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TMC > Patient Assessment > Flashcards

Patient Assessment Flashcards

1
Q

Urine Output

A

40 ml/hr

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2
Q

Heart Rate (Adult)

A

60-100/min

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3
Q

Diagnostic Chest Percussion (Normal)

A

Resonant

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4
Q

Breath Sounds

A

Vesicular

Bronchial breath sounds in lung periphery = lung consolidation

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5
Q

Heart Sounds

A

S1, S2

S3, S4 abnormal

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6
Q

Blood Pressure

A

Adult 120/80 mmHg Range 90/60 - 140/90 mmHg

Neonate 60/40 mmHg

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7
Q

ICP

A

5-10 mmHg

Therapy:
Hyperventilation
Minimize PEEP
Mannitol - diuretic for cerebral edema

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8
Q

CPP

A

CPP=MAP-ICP

70-90 mmHg

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9
Q

Exhaled CO (FECO)

A

< 7 for non-smokers
7-10 light smokers
11-20 moderate smokers
>20 heavy smokers

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10
Q

RBC

A

4-6 mill/mm3

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11
Q

Hb

A

12-16 g/dL

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12
Q

Hematocrit

A

40-50%

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13
Q

WBC

A

5,000-10,000/mm3

> 10,000 = Leukocytosis, bacterial infection
< 5,000 = Leukopenia, viral infection

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14
Q

Potassium

A

3.5-4.5

Hypokalemia: metabolic alkalosis, excessive excretion, vomiting, flattened T waves on EKG

Hyperkalemia: kidney failure, spiked T wave (metabolic acidosis)

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15
Q

Sodium

A

135-145

Hyponatremia: fluid loss from diuretics, vomiting, diarrhea, fluid gain from CHf, IV therapy

Hypernatremia: dehydration

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16
Q

Chlorine

A

80-100

Levels are closely associated with sodium

Hypochloremia: metabolic alkalosis

Hyperchloremia: metabolic acidosis

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17
Q

Creatinine

A

0.7-1.3 mg/dL

Evaluates kidney function, more specific to kidney function than BUN

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18
Q

Blood Urea Nitrogen (BUN)

A

8-25 mg/dL

Increased BUN = kidney failure

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19
Q

Clotting Time

A

Up to 6 mins

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20
Q

Platelet Count

A

150,000-400,000/mm3

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21
Q

Activated Partial Thromboplastin Time (APPT)

A

24-32 secs

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22
Q

Prothrombin Time - Warfarin (Coumadin) Therapy

A

12-15 secs

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23
Q

Troponin

A

< 0.1 ng/mL

Indicates Myocardial Infarction

Recommend O2, Morphine, Aspirin, Nitroglycerin

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24
Q

Brain Natriuretic Peptide (BNP)

A

< 100 pg/mL

Indicates heart failure
>300 - mild
>600 - moderate
>900 - severe

Recommend diuretics, positive inotropic agents

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25
Q

Term Infant

A

38-42 wks

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26
Q

APGAR Score

A

7-10

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27
Q

Temperature (Infant)

A

36.5 degrees Celsius

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28
Q

Heart Rate (Infant)

A

110-160/min

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29
Q

Respiratory Rate

A

30-60

30
Q

Blood Glucose (Infant)

A

> 30 mg/dL

31
Q

L/S Ratio

A

2:1 or higher

Near 0 = hyaline membrane disease or IRDS

Recommend surfactant replacement therapy

32
Q

Mean Arterial Pressure (MAP)

A

93-94 mmHg

MAP = (2 x Diastolic) + Systolic / 3

33
Q

Right Arterial Pressure or CVP

A

2-6 mmHg
or
4-12 cmH2O

Increase = right sided heart problem

34
Q

Pulmonary Artery Pressure (PAP)

