Module 1 Flashcards
Nociceptive (somatic) pain
linked to damage of skin, musculoskeletal, or viscera
Neuropathic pain
pain related to somatosensory system (nerve related). often no physical appearance
Psychosogenic pain
psychiatric/coping/personality/cultural
Idiopathic pain
no etiology/course
Attempting to treat pain/4 As
- analgesia
- ADLs
- adverse drug rxns
- aberant drug related behaviors
10-15mmHg blood pressure difference between arms could mean
- aortic dissection
- supravalvular aortic stenosis
- subclavian steal syndrome
too small of blood pressure cuff
elevated reading
too large of a blood pressure cuff
low reading
too loose of blood pressure cuff
elevated reading
ausculatory gap
silent interval between systolic and diastolic-can lead to underestimation of systolic and overestimation diastolic
ausculatory gap is associated with
arterial stiffness and arthlerosclerotic disease
normal blood pressure
less than 120/80
elevated blood pressure
systolic 120-129
diastolic <80
stage 1 HTN blood pressure
systolic 130-139 OR
diastolic 80-89
stage 2 HTN blood pressure values
systolic 140+ or diastolic 90+
white coat HTN
blood pressure >140/90 in office environment
masked HTN
in daytime setting, BP >130/80 in daytime but in ambulatory setting >135/85
seen in 10-30 percent of patients
Where pulses can be palpated
radial, bracial, femoral, popliteal, dorsalis petus, post tib
normal HR
60-90bpm
pulse deficit
there is a significant difference between apical and peripheral pulse
when does pulse deficit occur
Afib, heart failure, weak heart contraction, apical higher than peripheral
diminished pulse
can be seen with arthlerosclerotic peripheral vascular disease, low cardiac output
assymmetry of pulses
can indicated coarctation of aorta or aortic dissection
different in upper and lower extremeties
bounding pulse/water hammer
seen w/ aortic regurgitation or patent ductus arteriosus
pulsus alternans
amplitude of pulse alternates every other beat
Pericardial effusions
bradypnea
slow breathing, causes: physiologic, diabetic coma, drug induced respiratory depression, increased intracranial pressure
tachypnea
rapid, shallow breathing
causes: restrictive lung disease, pleuritic chest pain, elevated diaphram
obstructive breathing
expiration is prolonged due to narrowing of airways that increase resistance to airflow
causes: asthma, COPD, chronic bronchitis, foreign masses and bodies
hyperpnea/hyperventilation
rapid, deep breathing
causes: exercise, anxiety, metabolic acidosis, kidney failure, DKA
comatose-consider infarction, hypoxia, hyperglycemia
chyne stokes breathing
period of deep breathing alternating with periods of apnea
causes: normal in children, elderly when sleeping
pathologic if normal adult having these symptoms
causes: heart failure, uremia, drug induced respiratory depression, brain damage
Kussmauls respirations
labored, deep breathing, also rapid
seen with metabolic acidosis
ataxic
unpredictable breathing irregularity
shallow or deep with periods of apnea
causes:respiratory depression, brain damage
Normal temperature
37 Celcius
98.6 Farenheit
C to F formula
F=(C*1.8)+32
F to C formula
(F-32)/1.8
hyperprexia
temperature above 106 F or 41.1 C
hypothermia
temperature less than 95 or 35 C
can be due to decreased movement
interference with vasoconstriction
hypothyroidism or hypoglycemia
BMI chart
<18.5 underweight 18.5-24.9 normal 25-29.9 overweight 30-34.9 obese 1 35-39.9 obese 2 40+ obese 3
Level of consciousness consists of
- awake
- alert
- responsive
- oriented
alertness amount (5 levels of alertness)
- alert:totally looking and responding
- lethargic:appears drowsy, will respond and then fall back asleep
- obtunded:open eyes slow and confused, not alert, respond to stimuli (not painful)
- stuporous:arouses from sleep with painful stimuli, very little awareness
- comatose:no response even to pai
Scale of conciousness
Glassgow Coma scale
way of using the glassgow coma scale
eye opening 1-4 verbal response 1-5 motor response 1-6 scored between 3-15 15-normal 13-higher correlation of mild brain injury 9-12-moderate 8-severe
disadvantages of glassgow coma scale
-one area could possibly not be assessed due to trauma, intubation etc
other way to document LOC
- A+O
- A+O X3
A+O X4 means
awake and oriented to person place time situation (that order)
what can affect A+O
mood, memory, trust
orientation is lost in this order
situation then time then place then person
