Patient Assesment Flashcards
What are the four critical life functions?
Ventilation
oxygenation
circulation
perfusion.
What is ventilation?
Ventilation is moving air in and out of the lungs.
What is oxygenation?
Oxygenation is getting oxygen into the blood.
What is circulation?
Circulation is moving the blood through the body.
What is perfusion?
Perfusion is getting oxygen into the tissue.
What assessments will determine how well a patient is ventilating, six things
Respiratory rate
tidal volume 
chest movement
breath sounds
PaCO2
EtCO2
How would the therapist determine if a patient has a problem with oxygenation?
Heart rate
color
sensorium
PaO2
SPO2
How do we measure circulation what are the three vital signs?
Heart rate
strength
cardiac output
How do we measure perfusion, what are the five vital signs?
Blood pressure
sensorium
temperature
urine output
hemodynamics dynamics
When you have an emergency what are the four priorities list them in order?
First priority ventilation
oxygenation
circulation
perfusion
What is the most common problem out of the four life functions?
Oxygenation
Patient chart review
What are the five things needed and patience admission notes?
Admitting diagnosis
history of present illness
chief complaints
past medical history
current medical history
Patient chart review
What are signs?
objective information, Things you can see or measure (example color cause edema blood pressure etc.)
Patient chart review
What are symptoms give some example?
Subjective information things the patient must tell you (example dyspnea nausea muscle weakness)
What are the nine things included in patient chart review?
Admission notes 
signs and symptoms
occupation employment history or hobbies
allergies or allergic reaction
prior surgery Illness injury
vital signs
physical Examination
tobacco use
advance directive
Calculation for Pack yours ?
of packs/day x # of years smoked.
What is the definition for advance directive?
Set of instructions documenting what treatment a patient would want if he or she was unable to make medical decisions.
List and describe the four types of advance directives?
DNR do not resuscitate
DNI do not intubate
LivingWell
Durable power of attorney
What is a living will define it?
Describes treatment patient would want if he or she became Terminally ill.
What are the four things that have to be included in a Respiratory order?
Type of treatment
frequency
medicadosage
physician signature
What are the four type patient laboratory reports?
ABG
Pulmonary function testing
imaging reports
basic lab assessments
What is normal urine output?
40 mL per hour approximately 1 L per day
What is sensible water loss?
Urine 
vomiting
What is insensible water loss?
Lungs and skin
What findings might indicate that patient’s food intake has exceeded his urine output?
Weight gain
Electrolyte imbalance
increased hemodynamic pressure decrease lung compliance (stiff Lung)
What is normal Central venous pressure (CVP)
2-6 mm Hg
What does decrease central venous pressure CVP indicate?
Hypovolemia (recommended fluid therapy)
Changes in Value you can indicate hypovolemia?
Increase CVP recommended fluid therapy
 what are the six activities of daily living ADL
Dating
eating
dressing
toilet use
transferring
urine and bowl continents
ADL are evaluating using what system?
Katz scoring system
Orthopnea
Difficulty breathing except in a preposition example CHF
General malaise
Rundown feeling, nausea, weakness, fatigue, headache, example (electrolyte in balance)
Dyspnea
SOB, difficulty breathing
Dysphagia
Difficulty swallowing and hoarseness
What are the four factors to consider when conducting a patient interview?
- Asking open ended question
- Communicate using simple language(Kiss method)
- Utilize picture, diagram
- Begin to identify patient major problems
Define patient learning Needs?
1. Process of influencing patient behavior and producing the change and knowledge attitude and skills necessary to maintain or improve Health.
2. Assessment of patient and family learning needs to determine what learning needs to occur and how the learning can best occur.
What criteria is a patient’s ability to learn based on?
- cultural and religious value
- Emotional barriers
- Desire and motivation to learn
- Physical and cognitive limitations
- Language barriers
- age and educational level
What criteria is a patient’s nutritional status based on?
1. usual food intake
2. Food likes and dislikes
3. Appetite
Peripheral edema And pathology associated with and recommend a therapy?
Excess fluid and tissue mostly in arms and ankles
Pathology CHF
Recommended Therapy diuretics
Ascities Definition?
Pathology associated with it?
Accumulation of fluid an abdomen
Liver failure
Clubbing and pathology associated with it?
Angle of fingers and nail beds increased
Pathology chronic hypoxemia, suggesting pulmonary disease
venous distention pathology associated with it?
CHF, Syndrome exhalation in patient with obstructive lung disease
Capillary refill?
Indication of peripheral circulation
Diaphoresis and pathology associated with it?
Heavy sweating
Pathology,
heart failure, Fever infection
Ashen, Pallor indication?
Decrease in color, indicates anemia, blood loss
Erythema definition and indication?
Redness in skin
Indicates capillary congestion inflammation or infection
Cyanosis definition and indication?
Blue or blue gray and color indicates hypoxia reduced hemoglobin
Chess configuration
Kyphosis
Leaning forward, convex curvature
Scoliosis
Lean side to side, lateral Carracher of the spine
Barrel chest
Air trapped in lung for long period of time
COPD
Increase in AP diameter
Describe symmetrical chess movement
Bilateral equal chest rise and fall doing breathing
List five underlining pathologies that can contribute to a patient displaying asymmetrical chest movement
Post Long resection, post pneumonectomy
Atelectasis-Forward
Pneomthorax-Away
Flail chest-Paradoxical chess movement
Endotracheal tube insertion in right or left main stem bronchi

Eupnea
Normal respiratory rate, depth and Rhythm
Tachypnea
Increased respiratory rate greater than 20 breaths per minute
Condition
Hypoxia, fever, pain, CNS problem
Bradypnea
Decrease woke up breathing less than 12 breaths per minute
Condition
Sleep, drive, alcohol, metabolic disorder
Cheyenne-strokes 
Gradual increase then decrease of breathing with 60 seconds of apnea lasting 30 to 180 seconds
Condition
Increased intracranial pressure
Brainstem injury
Drug overdose
Kussmaul’s breathing
Increase respiratory rate and depth with a regular rhythm
Condition
Metabolic acidosis
Renal failure
Diabetic keto acidosis
What causes hypertrophy of the accessory muscles what type of patient might this be present in?
Increase in muscle size
COPD
Wasting away of muscle is also referred to as?
Atrophy
Cachexia
Describe the four neck pathologies the might complicate endotracheal intubation?
Short receding mandible
Enlarged tongue
Bulk neck
Limited range of motion of the neck
What is the normal range for a patient’s heart rate?
60 through 100 per minute
What times would be used to describe a heart rate of 160 per minute? What would this indicate? Recommendation?
Tachycardia
This would indicate
Hypoxemia, anxiety, stress
Recommendation
Oxygen therapy
What terms would be used to describe a pulse of 52 per minute? What would this indicate? Recommended therapy?
Bradycardias
Indicates
Heart failure, stroke, code/Emergency
Recommendation
Atropine
What is and what does paradoxical pulse/pulsus Paradoxus indicate?
Change in heart rate and blood pressure with every breath
Indicate
Severe air trapping,status asthmaticus, Tension pneumothorax, cardiac tamponade

Tracheal deviation pool to abnormal side(Towards pathology)?
A. Pulmonary atelectasis
B. Pulmonary fibrosis
C. Pneumonectomy
D. Diaphragmatic paralysis
Tracheal deviation push to normal side(Away from pathology)
A. massive plural effusion
B. Tension pneumothorax
C. Neck or thyroid tumor
D. Large mediastinal mass
What is tactile fremitus?
Vibration that has felt by the hand on the chest wall.
What is meant by tenderness?
Any place of body that has incision, chest tube, bruises, fractured bone, burns
What is meant by crepitus and what condition is associated with?
Bubble under skin
Indicates subcutaneous emphysema
Define resonant?
Normal air filled long (Gives Hollow sound)
Define flat?
Normal heard over sternum
Define dull?
Hurd over fluid filled organ
Ex: Heart, liver
Or
Plural effusion, pneumonia
Define tympanic?
Normally hurt over air filled stomach
Drums like sound
Indicates volume when heard over the lung
Define hyperresonant
Booming sound
Pneumothorax
Emphysema
What is the difference between vascular and adventitious breath sounds?
Vascular breath sounds: Normal breath sounds
Adventitious breath sounds: Abnormal breath sounds
What is Kopany and what does it indicate?
Says E but sounds like A
Indicates consolidation
What breath sounds would be expected in a patient with pulmonary edema?
CHF/pulmonary edema
Grade one dyspnea?
Dyspnea occurs after unusual exertion
Grade 2 dyspnea?
Breathless, after going uphill or stairs.
Grade 3 dyspnea?
Dyspnea while walking and normal speed.
Create four dyspnea?
Dyspnea slowly walking short distance.
Grade 5 dyspnea?
Dyspnea at Rust, shaving dressing, etc.
What is patience, ability to learn based on?
Cultural and religious values
Emotional barriers
Desire, motivation to learn
Physical and cognitive limitations
Language barriers
Age and education level
What are the five preferred learning styles?
Visual
Auditory
Hands-on
Lecture
Discussion
What are the four patient/family history?
History of present illness
Past medical history
Family history
Social history
What does general appearance include in physical assessment of patient?
Age, height, weight, nourishment, etc.
What are the two types of edema?
Peripheral edema, ascities
How does peripheral edema present itself?
1 presence of excessive fluid in the tissue known as pitting edema
2 occurs primarily in arms and ankle
3 it is caused by either heart failure or renal failure
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