Exam 1 - Physical Exam Flashcards
When should patient identification be completed?
Who is important to be involved?
- Prior to administration of mind altering substances
- The patient
Why is it important to chart core temperatures and have accurate post-op temperatures?
- Core temperatures are most accurate
- Post-op temperatures are typically a QI measure ($)
What is anthropometry?
The study of the measurements and proportions of the body
What does someone with redundant neck tissue and snoring alert you to?
The patient may have a difficuly airway and be prone to obstruct
What might recent weight gain or loss alert you to?
- Weight loss: cancer or undiagnosed T1DM
- Weight gain: CHF, hypothyroidsim
Approximately what should the axillary temp be in comparison to a core temperature?
- 1° lower
Why is it important to investigate patient reported allergies?
- Some reported allergies may just be medication side effects (ex: lido w/ epi can cause tachycardia, sedation from benzos)
What should we focus on with patients that have known or suspected drug abuse?
- Yes or no primarily, not necissarily doses
- Focus on drugs with high clinical significance like coke and meth
Why is an accurate pack year history important?
- Pack year history correlates to risk of lung cancer and median survival rate if diagnosed
Why is it important to review lab data trends for each specific patient?
Example?
- What may be normal for one patient, could be abnormal for another.
- Smokers are typically hemoconentrated, so is it from them smoking or are they dehydrated?
What is palpation used to assess?
- Texture
- Masses (firm or soft?)
- Fluid
- Skin temperature
How deep would one palpate with light palpation technique?
Deep palpation technique?
- 1-2 cm
- 4-5 cm
What is percussion used to assess?
- Evaluation of the prescence of air or fluid in body tissues
What is Mediate or Indirect Percussion?
How is it performed and what is its purpose?
- Plexor (striking finger) & pleximeter (finger being struck).
- Evaluation of abdomen and thorax
What is Immediate percussion? What is it utilized for?
- Striking of surface directly with fingers of the hand.
- Adult sinus or infant thorax evaluation.
What is Fist percussion? What is it utilized for?
- Flat hand on area to be evaluated being struck with a fist.
- Used to evaluate the back & kidney for tenderness.
What are the three forms of percussion?
- Mediate/Indirect percussion
- Immediate percussion
- Fist percussion
What would be expected with tympanic, drum-like percussion?
- Air-containg space (puffed out cheek, gastric air bubble, etc.)
What would be expected with resonant, hollow sounding percussion?
- Normal lungs
What would be an expected finding with assessed hyper-resonant, booming percussive sounds?
- Emphysematous lungs
What would be an expected finding with assessed dull, thud-like percussive sounds?
- Softer organs (ex. Liver)
What would be an expected finding with assessed flat percussive sounds?
- Denser organs (ex. muscle)
What temperature does one need to be to go to PACU?
96°
When is circumoral cyanosis primarily seen?
How might circumoral cyanosis present on patients with darker skin tones?
- In infants primarily above the upper lip.
- gray or white rather than blue