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FINAL SCENARIOS Flashcards

1
Q

WHAT IS PQRSTU? WHAT DOES IT STAND FOR?

A

P - PROVACTIVE (what brings it on? what makes it better?)
Q - QUALITY/QUANTITY (how does it feel? intensity?)
R - REGION/RADIATION (where is it? does it spread?)
S - SEVERITY SCALE (1-10)
T - TIMING (onset? duration? frequency?)
U - UNDERSTAND PATIENT’S PERCEPTION OF PROBLEM

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2
Q

MUSCULOSKELETAL ASSESSMENT - SUBJECTIVE ASSESSMENT

8 questions

A 
HEALTH HISTORY:
1. Back pain? PQRSTU.
2. Stiffness? Swelling? Heat? Redness?
3. Limitations in movement?
4. Deformities of bone or joint?
5. Accidents or trauma to bones?
6. Problems with ADL?
7. Medications?
8 Family history of OA or RA?
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3
Q

MUSCULOSKELETAL (SPINE EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT

ORDER OF ASSESSMENTS (3)

A
  1. INSPECTION
  2. PALPATION
  3. ROM OF SPINE
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4
Q

MUSCULOSKELETAL (SPINE EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT

INSPECTION (5)

A
  1. STRAIGHT SPINOUS PROCESS
  2. EQUAL HORIZONTAL POSITIONS OF SHOULDERS, SCAPULAE, ILIAC CRESTS, GLUTEAL FOLDS.
  3. EQUAL SPACES OF ARMS AND LATERAL THORAX
  4. KNEES AND FEET ALIGN WITH TRUNK, POINT FORWARD
  5. FROM SIDE, NOTE CURVATURE OF SPINE: CERVICAL (CONCAVE) THORACIC (CONVEX) AND LUMBAR (CONCAVE)
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5
Q

MUSCULOSKELETAL (SPINE EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT

PALPATION (3)

A
  1. SPINOUS PROCESSES
  2. PARAVERTEBRAL MUSCLES
  3. HIP ROM (TO CHECK FOR CREPITUS)
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6
Q

MUSCULOSKELETAL (SPINE EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT

ROM OF SPINE, ACTIVE (5)

A
  1. FLEXION
  2. EXTENSION
  3. LATERAL BENDING (RIGHT & LEFT)
  4. ROTATION (RIGHT & LEFT)
  5. STRAIGHT LEG RAISING (LASEGUE’S TEST - PAIN = POSITIVE)
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7
Q

MUSCULOSKELETAL (SHOULDER EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT

ORDER OF ASSESSMENTS (4)

A
  1. INSPECTION
  2. PALPATION
  3. ROM OF SHOULDER (ACTIVE OR PASSIVE)
  4. MUSCLE TESTING OF SHOULDER
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8
Q

MUSCULOSKELETAL (SHOULDER EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT

INSPECTION (5)

A
  1. SIZE
  2. CONTOUR
  3. COLOR
  4. SWELLING
  5. MASS OR DEFORMITY
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9
Q

MUSCULOSKELETAL (SHOULDER EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT

PALPATION (4)

A
  1. TEMPERATURE
  2. PAIN
  3. SWELLING OR MASS
  4. CREPITUS
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10
Q

MUSCULOSKELETAL (SHOULDER EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT

ROM OF SHOULDER (5)

A
  1. FLEX, EXTEND & HYPER EXTEND ARMS
  2. TOUCH HANDS TO SCAPULAE BEHIND BACK
  3. ABDUCT ARMS ABOVE HEAD PALMS TOGETHER
  4. BRING ONE ARM DOWN AT A TIME AND SWING ACROSS ABDOMEN
  5. CLASP BOTH HANDS TOGETHER BEHIND HEAD
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11
Q

MUSCULOSKELETAL ASSESSMENT - OBJECTIVE ASSESSMENT

MUSCLE TESTING OF SHOULDER (3)

A
  1. SHRUG THE SHOULDER
  2. FLEX THEM FORWARD AND UP
  3. ABDUCT THEM AGAINST RESISTANCE
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12
Q

ABDOMINAL ASSESSMENT - SUBJECTIVE ASSESSMENT

9

A
  1. APPETITE (CHANGE OR LOSS OF)
  2. SWALLOWING (DIFFICULTY)
  3. FOODS YOU CANNOT TOLERATE
  4. ABDOMINAL PAIN - PQRSTU
  5. BM (FREQUENCY OF)
  6. NAUSEA OR VOMITING
  7. HISTORY OF GI DISEASE
  8. MEDICATIONS
  9. ALL FOOD IN LAST 24 HOURS.
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13
Q

ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT

ORDER OF ASSESSMENTS (4)

A
  1. INSPECTION
  2. AUSCULTATION
  3. PERCUSSION
  4. PALPATION
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14
Q

ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT

INSPECTION (8)

A
  1. CONTOUR OF ABDOMEN
  2. GENERAL SYMMETRY
  3. SKIN COLOUR & CONDITION
  4. PULSATION & MOVEMENT
  5. UMBILICUS
  6. HAIR DISTRIBUTION
  7. STATE OF HYDRATION & NUTRITION
  8. FACIAL EXPRESSION & POSITION
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15
Q

ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT

AUSCULTATION (2)

A
  1. BOWEL SOUNDS
  2. NOTE ANY VASCULAR SOUNDS
    (AORTIC, RENAL, ILLIAC, INGUINAL/FEMORAL)
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16
Q

ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT

PERCUSSION (3 AREAS, 1 ADDITIONAL)

A
  1. PERCUSS ALL 4 Qs
  2. PERCUSS BORDERS OF LIVER SPAN
  3. PERCUSS SPLEEN
  4. IF SUSPECT ASCITES, TEST FLUID WAVE AND SHIFTING DULLNESS
17
Q

ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT

4 THINGS TO LOOK FOR WITH LIGHT PALPATION:

A
  1. MUSCLE WALL
  2. TENDERNESS
  3. ENLARGED ORGANS
  4. MASSES
18
Q

ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT

7 THINGS TO LOOK FOR WITH DEEP PALPATION:

A
  1. MASSES
  2. CONTOUR OF LIVER
  3. SPLEEN
  4. KIDNEYS (DUCK BILL)
  5. AORTA
  6. REBOUND TENDERNESS
  7. CVA TENDERNESS
19
Q

ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT

ADDITIONAL TESTS IF INDICATED

A
  1. INSPIRATORY ARREST (MURPHY’S SIGN)
  2. ILIOSOAS MUSCLE TEST (STRAIGHT LEG)
  3. OBTURATOR TEST (LEG BENT AT 90 DEGREES)
NEGATIVE = NO PAIN
POSITIVE = PAIN
20
Q

PERIPHERAL VASCULAR SYSTEM ASSESSMENT - SUBJECTIVE ASSESSMENT

(9 questions)

A
  1. Pain? PQRSTU
  2. Skin changes?
  3. Skin lesions or sores?
  4. Swelling?
  5. Swollen glands?
  6. Facial skin ever turn blue or ashen?
  7. Medication?
  8. Past history of hear/PV disease?
  9. Family history of heart, PV, disease?
21
Q

PERIPHERAL VASCULAR SYSTEM ASSESSMENT - OBJECTIVE ASSESSMENT

ORDER OF ASSESSMENTS (4)

A
  1. INSPECTION
  2. PALPATE
  3. AUSCULTATE
  4. ADDITIONAL TESTS
22
Q

PERIPHERAL VASCULAR SYSTEM ASSESSMENT - OBJECTIVE ASSESSMENT

INSPECTION (5)

A
  1. COLOUR
  2. HAIR DISTRIBUTION
  3. VENOUS PATTERN/VISCOSITIES
  4. SWELLING OR EDEMA OR ATROPHY - MEASURE CIRCUMFERENCE (R&L)
  5. SKIN LESIONS OR ULCERS
23
Q

PERIPHERAL VASCULAR SYSTEM ASSESSMENT - OBJECTIVE ASSESSMENT

PALPATION (5)

A
  1. TEMP
  2. TENDERNESS
  3. LYMPH NODES
  4. LOCATE AND GRADE PULSES
  5. CHECK EDEMA (GRADE PITTING)
24
Q

PERIPHERAL VASCULAR SYSTEM ASSESSMENT - OBJECTIVE ASSESSMENT

AUSCULTATION (1)

25
Q

PERIPHERAL VASCULAR SYSTEM ASSESSMENT - OBJECTIVE ASSESSMENT

ADDITIONAL TESTS

A
  1. MANUAL COMPRESSION TEST
  2. CHECK COLOUR CHANGE: ELEVATE THEN DANGLE, COLOUR RETURNS IN ______ SECS
  3. ANKLE BRACHIAL INDEX (ABI) - BP MEASURED AT ANKLE COMPARED TO BP MEASURED AT ARM.
26
Q

