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Patient Assessment > Midterm 1 > Flashcards

Midterm 1 Flashcards

1
Q

What is the normal temperature in an adult

A

36.5-37.5

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2
Q

What is the normal heart rate in an adult

A

60-100

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3
Q

What heart rate is tachycardia

A

> 100

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4
Q

What heart rate is bradycardia

A

<60

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5
Q

Where do you measure pulse

A

Right radial artery

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6
Q

Where do you measure pulse in a hypotension patient

A

Central pulse. Carotid, femoral.

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7
Q

What arrhythmia is unfavourable

A

irregularly irregular

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8
Q

What is Bigeminy

A

rhythm coupled in pairs

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9
Q

What is trigeminy

A

rhythm coupled in threes

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10
Q

Pulse grade

A 
4+: Bounding
3+: Increased
2+: Brisk
1+: Diminshed
0: Absent
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11
Q

What is Tachypnea

A

Rate above normal

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12
Q

What is Bradypnea

A

Rate below normal (uncommon)

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13
Q

What is Hyperpnea

A

Minute volume increased (uncommon)

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14
Q

What is Hypopnea

A

Minute volume decreased

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15
Q

Stages of Patient Clinician Interaction

A
  1. Chart review stage
  2. Introductory stage
  3. Initial Assessment stage
  4. Treatment and monitoring stage
  5. Follow-up stage
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16
Q

Social Space

A

4-12 ft from patient

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17
Q

Personal Space

A

2-4 ft from patient

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18
Q

Intimate Space

A

0-2 ft from patient

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19
Q

Expressing Genuine Concern

A 
Face patient squarely 
Use eye contact appropriately 
Maintain an open posture 
Consider an appropriate use of touch
Be an active listener
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20
Q

Pulsus Alternan

A

Alternating between strong and weak beats.

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21
Q

Standard Safety Precautions

A

Hand hygiene, gloves, gown, face masks, eye protections, patient care equipment, needles and sharps, patient resuscitation devices

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22
Q

Chief Complaint

A

The reason a patient is seeking medical care

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23
Q

Symptoms associated with lung disease

A

cough, dyspnea, chest pain, and wheezing

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24
Q

History of present illness

A

Narrative description of each symptom described in the chief complaint

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25
Q

Symptoms in HPI reviewed for

A

Onset, location, severity, quantity, quality, duration, course, aggravating factors, and alleviating factors

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26
Q

PQRST mnemonic

A

P: Provocative/palliative: What causes it? What makes it better? What makes it worse?
Q: quality/quantity: How much is involved? How does it look/feel/sound?
R: region/radiation: Where is it? Does it spread?
S: severity scale: Does it interfere with activities? (scale of 1-10)
T: timing: When did it begin? How often does it occur? Is it sudden or gradual?

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27
Q

What is included in the past history

A

Illness, surgeries, accidents, allergies, medications, habits, general health

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28
Q

What is SAMPLE?

A 
To remember important questions
S: symptoms
A: allergies
M: Medications
P: Past history
L: Last meal
E: Events leading up to the problem
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29
Q

Some diseases with hereditary link

A

asthma, lung cancer, cystic fibrosis, emphysema, and sleep apnea

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30
Q

What is the admission note

A

Written by attending physician. Important facts related to the patient’s admission.

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31
Q

What are physicians orders

A

written by physician. List of treatments, therapies, and monitoring techniques

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32
Q

What are progress notes

A

Written by physicians and other health care providers each day. Shows patient’ response to treatment.

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33
Q

What are signs vs. symptoms

A

Signs: Objective
Symptoms: Subjective

34
Q

Primary symptoms of cardiopulmonary disorders

A

Cough, sputum production, hemoptysis, SOB, chest pain

35
Q

Cough nervous system pathways

A

Afferent: Vagus, glassopharyngeal, trigeminal
Efferent: smooth muscles of larynx and tracheobronchial tree via phrenic and spinal nerves

36
Q

Phases of cough

A

inspiratory
compression
expiratory

37
Q

Types of cough

A

Acute: sudden, severe and short course
Chronic: Persistent, >3 weeks
Paroxysmal: Periodic, prolonged, forceful episodes

38
Q

Associated symptoms of cough

A

wheezing, stridor, chest pain, dyspnea.

