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Clinical History > Intro to Clinical Skills > Flashcards

Intro to Clinical Skills Flashcards

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1
Q

pt w/ musculoskeletal complaint

A

look at joint above and joint below

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2
Q

Pt complaining of eye pain

A

check ENT– i.e. surrounding connected systems

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3
Q

OSCE’s

A

observed structured clinical exams

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4
Q

skills focused on

A

normals

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5
Q

who takes vitals

A

varies–rarely us, but must be able to explain why they’re divergent by end of visit

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6
Q

pyrexia

A

fever= temp over 105 F

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7
Q

hypothermia

A

body temp under 95 rectally

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8
Q

euthermic

A

norma temp in healthy person = roughly 98.2 F

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9
Q

Temp–fever is

A

critical vital sign associated with many infectious and non-infectious diseases

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10
Q

Fever causes

A

bacterial or viral, trauma, surgery, crush, malignancy, blood disorders, rx

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11
Q

rectal temps are

A

1 degree higher than PO

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12
Q

thermometer colors

A

blue=PO

red=rectal rr

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13
Q

tympanic temperature

A

clean cerumen, aim probe at TM,

inaccurate reading if doesn’t hit TM

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14
Q

Axillary temp

A

least reliable

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15
Q

Pulse wave

A

force of ejection PLUS elasticity of arteries

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16
Q

vegal stimulation

A

can decrease HR (breath holding, etc)

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17
Q

vol, rate, and rythm

A

countour of pulse wave (how “big”)

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18
Q

best pulse point for contour

A

carotid pulse

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19
Q

if can’t find pulse periferaly

A

auscultate– w/ stethoscope (often with infants)

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20
Q

how long to listen to normal pulse

A

30 sec X 2

21
Q

in emergency pulse point

A

carotid

22
Q

normal pulse in adults

A

50-95 BPM – 95% of people

23
Q

tachypnea

A

resp rate >27/min predicts cardiopulmonary arrest

24
Q

major factor for innacurate BP

A

weren’t taught right

25
Q

most frequent BP error

A

undercuffing big arms–result will be too high

26
Q

BP 2 methodes

A

direct and indirect

27
Q

Direct BP

A

intra-arterial catheter

28
Q

Indirect BP

A

sphygmomanometer

29
Q

inflation of cuff

A

occludes brachial artery

30
Q

release pressure of cuff

A

listen for Korotkoff sounds KS

31
Q

phases of Korotkoff sounds

A

5

32
Q

Korotkoff sound phases

A
  1. appearance of clear tapping–coincides w/ reappearance of palp pulse
  2. sounds grow softer and longer
  3. sounds again become crisp
  4. sounds are muffled, liss distinct, softer
  5. sounds disappear completely–when brachial a. is fully unoccluded (diastolic)
33
Q

How high to inflate cuff

A
  1. Inflate cuff until brachial pulse is eradicated (by palpation)
  2. deflate cuff and wait 30 seconds
  3. reinflate cuff rapidly to 30 mm Hg above eradication point
34
Q

first visit BP

A

take BP on both arms–in future take on higher side

35
Q

cuff too large

A

falsely lowers BP

36
Q

cuff too small

A

Falsely raises BP

37
Q

loose cuff

A

falsely lowers BP

38
Q

pt has to support own arm during BP

A

falsely raises BP

39
Q

KS appear then disappear for short segment of time

A

auscultory gap

40
Q

hypotension

A

when low systolic BP isn’t accompanied by rise in pulse–indicative of autonomic insufficiency.

41
Q

BP normals

A

140/90 = hypertension

42
Q

measurement of hemoglobin saturated with O2

A

“pulseox” – SpO2 – can diagnose pneumonia

43
Q

Pulseox

A

finger, toe, earlobe
no nailpolish
cold extremity/movement make inacurate

44
Q

box at bottom of sphigmomanometer

A

for calibration–if outside box, needs calibration

45
Q

abnormal SpO2

A

<90% – pt will be very sick

46
Q

Normal SpO2

A

> 95% –

47
Q

∆’s in weight

A

could be intentional (dieting) or unintentional (hormonal, metabolic, bulimia, anorexia)

48
Q

Height important for

A

young and old – in inches or metric consistantly–lood for norms

49
Q

for BP where should arm be

A

at level of heart

Clinical History (10 decks)

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