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NPS Certification > Patient Assessment > Flashcards

Patient Assessment Flashcards

1
Q

What are the 4 Life Functions?

A

Ventilation, Oxygenation, Circulation, Perfusion

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2
Q

What is Gravida (G)?

A

Any pregnancy regardless of duration. Measuring how many times mom was pregnant

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3
Q

What is Para (P)?

A

Birth after 20 weeks regardless of whether infant is viable

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4
Q

What is LGA/SGA/NGA?

A

Large for Gestational Age
Small for Gestational Age
Normal for Gestational Age

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5
Q

What are some Tx used in maternal Hypertension?

A

Bed rest
Diet
antihypertensive meds

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6
Q

Magnesium sulfate is used for what purpose?

A

Lower blood pressure and delay preterm delivery

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7
Q

How can we estimate gestational age of a baby in the womb?

A 
Fetal Ultrasound 
Biophysical Profile (BPP)
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8
Q

What is amniocentesis? And why do we do it?

A

A procedure where a needle is used to extract amniotic fluid.

Gives us L/S ratio and help us determine lung development

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9
Q

What is Amniotic Fluid Index (AFI)?

A

Used to quantify amniotic fluid volume, obtained by ultrasound as they measure the largest pocket of fluid in uterine quadrants

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10
Q

What is a Normal AFI?

A

Normal = 8-18

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11
Q

An AFI of <5-6 is considered what? And what can this lead to?

A

Oligohydramnios or a reduced amount of amniotic fluid (usually resulting in IUGR, poor lung development, prematurity

Can lead to, Potters syndrome

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12
Q

An AFI of >20-24 is considered what? and what can it lead to?

A

Polyhydramnios or excessive amount of amniotic fluid

Can lead to T-E fistulas and esophageal atresia

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13
Q

What is a Normal L/S ratio? What should be considered if it is Low?

A

2:1 is normal but 3:1/4:1 is also okay

If Low, consider surfactant

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14
Q

How can you test lung maturity of a baby more accurately in a diabetic mother?

A

Phosphatidylglycerol (PG) Test

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15
Q

What are some other ways to test for lung development and presents of surfactant?

A

Surfactant/Albumin (S/A) Ration = needs 1ml sample, Less expensive than L/S ratio, Normal is 55mg/g

Shake Test = Mix amniotic fluid and 95% ethanol and shake if solution foams/bubbles surfactant is present

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16
Q

What is a Coombs Test?

A

Evaluates blood type incompatibility

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17
Q

Most commonly used medications to inhibit uterine contractions by relaxing smooth muscle?

A

Terbutaline and Magnesium Sulfate

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18
Q

What is the range for a normal fetal heart rate (FHR)?

A

Normal = 110-160/min

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19
Q

What is early deceleration or Type I when talking about a FHR?

A

During a uterine contraction, FHR slows down to near or below 110. This is a normal response due to head compression

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20
Q

What is Late deceleration or Type II?

A

FHR begins to slow down after the start of a contraction and persist after it has ended

Tx = Administer Oxygen to Mother

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21
Q

What is Variable deceleration or Type III?

A

FHR decelerates independently from uterine contractions, This is a high-risk delivery

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22
Q

Corticosteroids may be administered to mom before baby is born for what reason?

A

To stimulate surfactant production

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23
Q

What are 2 postnatal methods to estimate gestational age?

A

Dubowitz method = for infants greater than 28 weeks

New Ballard score = for infants less than 28 weeks

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24
Q

What does APGAR stand for? and what is a good APGAR score?

A 
A = Appearance (color) 
P = Pulse 
G = Grimice (Reflex) 
A = Activity (Muscle tone) 
R = Respiratory Effort

A score of 7 or higher is considered good.

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25
Q

What is the Silverman Anderson Scoring?

A

Like the APGAR score it is used to evalute neonates in Respiratory distress but only looking at how baby is breathing, however the higher the score the worse the baby is doing.

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26
Q

Why do we use Pre and Post ductal blood gases?

A

To identify the presence of a Right-to-Left cardiac shunt. If the Pre-ductal PaO2 is 15 torr higher than Post-Ductal PaO2 you have a Right-to-Left shunt.

{ You can also used two pluse oximeters and if there is a difference of 10% + then you have Right-to-Left shunting }

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27
Q

What causes a Right-to-Left shunt?

A

Congenital Heart Defect
Patent ductus arteriosus (PDA)
Persistent Pulmonary hypertension of the newborn (PPHN)

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28
Q

What test can help in determining if the Right-to-Left shunt is caused by the Lungs or the Heart?

A

Oxygen challeng Test

PaO2 is evaluated on room air and after adminstration of 100% O2 for 10 mins

Minimal or no increase in PaO2 indicates right-to-left shunting caused from the heart and not the lungs.

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29
Q

What is a normal body temp for babies?

A

36-37 degrees celcius

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30
Q

What can happen to a baby if it becomes hypothermic?

A

Increased Oxygen consumption
Apnea
Bradycardia

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31
Q

What is a Normal Na+ (Sodium)?

A

133-149 mmol/L

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32
Q

What is a normal Cl- (Chloride)?

A

87-114 mmol/L

33
Q

What is a normal K+ (Potassium)?

A

5.3-6.4 mmol/L

34
Q

What is a normal HCO3- (Bicarbonate)?

A

19-24 mmol/L

35
Q

What is a normal BUN?

A

4-17 mg/dl

36
Q

What is a normal Creatinine?

A

0.11-0.68 g/24hr

37
Q

What is a normal urine output of a baby?

A

1ml/kg/hr

38
Q

What is a normal range for RBC?

