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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
Term Infant
38-42 wks
26
APGAR Score
7-10
27
Temperature (Infant)
36.5 degrees Celsius
28
Heart Rate (Infant)
110-160/min
29
Respiratory Rate
30-60
30
Blood Glucose (Infant)
> 30 mg/dL
31
L/S Ratio
2:1 or higher Near 0 = hyaline membrane disease or IRDS Recommend surfactant replacement therapy
32
Mean Arterial Pressure (MAP)
93-94 mmHg MAP = (2 x Diastolic) + Systolic / 3
33
Right Arterial Pressure or CVP
2-6 mmHg or 4-12 cmH2O Increase = right sided heart problem
34
Pulmonary Artery Pressure (PAP)
25/8 mmHg Mean 13-14 mmHg Increase PAP = lung diseases
35
PCWP
4-12 mmHg Increase = left sided heart problem
36
Cardiac Output
4-8 LPM
37
Cardiac Index
Cardiac Output/BSA 2.5-4 L/min/m2
38
Pulse Pressure
Systolic - Diastolic | 40 mmHg
39
Pulmonary Vascular Resistance
< 20 mmHg/L/min or 1600 Dynes MPAP-PCWP/Cardiac Output
40
Systemic Vascular Resistance
< 2.5 mmHg/L/min or 200 Dynes MAP-CVP/Cardiac Output
41
Ascites
Accumulation of fluid in the abdomen generally caused by liver failure
42
Tachypnea
> 20 bpm Causes: hypoxia, fever, pain, CNS problem
43
Bradypnea
< 12 bpm Variable depth and irregular rhythm Causes: sleep (normal), drugs, alcohol, metabolic disorders
44
Cheynes-Stokes
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
Biot's
increased respiratory rate and depth with irregular periods of apnea, each breath has same depth Causes: CNS problem
46
Kussmaul's
Increased respiratory rate (usually > 20), increased depth, irregular rhythm, breathing sounds labored (hyperventilation) Causes: metabolic acidosis, renal failure, diabetic ketoacidosis
47
Apneustic
prolonged gasping inspiration followed by extremely short, insufficient expiration Causes: problem with respiratory center, trauma or tumor
48
Tachycardia
> 100 bpm Indicates hypoxemia, anxiety, stress Recommend O2 therapy
49
Bradycardia
< 60 bpm Indicates heart failure, shock Recommend Atropine
50
Paradoxical pulse/Pulsus paradoxus
pulse/blood pressure varies with respiration May Indicate severe air trapping - status asthmaticus, tension pneumothorax, cardiac tamponade
51
Egophony
Patient says E, sounds like A Indicates consolidation - pneumonia
52
Coarse Crackles
Rhonchi that clear with cough - large airway secretions Suction or instruct to cough
53
Medium Crackles
Middle airway secretions Recommend bronchial hygiene therapy (chest PT)
54
Fine Crackles
Moist crepitant rales - in alveoli, fluid Associated with CHF/pulmonary edema Recommend: O2, CPAP, positive inotropic agents (Digoxin, Digitalis), diuretics
55
Stridor
High-pitched or crowing inspiratory sound Cause: Upper airway obstruction Recommend racemic epinephrine
56
Lateral Decubitus
Detects small pleural effusions
57
End Expiratory Image
Detects small pneumothorax
58
CT Scan
Spiral CT scan may be used to diagnosis pulmonary embolism
59
V/Q scan
normal ventilation scan with abnormal perfusion scan = pulmonary embolus
60
Bronchogram
for obstructing tumors and Bronchiectasis
61
Pulmonary Angiogram
To diagnosis pulmonary emoblism
62
Ventricular tachycardia
Pulse present: cardiovert Pulse absent: defibrillate, CPR, Epinephrine, Amiodarone
63
Ischemia is indicated by a
Depressed or inverted T wave
64
Injury is indicated by an
Elevated S-T segment
65
Infarction is diagnosed by
Significant Q waves
66
Apnea (Infants)
Short apnea: 10-20 secs may be normal Long apnea: > 20 secs, always abnormal
67
Silverman Score
Assessment of respiratory distress for infants
68
Ballard or Dubowitz Score
Assessment of gestational age
69
Co-oximeter/Hemoximeter
Used to diagnose Carbon Monoxide poisoning Normal CoHb = 0-1% Smokers = 2-12% CO poisoning = > 20%
70
Exhaled Nitric Oxide (FENO)
Used to monitor anti-inflammatory (corticosteroid) treatment in patients with asthma, cystic fibrosis, or COPD
71
Phosphatidylglycerol (PG)
Most reliable indicator of pulmonary maturity even with diabetes
72
Phosphatidylcholine (PC) or (DPPC)
Indicator for lung maturity

TMC (9 decks)

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