General Flashcards
Inspection
Info gathered from observation-vision, hearing smell
Palpation
systematic sweeping motions of the skin, palpation, temperature
Percussion
Tapping to determine density of underlying anatomy
Auscultation
listening to bodily functions with stethoscope, never listen over clothing, heart sounds/breath sounds
Its important to keep your patient ….
Informed and explain steps, talk before touch
General Survey (6 things)
Overall state of health, height (posture/build), dress/hygiene, facial expressions, body language, speaking, awareness
Height and weight
Measure height without shoes, obtain weight with less clothing
Don’t weight children if they have a
wet/dirty diaper, creates extra weight
Normal temp?
98.6
Fever?
> 100.4
Measurement of temp? (4)
- Rectal: higher than oral
- Oral: affected by beverages and respiratory rate
- Axillary: lower than
- Infrared: tympanic membrane (close to core temp) or temporal (affected by skin and vascular changes)
How to take radial pulse
Count 15 secondsx4 or 60 seconds, if any irregularity count 60 seconds, note quality of pulse (strength, irregularities)
Types of pulse (3)
Radial, brachial (better with kids), apical (if peripheral pulse is hard to obtain)
Normal pulse
60-100 per min
Tachycardia
> 100 bpm
Bradycardia
<60 bpm
How to record respiration
Keep fingers on radial pulse but watch chest rise and fall, count 15-30 seconds
Note effort on exertion, inhalation
Normal respiration
14-20 /minutes
Tachypnea
> 20
Bradypnea
<14, slow
How to measure BP
Sphygmomanometer, mmHG
Systolic
peak pressure
Diastolic
Trough pressure
Difference between SBP and DBP
Pulse pressure
BP cuff size
for accurate measurement, large vs pediatric, do not take BP over clothing
Patient position for BP measurement
sit for 5 minutes feet on ground, no caffeine, smoking, or exercise for 30 minutes, calm room,arm should be relaxed and slightly flexed at elbow but support arm while taking pressure, brachial artery at level of heart
Bladder cuff should be positioned?
2cm above antecubital crease
BP technique
Bell/diaphragm over brachial artery and listen for Korotkoff sounds
- First two beats=systolic
- Disappear- diastolic
Consider this is you get an abnormal BP reading
-Size of cuff, clothing, compare with other arm, wait 15-30 min to recheck, have someone else compare readings
Orthostatic BP
Patient supine for 5 min before initial readings
-Check supine, sitting, and standing : within three minutes of position change
Abnormal Orthostatic reading
> 20 mmHG drop in SBP or >10 mmHG drop in DPP or increase of >20mmHG SBP