A

25/8 mmHg
Mean 13-14 mmHg

Increase PAP = lung diseases

35
Q

PCWP

A

4-12 mmHg

Increase = left sided heart problem

36
Q

Cardiac Output

A

4-8 LPM

37
Q

Cardiac Index

A

Cardiac Output/BSA

2.5-4 L/min/m2

38
Q

Pulse Pressure

A

Systolic - Diastolic

40 mmHg

39
Q

Pulmonary Vascular Resistance

A

< 20 mmHg/L/min or 1600 Dynes

MPAP-PCWP/Cardiac Output

40
Q

Systemic Vascular Resistance

A

< 2.5 mmHg/L/min or 200 Dynes

MAP-CVP/Cardiac Output

41
Q

Ascites

A

Accumulation of fluid in the abdomen generally caused by liver failure

42
Q

Tachypnea

A

> 20 bpm

Causes: hypoxia, fever, pain, CNS problem

43
Q

Bradypnea

A

< 12 bpm

Variable depth and irregular rhythm

Causes: sleep (normal), drugs, alcohol, metabolic disorders

44
Q

Cheynes-Stokes

A

Gradually increasing then decreasing rate and depth in a cycle lasting from 30-180 secs, with periods of apnea lasting up to 1 min

Causes: increased ICP, brainstem injury, drug overdose

45
Q

Biot’s

A

increased respiratory rate and depth with irregular periods of apnea, each breath has same depth

Causes: CNS problem

46
Q

Kussmaul’s

A

Increased respiratory rate (usually > 20), increased depth, irregular rhythm, breathing sounds labored (hyperventilation)

Causes: metabolic acidosis, renal failure, diabetic ketoacidosis

47
Q

Apneustic

A

prolonged gasping inspiration followed by extremely short, insufficient expiration

Causes: problem with respiratory center, trauma or tumor

48
Q

Tachycardia

A

> 100 bpm

Indicates hypoxemia, anxiety, stress
Recommend O2 therapy

49
Q

Bradycardia

A

< 60 bpm

Indicates heart failure, shock
Recommend Atropine

50
Q

Paradoxical pulse/Pulsus paradoxus

A

pulse/blood pressure varies with respiration

May Indicate severe air trapping - status asthmaticus, tension pneumothorax, cardiac tamponade

51
Q

Egophony

A

Patient says E, sounds like A

Indicates consolidation - pneumonia

52
Q

Coarse Crackles

A

Rhonchi that clear with cough - large airway secretions

Suction or instruct to cough

53
Q

Medium Crackles

A

Middle airway secretions

Recommend bronchial hygiene therapy (chest PT)

54
Q

Fine Crackles

A

Moist crepitant rales - in alveoli, fluid

Associated with CHF/pulmonary edema

Recommend: O2, CPAP, positive inotropic agents (Digoxin, Digitalis), diuretics

55
Q

Stridor

A

High-pitched or crowing inspiratory sound

Cause: Upper airway obstruction

Recommend racemic epinephrine

56
Q

Lateral Decubitus

A

Detects small pleural effusions

57
Q

End Expiratory Image

A

Detects small pneumothorax

58
Q

CT Scan

A

Spiral CT scan may be used to diagnosis pulmonary embolism

59
Q

V/Q scan

A

normal ventilation scan with abnormal perfusion scan = pulmonary embolus

60
Q

Bronchogram

A

for obstructing tumors and Bronchiectasis

61
Q

Pulmonary Angiogram

A

To diagnosis pulmonary emoblism

62
Q

Ventricular tachycardia

A

Pulse present: cardiovert

Pulse absent: defibrillate, CPR, Epinephrine, Amiodarone

63
Q

Ischemia is indicated by a

A

Depressed or inverted T wave

64
Q

Injury is indicated by an

A

Elevated S-T segment

65
Q

Infarction is diagnosed by

A

Significant Q waves

66
Q

Apnea (Infants)

A

Short apnea: 10-20 secs may be normal

Long apnea: > 20 secs, always abnormal

67
Q

Silverman Score

A

Assessment of respiratory distress for infants

68
Q

Ballard or Dubowitz Score

A

Assessment of gestational age

69
Q

Co-oximeter/Hemoximeter

A

Used to diagnose Carbon Monoxide poisoning

Normal CoHb = 0-1%
Smokers = 2-12%
CO poisoning = > 20%

70
Q

Exhaled Nitric Oxide (FENO)

A

Used to monitor anti-inflammatory (corticosteroid) treatment in patients with asthma, cystic fibrosis, or COPD

71
Q

Phosphatidylglycerol (PG)

A

Most reliable indicator of pulmonary maturity even with diabetes

72
Q

Phosphatidylcholine (PC) or (DPPC)

A

Indicator for lung maturity

TMC (9 decks)

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