Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MAP practical > Examination skills > Flashcards

Examination skills Flashcards

1
Q

Orthostatic hypotension #s?

A

drop greater than 20bpm with a change in pos.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Procedure forOrthostatic hypotension?

A

♣ Rest 2-3 minutes supine
♣ Take baseline BP supine
♣ Take measurements sitting and standing
♣ Normal – slight decrease (less than 10) when standing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Cause of OH?

A

♣ Gravity –> blood pools –> baroreceptors –> brain centers increase HR and vasoconstrict BV
♣ Abrupt peripheral vasodilation w/o compensatory cardiac output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What to do for OH?

A

o Should put them in previous position –> do a different activity in that position –> try changing position later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ABI? how to perform?

A

♣ Pt must be supine for 10 minutes before measurements
♣ Measure systolic in both arms (brachial)
• Record 1st doppler sound as cuff is deflated
• Use highest of two arm pressures
♣ Measure systolic in both legs
• Record 1st Doppler sound as cuff is deflated
o Dorsalis pedis
o Posterior tibial
• Use highest ankle pressure for each leg
♣ Calculate ankle to brachial pressure (divide each ankle buy highest brachial)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Interpretation of ABI values?

A

Normal >.90

PAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

False negatives for ABI?

A

♣ Diabetes
• Vessels are poorly compressible
• Results in falsely elevated ankle pressure
• Heart Sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Heart sounds? Normal vs. Abnormal?

A 
♣	Normal
•	S1: Lub = closure of atrioventricular valves
•	S2: Dub = closure of semilunar valves 
♣	Abnormal
Murmur- Woosh - valve problems 
•	S3: lub Dub Dub - Heart failure
S4: lub lub Dub
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

o auscultation of heart?

A

♣ Aortic valve: 2nd intercostal space on the right
♣ Pulmonic valve: 2nd intercostal space on the left
♣ Tricuspid valve: left inferior border of the sternum
♣ Bicuspid valve: mid-clavicular in 5th intercostal space
• Normal heart sound: lub-dub
• Abnormal heart sound: “whoosh”
• Lung Sounds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Lung sounds abnormal?

A 
o	Abnormal Sounds
♣	Wheeze during exhale
•	Caused  airway narrowing
•	Asthma, COPD
♣	Crackle during inhale
•	Caused by fluid
•	Pneumonia, congestive heart failure 
o	Patient presents with COPD or asthma – auscultate
♣	Use to find out where their mucous is
a
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lung auscultation pattern?

A

♣ 7 listening points between C7-T10, bilaterally (between SP and scapula)
♣ 8 and 9 laterally at level of T10
♣ Active inhale and exhale at each point

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

• SaO2 w/ activity

A

o Measure
♣
o Normal vs. Abnormal
♣ Contraindication:

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

• Assess Breathing Pattern (Lab 3)

A 
o	Depth (Using tape measure)
o	Rate 
o	Bucket Handle – 
♣	Symmetry and depth
o	Pump Handle
o	Symmetry
♣	Anything that has to do with breath. Any respiratory problem. 
♣	First place to start to assess if breathing is abnormal.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

• Assess cough effectiveness

A

o Pneumonia, Cystic fibrosis
♣ Are you having a productive cough?
♣ Check to see if their cough is restrictive.
• PIP should say that they have blockage?
o Have Kleenex handy
o Have pt cough “show me how you have been coughing”
♣ Adequate inhale
♣ Glottal closure (sharp Cuh)
♣ Increase intraabdominal pressure
♣ Increase glottal opening (strong Huh)
o Determine effectiveness: if it is a productive cough, or auscultate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

• Measure chest expansion with tape measure and/or symmetry (Lab 6)

A

o 3 Landmarks
♣ sternal angle (angle of Louie at 2nd rib)
♣ Xiphoid
♣ Between xiphoid and belly button

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

• Measure extremities for girth. Identify potential reasons for edema located in one or both extremities. What questions could you help clarify for edema?

A 
o	Pitting edema. 
♣	1+ disappears in 1-2 sec
♣	2+ slight indentation 15 sec
♣	3+ deep indentation 30 sec
♣	4+ greater than 30 
o	use as outcome measure. 
o	Can be caused by 
♣	DVT	
♣	Emphysema
•	Damage to lungs can sometimes lead to heart damage
♣	Right sided heart failure
o	Pulmonary edema 
♣	Due to left sided heart failure and fluid in lungs
♣	Crackles on inhale
17
Q

• Perform history intake on pt with cardiac

A 
o	Cardio
♣	Do you experience SOB or dizziness
♣	When do you experience SOB
♣	Do you have chest pain
♣	Do you have swelling in your lower extremeties
o
18
Q

Perform history intake pulmonary

A

♣ Are you a smoker
♣ Do you have a history of lung disease
♣ Do you experience excessive coughing
♣ Do you cough sputum? Blood?
♣ Do you frequenctly have to clear the throat
♣ Do you have more trouble breathing in or out?
♣ Does it feel like it is hard to breathe?
Do you feel like breathing limits your daily activities

19
Q

Normal RR

Normal expanse of rib cage during breathing?

A

12-18

2.5 inches

20
Q

Perform 6MWT

Purpose

A

o : assess functional capacity, especially for those with heart/lung disease
♣ Measures the distance walked on flat, hard surface for 6 minutes

21
Q

6MWT

Contra

A

♣ Unstable angina during previous month (angina at rest or lower levels of exercise, outside normal patten)
♣ MI during previous month
♣ Relative: resting HR greater than 120, systolic more than 180, diastolic more than 100

22
Q

6MWT

stop if?

A

♣ Chest pain, intolerable dyspnea, leg cramps, staggering, pale
♣ If stopped, pt should sit or lie supine

23
Q

6MWT

how to perform?

A

♣ 100 ft. Hallway, marked every 3m, turnaround pt. marked with cone, starting/finishing line marked
♣ No warm up
• Steps
o Sitting in chair near starting position for at least 10 min before test
♣ Check for contraindications, appropriate clothing
o Have patient stand and rate Dypnea and fatigue (Borg)
o Instruct patient “purpose of this test is to walk was foar as possible for 6 minutes. You can slow down, lean against wall, stop, and rest as necessary. Walk and turn without hesitation. (Demonstrate) Rememver, the object is to was as far as possible for 6 minutes, no jogging or running.”
o When timer rings, “stop!” And bring chair to pt, mark spot
o Count laps
o Record post walk dyspnea and fatigue level
♣ “what if anything kept you from walking farther”
♣ Other

24
Q

6MWT

Other

A
  • No talking during the walk

* Even tone of voice and standard phrasing “you are doing well/keep up the good work/ you have _ minutes remaining

25
Q

VO2 test

risk classes?

A

♣ A: apparently healthy
♣ B: known stable CV disease
♣ C: moderate to high risk of cardiac complications during exercise
♣ D: unstable disease with exercise restriction

26
Q

VO2

protocols

A

♣ Total time: 8-12 minutes

♣ 1 MET/stage, 2mph increase per grade, 10-15 watts/stage

27
Q

V02

during testing

A 
♣	ECG: 
•	ST depression =  ischemia
•	ST  elevation reflects aneurysm 
•	Dysrhytmias 
♣	HR
♣	BP
♣	RPE
28
Q

V02

Terminate testing

A

♣ BP
♣ Angina
♣ ECG
Signs

MAP practical (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions