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Health Assessment > Lesson 4 > Flashcards

Lesson 4 Flashcards

1
Q 
Temperature
Abnormally low:
Normal: 
Abnormal high:
Abnormal high (severe):
A

Abnormal low: 35 C
Normal: 37 C
Abnormal high: 38.5 C
Abnormal high (severe): 40 C

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2
Q 
BP
Normal:
Prehypertension:
Stage 1 HTN:
Stage 2 HTN:
A

Normal: SBP 90-119 DBP: 60-79
Prehypertension: SBP 120-139 DBP: 80-89
Stage 1 HTN: SBP 140-159 DBP: 90-99
Stage 2 HTN: SBP >160 DBP: >100

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3
Q

Where do you do oral temperature and what would you instruct the patient to do?

A

Place under the tongue (sublingual pocket) and instruct patient to keep their lips closed

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4
Q

Where do you do axillary temp?

A

Place snugly in the axilla (arm pit)

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5
Q

What is the most accurate temp route?

A

Rectal

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6
Q

Where do you do rectal? And describe technique.

A

Rectum; Wear gloves; insert ubricated thermometer (with cover) 2-3 cm in the adult rectum toward the umbilicus. Do not let go of the thermometer while testing

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7
Q

Where do you do tympanic membrane temp?

A

Patients ear canal and aim the infrared beam at the tympanic membrane; do not occlude the canal

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8
Q

Where do you do temporal artery temp? and How?

A

Forehead and behind the ear; slide the probe across the forehead and behind the ear

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9
Q

What artery do you palpate to measure HR?

A

Radial

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10
Q

If you are measuring HR and everything is normal, how long would you be counting for? And what would you do?

A

30 seconds; multiply by 2

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11
Q

If you are measuring HR and during the first 30 seconds notice something abnormal, how long would you be counting for?

A

60 seconds

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12
Q 
HR:
3+:
2+:
1+:
0:
A

3+: Full, bounding (anxiety, exercise, some abnormal conditions)
2+: Normal
1+: Weak, thready (decreased stroke volume)
0: Absent

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13
Q

When do you count respirations? Why is it best to be sneaky about this?

A

Count respirations for 30 seconds after you count HR. If you suspect something normal, count the full minute. It is best to be sneaky about this because if you are not sneaky and tell the patient you are counting respirations, they will begin to breathe oddly

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14
Q

What procedure do you allow the patient to rest for 5 minutes before testing?

A

BP

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15
Q

What are the pros and cons for measuring temporal temp?

A

Pro: Accurate
Con: If you are sweating (common with fever), you may not get an accurate temp

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16
Q

What are the pros and cons of measuring tympanic temp?

A

Con: Not very accurate due to earwax

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17
Q

What are the pros and cons of measuring axillary temp?

A

Con: Measuring under the weak arm of a stroke patient will give a false reading
Con: Not as accurate because it is external

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18
Q

What are the pros and cons of measuring oral temp?

A

Con: Hard with noncompliant/unconscious patients
Con: Chewing gum and recently eating changes temperature

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19
Q

What are the pros and cons of measuring rectal temp?

A

Pro: Accurate
Con: Invasive

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20
Q

What color thermometer is used to measure rectal temp?

A

Red

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21
Q

What color thermometer is used to measure oral/axillary temp?

A

Blue

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22
Q

A 35 C temp means they may be _____.

A

Hypothermic

23
Q

A 37 C temp means it is ____.

A

Normal

24
Q

A 38.5 C temp means the patient has a _____.

A

Fever

25
Q

A 40 C temp means the fever is ____.

A

A “scary fever”

26
Q

What does bacteremia mean?

A

Bacteria in the blood

27
Q

What is a significant indicator of the possible presence of bacteremia?

A

Fever, along with other symptoms (shaking chills)

28
Q

Fever + 41.1 C means it is ____ bacteria.

A

Gram negative

29
Q

Fever + Bradycardia means it is _____ bacteria.

A

Intracellular

30
Q

Fever + Anhidrosis (no sweating) means _____.

A

Heat stroke

31
Q

Fever + rigidity = ______ or ______.

A

NMS (neuroleptic malignant syndrome) or SS (serotonin syndrome)

32
Q

Tachycardia + ____ = LR of 3 for death.

A

MI

33
Q

Tachycardia + _____= LR of 2 for death

A

Septic shock

34
Q

Tachycardia + ______= LR of 1 for death

A

Pneumonia

35
Q

What is sinus arrhythmia?

A

HR increases when breathing IN

HR decreases when breathing OUT

36
Q

What is the mechanism that underlies sinus arrhythmia?

A

When breathing in, there is less place for blood to enter the heart, thus SV decreases and HR increases because body wants to keep the same blood flow rate

37
Q

Why is there lack of evidence for many pediatric heart and respiratory reference ranges?

A
  • There is little data to support the values that are given as “normal”
  • Most cannot be considered applicable to healthy children in the developed world of the 21st century
38
Q

Describe cheyne-strokes.

A

Hyperpnea for ~30 seconds, Apnea for ~25 seconds, Hyperpnea for ~30 seconds

39
Q

What 3 type of patients is cheyne-strokes common in?

A
  • 30% of CHF clients
  • Neurological disorders
  • Normal for some people when they sleep or in high altitudes
40
Q

Define: systolic

A

Ventricles are contracting

41
Q

Define: diastolic

A

Ventricles are resting/filling

42
Q

Define: Pulse pressure

A

Difference between systolic and diastolic

43
Q

Define: MAP

A

Mean arterial pressure; average blood pressure

44
Q

What is orthostatic hypotension?

A

Someone who has hypotension when standing straight

45
Q

How do you determine if a patient has orthostatic hypotension?

A

Have a patient lie flat for ~5 min and check their BP and HR, then have them stand up and check it again

A drop of 20 mmHg in your SBP indicates it OR
An increase in pulse rate >= 20 beats per min

46
Q

How do you calculate MAP?

A

[SBP + (DBPx2)] / 3

47
Q

Can a MAP kill you?

A

Yes

48
Q

What is an auscultatory gap?

A

Period when Korotkoff sounds disappear during auscultation

49
Q

Who is more likely to have an auscultatory gap?

A

Hypertension patients

50
Q

What are 5 common errors that can falsely raise or lower a clients BP?

A
  • Taking it when they are angry, anxious, or active (false high)
  • Inaccurate cuff size (more common error)
  • Pushing stethoscope too hard on brachial artery (false low DBP)
  • Failure to wait 1-2 min before repeating entire reading (false high DBP)
  • Faulty leg position (false high DBP and SBP)
51
Q

What condition could cause a significant different (greater than 10mmHg) between arms when taking their BP?

A

Arterial obstruction on side with lower reading

52
Q

How would you expect a clients thigh pressure to compare to their arm pressure?

A

Thigh pressure is higher

53
Q

Which clients should have thigh pressure checked?

A
  • Adolescents and young adults to check for coarctation of the aorta (who have an excessively high arm BP)
  • Someone with a cast on both arms
54
Q

What condition might cause an elevated arm pressure but a decreased thigh pressure?

A

Coarctation of the aorta: because the blood supply to the thigh is below the constriction

Health Assessment (26 decks)

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