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health assessment > exam 2 > Flashcards

exam 2 Flashcards

1
Q

apical heart rate can be auscultated where

A

Erb point

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2
Q

what helps determine how much pressure in the right atrium

A

neck veins

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3
Q

locations where to auscultate heart sounds

A

aortic area, pulmonic area, Erb point, tricuspid area, mitral area

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4
Q

what causes variations in heart sounds

A

timing of heart valve closure
structure of heart valves
how quickly pressure rises in vessels

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5
Q

a third heart sound is a indication of

A

congestive heart failure, myocardial failure, valvular disease

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6
Q

degree of bed when looking at patient neck vessels

A

30-45

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7
Q

high pitched noise that increases with inhalation in third intercostal space on left sternal border

A

pericardial friction rub

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8
Q

what system has more pressure: arterial or venous

A

arterial

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9
Q

picks up all extra interstitial fluid

A

lymphatic capillaries

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10
Q

what disease is known to cause muscle atrophy

A

peripheral vascular disease

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11
Q

signs of arterial disease

A

decreased capillary refill, delayed wound healing

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12
Q

signs of DVT or thrombophlebitis

A

erythema, edema, tenderness

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13
Q

finding that is most suggestive of skin cancer

A

8-mm diameter

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14
Q

fluid filled lesion on skin

A

vesicle

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15
Q

turgor

A

speed with which skin returns into place

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16
Q

the sound made from air passing through narrowed bronchioles

A

wheezing

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17
Q

high pitched, soft, brief sounds on inspiration

A

fine crackles

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18
Q

low pitched, moist, lung sounds on inspiration

A

coarse crackles

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19
Q

continuous, high pitched sounds caused by narrowing of small airways

A

wheezing

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20
Q

load, coarse, low pitched grating or creaking sound

A

pleural friction rub

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21
Q

low pitched snoring or gurgling sound that may clear with coughing

A

rhonchi noise

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22
Q

high, harsh sounds with short inspiration and long expiration while ausculating trachea

A

bronchial breath sounds

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23
Q

when does wheezing occur

A

when air passes thru a constricted passageway

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24
Q

what causes crackles in breath sounds

A

moisture in airways

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25
Q

normal lung sound for most of lung for normal adult

A

vesicular

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26
Q

turbulence in blood flow

A

murmur

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27
Q

when does s4 happen

A

immediately before s1

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28
Q

what happens at start of systole

A

mitral and tricuspid valve need to close

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29
Q

what happens during P wave

A

depolarization of atria. atrial pressure increases, ventricular volume increases

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30
Q

what happens during QRS complex

A

depolarization of ventricles. increase in ventricular pressure

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31
Q

what happens during T wave

A

ventricular repolarization. ventricular pressure goes down

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32
Q

what does phonocardiograms do

A

shows sound of heart beat

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33
Q

S1

A

Tricuspid and mitral valve close

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34
Q

S1

A

Tricuspid and mitral valve close

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35
Q

S2

A

aortic and pulmonary valve close

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36
Q

split s2

A

heard only during inspiration. pulmonary valve was delayed in closing

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37
Q

split S1

A

mitral closes before tricuspid. this can be heard the best on apex. does not vary with respiration

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38
Q

usually closes after birth. if it doesn’t close, oxygenated blood mixes with deoxygenated blood

A

Atrial septal defect (ASD)
ventricular septal defect (VSD)

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39
Q

Jugular venous distention

A

backup of blood flow. right atria has high pressures

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40
Q

JVP

A

high pressure that reflects right atrial pressure.
would be seen on right internal jugular vein over the left, but could be both

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41
Q

what should bed be at to detect JVP

A

30-45 degrees

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42
Q

dyspnea

A

SOB

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43
Q

orthopnea

A

SOB when patient is laying down but improves when standing

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44
Q

paroxysmal nocturnal dyspnea

A

sudden SOB that wakes someone up from sleep. makes a person physically stand to breathe

