Exam 4 Flashcards
Heart, Thorax & Lungs, & Abdomen
Congestive Heart Failure
Condition in which the heart is unable to pump sufficient blood to meet metabolic needs of the body. Common symptoms include fatigue, shortness of breath, and edema in ankles or feet, in sacral area, or throughout body. Ascites may cause Pt to feel bloated and may compromise respiratory effort.
Onset of symptoms may be rapid or gradual, depending on underlying etiology.
Left-sided Heart Failure (Pulmonary)
Orthopnea, pulmonary edema, crackles or wheezes, dysrhythmias, tachycardia, tachypnea, dyspnea, anxiety, cyanosis, HTN (early CHF), low BP (late CHF), and decreased CO.
Right-sided Heart Failure (Systemic Circulation)
Dependent edema, JVD, bounding pulses, oliguria, dysrhythmias, Heptomegaly, Splenomegaly, increased CVP, and altered liver function tests.
Bruit
A low-pitched blowing or swooshing sound manifested from turbulent blood flow movement in a peripheral vessel
Sinus Arrhythmia
A mild cycle of decelerations and accelerations of the heart rate that coincide with respirations; a normal assessment finding in children
Pitch
Frequency-The number of vibrations per second of a note.
Amplitude
Intensity-How loud/soft a sound is.
Timbre
Quality-Asubjective difference due to a sounds overtones.
Resonance
Hollow, low-pitched (Air-filled organs, Lungs)
Hyperresonance
An increased resonance produced when an area is percussed. (Gaseous, distended abdomen)
Tympany
Drum (Hollow organs, Bowels)
What is the size of Lymph nodes?
<1 cm round & smooth (Filter Pathogens)
Bronchovesicular
Moderate pitched, inspiration=expiration
Pleural Friction Rub
Coarse, low-pitch during inspiration & expiration, patient complains of pain with breathing. Fluid in pleural cavity
What happens to breathing with ^intracranial pressure?
The pattern changes without our awareness.
Where is the respiratory center located?
The brain stem
At what week, in utero, is surfactant present in adequate amounts needed for sustained inflation of the lungs?
32 Weeks
Foramen Ovale
Hole in septum of newborn which closes after birth.
Homan’s Sign
Calf pain that occurs when the foot is dorsiflexed (flexed up toward knee); may occur with deep vein thrombosis, phlebitis, achilles tendonitis, or muscle injury.
Allen Test
Compress both the radial and ulnar arteries and ask the patient to open and close the fist several times until the palm blanches, release pressure on the ulnar artery only. Color should return to the palm within 5 sec if the ulnar artery is functioning and it will be safe to draw an ABG.
Claudication
Cramping pain during exercise that limits movement of arms and legs.
Pitting Edema
\+1 = 2mm, disappears rapidly; No swelling \+2 = 4mm, 10-15 sec; No swelling \+3 = 6mm, >1 min; Extreme swelling \+4 = 8mm, 2-3 min; Gross swelling
Infarction
Death of tissue due to lack of blood flow.
How do you calculate a pulse?
Systolic-Diastolic=Pulse
Scaphoid
Abnormally sunken abdominal wall, as in malnutrition.
Blumberg’s Sign
(Rebound tenderness) Elicit or intensify pain in the abdomen during palpation when the pressure is suddenly released.
Murphy’s Sign
Palpate right mid-clavicular line, if painful on deep inspiration = inflamed gallbladder.
pneumonia
Cough, SOB, and fever although these symptoms are not universal. Bacterial pneumonias are marked by abrupt onset, high fevers, shaking chills, pleuritic chest pain, and prostration.
Vesicular
Low, soft, & rustling (Like the wind)
Bronchial
High, loud, harsh, & hollow tubular
Bronchophony
“99”
Pathological conditions that increase lung density will enhance the transmission of voice sounds.
Bronchophony & Egophony
Pedi respiratory distress?
Flaring nostrils, sternal retractions, trouble eating.
Venous Disease
Causes signs and symptoms of metabolic waste build-up.
Chronic: calf; aching, tiredness, feeling of fullness; Chronic pain increases at end of day; Aggravating: Prolonged standing; Symptoms: Edema, Varicosities, Weeping ulcers at ankles.
Acute: Calf; Intense, sharp, deep muscle tender to touch; Sudden onset, within 1hr; pos. Homan’s sign; Red, warm, swollen leg.
Arterial Disease
Signs & symptoms of oxygen deficit.
Chronic: Deep muscle pain calf & foot dorsal; Intermittent claudication; Chronic pain, onset gradual after exertion, pain at rest indicates severe involvement.
Acute: Distal to occlusion, may involve entire leg; 6 P’s (Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Coldness
