Module 3: Patient Intake and Vitals Flashcards
Medication reconciliation
Comparing the patient’s list of medications to the medical record as a safety measure to reduce the risk of improperly prescribing an incorrect or contraindicated prescription, including medication interactions and adverse reactions.
The Patient Health Questionnaire-2 (PHQ-2)
focuses on the patient’s frequency of depressed mood over two weeks.
What does the MA do if a patient reflects a positive response to depression in the PHQ-2?
proceed to the Patient Health Questionnaire-9 (PHQ-9)
Patient Health Questionnaire-9 (PHQ-9)
questions to assess if the patient meets the criteria for a depressive disorder diagnosis.
white coat syndrome
anxiety related to seeing a health care provider for an evaluation
GAD-7 questionnaire
for general anxiety and used to screen patients for anxiety.
What is the difference bw the systolic pressure and diastolic pressure
S: Measurement of force while the heart is contracting
D: Measurement of force while the heart is relaxing
What are the 5 phases of the korotkoff sounds?
- the first sound heard, systolic
- swishing sound as more blood flows through the artery
- **sharp tapping ** sounds are noted as more blood surges
- soft tapping sound which begins to muffle
- the final sound heard, diastolic
Using the wrong cuff size can impact the systolic and diastolic pressure up to
6.9 mm Hg
If a patient has their legs crossed while taking their blood pressure, the systolic blood pressure may be raised by
2 to 8 mm Hg
An increase in blood volume can ______ a person’s blood pressure, while a decrease in blood volume can ____ a person’s blood pressure.
a) increase
b) decrease
Expected BP for older than 12 years old
110-130 / 65-80
Expected BP for 6-12 years
100-120 / 60-75
Expected BP for 3-6 years
95-110 / 60-75
Expected BP for 1-3 years
90-105 / 55-70
Based on the stages of hypertension, what is a normal systolic and diastolic bp?
S: less than 120
D: less than 80
Based on the stages of hypertension, what is a elevated systolic and diastolic bp?
S: 120-129
D: less than 80
Based on the stages of hypertension, what is a stage 1 systolic and diastolic bp?
S: 130-139
d: 80-89
Based on the stages of hypertension, what is a stage 2 systolic and diastolic bp?
S: 140 or high
D: 90 or higher
Based on the stages of hypertension, what is the systolic and diastolic bp if emergency care is needed?
S: higher than 180
d: higher than 120
orthostatic hypotension
- A drop in blood pressure during positional changes, when pt is moving from lying to sitting or from sitting to standing;
- increase pulse rate
- also known as postural hypotension.
How to take orthostatic vital signs?
- have pt lie for 5 mins
- measure bp and HR
- have pt stand for 1-3 min
- repeat bp and HR
- An increased HR of at least 10 bpm and a decreased bp of at least 20 points between positions indicate orthostatic hypotension
What are the most common sites to palpate a pulse?
- radial pulse
- brachial pulse
- carotid pulse
HR range for adolescents and older
60-100
HR range for 6-15 years
75-118
HR range for 3-5 years
80-120
HR range for 1-2 years
98-140
HR range for 1-12 months
100-180
Hyperventilation
- fast/rapid breathing
- caused by intense pain, anxiety and panic attacks
Hyperpnea
- excessively deep breathing
- cause by extreme pain or anxiety
dyspnea
- difficult or painful breath
- caused by COPD, pneumonia, asthma, high altitudes and physical exterion
Orthopnea
- difficulty breathing unless in the upright positiong
- caused by congestive heart failure and COPD
Wheezing
- whistling sound during breathing
- asthma
Rales
- small clicking, bubbling, or rattling sounds
- fluid in air sacs and pneumonia
Ronchi
- large airway sounds
- COPD, chronic bronchitis and pneumonia
RR expected range for adolescents and older
12-20 bpm
RR expected range for 6-15 years
18-25 bpm
RR expected range for 3-5 years
20-28 bpm
RR expected range for 1-2 years
22-37 bpm
RR expected range for 1-12 months
30-53 bpm
How to use a tympanic thermometer
insert it into the ear
How to use an axillary thermometer
place in the armpit
How to use a rectal temperature
insert in the rectum
How to use a temporal artery scanner thermometer
moved across the forehead and behind the ear to produce a temperature reading
Axillary temperature (Ax) is approximately 1° F (0.6° C) higher or lower than an oral reading
lower because axillary readings are not taken in an enclosed body cavity
Tympanic, rectal, and temporal artery temperatures are approximately 1° F (0.6° C) higher or lower than oral readings.
higher
Age-Related Temperature Norms for a newborn taken in the axillary
98.2 F
Age-Related Temperature Norms for a 1 year old taken in tympanically
99.7 F
Age-Related Temperature Norms for 6 years-adult taken in orally
98.6 F
Age-Related Temperature Norms for 70+ years old taken in orally
96.8 F
In addition to documenting the number for the pain level, which characteristics of the patient’s pain need to be documented?
Location
Duration
Characteristics
Onset
What is the impact of Exertion (such as a long walk to the exam room) in vital sign measurements
Increased blood pressure
Increased heart rate
Lower oxygen levels
What is the impact of illness in vital sign measurements
Increased temperature
What is the impact of beta-blocker medication in vital sign measurements
Decreased blood pressure
Decreased heart rate
What is the impact of age in vital sign measurements
- Increased temperature fluctuation in young children (inability to regulate)
- Decreased temperature in older adults (loss of insulation in the form of body fat)