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45
Q

what could cause chest pain

A

angina pectoris, CAD, MI, acute coronary syndrome

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46
Q

swelling on lower part of body. legs, sacrum, feet

A

dependant edema

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46
Q

swelling on lower part of body. legs, sacrum, feet

A

dependant edema

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47
Q

poor oxygenated of body

A

cyanosis or pallor

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48
Q

fatigue in cardio patients

A

signals heart is not adequately supplying oxygen

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49
Q

what could rheumatic fever cause

A

cardiac dysfunction

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50
Q

assessing carotids

A

one at a time. do not massage them. Patients need to be laying down

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51
Q

All Patients Eventually Take Meds acronym

A

aortic
pulmonic
ERBs point
Tricuspid
Mitral

5 areas of listening to heart

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52
Q

where to listen to aortic

A

right 2nd intercostal space

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53
Q

where to listen to pulmonic

A

left 2nd intercostal space

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54
Q

where to listen to ERBs point

A

left 3rd intercostal space

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55
Q

where to listen to tricuspid

A

lower left sternal border/4th intercostal

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56
Q

where to listen to mitral

A

left 5th intercostal
medial to midclavicular line

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57
Q

high rate of blood flow thru normal valves

A

murmer

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58
Q

normal blood flow thru abnormal valves

A

murmer

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59
Q

grade 1 murmer

A

very faint. may not be heard in all positions

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60
Q

grade 2 murmer

A

quiet, but heard immediately after placing stethoscope on chest

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61
Q

grade 3 murmer

A

moderately loud

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62
Q

grade 4 murmur

A

loud with palpable thrill (vibration)

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63
Q

grade 5 murmur

A

very loud with thrill. may be heard when stethoscope is partly off chest

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64
Q

grade 6 murmur

A

very loud with thrill. can be heard with stethoscope entirely off chest

65
Q

risk factors in coronary heart disease

A

diabetes, hypertension, increased cholesterol, smoking, obesity, inactivity

66
Q

risk factors of hypertension

A

alc consumption, obesity, excess sodium intake, smoking, inactivity, not enough K+

67
Q

healthy fats

A

foods high in monounsaturated fats, polyunsaturated fats, and omega 3 fatty acids

68
Q

lymphatic system

A

takes fluid out of capillary beds, if fails, edema occurs

69
Q

should you be able to palpate lymph nodes in healthy normal adults

A

no

70
Q

brawny edema

A

nonpitting

71
Q

scale 1 edema

A

2 mm depression - pitting

72
Q

scale 2 pitting edema

A

4 mm depression

73
Q

scale 3 pitting edema

A

6 mm depression

74
Q

scale 4 pitting edema

A

8 mm depression

75
Q

intermittent cladication

A

pain in legs during activity caused by insufficient arterial blood flow

76
Q

symptoms/signs of PAD

A

sharp pain that’s worse at night
intermittent claudication
weak pulse in extremities
cool temp
pale
hairless, dry, scaly skin
gangrene- tissue death from lack of blood
round, punched out wounds

77
Q

signs/symptoms of PVD

A

dull,achy pain
edema
warm legs
stasis dermatitis- brownish/yellow skin
irregular shaped wounds

78
Q

what causes swollen lymph nodes

A

infection, tumor, malignancy

79
Q

0 grading for pulse

A

absent pulse. try doppler before writing this

80
Q

1+ grading pulse

A

diminshed, weak pulse

81
Q

2+ grading pulse

A

brisk, expected (normal)

82
Q

3+ grading pulse

A

bounding pulse

83
Q

when inspecting edema

A

measure difference, note color and texture of skin, note wounds

84
Q

when assessing hair

A

access color, condition of shaft, if hair shafts are shiny, cleanliness, parasites, lesions

85
Q

A high-pitched crowing sound from the upper airway results from tracheal or laryngeal spasm and is called what?

A

stridor

86
Q

sound to suspect client has chronic lung disease

A

hyperresonance

87
Q

When assessing posteriorly, where would the trachea bifurcate into its mainstem bronchi?

A

T4 spinous process

88
Q

What replaces resonance when fluid or solid tissue replaces air-containing lung or occupies the pleural space?

A

dullness

89
Q

what causes jaundice

A

liver issues.
Too much Bilirubin.
you can tell if someone has jaundice by the sclera of the eye

90
Q

what causes cyanosis

A

lack of oxygen or bloodflow

91
Q

ecchymosis

A

bruising

92
Q

what is erythema and what causes it

A

reddening of the skin
caused by increased blood flow

93
Q

carotenemia

A

comes from a diet high in beta carotene. yellow/orangish skin

94
Q

vitiligo

A

absence of melanin pigment

95
Q

mobility

A

ease at which skin lifts

96
Q

turgor

A

speed at which skin returns to place

97
Q

characteristics of psoriasis

A

red and angry looking
on extensor surfaces

98
Q

linear skin pattern

A

in line

99
Q

geographic skin pattern

A

map like appearence

100
Q

clustered skin lesion

A

several lesions that are grouped together

101
Q

serpiginous lesion

A

wavy border

102
Q

annular lesion

A

ring shaped

103
Q

acriform lesion

A

arc shaped

104
Q

plaque

A

elevated lesion. 1cm or larger

105
Q

patch

A

larger than cm. flat, nonpalpable

106
Q

macule

A

less than cm. flat, non palpable

107
Q

wheals

A

localized, palpable skin edema

108
Q

cyst

A

nodule with accessible material like pus

109
Q

vesicle

A

clear appearance with fluid

110
Q

bulla

A

vesicles that are a cm or larger with fluid

111
Q

pustule

A

palpable lesion filled with pus

112
Q

what causes secondary skin lesions

A

over treating other skin issues or continuous scratching

113
Q

lichenification

A

chronic rubbing or scratching

114
Q

keloid

A

over scarring

115
Q

erosion

A

loss of superficial epidermis

116
Q

fissure

A

skin cracks due to dry skin

117
Q

spider angioma

A

bright red, up to 2 cm. has middle with leg like appearance. throb or pulse feeling present

118
Q

spider vein

A

could be several inches, common in legs or anterior chest. from increased pressure in veins

119
Q

cherry angioma

A

bright red. no pulse feeling

120
Q

petechiae / purpura

A

blood accumulated outside blood vessel. fades to look like bruise overtime

121
Q

nevus

A

mole

122
Q

stage 1 ulcer

A

reddend slin

123
Q

stage 2 ulcer

A

skin is broken. superficial

124
Q

stage 3 ulcer

A

wound near to reaching muscle

125
Q

stage 4 ulcer

A

wound is down to bone

126
Q

characteristics of alopecia

A

skin looks healthy, clear borders

127
Q

trichotilomania

A

broken hair loss is seen. from plucking or pulling

128
Q

clubbing nails

A

rounded. means chronic hypoxia

129
Q

basal cell carcinoma

A

basal level of epidermis
most common and rarely metastasize

130
Q

squamous cell carcinoma

A

upper layer of epidermis
can metastasize
ulcerated and scaly looking

131
Q

melanoma

A

arise from melanocytes in epidermis
dangerous- metastasizes easy
dark with irregular looking border

132
Q

how many lobes in lung

A

left-2
right-3

133
Q

accessory muscles breathing

A

can see if there is trouble with respiration

134
Q

hemoptysis

A

bloody sputum

135
Q

purulent sputum

A

pus in sputum

136
Q

sudden onset dyspnea examples

A

anaphylaxis, pulmonary embolism, spontaneous pneumothorax, anxiety

137
Q

progressive onset wheezes

A

pneumonia, bronchitis, copd, interstitial lung disease, left sided heart failure

138
Q

wheezing

A

from airway obstruction or inflammation

139
Q

pleuritic pain

A

very painful with inspiration, coughing, or movement
-inflammation of pluera

140
Q

funnel chest

A

chest indents. could lead to lung or cardiac issues

141
Q

barrel chested

A

from air trapping

142
Q

pigeon chest

A

from cartilage displacement. effects breathing

143
Q

pigeon chest

A

from cartilage displacement. effects breathing

143
Q

pigeon chest

A

from cartilage displacement. effects breathing

144
Q

spine issues not allowing good expansion

A

thoracic kyphoscoliosis

145
Q

tactile fremitus

A

patient say 99
If vibration heard in all location, normal finding
use hand

146
Q

bronchoscopy

A

patient say 99
Sound becomes less distinct as moving down
Use stethoscope
If same throughout- abnormal

147
Q

egophony

A

patient say E
Use stethoscope
Normal if E is more distinct
If it sounds more like AAA then abnormal finding

148
Q

whispered pectoriloquy

A

Whisper 99
Use stethoscope
It should sound faint, if distinct as you keep going down, abnormal

149
Q

low pitch, loud sound

A

resonance
sound of a healthy lung

150
Q

high pitch soft sound

A

flatness
ex-thigh

151
Q

medium pitch and sound

A

dullness
ex-liver

152
Q

very loud, low pitch

A

hyperresonance

153
Q

loud, high pitch

A

tymphany

154
Q

crackles

A

fluid in lungs
could be fine or course

155
Q

friction rub

A

could be from pleura or pericardium

156
Q

rhonchi sounds

A

from thick mucus

157
Q

measures how fast you can push air out the lungs when you blow as hard as you can

A

peak flow measure

158
Q

Hair follicles, sebaceous glands, and sweat glands originate from the

A

dermis

159
Q

ABCDE melanoma

A

Asymmetry
border
color
diameter
evolving

160
Q

The nurse should carefully inspect which part of the body in an effort to differentiate central cyanosis from peripheral cyanosis?

A

oral mucosa

health assessment (4 decks)

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