Objective - Xtian Flashcards
normal HR/PR
60-100 bpm
tachycardia HR/PR
> 100 bpm
bradycardia
< 60 bpm except athletes
irregular HR/RR
dysrhytmia
pulse grading
0: absent
1+: diminished, weak or thready
2+: normal
3+: inc strength
4+: bounding or too strong
discuss apical pulse
5th ICS midsternum - auscultate
full 60 sec count
how to measure if pulse is diminished
use bell of stethoscope
how to measure apical-radial pulse
60 secs c 2 PTs
HTN urgency
no acute end-organ damage
180 or more and 110 or more
HTN emergency
acute end-organ damage
180 or more and 110 or more
discuss OH
drop of 20 in SBP or 10 in DBP c 10-20% inc in PR
3 min p standing from supine (60% angle) for 5 mins
RR values
normal: 12-20 cpm
tachypnea: more than 20
bradypnea: less than 12
variable
temperature values
afebrile: 36-37.5
febrile: 38 above
hypertherimia: more than 41.1
hypothermia: less than 35
where to take pulse ox
3rd or 4th finger
O2 sats values
95-100: normal
91-94: mild hypoxemia but can still PT
85-90: mod hypoxemia needs supp O2
80-85: severe hypoxemia; O2 immed
<80: severe; hospitalize
70: cyanosis and acute danger
body types of chronic bronchitis vs emphysema
CB: endomorph; blue bloater
emphysema: ectomorph; pink puffer
what to OI on extremities
swollen or clubbed fingers
nicotine stain
asterixis
invasive attachments for medication/fluids
arterial line
IV
central line
swan-ganz catheter
non-invasive ventilation
CPAP
BiPAP
ambu bag
nasal cannula
simple mask
aerosol mask
venturi mask
invasive ventilatory devices
oropharyngeal
nasopharyngeal
endotracheal
tracheostomy
mech vent
chest tube thoracostomy
chest of deformities
barrel chest - emphysema
pectus carinatum and excavatum
flail chest - (+) hoover’s sign
dyspnea
N rate, S depth, R rhythm
accessory muscle activity
prolonged expiration
COPD
fast inspi and long expi pero normal na lahat
psychogenic disorders
N rate c intervals sighing
c anxiety
heart sounds auscultation landmarks
aortic: 2 (R) ICS
pulmonic: 2 (L) ICS
tricuspid: 4(L) ICS
mitral: 5 (L) ICS
erb’s: 3 (R) ICS
apex: 5 (L) ICS
first heart sound
S1 - 0.10 s
closing of AV valves - ventricular sys
second heart sound
S2 - < 30 ms
closing of semilunar - ventricular diastole
can split during inspiration - physiologic split
ventricular gallop
S3 - CHF
faint and low
early diastolic filling after AV open
atrial gallop
rapid ventricular filling after atrial contraction
at late diastole before S1
systolic murmurs
bet S1 and 2
diastolic murmurs
bet S2 and 1
heart sounds grading
1: faint
2: audible imeed
3: louder than 2
4: liud
5: very loud
6: s stethoscope
landmarks for breath sounds
T2, 6, 10
axilla, nipple, subcostal
abnormal breath sounds
bronchial: tubular on peripheral tissue
dec or absent
adventitious breath sounds
rales/crackles: fine on inspi
ronchi: low pitched sonorous on expi
stridor: inspi wheeze
wheeze: high pitch on expi
friction rubs: coarse grating on inspi/expi
voice sounds
bronchophony: 99
whispered petriloquy: whisper 99
egophony: EE
cough and sputum assessment
F, WF, NF, 0
COAT
landmarks for chest symmetry
upper chest: 4th rib ant
middle chest: axilla ant
lower chest: below scap post
max inhale and exhale
ipsi mediastinal shift
atelectasis
lobectomy
pnuemonectomy
contra mediastinal shift
pleural effusion
organ herniation
pericardial tamponade
mediate percussion
resonant: hollow and low; normal
hyperresonant: tympanic; air
hyporesonant: dull; fluid or mucus
tactile fremitus
inc vibration: lung consolidation
dec: plueral effusion, pneumothorax and atelectasis
NYHA heart failure sx
1: no limit on physical activity
2: slight limit c SOB, fatigue and palpitation
3: marked limitation; sx at less than ordinary
1-3: comfy at rest
4: even at rest may sx
NYHA heart failure obj assessment
A: no evidence
B: mild evidence
C: mod esevere
D: sever
A-c: comfy at rest
same lang nag ka evidence lng
NYHA therapeutic classificatoin
A: no restriction
B: no competitive sports
C: restricted ordinary activity and no strenous
D: ordinary restricted
E: confined to bed or w/c
