General Exam 1 Flashcards
What indicates a fever?
100.4, chills indicate a rising temperature, hot and sweaty are FALLING temperature
always ask what time of day
What manipulates temperature?
time of day, recent exposures, smoking, technique, medications
What is the gold standard core temp?
pulmonary artery temperature
What do you do for temp?
rectal –> oral –> axillary is last
What BMI numbers are important to recognize?
> 25 is overweight, >30 is obese
What is weight loss that should be concerning?
5% or more over 6 months
What should you notice upon entering the room?
appearance of health, level of consciousness, signs of distress, skin color and obvious lesions, dressing, grooming, hygiene, facial expression, odors, posture, height and weight
What else should you measure when looking at risk of HTN, DM, and CAD?
waist circumference, >35 in women, >40 in men
What are blood pressure syndromes to be aware of?
white coat syndrome, masked HTN
What should you remember about the cuff regarding getting an accurate blood pressure?
too narrow = false elevated pressure
too wide = false low on small, false high on large
length should be 80%
width should be 40%
What should you double check before taking the blood pressure?
no smoking, caffeine, exercise 30 min prior
feet flat
arm free of clothing
2.5 cm of antecubital crease
What is stage 1 versus stage 2 HTN?
Stage 1 130s, stage 2 140s
What is orthostatic hypotension?
drop in systolic of 20 or diastolic of 10
What is the normal heart rate and respiratory rate?
60-100 bpm, and 12-20 rr
What type of pain presents as dull, pressing, pulling, throbbing, boring, spasmodic, colicky?
nociceptive/somatic
What type of pain presents as burning, stabbing, shock-like, pins and needles
neuropathic
What is the helpful mnemoic to remember eye movements and cranial nerves?
LR6 SO4 AO3
lateral rectus 6
superior oblique 4
all others 3
What does the inferior oblique do in the eye?
out and up
What’s the difference between lid lag and ptosis?
ptosis is when the eyelid sags and covers the sclera
What does the superior oblique do in the eye?
In and down
What is an eye characteristic of Wilson disease?
copper ring around the eye from copper deposition “kayer-fleischer ring”
What is a corneal arcus?
white ring around eye
When there is an injury to the trochlear nerve and your patient says it helps to tilt their head to the right and worsens when tilting to the left, where is the lesion, where is the eye issue?
the eye issue is always the opposite of where they are tilting. So, the issue is in the left side. Where the lesion is is always where they are tilting. So
lesion = on the right
affected eye = left
How does the trochlear nerve work?
It is contralateral
How do you test the first cranial nerve?
Smell, see if they can smell and occlude each nostril
How do you test the second cranial nerve?
Visual acuity and visual fields test the optic nerve
How do you test the third, fourth, and sixth cranial nerves?
EOMs
How do you test the fifth cranial nerve?
feeling of three sections of face with q tip, and feeling clenching of jaw in temple and jaw
How do you test the seventh cranial nerve?
Facial nerve – smile, frown, raise eyebrows, try to open eyes
How do you test the eighth cranial nerve?
Whisper test
How do you test the ninth and tenth cranial nerve?
During mouth examination, say “ah”, and gag reflex
How do you test the eleventh cranial nerve?
Shrug shoulders and nod, shake head against your hand
How do you test the twelveth cranial nerve?
Stick tongue out and move side to side
How do you check CN VIII in a comatose patient?
vestibuo-ocular reflex
towards cold water in the ear
away from hot water in the ear
