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Patient Assessment > Final (All Subjects) > Flashcards

Final (All Subjects) Flashcards

1
Q

Why is temperature taken?

A

take to reflect homeostasis of the body

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2
Q

What is the normal temperature range?

A

97.6-99.0 degrees F

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3
Q

What are the routes at which temperature can be taken?

A
  • Oral
  • Rectal (high +1)
  • Axillary (lower -1)
  • Tympanic (high +1)
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4
Q

What are some causes for temperature variation?

A
  • Diurnal variation
  • Recent hot or cold ingestion
  • Cigarette smoking in mouth
  • Cerumen in ear
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5
Q

What is the normal range for radial pulse in adults?

A

60-100 bpm

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6
Q

What heart rate is considered to be tachycardia?

A

> 100 bpm

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7
Q

When is respiratory rate counted?

A

While palpating pulse

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8
Q

What is the normal respiratory rate for adults?

A

12-20 breaths/min

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9
Q

What does bradypnea mean?

A

slow respirations

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10
Q

What does tachypnea mean?

A

fast respirations

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11
Q

What does hyperpnea mean?

A

deep respirations

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12
Q

What does apnea mean?

A

no respirations

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13
Q

What is blood pressure?

A

BP is the pressure required to move oxygenated blood through the heart. The pressure depends on the energy needed for the heart to pump, the elasticity of its arterial walls, and the volume and viscosity of the blood.

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14
Q

What is the formula for blood pressure?

A

BP= Cardiac output (CO) X Peripheral Resistance (PR)

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15
Q

What is the formula for cardiac output (CO)?

A

CO= Stroke volume + Heart rate

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16
Q

What does systolic mean?

A

Maximum pressure at the end of the stroke output (emptying) of the left ventricle

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17
Q

What does diastolic mean?

A

Minimum pressure at the end of left ventricular filling (resting) of the heart

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18
Q

What nonpharmacologic factors decrease blood pressure?

A

-Dehydration

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19
Q

What is orthostatic hypotension?

A

significantly lowered blood pressure upon standing, associated with dizziness/fainting

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20
Q

What nonpharmacologic factors increase blood pressure?

A
  • Lack of sleep
  • Pain
  • Stress
  • Smoking
  • Licorice
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21
Q

What are you looking for in Brudzinski’s sign?

A
  • Stiff neck, indication of meningitis

- Flexion of neck –> flexion of knees

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22
Q

What are you looking for in Kernig’s sign?

A

high and knee flexed, pain upon straightening the knee

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23
Q

What are some common ear symptoms?

A
  • Hearing loss
  • Vertigo
  • Tinnitus
  • Pain (otalgia)
  • Itching
  • Discharge (otorrhea)
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24
Q

What are some common ear disorders?

A
  • Hearing loss
  • Otitis media
  • Otitis externa
  • Eustachian tube dysfunction
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25
Q

What is air conduction hearing?

A

uses the bones of the middle ear to amplify sound waves

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26
Q

What is bone conduction hearing?

A

uses sound waves traveling on the surface of the bones of the skull to transmit sound to the cochlea without using the ear canal

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27
Q

What does conductive ALWAYS mean?

A

air conduction

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28
Q

What is sensorineural loss?

A

When cochlea or CN VIII is damaged. Occurs when sound waves are not processed correctly

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29
Q

What is conductive hearing loss?

A

occurs when sound waves do not reach the inner ear

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30
Q

What are the tests for CN VIII?

A
  • Whisper test

- Rub test

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31
Q

What does the Rinne Test test for?

A

Bone and air conduction

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32
Q

What medications can have an adverse effect on hearing?

A
  • Aminoglycoside antibiotics
  • Vacomycin
  • Loop diuretics
  • Aspirin (at high doses)
  • Anti-convulsants
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33
Q

What is landmark for a healthy tympanic membrane?

A

Maleus and cone of light

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34
Q

What is the most common cause of epistaxis?

A

nose picking

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35
Q

What is the cornea?

A

protects iris and pupil

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36
Q

What is the iris?

A

muscles that control amount of light entering eye

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37
Q

What is the pupil?

A

allows light into the eye

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38
Q

What is the lens?

A

changes shape to focus

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39
Q

What is conjunctiva?

A

(sclera) lines the surface of the eyeball and inner part of the lids

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40
Q

What is the retina?

A

thin film that lines the inner globe and is composed of billions of nerve endings that respond to light and color

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41
Q

What is the optic nerve?

