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Phys. Diag. and Pat. Eval Lab > History Taking/General Survey/Vital Signs Exam > Flashcards

History Taking/General Survey/Vital Signs Exam Flashcards

1
Q

What are some vital signs you can take on your patient?

A 
Blood pressure
Heart Rate
Respiratory Rate
Temperature
Can also be;
Height/Weight
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2
Q

What is the 5th vital sign?

A

Pain

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3
Q

What are some kinds of pain?

A

Nociceptive, neuropathic, psychogenic, idiopathic

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4
Q

What is nociceptive pain?

A

somatic pain. pain linked to tissue damage of skin, musculoskeletal system or viscera

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5
Q

what is neuropathic pain?

A

pain related to direct affect to somatosensory system

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6
Q

what can cause psychogenic pain?

A

psychiatric conditions, personality/coping styles, cultural influences

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7
Q

idiopathic pain?

A

no identifiable eitology

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8
Q

4 A’s when monitoring patient outcomes

A

Analgesia
Activities of daily living
Adverse effects
Aberrant drug-related behaviors

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9
Q

what are types of blood pressure cuffs?

A

sphygmomanometer (aneroid, electronic, hybrid), mercury blood pressure cuffs, home blood pressure monitoring, and ambulatory blood pressure

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10
Q

best place to hear for BP

A

brachial artery

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11
Q

Slow or repetitive inflations of the cuff cause what?

A

venous congestion

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12
Q

how much should the cuff be deflated?

A

2-3 mmHg per second

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13
Q

Blood pressure differences of >10-15 mmHg suggest what?

A
  • subclavian steal syndrome
  • aortic dissection
  • supra-valvular aortic stenosis
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14
Q

what conditions is auscultatory gap associated with?

A

arterial stiffness and atherosclerotic disease

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15
Q

what is the auscultatory gap?

A

silent interval that may be present between systolic and diastolic pressures. can lead to under-estimation of systolic pressure or over-estimation of diastolic pressure.

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16
Q

what is the gold standard for confirmation of elevated BP?

A

24 hour ambulatory blood pressure

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17
Q

what are issues with the 24 hour ambulatory blood pressure?

A

limited availability and poor insurance coverage

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18
Q

when is hypertension diagnosed in the office?

A

after 2 office readings >140/90 on two sep. occasions

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19
Q

when is hypertension diagnosed at home?

A

after two home readings >135/85

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20
Q

when is the hypertension diagnosed after ambulatory automated BP?

A

24 hour average >130/80, or daytime >135/85, sleep readings >120/70

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21
Q

What is white coat HTN?

A

linked to anxiety response. in 20% of patients. high BP in a medical setting (>140/90)

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22
Q

What is masked HTN?

A

BP in a medical setting <140/90. When the BP is normal in a medical setting but may be high at home. Ambulatory BP measurements may be >135/85. 10-30% of patients.

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23
Q

Normal BP

A

<120/80

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24
Q

Pre-HTN

A

120-139/80-89

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25
Q

Stage 1 (<60 years old)

A

140 – 159/90 – 99

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26
Q

Stage 1 (>60 years old)

A

150 – 159/90-99

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27
Q

Stage 2

A

> 160/>100

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28
Q

what are orthostatic blood pressure changes?

A

decreased systolic reading >20 mmHG and decreased diastolic reading of >10 mmHG

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29
Q

what are causes of orthostatic blood pressure changes?

A

drugs, blood loss, prolonged bed rest, and diseases of autonomic nervous system

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30
Q

Where can your heart rate be assessed?

A

radial, brachial, femoral, cardiac apex, carotid

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31
Q

Normal heart rate

A

60-90 beats a min

32
Q

What can cause HR to alter?

A

anxiety, pain, medication effect, cardiac conditions, pulmonary conditions, thyroid disease, and anemia

33
Q

What causes pulse deficits?