A

4.1-5.7 mm

39
Q

What is a normal rage for Hemoglobin?

A

12.7-18.6 g/dl

40
Q

What is a normal Hematocrit?

A

43-63%

41
Q

What are 2 types of abnormal hemoglobins?

A

Hemoglobin S = present in Sickle cell disease

Hemoglobin C = does not carry oxygen well

42
Q

What is a normal range for a WBC?

A

10,000 - 30,000 mm

43
Q

Normal range of Blood Glucose in a baby

A

50-100 mg/dl

44
Q

What is a normal Albumin/Globulin Ratio? And what should you be worried about if it is reduced or elevated?

A

Normal = 0.8 - 2.0

If Elevated or Reduced, this can lead to Renal failure and Liver disease

45
Q 
What do these colors of sputum indicate? 
Clear 
Mucoid 
Yellow 
Green
A 
Clear = Normal 
Mucoid = white/gray (normal) 
Yellow = Presence of WBC, infection, Gram + 
Green = Infection, Gram -
46
Q

What do these colors of sputum indicate?
Brown/Dark
Bright Red
Pink frothy

A

Brown/Dark = Old blood
Bright red = hemoptysis, active bleeding
Pink frothy = pulmonary edema

47
Q

Why would an infant have the appearance of Mottling?

A

This may result from chilling or prolonged apnea

48
Q

What is a Normal Respiratory rate of an infant?

A

30-60 breath/min

49
Q

Respiratory distress that decreases during crying may indicate what?

A

Choanal atresia

50
Q

What is Transillumination and when is it used?

A

Placing a bright light against the babies chest. Usually used to rule out pneumothorax.

If you place the light on the chest and that hemithorax lights up, this indicates a pneumothorax.

If you have a decreased or no light passing through. this indicatess diaphragmatic hernia, or consolidation

51
Q

What is Omphalocele?

A

intestines are protruding from the stomach but contained in a sac.

Needs surgical intervention

52
Q

What is Gastroschisis?

A

Intestines are protruding from the stomach that are not contained in a sac.

53
Q

What is Myelodysplasia?

A

A condition where the cerebrospinal fluid is protruding from the spine. Also called spina bifida

Keep baby on there stomach

54
Q

What is DiGeorge’s Syndrome?

A

Condenital defect on chromosome 22

characterized by: low set ears, small mouth, wide set and downward slanting eyes

55
Q

What is Potter Syndrome?

A

An atypical physical appearance of a neonate caused by lack of amniotic fluid which disrupted babies development.

56
Q

What is a normal pulse for a baby?

A

120-170/min

57
Q

What should you suspect if you hear a bounding pulse in an infant?

A

PDA
A-V Fistula
Tetralogy of Fallot

58
Q

What is Pulsus Alternans?

A

When the pulse is alternating between a weak and strong beat

This may indicate myocardial failure

59
Q

What is it called when a pulse is weaker on inspiration and stronger on exhalation?

A

Pulsus paradoxus or paradoxical pluse

This indicates and emergency like cardiac tamponade, pericardial effusion, severe RDS, Tension pneumothorax

60
Q

What causes tracheal deviation toward the affected side?

A

Pulmonary atelectasis

61
Q

What causes tracial deviation away from the affected side?

A

Tension pneumothorax

Large mediastinal mass

62
Q

When percussing the chest, you hear a hyper resonance sound. What does that mean?

A

This means air trapping or pneumothorax. There is more air then there should be

63
Q

When percussing the chest, you hear a dull or Flat sound. What does that mean?

A

This mean consolidation or having more fluid or tissue in a area then should be there

64
Q

When Auscultating the chest you hear crackles, what does this mean?

A

lungs are filled with secreations/fluid

Fine crackles = indicate fluid in the alveoli, (plumonary edema)

65
Q

When Auscultating the chest you hear Wheezing, what does this mean?

A

Airway diameter is narrowed i.e. Bronchospasm, airway edema, foreign body, asthma, BPD

Tx = bronchodilators

66
Q

Unilateral wheezing may indicate what?

A

Foreign body aspiration

67
Q

What is normal blood pressure for a baby?

A

they base it of the weight of the baby

2000 g = 50/30

Good rule => Mean arterial pressure should be greater than gestational age

68
Q

What is a Glasgow Coma Scale (GCS)?

A

This scale measures the responsiveness of the pt. in a coma

The higher the number the better the score

69
Q

Difficulty breathing except in the upright position is called what?

A

Orthopnea (this usually associated with cardiac problems)

70
Q

What is general malaise and what is it associated with?

A

This is a general run down feeling, nausea, weakness. And it is associated with an electrolyte imbalance

71
Q

What is the sweat test?

A

This test is used to dx cystic fibrosis.

If you have a value of >60mmol/L this mean you are confirmed to have CF

72
Q

A redness of the skin is called

A

Erythema

73
Q

Cheyne-Stokes breathing pattern is usually associated with

A

Increased ICP

drug overdose

74
Q

Biot’s breathing pattern is associated with what

A

CNS problems

75
Q

Kussmaul’s breathing pattern is usually associated with what

A

metabolic acidosis
renal failure
diabetic ketoacidosis

76
Q

What is tactile fremitus and what does an increased or decreased finding mean?

A

Tactile fremitus = vibrations felt by touch on the chest

Increased = consolidation/Pneumonia

Decreased = Pleural effusion

77
Q

When would you get a lateral decubitus film?

A

When you are trying to rule out a pleural effusion

78
Q

When would you get a Lateral Neck film?

A

When trying to dx croup or epiglottitis

NPS Certification (3 decks)

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