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patient centered care > genreal assessment and vital signs > Flashcards

genreal assessment and vital signs Flashcards

1
Q

What areas are involved in the physical assessment?

A

head, eyes, ears, nose, throat, neck, CV, lungs, abdomen, extremities, neuro, psych, skin

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2
Q

Underweight BMI

A

less than 18.5

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3
Q

Normal weight BMI

A

18.5-24.9

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4
Q

Overweight BMI

A

25-29.9

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5
Q

Class 1 obesity BMI

A

30-34.9

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6
Q

Class 2 obesity BMI

A

35-39.9

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7
Q

Class 3 obesity BMI

A

greater than 40

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8
Q

BMI inaccuracies

A

does not consider muscle mass or body fat percentage
was created over 200 years ago for white race
nothing currently studied to replace BMI clinically

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9
Q

Edema

A

fluid leaking into tissues or swelling

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10
Q

Causes of edema

A

heart, kidney, or liver function
medication
inflammation
injury
diet
blood clot/obstruction
pregnancy

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11
Q

Edema grades

A

1: mild pitting, slight indentation, no visible swelling
2: moderate pitting, indentation subsides quickly, no visible swelling
3: deep pitting, indentation may last up to a minute, visible swelling
4: very deep pitting, indentation lasts 2-5 minutes, significant swelling

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12
Q

Normal body temperature

A

96.8-99 F
36-37.2 C

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13
Q

Where is body temperature most commonly taken?

A

rectal (most accurate)
temporal (accurate)
tympanic (accurate)
oral (0.5-1 F lower than rectal)
axillary (1-2 F lower than rectal)

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14
Q

When should you refer for a fever?

A

temp greater than 104
temp greater than 100.4 plus nonresponsive to medication and lasts longer than 3 days
greater than 100.4 and symptomatic

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15
Q

Normal adult and child (6-12) pulse and respiratory rate

A

adult:
60-100
12-20
child:
80-120
12-20

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16
Q

How to check pulse rate

A

using the pads of your first and second fingers, place your fingers on the wrist medial to the radial bone
press down until you can feel the pulse
count the number of beats you feel in 30 seconds and multiply by 2

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17
Q

When should you refer for pulse?

A

greater than 100 BPM while resting AND chest pain or discomfort, SOB, weakness, dizziness, or fainting
less than 40 BPM while awake AND chest pain or discomfort, SOB, dizziness, fainting, or confusion

18
Q

How to check respiratory rate

A

continue to pretend to take pulse
watch patient’s chest and abdomen for respirations
count the number of respirations in 30 seconds and multiply by 2

19
Q

When should you refer for respiratory rate?

A

greater than 25 RPM AND low BP or change in consciousness
greater than 25 RPM AND difficulty breathing, coughing, wheezing, and increased mucous
less than 12 RPM AND goes limp, change in consciousness, or turns blue

20
Q

Systolic BP

A

maximum pressure on the arteries during contraction of the left ventricle (regulated by stroke volume)

21
Q

Diastolic BP

A

resting pressure between ventricle contractions

22
Q

Systolic/Diastolic BP

A

most reported
well established CV disease risk factors

23
Q

MAP

A

[SBP + (2xDBP)] /3
1/3SBP +2/3DBP

24
Q

Auscultatory technique

A

manual/traditional method
brachial artery occluded to stop blood flow
stethoscope to detect appearance and disappearance of Korotkoff sounds
error prone

25
Q

Oscillometric technique

A

automatic cuff
read based on amplitude of oscillations recorded in the lateral walls of the upper arm
software on device

26
Q

What is the proper position the patient should be in when taking BP?

A

seated
arm supported at heart level
back supported
uncrossed legs
feet flat on the floor

27
Q

How should the BP cuff be placed on the patient’s arm?

A

bare skin and not over clothing (rolling up sleeves could create a tourniquet effect)
bottom of cuff should be 1/2 inch above the elbow
once cuff is in place it should be snug and finger should easily fit at the top and bottom

28
Q

How should you place the stethoscope when taking BP?

A

stethoscope should be placed over brachial artery at antecubital space
make sure the cuff is aligned so that the artery marker points to the brachial artery

29
Q

What are the 5 phases of Korotkoff sounds?

A

phase 1: faint and clear tapping (systolic)
phase 2: swooshing sound
phase 3: more intense, crisp tapping
phase 4: muffled sound
phase 5: sound stops (diastolic)

30
Q

What patient factors can alter BP?

A

medications
drugs of abuse
caffeine consumption
nicotine consumption
exercise in the past 30 minutes
time of day
pain/stress
talking during measurement
full bladder

31
Q

Steps to taking a manual BP

A
  1. insert the earpieces of the stethoscope (pointing forward) into your ears
  2. place the bell of the stethoscope over the palpable brachial brachial artery lightly (with an air-tight seal)
  3. inflate the cuff rapidly to the maximum inflation level (180 in a normal patient, 220 in hypertensive patients)
  4. release the air slowly (2-3 mmHg/sec)
  5. note the pressure when the first sound is heard (systolic pressure)
  6. note the pressure when the last sound is hears (diastolic)
  7. continue listening until 20 mmHg below last sound
32
Q

Normal adult BP

A

less than 120 and less than 80

33
Q

Elevated adult BP

A

120-129 and less than 80

34
Q

Stage 1 hypertension BP

A

130-139 or 80-89

35
Q

Stage 2 hypertension BP

A

140 or higher or 90 or higherh

36
Q

Hypertensive crisis BP

A

higher than 180 and/or higher than 120

37
Q

Hypertensive urgency

A

SBP > 180 mmHg
and/or DBP > 120 mmHg

38
Q

Hypertensive emergency

A

SBP > 180 mmHg
and/or DBP > 120
AND target organ damage

39
Q

When should you refer for BP?

A

SBP > 180 mmHg
and/or DBP > 120
AND target organ damage (chest pain, SOB, numbness or weakness, vision changes, difficulty speaking, severe headache)

40
Q

Lifestyle changes that can impact BP

A

weight loss
DASH dietary plan
reduced dietary sodium
increased dietary potassium
physical activity
moderation in alcohol
tobacco cessation

patient centered care (4 decks)

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