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Exam 4 Flashcards

1
Q

What is the definition of overweight in children?

A

85-95% BMI percentile

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2
Q

What is the definition of obese in children?

A

Over 95% BMI percentile

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3
Q

True or false - you classify babies by birth weight and gestational age.

A

True

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4
Q

What is precocious puberty in a male?

A

Before age 9

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5
Q

What is precocious puberty in a female?

A

Before age 8

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6
Q

What is delayed puberty in a male?

A

No evidence of puberty by 14

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7
Q

What is delayed puberty in a female?

A

No evidence of puberty 13 or no menarche by 16

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8
Q

Describe Tanner Stages for the female.

A

2: breast budding and sparse hair
3: continued breast enlargement, darker, courser, curlier hair
4: areola and papilla form a secondary mound, adult type hair but decreased distribution
5: mature female breasts and adult hair

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9
Q

Describe Tanner Stages in a male.

A

2: Enlargement in testicles and change in texture, sparse pigmented hair
3: growth in length and circumference, darker courser curlier hair
4: develop glans penis, darkening of scrotal skin, adult hair, decreased distribution
5: adult

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10
Q

What is the HEADS mnemonic for psychosocial screening?

A 
H: Home
E: Education, Eating
A: Activities, Affect
D: Drugs
S: Sexuality, Safety
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11
Q

What are the aspects of guided questioning?

A
  1. Open ended to focused
  2. Eliciting a graded response
  3. Asking a series of questions one at a time
  4. Offering multiple choices
  5. Clarifying what the patient means
  6. Encouraging with continuers
  7. Echoing
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12
Q

What are the three parts of a plan?

A
  1. Diagnostic
  2. Therapeutic
  3. Education
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13
Q

What are reasons to admit a patient to the hospital?

A
  1. Concerned about a life threatening diagnosis
  2. Unstable condition like hypotension
  3. Need IV medication
  4. Unable to tolerate anything by mouth (vomiting/dehydration)
  5. Social reason (safety)
  6. Psych
  7. Treatment not available at home
  8. Failure to respond to appropriate outpatient regimen and getting worse
  9. Isolation
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14
Q

What is the mnemonic for admitting orders?

A

ADC
VAAN
DISML

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15
Q

What are the first three steps of admitting (ADC)?

A
  1. Admitting
  2. Diagnosis
  3. Condition
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16
Q

What are the next 4 steps of admitting (VAAN)?

A
  1. Vital signs
  2. Activity
  3. Allergies
  4. Nursing
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17
Q

What are the last 5 steps of admitting (DISML)?

A
  1. Diet
  2. IV fluids
  3. Special orders
  4. Medications
  5. Lab tests
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18
Q

What is heard best with the diaphragm?

A
  1. High pitched sounds (S1, S2, midsystolic click, AR, MR)
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19
Q

What is heard best with the bell?

A
  1. Low pitched sounds (S3, S4, MS)
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20
Q

Which is longer, systole or diastole?

A

Diastole (usually)

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21
Q

What is S1?

A

Closing of mitral and tricuspid valves (beginning of systole)

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22
Q

What is S2?

A

Closing of aortic and pulmonic valves (beginning of diastole)

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23
Q

In S1, which valve is heard first?

A

Mitral (before tricuspid)

24
Q

In S2, which valve is heard first?

A

Aortic (before pulmonic)

25
Which heart sounds are louder, left or right?
Left
26
Where is S1 heard loudest?
Apex
27
Where S1 heard quietest?
Base
28
Where is splitting of S1 normal?
Left lower sternal border (tricuspid area)
29
Where is S2 heard loudest?
Aortic area
30
When do we hear physiologic splitting of S2?
Inspiration at the pulmonic area
31
What are the three types of pathologic splitting of S2?
1. Fixed (A2 before P2) 2. Paradoxical (P2 before A2, happens with expiration) 3. Wide (increases with inspiration)
32
What are 2 causes of pathologic fixed splitting of S2?
1. ASD | 2. RV failure
33
What is 1 cause of pathologic paradoxical splitting of S2?
1. LBBB
34
What are 2 causes of pathologic widened splitting of S2?
1. RBBB | 2. Pulmonic stenosis
35
What are the two extra heart sounds heard in systole?
1. Early ejection sound | 2. Systolic click
36
What grade of murmur indicates the murmur can be palpated?
IV
37
What type of murmur can be innocent?
Midsystolic murmur
38
If you hear an early ejection sound, what type of disease is usually implicated?
Aortic valve disease
39
If you hear a systolic click, what disease is likely occurring?
MV prolapse
40
The general cause of S3 is ___.
Fluid overload
41
Which extra heart sound is always pathologic?
S4
42
The general cause of S4 is ___.
Stiff ventricle
43
If you hear an opening snap, what is likely occurring?
Mitral/tricuspid stenosis - sound caused by restricted valve leaflet motion
44
If you hear a murmur that is of musical quality, it is likely a ___ murmur.
Innocent
45
What are some of the causes of physiologic systolic murmurs?
1. High flow in anemia 2. Pregnancy 3. Fever 4. Hyperthyroidism
46
Define echogenic.
Structure or medium capable of reflecting or transmitting ultrasound waves
47
Define anechoic.
Image appears black (fluid)
48
Define hyperechoic.
Image appears brighter/whiter than surroundings (bone)
49
Define hypoechoic.
Image appears darker than surroundings
50
Define isoechoic
Image appears similar in brightness to surroundings
51
In a subxiphoid view what is seen at the top and bottom of the image?
Top: liver Bottom: atria
52
How is the probe oriented in a parasternal long view?
Indicator toward patient's right shoulder or left hip
53
In a parasternal long view what is seen at the top and bottom of the image?
Top: RV outflow tract Bottom: inferior wall
54
In a parasternal short view what is seen at the top and bottom of the image?
Top: RV Bottom: LV/inferior wall
55
What can be seen on ultrasound to indicate a pulmonary embolism?
Dilated right ventricle

PCM2 (16 decks)

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