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Bedside assessment > Interviewing the patient > Flashcards

Interviewing the patient Flashcards

1
Q

It is the process of interviewing and examining a patient for signs and symptoms of disease and the effects of treatment

A

Bedside assessment

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2
Q

Two key sources of patient data are the

A

medical history and the physical examination

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3
Q

What are the 3 purposes of interview

A
  1. To establish a rapport between the clinician and patient
  2. To obtain essential diagnostic information
  3. To help monitor changes in the patient’s symptoms and
    response to therapy
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4
Q

The ideal interview is one in which the patient feels_______ about important personal matters.

A

Secure and free to talk

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5
Q

Each interview should begin with the RT______

A

introducing himself or herself to the patient and stating the purpose of the visit.

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6
Q

The introduction is done in the______ , approximately_______

from the patient.

A

social space, 4 to 12 feet

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7
Q

How long does personal space to begin the interview?

A

2 to 4 feet from the patient

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8
Q

encourage patients to describe events and priorities as they see them, helping to
bring out concerns and attitudes and to promote understanding.

A

Open-ended questions

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9
Q

Type of question that focuses on specific information and provides clarification.

A

closed questions

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10
Q

can be open-ended or closed and always end in a question mark. Although they are used to obtain specific information, a series of direct questions or frequent use of the question “Why?” can be intimidating and cause the patient to minimize his or her responses to questions.

A

Direct question

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11
Q

are less threatening than direct questions because they sound like statements (e.g., “I gather your doctor told you to take the treatments
every 4 hours”)

A

Indirect question

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12
Q

Type of questions that are preferred for all interactions with the patient.

A

Neutral question

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13
Q

is a series of focused questions that pursue specific information related to a tentative diagnosis.

A

Interview

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14
Q

a general term describing the sensation of breathing discomfort. It is the most important symptom that the RT is called on to assess and treat

A

Dyspnea

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15
Q

Is dyspnea subjective or objective

A

subjective

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16
Q

what is the primordial sensation of life

A

breathing

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17
Q

specifically to describe difficulty in the mechanical act of breathing.

A

Dyspnea

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18
Q

Dyspnea is characterized by The_______is proportionally greater than______

A

Effort to breath, tidal volume achieved

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19
Q

When the neuronal signals governing these sensations become unbalanced, breathing is perceived to be abnormal and unpleasant. The technical name for this imbalance is

A

neuromechanical dissociation

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20
Q

Is the specific sensation of an unpleasant urge to breathe.

A

Breathlessness

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21
Q

It is believed to be the conscious perception of intense neural discharge to the
respiratory muscles.

A

Breathlessness

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22
Q

Breathlessness can be triggered by what 3 conditions

A

acute hypercapnia and acidosis and by hypoxemia

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23
Q

What type of dyspnea assumes the reclining position. It is common in patient with what diseases

A

Orthopnea, CHF

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24
Q

Orthopnea is also a symptom of bdp or?

A

bilateral diaphragmatic paralysis.

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25
Q

Dyspnea in the upright position is known as

A

platypnea

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26
Q

Orthopnea is apparently is caused by the sudden

A

increased venous return

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27
Q

Platypnea may be accompanied by ______, which is oxygen desaturation on assuming an upright position.

A

orthodeoxia

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28
Q

Patients with asthma frequently complain of

A

chest tightness

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29
Q

patients with interstitial lung disease tend to focus on the sensations of

A

increased work of breathing, shallow breathing, and gasping.

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30
Q

Patients with CHF are seemingly unique in frequently feeling

A

suffocated.

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31
Q

It may be very difficult for patients with ______ from any cause to speak more than a few words at a time.

A

severe dyspnea

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32
Q

The intensity of dyspnea can be documented using a

A

numeric intensity or visual analog scale

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33
Q

There are perplexing situations in which patients with normal cardiopulmonary function complain of intense dyspnea or suffocation. This condition is known
as

A

psychogenic hyperventilation syndrome and is associated

with panic disorders

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34
Q

This syndrome may be either______ and

often is self-perpetuating

A

sporadic or chronic

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35
Q

T/F……The RT always must approach any situation involving
hyperventilation or dyspnea as if it had a pathophysiologic
basis.

A

T

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36
Q

The first priority is to measure _____, _____, _______, ________

A

Vitals signs, O2 sat, 12-lead electrocardiogram, ABG

37
Q

is the most common, yet nonspecific symptom seen in patients with pulmonary disease.

A

Cough

38
Q

forceful expiratory maneuver that expels mucus and foreign material from the airways.

A

Coughing

39
Q

Location of cough receptors

A

larynx, trachea and larger bronchi

40
Q

Cough receptors are stimulated by

A

inflammation, mucus, foreign materials, or noxious gases

41
Q

The effectiveness of a cough depends on the ability of

the individual to

A

take a deep breath, lung elastic recoil, expiratory muscle strength, and level of airway resistance.

42
Q

The ability to take a deep breath or exhale forcefully is

often impaired in patients with

A

neuromuscular disease

43
Q

The most common cause of an acute, self-limited cough is

a

A

viral infection of the upper airway

44
Q

mucus from the tracheobronchial tree that has not been contaminated by oral secretions is
called

A

phlegm

45
Q

Mucus that comes from the lung but passes through the mouth as it is expectorated is called

A

sputum

46
Q

Sputum that contains pus cells is said to be______ , suggesting
a______

A

purulent, bacterial infection

47
Q

Purulent sputum appears

A

thick, colored and sticky

48
Q

Sputum that is foul-smelling is said to be

A

fetid

49
Q

Sputum that is clear and thick is______ and is commonly seen in patients with airways disease (i.e., asthma).

