General Appearance & Vitals Flashcards
1
Q
IPPA
A
Inspection
Palpation
Percussion
Auscultation
2
Q
Steps for identifying Problems/Making Diagnosis (7)
A
- ID abnormal findings
- Localize findings anatomically
- Cluster the clinical findings
- Search for the probable cause of the diagnosis
- Cluster the clinical data
- Generate hypothesis
- Test hypothesis
3
Q
SOAP note?
A
Subjective, Objective, Assessment, Plan
4
Q
Rapid changes in weight over a few days may suggest?
A
Changes in body FLUID and NOT tissue
aka edema
5
Q
Define fatigue?
A
sense of weariness or loss of energy
6
Q
Define weakness
A
Demonstrable loss of muscle power
7
Q
Localized weakness can suggest?
A
Myopathy or neuropathy
8
Q
Recurrent shaking chills can be_____?
A
Bacteremia
9
Q
Sweating can indicate?
A
- Fever
- Menopause**
10
Q
Night sweats make you think of? (3)
A
TB
menopause
malignancy
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
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
13
Q
Top three topics to discuss with PT during health promotion and counseling
A
- Weight, nutrition and diet
- BP and dietary sodium
- Exercise
14
Q
Four steps to promote optimal weight and nutrition?
A
- Measure BMI and waist circumference
- Assess dietary intake
- Assess PT’s motivation to change
- Provide counseling about nutrition and exercise
15
Q
Two main components to general survery?
A
General appearance and ht/wt
16
Q
Parts of the general appearance? (8)
A
- Apparent state of health
- Level of consciousness
- Signs of distress present?
- Skin color and obvious lesions
- Dress, grooming and personal hygiene
- Facial expression
- Odors of body and breath
- Posture, gait and motor activity
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
18
Q
masked facies?
A
Associated with Parkinson’s
-loss of facial expressions
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?
20
Q
How do you calculate BMI?
A
Weight (lbs) x 700
_______________
height (inches)
21
Q
BMI <18.5?
A
Underweight
22
Q
BMI of 18.5-24.9?
A
Normal
23
Q
BMI 25.0-29.9?
A
Overwt
24
Q
BMI 30.0-34.9
A
Obesity I
25
BMI 35.0-39.9?
Obesity II
26
BMI >or equal to 40?
Extreme obesity
27
List the vital signs
```
BP
HR/rhythm
RR and rhythm
temp
Pain
```
28
Avoid ____ and _____ before taking a BP?
| -How many minutes prior?
smoking or drinking caffeinated bevs 30 minutes prior
29
Feet on the ____ for at least ___ minutes prior to taking BP
feet on the floor for at least 5 minutes
30
Which artery do we palpate prior to taking BP?
brachial
31
WIDTH of BP should be ___% of upper arm circumference
40%
32
LENTH of BP should be ___% of upper arm circumference
80%
33
Place BP cuff ___cm above ____?
2.5 cm above antecubital crease
34
Define auscultatory gap and what disease it indicates
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
+ orthostatic?
SBP drops > 20mmHg or diastolic DBP drops >10mmHg
36
Normal SBP and DBP for adults
SBP: <120mmHg
DBP: <80 mmHg
37
If BP is elevated, what steps do you take next?
1. repeat BP and verify in contralateral arm
| 2. consider white coat HTN
38
PreHTN readings?
SBP: 120-139
DBP: 80-89
39
HTN stage 1 readings?
SBP: 140-159
DBP: 90-99
40
HTN stage 2 readings?
SBP: >159
DBP: >100
41
If the brachial artery is BELOW heart level, the BP reading will be _____?
HIGHER
42
If the brachial artery is ABOVE heart level, the BP reading will be _____?
LOW
43
Pressure difference of 10 to 15 mmHg can indicate what pathologies? (3)
Aortic Dissection
Subclavian steal syndrome
Supravalvular aortic stenosis
44
A BP Difference of ___ and ___ may indicate aortic dissection
10-15 mmHg
45
We observe the respiratory rate for adequate?
- rate
- rhythm
- depth
- effort of breathing
46
normal RRs?
around 18 BPM
47
AVG oral temp in C and F
37C
| 98.6F
48
Diurnal variation of temperate means?
body temp varies throughout the day
49
Rectal temp is higher or lower than oral temp?
| By how much?
higher
| 0.5C or 1F
50
Axillary temp is higher or lower than oral temp?
| By how much?
lower by 0.5C or 1F
51
Tympanic temp is higher or lower than oral temp
| by how much?
0.8C or 1.4 F
52
Pain assessment questions? (6)
```
location
severity
associated features
attempted txs/medications
related illness
impact on daily activities
```
53
Nociceptive or somatic pain related to?
tissue damage
54
neuropathic pain results from?
direct trauma to peripheral or central NS
55
Psychogenic pain relates to?
factors that influence PTs report of pain
- psychiatric conds
- personality and coping style
- cultural norms
- social supp system
56
idiopathic pain
no identifiable cause
57
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
B: repeat BP and verify in contralateral arm
58
Fatigue is common symptom in which disorders?
- depression
- Anxiety
- Infections
- Endocrine disorders
- HF
- Chronic disease of lungs, kidneys or liver
- anemia
- malignancy
- nutritional deficits
- medications
59
Immunocomp PTs with sepsis describe fever?
Absent, low-grade or hypothermic even
60
what is present in HF, nephrotic syndrome, liver failure and venous stasis?
extravascular fluid retention aka edema
61
List drugs that are associated with WT gain?
```
TCA
insulin
sulfa
contraceptives
glucocorticos
steroids in general
paroxetine
gabapentin
valproate
propranolol
```
62
List some causes of weight loss
- GI disease
- endocrine disorders--DM, hyperthyroidism, adrenal insufficinecy
- chronic infections HIV/AIDS
- malignancy
- chronic cardiac, pulm, or renal failure
- depression
- anorexia/bulimia
63
WT loss with high food intake suggests? (4)
- DM
- hyperthyroidism
- malabsorption disease
- bulimia
64
List some factors that increase PT risk of malnutrition?
```
poverty
old age
physical disability
emotional or mental impairment
lack of teeth
ill-fitting dentures
alcoholism
drug abuse
```
65
Drug classes associated with WT loss? (6)
- anticonvulsants
- antidepressants
- levodopa
- digoxin
- metformin
- thryoid meds
66
Breath of acetone indicates?
DM (fruity odor)
67
PTs with COPD prefer to position themselves ____?
leaning forward
68
PTs with CHF prefer to sit ____?
upright
69
Auscultatory gap can lead to underestimation and overestimation of what?
Underestimation of SBP and overestimation of DBP
70
Causes of orthostatic hypotension (4)
prolong bed rest
medications
moderate-severe blood loss
disease of ANS
71
Systolic HTN in upper extremities and lower BP in legs can indicate what?
Coarcation of aorta
| occlusive aortic disease
72
Prolonged expiration associated with?
COPD
73
Pyrexia?
Elevated body temp
| fever
74
Hyperpyrexia?
-extreme elevation in temperature above 41.1C or 106F
75
Hypothermia?
Abnormally low body temp
| <35C or 95C
76
causes of fever? (5)
- infection
- trauma like surgery or crushing injuries
- malignancy
- drug rxns
- immune disorders: collagen vasc disease
77
Chief cause of hypothermia?
| -other causes
-exposure to cold MCC
OTHERS:
- reduced movement--paralysis
- interference with vasoconstriction--sepsis or excess ETOH
- starvation
- hypothyroidism
- hypoglycemia
