Patient assessment Flashcards
Natural factors which increase body temperature
Late afternoon is highest point but ovulation, exercise and first 5 months of pregnancy increase temperature as well!
Les’ preferred normal temperature range for patients?
36.5-37.5 degrees C
What point of day has lowest body temperature?
The morning
What temperature method is recommended for peds?
Axillary
Common temperature taking methods
Tympanic, axillary and oral
Normal HR
Tachy HR
Brady HR
60-100 normal
Over 100 is tachy
Under 60 is bradycardia
Define
Bigeminy and trigeminy
And what your first step would be upon discovering one
Trigeminy beats in groups of 3
Bigeminy is beats in groups of 2
Needs an ECG
Name the categories of pulse grade
4+ pulse strong and impossible to occlude 3+ pulse difficult to occlude 2+ brisk or normal pulse 1+ thready or weak pulse 0 no pulse
3 key factors when reporting pulse
Rate rhythm and grade
define: Tachypnea bradypnea hyperpnea hypopnea
tachypnea- RR above normal
Bradypnea RR below normal
hyperpnea- minute volume increased
hypopnea- minute volume decreased
2 factors to report for breathing?
RR and rhythym/pattern
define the values for the following:
normal BP
hypertension
hypotension
normal= 120/80 hypertension= 140/90 or over hypotension= less than 90/60
optimal bladder arm coverage %
in adults
in peds
adutls is 80%
peds is 100%
which korotokoff phases are used to asses BP?
phase 1- systolic pressure
phase 5 diastolic
what can succesfull patient centered care proportedly improve?
patient safety
communication
compliance with treatment plan
what are the 4 stages of patient client interaction?
1- chart review. clarify in your mind and with charts what your role is today.
2- introdctory stage. establish rapport with the patient
use their name formally until they tell you not too
3-initial assesment. identify patients baseline condition and need for treatment as physician has ordered
4-follow up stage. communicate with the patient for a moment. “do you have any questions for me” on way out always look back and do one final glance over patient and room.
3 categories of space
intimate 0-2 ft
personal 2-4
social 4-12
tips to express genuine concern
face patient square on
use eye contact
be an active lsitener
consider appropriate touch
what does the acronym PQRST stand for
and when should we use it?
Provocative "what caused it" Qualtiy or quantity "burning, sha R region/radiation S severity "out of 10 T timing "since when does it hurt" it is for pain
what acronym is used for a primary survey?
SAMPLE
what does sample stand for?
Symptoms allergies medication Past history last meal events prior
what are to factors which can be used in predictive medicine?
family history
or
occupational/ environemental histoy
3 key things to review on patient file before meeting them
admission note-describes pertinent facts ot their admission
physicians orders- lists treatments and hterapies
progress reports- descrie the patients response to treatment
define DNR
do no resusitate
aka do not attempt to revive patient
common in elderly
define and distinguish between symtpoms and signs
signs are objective “measureable imperical data”
symptoms are subjective what the patient says
what is a cough and what causes it?
a protective reflex triggered by stimulation of cough receptors.
primary symptoms of cardiopulmonary disorders
cough sputum production hemoptysis SOB chest pain
your patient grimaces when they are being interiveiwed post op. She is suffering some confusion about her responses. What could be impeding her communication skills? self-concept listening habits pain and anxiety hearing impairment
pain and anxiety
active listening is most essential of what stage of the clinical encounter?
the initial assesment stage
what are the 4 stages of the clinical encounter
introductory stage
initial assesment stage
treatment and monitoring
follow up
patient is having difficulty learning to use their enhaler. after many attempts they stil cannot use it independently and properly. what should your next step be?
request permission from doctor to find more acceptable delivery system
cease attempts and give up
push the patient to try harder and practice more
chart trx as not given and return later
request permission from patients doctor to find more acceptable delivery route
what space is appropriate to develop patient rapport
social
why should you always log off your computer when leaving the computer?
