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MSS PCM Exam 1 > General Assessment and Vital Signs > Flashcards

General Assessment and Vital Signs Flashcards

1
Q

what is the traditional examination position?

A

patients right side

-for JVD assessment, PMI, and hidden left kidney

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2
Q

PMI

A

point of maximal impulse of the heart

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3
Q

two types of exams?

A

comprehensive and problem-focused

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4
Q

comprehensive exam?

A

new patient, annual PE, general exam of all alreas

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5
Q

problem-focused exam?

A

established patients, specific concerns, routine or urgent exam

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6
Q

subjective

A

what the patient tells you

-history, from chief complaint through ROS

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7
Q

objective

A

what you collect during your physical exam of the patient

-inspect, palpate, auscultate, percuss

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8
Q

core vitals?

A

blood pressure
heart rate and rhythm
respiratory rate and rhythm
temperature

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9
Q

additional vitals

A

height and weight
BMI
SaO2
Pain Level

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10
Q

BMI?

A

body mass index

weight (kg) / height (m*2)

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11
Q

what does the bell of the stethoscope hear?

A

low frequency

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12
Q

what does the diaphragm of the stethoscope hear?

A

high frequency

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13
Q

size of BP cuff?

A

width 40% of upper arm

length 80% of upper arm circumference

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14
Q

where to take blood pressure?

A

left arm at heart level
-patient sits at least 5 minutes

**patient should avoid smoking and caffeine (30 minutes)

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15
Q

exception for changing side of BP?

A

history of axillary node dissection on left side

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16
Q

where should the blood pressure cuff be?

A

one inch above antecubital crease

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17
Q

two types of blood pressures?

A

palpatory and ausculatory

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18
Q

palpatory blood pressure?

A

brachial or radial artery

palpatory pressure is when inflate cuff and pulse disappears
-can also deflate and return pulse return

add 30 to the number and use as future inflation target**
-avoids pain and auscultatory gap

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19
Q

auscultatory gap

A

silent episode between systolic and diastolic endpoints

might get a silent systolic

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20
Q

auscultory blood pressure

A

can use bell or diaphragm

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21
Q

kortokoff sounds

A

low pitched and are the turbulent flow during BP measure

22
Q

average BP?

A

two measurements and 2 minutes between readings

more than 10mm difference - check again

23
Q

pathology in bilateral BP?

A

difference greater than 10-15 mmHg

24
Q

normal BP?

A

less than 120 / less than 80

25
Q

pre-hypertension, stage 1, and stage 2 BP?

A

pre-HTN - 120-139 / 80-89
stage 1 - 140-159 / 90-99
stage 2 - greater 160 / greater 100

26
Q

orthostatic BP?

A

postural hypotension

2 or three positions
-supine - sitting - standing

within 3 minutes

drop of 20mm systolic or 10mm diastolic
-pathologic

27
Q

radial pulse

A

15 seconds x 4

also, pay attention to rhythm

28
Q

normal HR?

A

60-100

29
Q

respiratory rate

A

be sneaky

should be regular

30
Q

normal RR?

A

14-20

31
Q

prolonged exhalation?

A

in COPD patients

32
Q

bradypnea

A

slow rate

33
Q

tachypnea

A

fast rate and shallow

34
Q

hypernea

A

deep and fast

35
Q

cheyne-stokes

A

growing and diminishing depths

36
Q

peripheral oxygen saturation

A

SpO2

measure of oxygen in blood
want greater than 92 (normal 97-99)

low O2 look for signs of cyanosis

37
Q

normal temperature?

A

98.6 and 37

range 96.4-99.1

38
Q

axillary temp?

A

lower by 1 degree

39
Q

tympanic temp?

A

higher by 0.8 with no wax

40
Q

oral temp?

A

gold standard?

41
Q

rectal temp?

A

higher by o.4

42
Q

underweight BMI?

A

less than 18.5

43
Q

normal BMI?

A

18.5 - 24.9

44
Q

overweight BMI?

A

25-29.9

45
Q

obese BMI?

A

greater than 30

46
Q

extremely obese BMI?

A

greater than 40

47
Q

pain level

A

is subjective, but can be used objectively

48
Q

why head to to physical exam?

A

encourage systemic approach (more efficient)
more hygienic
facilitate relationship before more sensitive areas

49
Q

percussion?

A

striking or plexor finger (3rd)

50
Q

general assessment

A

first part of physical exam (9 parts)

apparent state of health
LOC
signs of distress
height, build, weight
skin color and easily seen lesions
dress/personal hygiene, body breath odor
odors are clues to diagnosis
facial expression and eye contact
posture, gait, motor activity

MSS PCM Exam 1 (10 decks)

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