A

a-fib, heart failure, weak heart contractions

34
Q

what do diminished pulses show?

A

arteriosclerotic peripheral vascular disease, low cardiac output

35
Q

what do asymmetry of pulses show?

A

indicate coarctation of the aorta or aortic dissection

36
Q

what does a bounding pulse show?

A

also called water hammer pulse. can be seen with aortic regurgitation or patent ductus arteriosis

37
Q

what does pulsus alternans show?

A

amplitude of pulse alternatives every other beat associated with pericardial effusions

arterial pulse with alternating strong and weak beats

38
Q

Normal adult respirations

A

14-20 breaths a min

39
Q

what are frequent sighs associated with?

A

hyperventilation syndrome

40
Q

bradypnea

A

slow breathing

41
Q

causes of bradypnea

A

physiologic, diabetic coma, drug-induced respiratory depression, increased intracranial pressure

42
Q

tachypnea

A

rapid, shallow breathing

43
Q

causes of tachypnea

A

restrictive lung disease, pleuritic chest pain, elevated diaphragm

44
Q

obstructive breathing

A

Expiration is prolonged due to narrowing of airways that increase resistance of air flow

45
Q

causes of obstructive breathing

A

asthma, chronic bronchitis, COPD

46
Q

hyperpnea/hyperventilation

A

rapid, deep breathing

47
Q

causes of hyperpnea

A

exercise, anxiety, metabolic acidosis; kidney failure and DKA

48
Q

causes of hyperpnea if the patient is comatose

A

infarction, hypoxia, hypoglycemia

49
Q

cheyne-stokes breathing

A

period of deep breathing alternating with periods of apnea

50
Q

causes of cheyne-stokes breathing

A

normal in children and elderly when sleeping, heart failure, uremia, drug-induced respiratory depression, brain damage

51
Q

kussmauls respirations

A

labored, deeper breathing rate

52
Q

causes of kussmaul respirations

A

metabolic acidosis (DKA)

53
Q

ataxic breathing

A

unpredictable breathing irregularity. breaths may be shallow or deep, with periods of apnea

54
Q

causes of ataxic breathing

A

respiratory depression or brain damage

55
Q

normal temp

A

37 degrees C, 98.6 degrees F

56
Q

C to F

A

C times 1.8 + 32

57
Q

F to C

A

F minus 32 divided by 1.8

58
Q

hyperprexia

A

> 41.1 degrees C or >106 degrees F

59
Q

hypothermia

A

< 35 degrees C or <95 degrees F

60
Q

causes of hypothermia

A

can be associated with decreased movement, interference with vasoconstriction, hypothyroidism, and hypoglycemia

61
Q

what is the gold standard to obtain temperature?

A

pulmonary artery

62
Q

other ways to obtain temp

A

oral, rectal, axillary, tympanic, temporal

63
Q

causes for fever

A

infection, trauma, malignancy, drug reactions, immune disorders

64
Q

general survey

A

initial impression of the patient. should distinguish a patient from the crowd.

65
Q

LOC

A

assesses a patients ability to respond to situations

66
Q

lethargy

A

appears drowsy, will easily respond to questioning but then fall back asleep

67
Q

obtunded

A

Pt will open eyes and look, but responds slowly and confused. Alertness and interest in surroundings is decreased. Responds to stimuli (not painful)

68
Q

stuporous

A

arouses from sleep only with painful stimuli. minimal awareness of self or surroundings

69
Q

comatose

A

unarousable with painful stimuli

70
Q

glasgow coma scale

A

used to provide info regarding LOC

71
Q

mild brain injury

A

13 or higher

72
Q

moderate injury

A

9 to 12

73
Q

severe brain injury

A

8 or less

74
Q

Ax4

A

person, place, time, situation

75
Q

differential diagnosis

A

considered after obtaining CC, HPI, ROS

Phys. Diag. and Pat. Eval Lab (1 decks)

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