A

CN II- transmits visual info to the brain

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42
Q

What causes nystagmus?

A

phenytoin

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43
Q

What is a sign of icterus?

A

Jaundice/yellowing of the eye (sign of liver dysfunction)

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44
Q

What is the typical size of the pupils?

A

3-5 mm

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45
Q

What is mydriasis?

A

dilation of the eye

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46
Q

What is miosis?

A

constriction of the eye

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47
Q

What is an observation of the eyes that can indicate anemia?

A

inside the eyelid, color

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48
Q

What is an observation of the eyes that can indicate allergies?

A

watery eyes, redness

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49
Q

What is an observation of the eyes that can indicate hyperthyroidism?

A

bulging eyes

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50
Q

What is an observation of the eyes that can indicate hypothyroidism?

A

short eyebrows

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51
Q

What cranial nerve is tested for with visual acuity?

A

CN II

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52
Q

What chart is used to test for far vision?

A

Snellen chart

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53
Q

What chart is used to test for near vision?

A

Rosenbaum chart

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54
Q

What is hyperopia?

A

far-sighted (impaired near vision)

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55
Q

What is presbyopia?

A

far-sighted as lens get more rigid with age

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56
Q

What cranial nerves do pupillary reactions to light test?

A

CN II, III

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57
Q

What cranial nerve does pupillary reaction to accommodation test?

A

CN III

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58
Q

Which cranial nerves control eye movement?

A

CN III, IV, and VI

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59
Q

What does point of care device mean?

A

tests designed to be used at or near the site where the patient is located, that do not require permanent dedicated space, and are performed outside the physical facilities of clinical laboratories.

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60
Q

What are some examples of point of care devices?

A
  • Blood glucose
  • Cholesterol
  • A1c
  • INR
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61
Q

What are CLIA-waivers?

A

Clinical Laboratory Improvement Amendments of 1988 (CLIA) law “specified laboratory requirements be based on the complexity of the tests and established provisions for categorizing a test as waived”

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62
Q

What is the main objective of the CLIA-waivers?

A

to ensure quality laboratory testing

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63
Q

What is OSHA?

A

Occupational Safety and Health Administration- regulates workplace safety; including protecting employees from exposure to blood borne pathogens/hazards

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64
Q

When sticking someone else, one must always wear _________

A

GLOVES

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65
Q

What can mucoid sputum (translucent, white, or gray in color) indicate?

A

viral infections

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66
Q

What can purulent sputum (yellowish or greenish) indicate?

A

bacterial infection

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67
Q

What can rust-color, pink sputum indicate?

A

pneumonia, tuberculosis

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68
Q

What can hemoptysis sputum indicate?

A

pulmonary emboli, TB, cystic fibrosis, ADR (warfarin)

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69
Q

What can tenacious (sticky) sputum indicate?

A

cystic fibrosis, COPD

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70
Q

What does barrel chest indicate?

A

accompanies aging, COPD

71
Q

What are some possible causes of tactile fremitus?

A

Mass, fluid, COPD, fibrosis, pneumonia (increased fremitus)

72
Q

What does a resonant percussion sound indicate?

A

percussion note over healthy lung

73
Q

What does a dull percussion sound indicate?

A

note over consolidated lung or liquid in pleural cavity (pneumonia, TB)

74
Q

What does a flat percussion sound indicate?

A

similar to dull

75
Q

What does a hyper-resonant percussion sound indicate?

A

note over hyper-aerated lung or air in the pleural cavity (asthma, emphysema)

76
Q

What does a tympanic percussion sound indicate?

A

note over air-filled structure (pneumothorax)

77
Q

What do short, sounds of alveoli “popping open” indicate?

A
  • Crackles or rales

- fluid, edema, pneumonia

78
Q

What do high pitched whistling sounds indicate?

A
  • Wheezes

- Asthma, COPD

79
Q

What do harsher, coarser, low-pitched, “snoring” sounds indicate?

A
  • Rhonchi

- Bronchitis

80
Q

What does the conversion of “EE” to “AY” sound indicate?

A
  • Egophony

- Fluid or mass (pneumonia)

81
Q

What disease should a peak flow meter be used to help detect and monitor?

A

asthma

82
Q

What is peak expiratory flow?

A

fastest speed (L/min) which air is forced out from lungs after taking a deep breath

83
Q

What does a volumetric exerciser measure?

