Practical 571 Unit II

Question 1

Blood Pressure Assessment

Answer 1

1. Explain Procedure
2. safety and comfort of pt. Antecubital space of arm exposed and at level of the heart
3. Deflated Cuff apply to pt to upper arm with center of bladder over the medial aspect of the arm, and distal aspect of the cuff approx 3m above the antecubital fossa
4. Brachial or radial pulse palpated correctly
5. Cuff inflated until pulse is no longer palpable pressure is noted and cuff deflated
6. stethoscope oriented correctly in ears, diaphragm placed level on skin over the brachial artery and contact is maintained
7. Cuff reinflated additional 20-30mmHg than the pressure upon which the pulse was no longer palpable then the cuff is deflated and correct systolic and diastolic pressure identified

Question 2

Breathing Pattern Assessment

Answer 2

1. explain procedure
2. pt is safe and comfortably with appropriate exposure of the chest wall for optimal observation
3. LOOK aspect of the assessment (3observations of normal and abnormal breathing)
4. Correctly define paradoxical breathing pattern and give example of related pt diagnosis
5. FEEL aspect define the normal breathing pattern during inspiration
6. Perform a chest wall excursion assessment. properly identifying landmarks and hand position as well as expected movements that should be felt in each of the areas
7. Able to explain a procedure that would allow for more objective and measurable assessment of chest wall excursion

Question 3

Cardiac Auscultation

Answer 3

1. Explain to patient
2. pt is safe and comfortably positioned with the chest area exposed
3. stethoscope ear pieces are oriented correctly and the diaphragm of the stethoscope is placed on the chest
4. Able to verbalize and place stethoscope over all 4 locations for cardiac auscultation
5. Student listens for abnormal heart sounds with the bell of the stethoscope (low frequency sounds)

Question 4

ECG interpretations

Answer 4

1. Interpretation of regularity/rhythm
2. correct interpretation of rate
3. correct interpretation of P wave
4. correct interpretation of PR interval
5. QRS complex
6. identification of dyshythmia name and clinical significance

Question 5

Pulmonary Auscultation

Answer 5

1. Procedure explained to pt
2. pt is appropriately positioned with body part appropriately exposed in a quiet environment
3. student uses diaphragm of stethoscope to listen for breathing sounds
4. Pt instructed to breathe slow deep breaths through the mouth
5. auscultated at least one full breath in each lobe in a systematic method with correct location of stethoscope (auscultate min 5 locations on anterior chest and 4 on posterior chest)