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Physical Assessment 1 > General Appearance & Vitals > Flashcards

General Appearance & Vitals Flashcards

1
Q

IPPA

A

Inspection
Palpation
Percussion
Auscultation

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2
Q

Steps for identifying Problems/Making Diagnosis (7)

A
  1. ID abnormal findings
  2. Localize findings anatomically
  3. Cluster the clinical findings
  4. Search for the probable cause of the diagnosis
  5. Cluster the clinical data
  6. Generate hypothesis
  7. Test hypothesis
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3
Q

SOAP note?

A

Subjective, Objective, Assessment, Plan

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4
Q

Rapid changes in weight over a few days may suggest?

A

Changes in body FLUID and NOT tissue

aka edema

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5
Q

Define fatigue?

A

sense of weariness or loss of energy

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6
Q

Define weakness

A

Demonstrable loss of muscle power

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7
Q

Localized weakness can suggest?

A

Myopathy or neuropathy

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8
Q

Recurrent shaking chills can be_____?

A

Bacteremia

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9
Q

Sweating can indicate?

A
  • Fever

- Menopause**

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10
Q

Night sweats make you think of? (3)

A

TB
menopause
malignancy

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11
Q

Weight loss can point to which body systems? (6)

A 
GI
Endocrine (Thyroid or DM) 
Chronic infection 
HIV/AIDS 
Malignancy 
PSYCH: depression, anorexia/bulimia
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12
Q 
PT presents with a 6 day hx of rapid weight agin. Most likely explanation is: 
A. Dysphagia 
B. Excessive absorption of nutrients 
C. DM 
D. Accumulation of body fluids
A

D: accum of body fluid

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13
Q

Top three topics to discuss with PT during health promotion and counseling

A
  1. Weight, nutrition and diet
  2. BP and dietary sodium
  3. Exercise
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14
Q

Four steps to promote optimal weight and nutrition?

A
  1. Measure BMI and waist circumference
  2. Assess dietary intake
  3. Assess PT’s motivation to change
  4. Provide counseling about nutrition and exercise
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15
Q

Two main components to general survery?

A

General appearance and ht/wt

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16
Q

Parts of the general appearance? (8)

A
  1. Apparent state of health
  2. Level of consciousness
  3. Signs of distress present?
  4. Skin color and obvious lesions
  5. Dress, grooming and personal hygiene
  6. Facial expression
  7. Odors of body and breath
  8. Posture, gait and motor activity
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17
Q

What can be inferred from a PT wearing excessive clothing?

A
  • Anorexia
  • Hiding track marks
  • Hypothyroidism if they are always cold
  • Slipper–gout or edema
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18
Q

masked facies?

A

Associated with Parkinson’s

-loss of facial expressions

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19
Q

If obese, what is important to note about body apperance?

A

Is fat distributed evenly or concentrated over trunk upper torso or around hips?

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20
Q

How do you calculate BMI?

A

Weight (lbs) x 700
_______________
height (inches)

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21
Q

BMI <18.5?

A

Underweight

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22
Q

BMI of 18.5-24.9?

A

Normal

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23
Q

BMI 25.0-29.9?

A

Overwt

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24
Q

BMI 30.0-34.9

A

Obesity I

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25
Q

BMI 35.0-39.9?

A

Obesity II

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26
Q

BMI >or equal to 40?

A

Extreme obesity

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27
Q

List the vital signs

A 
BP 
HR/rhythm 
RR and rhythm
temp
Pain
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28
Q

Avoid ____ and _____ before taking a BP?

-How many minutes prior?

A

smoking or drinking caffeinated bevs 30 minutes prior

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29
Q

Feet on the ____ for at least ___ minutes prior to taking BP

A

feet on the floor for at least 5 minutes

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30
Q

Which artery do we palpate prior to taking BP?

A

brachial

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31
Q

WIDTH of BP should be ___% of upper arm circumference

A

40%

32
Q

LENTH of BP should be ___% of upper arm circumference

A

80%

33
Q

Place BP cuff ___cm above ____?

A

2.5 cm above antecubital crease

34
Q

Define auscultatory gap and what disease it indicates

A

Silent interval that may be present b/w the SBP and DBP

  • i.e. the sound disappears for a while.. then reappears
  • indicates atherosclerotic disease
35
Q

+ orthostatic?

A

SBP drops > 20mmHg or diastolic DBP drops >10mmHg

36
Q

Normal SBP and DBP for adults

A

SBP: <120mmHg
DBP: <80 mmHg

37
Q

If BP is elevated, what steps do you take next?

A
  1. repeat BP and verify in contralateral arm

2. consider white coat HTN

38
Q

PreHTN readings?

A

SBP: 120-139
DBP: 80-89

39
Q

HTN stage 1 readings?

A

SBP: 140-159
DBP: 90-99

40
Q

HTN stage 2 readings?

A

SBP: >159
DBP: >100

41
Q

If the brachial artery is BELOW heart level, the BP reading will be _____?