A

inspired air

84
Q

What contracts during systole and what valves open?

A
  • Ventricles contract

- Aortic and pulmonary valves open

85
Q

What relaxes during diastole and what valves open?

A
  • Ventricles relax

- Tricuspid and mitral valves open

86
Q

What sound does S1 make and what does it mean?

A
  • Lub

- Begins systole and tricuspid valve closure

87
Q

What sound does S2 make and what does it mean?

A
  • Dub

- Begins diastole and pulmonary valve closure

88
Q

What sound does S3 make?

A
  • Ventricular gallop
  • SLOSH-ing sound
  • abnormal after age ~40
89
Q

What sound does S4 make?

A
  • Atrial gallop
  • a-STIFF-wall sound
  • incidence increases with age
90
Q

Where is S1 the loudest?

A

at apex of the heart (mitral area)

91
Q

Where is S2 the loudest?

A

at the base of the heart (aortic and pulmonary area)

92
Q

Which part of a stethoscope is best for detecting high-pitched sounds like S1, S2, and systolic murmers?

A

diaphragm

93
Q

Which part of a stethoscope is best used for detecting low-pitched sounds like S3 and bruits?

A

bell

94
Q

What can cause a murmur?

A

blow flowing “backwards” or in any other way that results in turbulence

95
Q

What is a carotid endarectomy?

A

when you insert something to clean up build up in the arteries

96
Q

What is the normal pulse grade?

A

2

97
Q

List the major organs in the epigastric region

A
  • stomach
  • pancreas
  • liver
98
Q

List the organs in the RUQ

A
  • gallbladder
  • duodenum
  • liver
  • right kidney
99
Q

List the organs in the LUQ

A
  • stomach
  • spleen
  • left kidney
  • pancreas
  • liver
100
Q

List the organs in the RLQ

A
  • cecum
  • appendix
  • right ovary
  • right ureter
101
Q

List the organs in the LLQ

A
  • descending colon
  • sigmoid color
  • left ovary
102
Q

List the organs in the suprapubic region

A
  • bladder

- uterus

103
Q

What does pain/discomfort in the RLQ indicate?

A

appendicitis

104
Q

What does pain/discomfort in the epigastric region indicate?

A
  • stomach ulcer

- hepatitis

105
Q

What does pain/discomfort in the RUQ or LUQ indicate?

A

pyelonephritis

106
Q

What color stool/urine does taking iron produce?

A

black stool

107
Q

What color stool/urine does taking pyridium produce?

A

orange urine

108
Q

What color stool/urine does taking rifampin produce?

A

red

109
Q

What color stool/urine does taking pepto bismol produce?

A

black

110
Q

What is borborygmi and how often should you hear the gurgles?

A
  • bowel sounds
  • Hear every 5-10 seconds
  • If none heard in 2 min = absent
111
Q

What is the normal percussion sound for all four quadrants?

A

tympany (drum-like)

112
Q

What does a positive Lloyd’s sign indicate?

A

UTI because if painful, underlying kidney is inflamed

113
Q

What does a positive Murphy’s sign indicate?

A

Inflammation of the liver or gallbladder

114
Q

What is a ligament?

A

collagen connecting bone to bone

115
Q

What is a tendon?

A

collagen connecting muscle to bone

116
Q

What is cartilage?

A

collagen overlying bony surfaces

117
Q

What is bursae?

A

pouches of fluid that cushion movement of tendons and muscles over bone/other joint structures

118
Q

What would indicate RA upon inspection of the hand?

A

ulnar deviation of phalanges

119
Q

What would indicate osteoarthritis upon inspection of the hand?

A
  • Heberden’s nodes

- Bouchard’s nodes

120
Q

What does flexion mean?

A

decrease in angle between the surfaces of the joining bones

121
Q

What does extension mean?

A

increase in angle

122
Q

What does abduction mean?

A

movement away from the midline of the body

123
Q

What does adduction mean?

A

movement toward the midline

124
Q

What indicated carpal tunnel syndrome?

A
  • thumb abduction
  • Tinel’s sign (tapping on media nerve)
  • Phalen’s sign
125
Q

What is the normal for grading muscle strength?

A

5

126
Q

What is the normal reflex grading for deep tendon reflexes?

A

2

127
Q

Name the 5 areas tested for deep tendon reflexes

A
  1. biceps
  2. triceps
  3. brachioradialis
  4. patellar
  5. achilles
128
Q

Name the two types of pain

A
  • nociceptive pain

- neuropathic pain

129
Q

What are the two types of nociceptive pain?

