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Health Promotion and Assessment > Important concepts for MT1 > Flashcards

Important concepts for MT1 Flashcards

1
Q

What are the four basic techniques used in physical assessment? Which is ALWAYS completed first?

A

Inspection - completed first
Palpation
Percussion
Auscultation

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2
Q

What are the different lobes of the cerebral cortex? What are two important areas to assess for aphasia?

A

Parietal, occipital, temporal and frontal lobes.

assess Broca’s and Wernicke’s areas

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3
Q

What are the different components of the PNS?

A

12 Cranial nerves
31 spinal nerves
ANS (includes reflexes)

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4
Q

What are the different components of the neurological assessment?

A 
Vitals
GCS - LOC
Cranial Nerves
Cerebellar function
Proximal limb weakness
Sensation
reflexes
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5
Q

What are the different scores to look out for on the GCS?

A

Should be 15 if no issues
13+ - mild impairment
9-12 - moderate
8 or lower indicates coma (cannot protect airway)

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6
Q

What is the GCS score range?

A

3-15

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7
Q

Describe a decerebrate posture.

A

Decerebrate - damage to upper brain stem - extension

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8
Q

Describe a decorticate posture.

A

Decorticate - damage to one or more spinothalamic or dorsal column tracts - flexion

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9
Q

What is receptive aphasia?

What is expressive aphasia?

A

Receptive: isnt processing what is being asked but has no issues producing language

Expressive - understands what is being told to the person, but cannot get the words out

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10
Q

What are the mnemonics for the cranial nerves?

A

On old Olympus towering top a Fin and German viewed some hops
(II -optical, III -
oculomotor, VII - Facial, IX - Glossopharyngeal, X -Vagus)
Some say marry money but my brother says big brains matter more
(II - sensory, III - motor, VII - both, IX - both, X - both)

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11
Q

What is used to test CN II?

A

Snellen Chart

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12
Q

What is done to asses CN III?

A 
PERRLA (pupils equal, round, reactive to light, accomodation)
Direct light reflex
Consensual light reflex
Accomodation
6 cardinal fields of gaze
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13
Q

What are the 6 cardinal signs of gaze for?

A

Exaggerated H - for our case, testing CN III

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14
Q

What is done to assess CN 7?

A

Make the patient make faces (puff out cheeks, raise eyebrows, bare teeth, smile, etc.0

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15
Q

What is done to assess CN 9 and 10?

Why?

A

Make patient say ahh
See if the patient can swallow
This is to see if they can eat on their own - if the nerves are impaired - at huge risk for aspiration

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16
Q

For Cerebellar function, what assessments are done to evaluate balance and proprioception?

A

Evaluate gait
Tandem walking
Romberg’s test
Pronator drift

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17
Q

For cerebellar functioning, what is doe to evaluate coordination and skilled movements?

A

rapid alternating movements
finger to finger test
finger to nose test
heel to shin test

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18
Q

What is the babinski reflex?

A

Take something sharp and drag it along the outside of the foot and over the balls of the feet.
Positive = fanning of feet
negative = contraction of feet

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19
Q

Decreased or loss of motor nerve power due to problem with motor nerve or muscle fibers.

A

paralysis

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20
Q

Rapid, continuous twitching of resting muscle that can be seen or palpated (fine or coarse)

A

fasciculations

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21
Q

involuntary, compulsive, repetitive twitching of a muscle group (e.g. wink, grimace, head movement, shoulder shrug)

A

tic

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22
Q

rapid, sudden jerk at regular intervals (e.g. hiccups)

A

myoclonus

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23
Q

involuntary contraction of opposing muscle groups, results in rhythmic, back and forth movement of one or more joints

A

tremor

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24
Q

involuntary muscle twitching

A

chorea

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25
Q

slow, writhing (twisting), continuous, and involuntary movement of the extremities

A

athetosis

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26
Q

person stumbles and cannot keep in appropriate space

A

ataxia

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27
Q

What does S1 (sound) relate to?

A

beginning of systole - closing of mitral/tricuspid valve

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28
Q

What does S2 (sound) relate to?

A

Beginning of diastole - closing of aortic and pulmonary semilunar values

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29
Q

Where is the PMI?

A

Apical pulse - between 4th and 5th ICS at the midclavicular line
(left nipple for guys, about wire of bra for girls)

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30
Q

What is the expected heart rate range for adults?
Older adults?
Kids?

A

60-100

Higher for older adults and kids

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31
Q

What is important to document when assessing pulse?

A

Strength
rhythm
Rate
symmetry and location

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32
Q

Bradycardia

A

slow HR

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33
Q

Tachycardia

A

fast HR

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34
Q

pulse deficit

A

diff in pulse between assessment sites

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35
Q

asystole

A

no pulse

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36
Q

dysrhytmia

A

irregular rhythm

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37
Q

Cuff size should be what size?

A

20% of diameter of upper arm

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38
Q

What are the blood pressure sounds called? Which one’s are important?