A

HIGHER

42
Q

If the brachial artery is ABOVE heart level, the BP reading will be _____?

A

LOW

43
Q

Pressure difference of 10 to 15 mmHg can indicate what pathologies? (3)

A

Aortic Dissection
Subclavian steal syndrome
Supravalvular aortic stenosis

44
Q

A BP Difference of ___ and ___ may indicate aortic dissection

A

10-15 mmHg

45
Q

We observe the respiratory rate for adequate?

A
  • rate
  • rhythm
  • depth
  • effort of breathing
46
Q

normal RRs?

A

around 18 BPM

47
Q

AVG oral temp in C and F

A

37C

98.6F

48
Q

Diurnal variation of temperate means?

A

body temp varies throughout the day

49
Q

Rectal temp is higher or lower than oral temp?

By how much?

A

higher

0.5C or 1F

50
Q

Axillary temp is higher or lower than oral temp?

By how much?

A

lower by 0.5C or 1F

51
Q

Tympanic temp is higher or lower than oral temp

by how much?

A

0.8C or 1.4 F

52
Q

Pain assessment questions? (6)

A 
location 
severity 
associated features 
attempted txs/medications 
related illness 
impact on daily activities
53
Q

Nociceptive or somatic pain related to?

A

tissue damage

54
Q

neuropathic pain results from?

A

direct trauma to peripheral or central NS

55
Q

Psychogenic pain relates to?

A

factors that influence PTs report of pain

  • psychiatric conds
  • personality and coping style
  • cultural norms
  • social supp system
56
Q

idiopathic pain

A

no identifiable cause

57
Q

A patient presents a routine check-up. You see that the patient’s vital signs have already been recorded as follows:
T 98.4 F, HR 74, R 18, BP 180/98
What would be the MOST appropriate action related to this patient’s vital signs?

A. BP should be repeated at the next visit
B. Repeat BP and verify contralateral arm
C. Check the HR again to see if it is regular
D. Listen to PT’s lungs for adventitious sounds

A

B: repeat BP and verify in contralateral arm

58
Q

Fatigue is common symptom in which disorders?

A
  • depression
  • Anxiety
  • Infections
  • Endocrine disorders
  • HF
  • Chronic disease of lungs, kidneys or liver
  • anemia
  • malignancy
  • nutritional deficits
  • medications
59
Q

Immunocomp PTs with sepsis describe fever?

A

Absent, low-grade or hypothermic even

60
Q

what is present in HF, nephrotic syndrome, liver failure and venous stasis?

A

extravascular fluid retention aka edema

61
Q

List drugs that are associated with WT gain?

A 
TCA
insulin 
sulfa 
contraceptives 
glucocorticos 
steroids in general 
paroxetine 
gabapentin 
valproate 
propranolol
62
Q

List some causes of weight loss

A
  • GI disease
  • endocrine disorders–DM, hyperthyroidism, adrenal insufficinecy
  • chronic infections HIV/AIDS
  • malignancy
  • chronic cardiac, pulm, or renal failure
  • depression
  • anorexia/bulimia
63
Q

WT loss with high food intake suggests? (4)

A
  • DM
  • hyperthyroidism
  • malabsorption disease
  • bulimia
64
Q

List some factors that increase PT risk of malnutrition?

A 
poverty 
old age 
physical disability 
emotional or mental impairment 
lack of teeth 
ill-fitting dentures 
alcoholism 
drug abuse
65
Q

Drug classes associated with WT loss? (6)

A
  • anticonvulsants
  • antidepressants
  • levodopa
  • digoxin
  • metformin
  • thryoid meds
66
Q

Breath of acetone indicates?

A

DM (fruity odor)

67
Q

PTs with COPD prefer to position themselves ____?

A

leaning forward

68
Q

PTs with CHF prefer to sit ____?

A

upright

69
Q

Auscultatory gap can lead to underestimation and overestimation of what?

A

Underestimation of SBP and overestimation of DBP

70
Q

Causes of orthostatic hypotension (4)

A

prolong bed rest
medications
moderate-severe blood loss
disease of ANS

71
Q

Systolic HTN in upper extremities and lower BP in legs can indicate what?

A

Coarcation of aorta

occlusive aortic disease

72
Q

Prolonged expiration associated with?

A

COPD

73
Q

Pyrexia?

A

Elevated body temp

fever

74
Q

Hyperpyrexia?

A

-extreme elevation in temperature above 41.1C or 106F

75
Q

Hypothermia?

A

Abnormally low body temp

<35C or 95C

76
Q

causes of fever? (5)

A
  • infection
  • trauma like surgery or crushing injuries
  • malignancy
  • drug rxns
  • immune disorders: collagen vasc disease
77
Q

Chief cause of hypothermia?

-other causes

A

-exposure to cold MCC

OTHERS:

  • reduced movement–paralysis
  • interference with vasoconstriction–sepsis or excess ETOH
  • starvation
  • hypothyroidism
  • hypoglycemia

Physical Assessment 1 (7 decks)

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