate) 2
No response 1
What is the Glasgow coma scale for verbal response?
Oriented (x 3) - 5
Conversation - confused 4
Speech - inappropriate 3
Sounds incomprehensible 2
No response 1
What do the terms febrile/afebrile mean?
Fever/ without fever
What are rigors?
Shaking chills, starts with a fever, its a sign of an infection and it is a medical emergency.
What is pulse deficit?
Variance between apical and peripheral pulses