A

Korotkoff sounds
1 - systolic BP
5 - diastolic BP

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39
Q

What are the expected values for BP in adults?

What are the BP of children in relation?

A

<120/80

Children usually have a lower BP

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40
Q 
For adults, what ranges constitute:
hypotension
normotension
pre-hypertension
hypertension
A

Hypotension: S <90; D <60
Normotension: S <120; D <80
Prehypertension: S: 120-139; D: 80-90
Hypertension: S > 140 or D >90

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41
Q

What time of the day is the most common for heart attacks? Why?

A

Morning - higher amount of stress hormones

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42
Q

BP through the day?

A

Lower in the morning, rises through the day

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43
Q 
How do the following affect BP:
diabetes
ethnicity
gender
stress
pregnancy
A

diabetes - higher
ethincity - blacks have a higher BP, asians and indigenous too
gender - males higher after puberty, females higher after menopause
stress = up
pregnancy = down

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44
Q

What is orthostatic hypotension?

A

Decrease in blood pressure when standing from a lying or seated position

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45
Q

What temperature measurements are considered core?

Surface?

A

Core - tympanic and rectal

Surface - oral, skin, axilla

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46
Q 
What is the expected normal range for oral temperature?
Axillary?
Tympanic?
Temporal?
Rectal?
A 
Oral - 36.5-37.5
Axillary - 35.9-37.2
Tympanic - 36-37.5
temporal -36.5-37.5
Rectal - 37-37.5
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47
Q

Expected temperature range for oral temp?

A

36.5-37.5

48
Q

Expected temperature range for axillary?

A

35.9-37.2

49
Q

Expected temperature for tympanic?

A

36-37.5

50
Q

Expected temperature for temporal?

A

36.5-37.5

remember TempORAL is the same as oral

51
Q

Expected temperature for rectal?

A

37-37.5

52
Q

What temperature indicates fever?

A

38 - anywhere

53
Q

How does age impact temperature?

A

Geriatrics less able to mount fever.

Kids have more unstable temperatures.

54
Q

Describe how the circadian rhythm affects temperature.

A

temperature goes down at night, increases during the day (think about metabolism).

55
Q

What does febrile mean?

A

patient has a fever

56
Q

Afebrile

A

no fever

57
Q

what is a pyrogen?

A

substance that induces fever

58
Q

What are rigors?

A

chills - a step up from shivering

59
Q

Why isnt advil or Tylenol given before vacccinations anymore?

A

because it might affect the immune response

60
Q

How is ventilation measured/observed?

A

count rate of breathing, depth and rhythm (As well as effort), symmetry

61
Q

How is diffusion and perfusion measured?

A

SpO2

62
Q

When inspecting a patient who has respiratory difficulties, what kind of abnormalities could be observed?

A

use of extra muscles
cyanotic
poor cap refill

63
Q

Why would one asses respirations for more than 30 seconds?

A

if anything is irregular or for young children

64
Q

What is apnea?

A

Period of no breathing

65
Q

What is stridor?

A

Emergency situation related to narrowing of the airways

66
Q

What is tracheal tug?

A

Often seen in kids - the use of neck muscles to breathe

67
Q

What is the expected adult respiratory rate?

A

12-20 bpm

children and elderly people often breathe faster

68
Q

What is tachypnea? Bradypnea?

Dyspnea?

A

Tachypnea - fast breathing
bradypnea - slow breathing rate
dyspnea - laboured breathing

69
Q

What is ASEPTIC?

A 
A - appearance and behaviour
S - speech
E - emotion and affect
P - perception
T - thought process
I - insight
C - cognition
70
Q

What do we assess in a general survey?

A 
1 - General observations (appearance, psychomotor behaviour, attitude toward interviewer)
2 - Mood
3 - Affect
4 - Speech characteristics
5 - Perception
6 - Thought - content, process/form
7 - Sensorium - LOC, orientation, memory, attention and concentration, comprehension and abstract reasoning
8 - Insight
9 - Judgement
71
Q

What are the 3 components of the general observations of the general survey?

A

Appearance - groomed? Hygiene, appropriate?
Psychomotor behaviour - posture, gait, coordination, facial expression, maneurisms
Attitude towards interviewer - accomodating, cooperative, open, apathetic, bored, guarded, supsicious, hostile

72
Q

What is the difference between mood and affect?

A

Mood is what the patient tells us - subjective
mood is month - more long-term

Affect is what we describe the patient as - objective

73
Q

How can emotion be described in the general survey?

A

Euthymic - normal
euphoric - elated
Dysphoric - depressed, restless

74
Q

What are the different ways in which affect is described in the general survey?

A

Range - full or constricted
Intensity - heightened, blunted, flat
Appropriate -
stability - stable or labile

75
Q

How are speech characteristics charted or observed in the general survey?

A

Quantity - talkative vs. subdued
Rate of speech production - slow, fast, pressured
Quality - monotone, staccato, loud

76
Q

What are two perceptual disturbances?

