NHA Mod 3 Flashcards
vitals are key indicators of what
homeostasis
what factors can cause changes in vitals
stress, food/liquid intake, medical conditions, age, physical activity
list information apart of pt’s demographic
- name
- address
- phone number
- insurance info
- emergency contact
define MEDICATION RECONCILIATION
comparing pt’s list of meds to medical record to reduce risk of incorrect prescription, med interactions, & adverse reactions
when should medication reconciliation happen
every time pt is in office
what is included in administrative section of pt health record?
- pt info/demographics
- financial & insurance info
- correspondence
what is included in clinical section of pt health record?
- past medical/family/social history
- occupation
- orders/referrals
- clinical data
- progress notes
- diagnostic imagining info
- lab info
- medications/allergies
purpose of Patient Health Questionnaire-2 (PHQ-2)?
focus on pt’s frequency of depressed mood over 2 weeks
purpose of Patient Health Questionnaire-9 (PHQ-9)?
used of PHQ-2 is positive and asks additional questions to see if pt meets criteria for depressive disorder diagnosis
what is used on older adults for dementia/other degenerative disorder evaluation?
mini-mental examination
list common symptoms of depression
- difficulty going to sleep/staying asleep/getting up
- profound sadness & fatigue
- change in appetite
- loss of energy
define “white coat syndrome”
anxiety related to seeing health provider for evaluation
what is the purpose of the GAD-7 questionnaire?
screen patients for general anxiety
list common symptoms of anxiety
- heightened ability to observe/make connections
- difficulty focusing on details
- sense of panic
- irritability
- feeling cold/sweaty
- shortness of breath
- heart palpitations
List and describe the different phases of the Korotkoff sounds
- I: sharp tapping
- II: swishing
- III: knocking
- IV: muffled
- V: sound disappears
what phases of Korotkoff sounds are used for manual blood pressure
phase I & V
what is used during palpatory BP
palpation of brachial pulse
T/F: BP rises with age
true
list factors of BP
- age
- internal conditions
- external influences
- BP
- blood volume
- peripheral resistance
- condition of heart muscle
how does blood volume affect BP
increased blood volume increases blood pressure; decreased blood volume decrease blood pressure
how does peripheral resistance impact BP
smaller lumen = increase in BP
how does overall condition of heart muscle impact BP
overworked & weak –> can’t contract –> pressure increase in vessels to maintain adequate blood circulation
What are some reasons for error while doing BP
- limb w/cuff above heart
- cuff bladder not completely deflated
- pressure released too rapidly
- pt nervous/anxious
- pt drank coffee/smoked cigarette within 30 min
- cuff applied improperly
- cuff too large/small/tight/loose
- bladder not centered over artery/bulges from cover
- fail to wait 1-2 minutes between measurements
- instrument is defective
what limb should you use for a pt that has a one-sided mastectomy
use the arm on side not impacted by mastectomy
what limb should you use for pt that has bilateral mastectomy
leg
what limb should you use for pt that has lymphedema [arm]
leg
what limb should you use for pt that has dialysis fistula
use arm not affected
what is expected BP range for newborns
67-84/35-53
what is expected BP range for infants
72-104/37-56
what is expected BP range for toddlers (1-2 yrs)
86-106/42-63
what is expected BP range for preschoolers (3-5 yrs)
89-112/46-72
what is expected BP range for school-age kids (6-9 yrs)
97-115/57-76
what is expected BP range for preadolescent kids (9-11 yrs)
102-120/61-80
what is expected BP range for adolescents (11-15 yrs)
110-131/64-83
what is expected BP range for adults (+15 yrs)
< 120/< 80
what is the range of prehypertension
120-139/80-89
what is the range of stage 1 hypertension
140-159/90-99
what is the range of stage 2 hypertension
> 160/ > 100
what is the range of hypertension crisis
> 180/>110
for all stages of hypertension (including prehypertension) does both the systolic and diastolic values need to meet the criteria?
no, one or the other if not both
what size BP cuff should be used for 8.7-10.2 in arm circumference
small adult
what size BP cuff should be used for 10.6-13.4 in arm circumference
adult
what size BP cuff should be used 13.8-17.3 in arm circumference
large adult
what size BP cuff should be used for 17.7-20.5 in arm circumference
XL adult
define orthostatic hypotension
significant drop in BP and increase in pulse from positional changes
what are causes of orthostatic hypotension
- heart disease
- dehydration
- diabetes
- medications
- nervous system disorders
what are signs of orthostatic hypotension
decreased BP of at least 20 points and increased pulse of at least 10 bpm when comparing BP and pulse lying down, sitting, & standing 2-5 min between each check
normal pulse for 1-3 yr olds
80-150
normal pulse for 3-6 yr olds
70-120
normal pulse for 6-12 yr olds
60-110
normal pulse for people older than 12
60-100
normal respirations for 6-12 yr olds
16-22
normal respirations for 3-6 yr olds
20-24
normal respirations for 1-3 yr olds
22-30
where is the most common pulse site in kids
brachial
define hyperventilation
fast/rapid breathin
what are possible causes for hyperventilation
intense pain, anxiety, & panic attacks
what are possible causes of hyperpnea
extreme pain/anxiety
define hyperpnea
excessively deep breathing
define dyspnea
difficult/painful breathing
what are possible causes of dyspnea
COPD, pneumonia, asthma, high altitudes, and physical exertion
define orthopnea
difficulty breathing unless in upright position
what are possible causes of orthopnea
congestive heart failure & COPD
define wheezing
whistling sound during breahing
what are possible causes of wheezing
asthma & bronchitis
what are possible causes of rales
fluid in air sacs & pneumonia
define rales
small clicking/bubbling/rattling sounds
define rhonchi
large airway sounds
what are possible causes of rhonchi
COPD, chronic bronchitis, & pneumonia
what is the expected respiratory rate for newborns
30-40
what is the expected respiratory rate for infants
30-60
what is the expected respiratory rate for toddlers
26-32
what is the expected respiratory rate for children
20-30
what is the expected respiratory rate for adolescents
16-20
what is normal O2 saturation
95% or higher
what abbreviation should be used when documenting the temperature was taken tympanically
T or AU
what abbreviation should be used when documenting the temperature was taken from axillary
Ax
what abbreviation should be used when documenting the temperature should be taken rectally
R
what abbreviation should be used when documenting the temperature was taken from temporal artery
TA
what can affect oral temperature readings
- drinking hot/cold liquids
- chewing gum
- smoking
does the temperature site need to be documented if temp was gained orally?
no
until what point are head circumferences done
36 months
what effect does beta-blocker medications have on vitals
decreases pulse & BP