THORAX & LUNG ASSESSMENT - SUBJECTIVE ASSESSMENT

8 questions

A
  1. PQRSTU
  2. DO YOU HAVE A COUGH
  3. SHORTNESS OF BREATH
  4. CHEST PAIN WITH BREATHING
  5. HISTORY OF LUNG DISEASE
  6. SMOKE
  7. LIVING OR WORK CONDITIONS THAT AFFECT YOUR BREATHING
  8. LAST TB SKIN TEST, CHEST X-RAY OR FLU VACCINE.
27
Q

THORAX AND LUNG ASSESSMENT - OBJECTIVE ASSESSMENT

INSPECTION (6)

A
  1. THORACIC CAGE
  2. RESPIRATORY RATE & PATTERN
  3. SKIN
  4. POSITION
  5. FACIAL EXPRESSION
  6. LEVEL OF CONSCIOUSNESS
28
Q

THORX & LUNG ASSESSMENT - OBJECTIVE ASSESSMENT

PALPATION (3)

A
  1. CONFIRM SYMMETRICAL CHEST EXPANSION
  2. TACTILE FREMITUS
  3. DETECT ANY LUMPS, MASSES, TENDERNESS
29
Q

THORAX & LUNG ASSESSMENT - OBJECTIVE ASSESSMENT

PERCUSSION (2)

A
  1. PERCUSSION NOTE THAT PREDOMINATE OVER LUNG FIELDS (RESONNANCE)
  2. DIAPHRAGMATIC EXCURSION
30
Q

THORAX & LUNG ASSESSMENT - OBJECTIVE ASSESSMENT

AUSCULTATION (3)

A
  1. LISTEN: POSTERIOR, LATERAL, ANTERIOR
  2. NOTE NORMAL BREATH SOUNDS
  3. ANY ABNORMAL BREATH (ADVENTAGIOUS) SOUNDS ~ IF YES, PERFORM BRONCHOPHONY, WHISPERED PECTORILOQUY, EGOPHONY
31
Q

HEART & NECK VESSELS ASSESSMENT - SUBJECTIVE ASSESSMENT

9 questions

A

1) PQRSTU
2) Any chest pain
3) Do you have a cough
4) Do you tire easily?
5) Facial skin ever turn blue or ashen?
6) Any swelling of legs at feet?
7) History of heart disease?
8) Family history of heart disease?
9) Any shortness of breath?

32
Q

HEART & NECK VESSELS ASSESSMENT - OBJECTIVE ASSESSMENT

ORDER OF ASSESSMENTS (4)

A
  1. CAROTID ARTERIES
  2. JUGULAR VENOUS SYSTEM
  3. PRECORDIUM - INSPECT & PALPATE
  4. AUSCULTATION
33
Q

HEART & NECK VESSELS ASSESSMENT - OBJECTIVE ASSESSMENT

CAROTID ARTERIES (1)

A
  1. GRADE R & L (0, 1+, 2+, 3+ BOUNDING)
34
Q

HEART & NECK VESSELS ASSESSMENT - OBJECTIVE ASSESSMENT

JUGULAR VENOUS SYSTEM (2)

A
  1. EXTERNAL JUGULAR VEINS

2. INTERNAL JUGULAR PULSATIONS - ESTIMATE VENOUS PRESSURE

35
Q

HEART & NECK VESSELS ASSESSMENT - OBJECTIVE ASSESSMENT

PRECORDIUM - INSPECT & PALPATE (4)

A
  1. SKIN COLOUR AND CONDITION
  2. CHEST WALL PULSATIONS
  3. HEAVE OR LIFT
  4. APICAL IMPULSE IN THE 4TH/5TH INTERCOSTAL SPACE AT MIDCLAVICULAR LINE, SIZE (NORMALLY 1-2 CM), AMPLITUDE (ABSENT 0, 1+, 2+, 3+ BOUNDING)
36
Q

HEART & NECK VESSELS ASSESSMENT - OBJECTIVE ASSESSMENT

AUSCULTATION (4)

A
  1. ANATOMICAL AREAS TO LISTEN (AORTIC VALVE AREA, PULMONIC VALVE AREA, ERB’S POINT, TRICUSPID VALVE AREA, MITRAL VALVE AREA)
  2. RATE & RHYTHM
  3. IDENTIFY S1 & S2, AND ANY VARIATIONS
  4. LISTEN FOR: A) EXTRA HEART SOUNDS B) MURMURS

HEALTH ASSESSMENT (3 decks)

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