39
Q

Black Sputum

A

smoke or coal dust inhalation

40
Q

Brownish sputum

A

Cigarette smoker

41
Q

Frothy white or pink sputum

A

pulmonary edema

42
Q

Sand or small stone in sputum

A

Aspiration of foreign material, broncholithiasis

43
Q

Purulent sputum

A

infection

44
Q

Apple green, thick sputum

A

Haemophilus influenzae

45
Q

Pink, thin, blood streak sputum

A

Streptococci and staphylococci

46
Q

Red currant jelly sputum

A

Klebsiella species

47
Q

Rusty

A

Pneumococci

48
Q

Yellow or green, copious sputum

A

Pseudomonas species pneumonia, advanced

49
Q

Foul odor sputum

A

lung abscess, aspiration, anaerobic infection, bronchiectasis

50
Q

Mucoid sputum

A

Emphysema, pulmonary tuberculosis, early chronic bronchitis, neoplasms, asthma

51
Q

Grayish Sputum

A

Legionnaires

52
Q

Silicone like casts

A

Bronchial asthma

53
Q

Mucopurulent sputum

A

as above with infection, pneumonia, cystic fibrosis

54
Q

Blood streaked or hemoptysis

A

Bronchogenic carcinoma, tuberculosis, chronic bronchitis, coagulopathy, pulmonary contusion or abscess.

55
Q

Causes of hemoptysis

A

Bronchopulonary, cardiovascular, hematologic, or systemic disorders
Tuberculosis or fungal infections.

56
Q

What constitutes massive hemoptysis

A

400 ml/3h or 600 ml/24hr

57
Q

What is hematemesis

A

Vomiting blood.

58
Q

Cardinal symptom of cardiac disease

A

Shortness of breath

59
Q

What is Dyspnea

A

Subjective experience of breathing discomfort

60
Q

How do you score dyspnea

A

Modified borg scale- subjective

ATS SOB scale- objective

61
Q

Clinical types of dypnea

A

Cardiac and circulatory: primarily during exercise.
Psychogenic: Panic disorder
Hyperventilation: rate, depth exceed body’s metabolic need. Results in decreased cerebral blood flow.

62
Q

Causes of dyspnea

A

WOB abnormally high for given level of exertion: asthma, pneumonia
Ventilatory capacity is reduced: neuromuscular disease
Drive to breathe is elevated: hypoxemia, acidosis, exercise

63
Q

What is dependent edema?

A

Abnormal accumulation of fluid. Same as peripheral edema.

64
Q

When would there be a pulmonary disease without fever?

A

high dose corticosteroids
immunosupressants
immunocompromised (leukemia, AIDS)

65
Q

What pulmonary infections would cause fever?

A

Lung abscess, empyema, tuberculosis, pneumonia

66
Q

What is remittent fever? What infections are associated with it?

A

It is a fever that remains above baseline throughout the day despite having a rise and fall.
Mycoplasma pneumonia, legionnaires disease, acute viral infections

67
Q

Headache and lung disease

A

Cerebral hypoxia and hypercapnia

68
Q

Altered mental state and lung disease

A

hypercapnia can affect alertness to coma

69
Q

Incidences of OSA/SDB

A

10-12% in children

10-30% in adults

70
Q

Explain the complex presentation of CHF

A

see diagram

71
Q

What are vital signs used to do?

A

Determine the general status of the patient
Establish a baseline
monitor response to therapy
Observe for trends
Determine the need for further evaluation or intervention

72
Q

What are the four vital signs?

A

Temperature, pulse, respirations, bp

73
Q

How often to take vitals?

A

On admission, at beginning of each shift, before and after procedure, any time patient condition changes, based on protocol or physicians orders, as often as necessary for patient safety

74
Q

General clinical impression

A

information about personality, hygiene, culture and reaction to illness

75
Q

What temperature indicates infection

A

> 39

76
Q

Normal pulse pressure

A

35-45 mmHg

77
Q

Poor peripheral perfusion occurs at what pulse pressure

A

<30 mmHg

78
Q

Hypertension

A

> 140/90

79
Q

Hypotension

A

<90/60

80
Q

In what phase would an auscultatory gap occur?

A

II or III

81
Q

systolic pressure decrease on inspiration

A

normal: 2-4 mmHg

Pulsus Paradoxus: >10 mmHg drop

Patient Assessment (1 decks)

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