Lecture with professor Flashcards
Measure the widest part of the arm
What happens if the cuff is too big what does that do to the blood pressure reading? It’s falsely _______
low
What if cuff is too small what happens to the blood pressure? It’s falsely ________
high
Measuring circumference of arm is critical to make sure you have the right size cuff
Part of cuff aligns with the brachial artery which is an important step in blood pressure check list…if its not aligned its not proper placement and you will get points taken off for that
To align with brachial artery is proper inflation
Point of maximal inflation this is American heart association accurate way to take a blood pressure and what it does is you inflate the cuff and your palpating because your trying to estimate the systolic
So palpating and inflating…no stethoscope yet
The point at which the pulse disappears as your palpating it so your occluding the pulse is going to disappear its that number on the sphygmomanometer meaning it will disappear at 140 so I know that I need to inflate the cuff to 160 or 170 you add 20 to 30 points to it so that when your measuring the blood pressure you don’t miss the systolic coming down
Point of maximal inflation (PMI)
When measuring orthostatic which is performing a blood pressure measurement in the standing position, seated position, and then laying down flat its important to wait a minimum of three minutes in between position changes so that the body has time to compensate for the change in position and then measure a blood pressure and a pulse in each of those individual positions
It’s what you hear coordinated with what you see
Blood pressure is 126 over 88 (these are even numbers…if you give odd numbers you get points off..odd numbers CANNOT BE GIVEN BECAUSE ITS NOT ACCURATE
Ticks sphygmomanometer are even numbers
Lets say the first two consecutive beats were at 160 and then they went away and they came back at like 138 you would be wrong if you say the systolic is 138 it was the 160 of those two consecutive beats…a patient could come in immersive week that has an auscultatory gap and it typically happens in older adults…this is why its important to point of maximal inflation
Follow up when for high blood pressure?
in a week or 2
Sources of information helps to determine where in that note the information is going to be
The best source is ideally the patient if the pt can’t communicate for whatever reason perhaps it’s the family member maybe you have a pt that is the ICU and is intubated and can’t talk and then information is coming from the medical record so depending on what that source of information is…it could be from a variety of different sources
Clinical interview…scholarmac where you interviewing and counseling and putting all those pieces together
Standardized format like ScholarMac so you had a systematic approach
Review of Systems (ROS)
Review of Systems is a head to interview with the patient
Review of Systems is always in subjective part of a note. The subjective part of a note is the information that’s coming from the patient or the family member or the caregiver
Subjective is what the patient is telling you
SOAP notes is piece of communication btwn one healthcare provider to another as the drug expert we are communicating what we think the drug therapy should be or how it should be adjusted, stopped, or started
The _____________part is anything an everything that the patient tells you
subjective
The____________ part of a note is things that you perform as physical exam or their labs or tests or their calculations
objective
Medications and allergies should be listed in the subjective or objective depending on the source of information
Let’s say Ron is my patient…Ron what allergies do you have? Pt says penicillin…you ask ron what happens when you take penicillin? Rash… Ron is my patient and told you that…what section does that go in…the ___________
subjective