A

mucoid

50
Q

Nonproductive cough is caused by

A

1) Irritation of the airway
(2) Acute inflammation of the respiratory
mucosal membrane
(3) Presence of a growth
(4) Irritation of the pleura
(5) Irritation of the tympanic membrane

51
Q

contains normal mucus

A

White and translucent

52
Q

Yellow sputum indicates

A

indicates infection and contains

WBCs; called purulent sputum

53
Q

Green sputum contains

A

contains old, retained secretions

54
Q

Green and foul smelling: indicates

A

Pseudomonas infection

55
Q

Sputum that contains old blood

A

Brown

56
Q

Sputum that contains fresh blood

A

Red

57
Q

When a cough is productive, it is important to record the_______ because changes in these qualities over 24 hours are important in the diagnosis of pulmonary disease

A

amount, consistency, odor, and color of sputum

58
Q

may help facilitate coughing and secretion

removal.

A

Aerosolized hypertonic saline

59
Q

Characteristics of cough that usually indicates croup

A

Barklike

60
Q

Cough that indicates upper airway problems.

A

Harsh, dry cough with inspiratory stridor

61
Q

Cough that usually indicates lower airway pathology

A

Wheezing-type coughs

62
Q

A cough that is indicative of chronic bronchitis.

A

Chronic productive coughs

63
Q

may be the result of smoking or sinus or viral infection

A

Frequent hacking cough and throat clearing

64
Q

Coughing up blood or blood-streaked sputum from the

lungs is referred to as .

A

hemoptysis

65
Q

is the presence primarily of blood in the expectorant

A

Frank hemoptysis

66
Q

Hemoptysis is characterized as massive when ________ is expectorated over 24 hours, and this represents a medical emergency

A

more than 300 ml of blood

67
Q

It is vomiting blood from the gastrointestinal tract

A

hematemesis

68
Q

Nonmassive hemoptysis is caused most often by

A

airway infection, lung cancer, tuberculosis

69
Q

Common causes of massive hemoptysis include

A

bronchiectasis, lung abscess, and acute or old tuberculosis

70
Q

pleuritic chest pain usually is located______. It worsens when the patient takes a_______, and it is described as a________ type of pain.

A

laterally or posteriorly, deep breath, sharp, stabbing

71
Q

Cause of pleuritic chest pain

A

pneumonia or pulmonary embolism

72
Q

Nonpleuritic chest pain is located typically in the ________ and may radiate to the_________ . It is not affected by breathing, and it is described as a _______type of pain

A

center of the anterior chest, shoulder or back, dull ache or pressure

73
Q

A common cause of nonpleuritic chest pain which classically is a pressure
sensation with exertion or stress and results from coronary
artery occlusion.

A

Angina

74
Q

Other common causes of nonpleuritic chest pain includes

A

gastroesophageal reflux, esophageal spasm, chest wall pain (e.g., costochondritis), and gallbladder disease

75
Q

an elevated body temperature secondary to disease) is a common complaint of patients with an infection of the airways or lungs.

A

Fever

76
Q

_______typically accompanies common upper respiratory tract infections, whereas a_______ occurs with viral influenza infection

A

Low-grade fever, high fever

77
Q

a persistent fever of_________ is suggestive of pneumonia.

A

at least 38.9° C (102° F) for 2 days accompanied by chills

78
Q

Patients with a significant fever have an___________ The increased need for O2 intake and CO2 removal may cause__________

A

increased metabolic rate and an increased oxygen (O2) consumption and carbon dioxide (CO2) production, tachypnea

79
Q

Swelling of the lower extremities is known as

A

pedal edema

80
Q

It most often occurs with heart failure, which causes an increase in the________ of the blood vessels in the lower extremities. This increase in hydrostatic pressure causes fluid to leak into the_______ and leads to pedal edema, the degree of which depends on the level of heart failure

A

hydrostatic pressure, interstitial spaces

81
Q

What are the two subtypes of pedal edema?

A

Pitting and weeping edema

82
Q

When pressure is applied with a finger on a swollen extremity, an indentation mark left on the skin is called_________, is when a small fluid leak occurs at the point where pressure is applied.

A

pitting edema, Weeping edema

83
Q

Patients with chronic hypoxemic lung disease are especially prone to ________because of the heavy demands placed on the right ventricle when hypoxemia causes severe _________. Eventually, the right side of the heart begins to fail and results in a backup of pressure into the venous blood vessels, especially in the dependent regions such as the lower extremities. This situation promotes________

A

right-sided heart failure (cor pulmonale), pulmonary vasoconstriction, high intravascular venous hydrostatic pressures and pedal edema

84
Q

This section of the medical history represents a detailed account of each of the patient’s major complaints. It is written by the physician after his or her interview with the patient at admission to the hospital

A

chief complaint and history of present illness

85
Q

which describes all past major illnesses, injuries, surgeries, hospitalizations, allergies, and health-related habits. This information provides a basic understanding of the patient’s previous experiences with illness and health care and may have an impact on decisions made during the current hospitalization.

A

past medical history

86
Q

The smoking history is often recorded in_______ , which is determined by multiplying the number of packs smoked per day by the number of years smoked.

A

pack-years

87
Q

It is designed to uncover problem areas the patient forgot to mention or omitted. This information is usually obtained in a head-to-toe review of all body systems.

A

Review of Systems

88
Q

the medical record should be examined for information indicating any limits on the extent of care to be provided in the event of cardiac or respiratory arrest. This information is known as an_________, whereby the patient (or a legally authorized representative) has formalized his or her wishes for resuscitative efforts

A

advance directive

89
Q

This information may be found either in the_______ or within the body of the

A

admission note, physician’s progress notes

Bedside assessment (1 decks)

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