A
  • somatic pain

- visceral pain

130
Q

What are examples of somatic pain?

A
  • injury to tissues
  • nociceptor stimulation in injured tissue
  • throbbing, burning, tenderness
131
Q

What are examples of visceral pain?

A
  • injury to organs
  • stretching, injury or inflammation of organs
  • deep, cramping, pressure, dull
132
Q

What are examples of neuropathic pain?

A
  • idiopathic or injury to nerves
  • malfunctioning of peripheral or central nerves
  • postherpetic neuralgia, diabetic neuropathy, phantom pain
  • tingling, burning, itching, electrical shock
133
Q

What does PQRST stand for?

A
  • P- provokes and palliates
  • Q- quality
  • R- region and radiation
  • S- severity
  • T- time
134
Q

What is medication abuse?

A

using medication to alter state of consciuosness

135
Q

What is medication misuse?

A
  • using more medication or taking more often than prescribed
  • altering route of delivery
  • getting drugs from other sources
136
Q

What is medication diversion?

A
  • redirection of medication to someone else for illicit use

- may involve selling or trading medication

137
Q

What is the function frontal lobe?

A

executive function (thought, mathematics, complex reasoning?

138
Q

What is the function parietal lobe?

A

initiation of movement, sense of body, language comprehension (speech and written)

139
Q

What is the function cerebellum?

A

balance and coordination

140
Q

What is the function occipital lobe?

A

vision

141
Q

What is the function temporal lobe?

A

hearing, spatial relationships

142
Q

How many cranial nerves are there?

A

12

-both sensory and motor function

143
Q

How many pairs of spinal nerves are there?

A

31 pairs

-both sensory and motor function

144
Q

What does each spinal nerve contain and what is its function?

A
  • anterior root (motor function)

- posterior root (sensory function)

145
Q

CN I

A

Olfactory- sensory

146
Q

CN II

A

optic- sensory (retina)

147
Q

CN III

A

oculomotor- motor

148
Q

CN IV

A

trochlear- motor

149
Q

CN V

A

trigeminal- motor

150
Q

CN VI

A

abducens- motor

151
Q

CN VII

A

facial- motor

152
Q

CN VIII

A

acoustic/vestibulocochelar- sensory

153
Q

CN IX

A

glossopharyngeal- motor

154
Q

CN X

A

vagus- motor

155
Q

CN XI

A

spinal accessory- motor

156
Q

CN XII

A

hypoglossal- motor

157
Q

What diseases affect gait and balance?

A

Parkinson’s, vertigo

158
Q

What is illusion?

A

false perception of a real external stimulus; the mistaking of something for what it is not

159
Q

What is labile affect?

A

unstable; extreme at certain points

160
Q

What is loose associations?

A

patient’s responses do not relate to the interviewer’s questions – or one paragraph, sentence or phrase is not logically connected to those occurring before or after

161
Q

What is neologism?

A

new word or phrase of the patient’s own making or an existing word used in a new meaning

162
Q

What is obsession?

A

recurrent and persistent idea, thought, or impulse to carry out an act—a desire that cannot be voluntarily suppressed

163
Q

What is perseveration?

A

constant repetition of a meaningless word or phrase

164
Q

What is phobia?

A

any objectively unfounded morbid dread or fear that arouses a state of panic

165
Q

What is tangential?

A

person tends to digress readily from one topic to another (does not get to the point)

166
Q

What is blunted affect?

A

shallowness and a severe reduction in the expression of feeling

167
Q

What is circumstantial?

A

delayed in reaching the point because of unnecessary detail, although components of the discussion have a meaningful connection

168
Q

What is compulsion?

A

repetitive behaviors or mental acts that a person feels driven to perform as an unconscious mechanism to avoid ideas/desires

169
Q

What is delusion?

A

false belief or wrong judgment held with conviction despite evidence to the contrary

170
Q

What is echolalia?

A

involuntary parrot-like repetition of a word or sentence just spoken

171
Q

What is flat affect?

A

absence of or reduction in the outward emotional reaction

172
Q

What is flight of ideas?

A

streams of unrelated words and ideas occur to the patient at a rate that is impossible to vocalize despite a marked increase in the individual’s overall output of words

173
Q

What is hallucination?

A

apparent, often strong subjective perception of an object or event where no stimulus is present

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