HIPAA
what are some important cultural beliefs to explore with patient during the assesment stage.
concepts of health and disease
responses to authority
gender and family roles
reliigous values
what is an ill advised way to decrease patient anxiety?
prescription of analgesic
what are 4 key elements of a good patient action plan?
a specific measurable goal
barriers to goal measurement
actions to achieve the goal
a follow uo mechanism
what piece of equipment is essential to protect yourself from airborne hazards?
properly fitting N95
what are your first steps after a patient poorly responds to the trx you have given after patient is stablilzed
speak with nurse, chart response and chart whoseover you notified
in setting up a postural drainage treatment what info could be important for you to obtain?
patients med sched
pt ideal body weight
pt meal schedule
med sched
meal sched
all of the following are acceptable for an RT to suggest to a pt with COPD except what?
help pt develop good action plans
training pt in self care techniques
recomending diet or nutrition changes
providing information about disease process
diet and nutrition change recomendations shouldnt be given
T or F
proper diagnosis and trx are determined to a great extent by the accuracy and detal of the patients history
T
in what section of the patient history can a detailed description of the patients current symptoms be found?
history of present illness
information obtained form the patient an which cannot be percieved by the observer is known as?
subjective data
where in patient info could you find potential history of exposrure to asbestos?
occupational history
subjective manifestations of the disease are commonly known as?
symptoms
define pertinent negaitve
a sign or symptom assocaited woith the disease or suspected disease process which the patient denies having.
DNR means?
do no resusitate
family history can be helpful in diagnosing which of the following? acute bronchitis cystic fibrosis pnuemothorax pulmonary edema
CF
which of the following could lead to a weak cough?
a. Reduced lung recoil
b. Bronchospasm
c. Weak inspiratory muscles
all of the above
A cough described as being persistent for more than 3 weeks would be called which of the following? acute paroxysmal chronic nocturnal
chronic
Which of the following problems associated with hemoptysis?
a. Tuberculosis
b. Lung carcinoma
c. Pneumonia
all of the above
A patient’s complaint of breathlessness or air hunger would be defined as which of the following?
a. Hemoptysis
b. Wheezing
c. Dyspnea
d. Cyanosis
dyspnea
What term is used to describe shortness of breath in the upright position?
a. Orthopnea
b. Platypnea
c. Eupnea
d. Apnea
platypnea
What term is used to describe shortness of breath in the upright position?
a. Orthopnea
b. Platypnea
c. Eupnea
d. Apnea
increase in lung compliance
What term is used to describe difficult breathing in the reclining position?
a. Apnea
b. Platypnea
c. Orthopnea
d. Eupnea
orthopnea
\
radiates to the neck
Which of the following may cause syncope?
a. Severe cough
b. Pulmonary embolism
c. Hypovolemia
d. All of the above
all of the above
define syncope
temporary loss of consciousness due to low BP
Which of the following is (are) true regarding dependent edema cause by lung disease?
a. It is caused by pulmonary vasodilation
b. Accompanying hepatomegaly may be present
c. It is caused by acute systemic hypertension
d. All of the above
accompanying hepatomegaly may be present
Chronic pulmonary hypertension may lead to which of the following clinical findings?
a. Pedal edema
b. Inspiratory crackles
c. Hepatomegaly
d. A and C
hepatomegaly and pedal edema
define hepatomegaly
swollen liver
Which of the following is associated with night sweats?
a. Tuberculosis
b. Congestive heart failure
c. Asthma
d. Interstitial pulmonary fibrosis
TB
Which of the following symptoms is least likely to be associated with GERD?
a. Pedal edema
b. Hoarseness
c. Coughing
d. Wheezing
pedal edema
In what decade of life is snoring and obstructive sleep apnea (OSA) most likely to be present in adult males?
a. 20 to 29 years
b. 30 to 39 years
c. 40 to 49 years
d. 50 to 59 years
50-59
all of the following are included in the measurement of vital signs, except which one?
a. Pulse
b. Respiratory Rate
c. Urinary output
d. Blood pressure
urinary output
Which of the following changes is consistent with a fever?
a. Decreased respiratory rate
b. Increased pulse rate
c. Decreased oxygen consumption
d. Decreased blood pressure
increased pulse rate
Which of the following methods of temperature measurement is recommended for neonates?
a. Oral
b. Axillary
c. Rectal
d. Ear
axillary
What is the normal value of the resting pulse rate in the adult?
a. 30-60 beats/min
b. 60-100 beats/min
c. 80-120 beats/min
d. 100-150 beats/min
60-100 bpm
What is the normal range for respiratory rate for adults?
a. 6-10 breaths/min
b. 8-12 breaths/min
c. 12-20 breaths/min
d. 15-25 breaths/min
12-20 breaths
Which of the following causes tachycardia in the adult?
a. Hypothermia
b. Hypoxemia
c. Hypertension
d. Polycythemia
hypoxemia
Which of the following arterial sites is the most common for evaluating the pulse in the adult patient?
a. Pedal
b. Temporal
c. Radial
d. Femoral
radial