A

Hallucinations - feeling stimuli when they are absent

Illusions - misrepresenting actual stimuli

77
Q

What are the two components of thought that are assessed in the general survey?

A

content - what the person is thinking about

process/form - manner in which thoughts are formed and expressed

78
Q

What are the superficial aspects of cognition that are assessed in the general survey?

A

LOC - arousal or wakefulness

Orientation - ability to grasp the significance of environmental information - time, place, person

79
Q

What are the in-depth assessments of cognition in the general survey?

A

memory
attention and concentration
comprehension and abstract reasoning

80
Q

How is STM evaluated in the general survey?

A

3 unrelated words

81
Q

how is attention and concentration evaluted in the general survey?

A

serial 7s

82
Q

How is abstract reasoning evaluated in the general survey?

A

similarity between objects - train and bike

83
Q

Understanding the reality of a set of circumstances.

Awareness of own thoughts and feelings and an ability to compare them with the thoughts and feelings of others.

A

Insight

84
Q

ability to reach a logical decision about a situation and to choose course of action

A

judgement

85
Q

When you evaluate someone’s problem solving abilities and capacity to learn from the past, you are evaluating what?

A

judgement

86
Q

What are critiques of the general survey?

A

highly subjective, affected by SES and demographic factors, changes with experience of nurse

87
Q

Free nerve endings/receptors capable of responding to painful stimuli.

A

nociceptors

88
Q

nociceptors are located where?

What are they activated by?

A

throughout the body tissues

activated by thermal, mechanical and chemical stimuli

89
Q

Describe the transmission of pain.

A

pain stimulus in periphery –> impulse –> SC –> brain stem –> thalamus –> central structures of brain –> pain is processed

90
Q

What is nociceptive pain?

A

Normal processing of stimulus.

91
Q

What is neuropathic pain?

A

abnormal processing of sensory input

92
Q

What are examples of nociceptive pain? neuropathic?

A

Nociceptive - cutaneous, somatic, visceral, referred, parietal, phantom limb pain

Neuropathic - diabetic neuropathy, phatom limb pain

93
Q

Why is phantom limb pain considered both nociceptive and neuropathic?

A

because there was a trauma assocaited to the pain, but is the result of abnormal processing of stimuli.

94
Q

Pain can be classified by duration or frequency. Elaborate (i.e. what are the different subcategories)

A

duration
= chronic or acute

frequency
- continuous or intermittent

95
Q

What are some physiological responses that go along with the pain response?

A 
increase in HR
increase Respiratory rate
diaphoresis
vomitting
pallor
muscle tension
96
Q

If a person is unconscious, what do we assume in regards to pain?

A

present and needs to be treated

97
Q

What conditions of pain would be considered an emergency?

A

unexpected intense pain, particularly if sudden or associated with increased pulse, decrease pressure or fever

98
Q

What does OLDCARTS stand for?

A

onset, location, duration, charactierstics, aggravating, relieving, timing, severity, self-preception

99
Q

What does OPQRTSU stand for?

A 
Onset
provoking
quality
radiate
timing
severity
understanding
100
Q

Regarding bronchi, what is important anatomically and its relation to healthcare/

A

right bronchi is shorter and wider than the left one - greater risk for aspiration

101
Q

Where would a tracheotomy be performed?

What breathing abnormality occurs there?

A

Suprasternal notch

tracheal tug

102
Q

Why is C7 important?

A

Around where the lung apices are

103
Q

What is important about the costal angle?

A

Location of base of lung for posterior aspect

104
Q

What are some respiratory risk factors?

A

Smoking
environmetnal factors (occupational, travel, home)
determinants of health

105
Q

How is smoking reported in the history?

A

Pack years - number of packs smoked per day * number of years smoking

106
Q

How should the client be positioned for a respiratory assessment?

A

sit up, slightly hunched forward with rolled shoulders

(if they have to lie down, will assess laterally

107
Q

What is the normal anterior-posterior to lateral size ratio for the chest:?

A

1:2

108
Q

What is the anterior-posterior to lateral size ration for the chest in barrel chest patients?

A

1:1

109
Q

What is palpation in a respiratory assessment used for?

A

Find chest tenderness
Extra assessments (if no x-ray) - tactile fremitus, chest excursion (pneumo)
Abnormal findings - crepitus (rice krispies)

110
Q

Where would you hear bronchial sounds? Bronchovesicular?

Vesicular?

A

B - near the neck region
BV - sternal border
V - peripheral lung fields

111
Q

What is the general inspiration to expiration ratio for vesicular sounds?

A

3:1

112
Q

What are abnormal breath sounds called?

A

Adventitious sounds - when airways narrow or there is fluid or mucus or inflammation of airways

113
Q

Lack of oxygen perfusion

A

hypoxemia

114
Q

eupnea

A

unlaboured breathing

115
Q

expectorate

A

coughing

116
Q

hemoptysis

A

coughing up blood

Health Promotion and Assessment (13 decks)

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