*(PT III. Chapter 8) History Taking, Vital Signs, And Monitoring Devices

Question 1

What are associated symptoms?

Answer 1

Anything the patient complains of in addition to the chief complaint.

Question 2

What is glucometry?

Answer 2

Assessment of blood glucose levels.

Question 3

What are pertinent negatives?

Answer 3

Anything relevant to the chief complaint that the patient denies.

Question 4

What is trending in patient care?

Answer 4

Routine monitoring and reassessment to identify changes.

Question 5

What is the chief complaint?

Answer 5

The patient’s primary reason for calling EMS.

Question 6

What should be included in the History of Present Illness (HPI)?

Answer 6

• Basic patient information (age, sex, weight).
• Additional information about the chief complaint.
• Associated signs and symptoms.
• General health status.
• Past medical history.
• Medications.
• Allergies.

Question 7

What are open-ended questions, and when are they used?

Answer 7

• Require descriptive responses, not just “yes” or “no.”
• Used when more detail is needed from the patient’s perspective.

Examples:
- “Why did you call for help today?”
- “How would you describe the pain?”

Question 8

What are closed questions, and when are they used?

Answer 8

• Can be answered with “yes” or “no.”
• Preferred when time is short or the patient has difficulty speaking.

Example: “Are you choking?”

Question 9

What are active listening techniques?

Answer 9

• Maintain eye contact and show you are listening.
• Repeat what the patient says to clarify and elicit more information.
• Avoid interrupting or making biased or judgmental statements.
• Show empathy and ask important questions first.

Question 10

What is the SAMPLE history mnemonic?

Answer 10

• Signs and Symptoms: Objective findings (e.g., wheezing) and subjective feelings (e.g., pain).
• Allergies: Includes Rx, OTC, and food allergies.
• Medications: Current and recent medications, including illicit drugs.
• Past Pertinent History: Relevant past medical history.
• Last Oral Intake: Most recent food and fluid intake.
• Events Leading to Incident: Details about events causing the complaint.

Question 11

What is the OPQRST mnemonic for symptom assessment?

Answer 11

• Onset: “What were you doing when the pain started?”
• Provocation: “Does anything make it better or worse?”
• Quality: “How would you describe the pain?”
• Radiation: “Does the pain move anywhere?”
• Severity: “Rate the pain on a scale of 0 to 10.”
• Time: “When did the pain start?”

Question 12

What are associated symptoms and pertinent negatives?

Answer 12

• Associated Symptoms: Additional symptoms related to the chief complaint.
• Pertinent Negatives: Relevant symptoms the patient denies.

Question 13

What are special considerations for sensitive topics?

Answer 13

• Limit questions to necessary and relevant ones.
• Be direct, professional, and non-judgmental.
• Provide as much privacy as possible.

Question 14

What are examples of challenging patient situations?

Answer 14

• Patients under the influence of alcohol or drugs.
• Victims of assault or abuse.
• Non-communicative or overly talkative patients.
• Anxious or frightened patients.
• Patients with cognitive disabilities or behavioral problems.
• Hostile or threatening patients.
• Pediatric patients.

Question 15

How is respiratory rate assessed?

Answer 15

Observe the chest rise and fall or auscultate with a stethoscope. Count breaths for 30 seconds and double it for breaths per minute.

Question 16

What are normal respiratory rates?

Answer 16

• Adults: 12-20 breaths per minute.
• Children (school-age): 18-30 breaths per minute.
• Toddlers: 24-40 breaths per minute.
• Infants: 30-60 breaths per minute.

Question 17

What are abnormal respiratory rates?

Answer 17

• Tachypnea: Over 20 breaths per minute in adults.
• Bradypnea: Under 12 breaths per minute in adults.

Question 18

What is tidal volume?

Answer 18

The amount of air moving in and out of the lungs with each breath. Normal for adults: 400-500 mL.

Question 19

What is minute volume?

Answer 19

Minute volume = tidal volume × respiratory rate.

Example: 400 mL tidal volume × 12 breaths/min = 4,800 mL.

Question 20

What are the common lung sounds?

Answer 20

• Normal: Clear and equal bilaterally.
• Wheezing: High-pitched, whistling, more noticeable on expiration.
• Crackles/Rales: Wet, crackling on inspiration and expiration.
• Rhonchi: Low-pitched, congested sounds, often due to mucus.

Question 21

What are normal pulse rates?

Answer 21

• Adults: 60-100 bpm.
• Children: 80-120 bpm.
• Infants: 100-180 bpm.

Question 22

What are abnormal pulse rates?

Answer 22

• Tachycardia: Over 100 bpm in adults.
• Bradycardia: Under 60 bpm in adults.

Question 23

How is blood pressure defined?

Answer 23

• Systolic: Pressure during heart contraction.
• Diastolic: Pressure between contractions.

Question 24

What is pulse pressure?

Answer 24

The difference between systolic and diastolic pressure. Normal: 25%-50% of systolic pressure.

Question 25

What are normal blood pressure values?

Answer 25

• Adults: Below 120/80 mmHg.
• Children (ages 1-10): 80 + 2(age)/two-thirds systolic (e.g., 5-year-old: 90/60).

Question 26

What are abnormal blood pressure findings?

Answer 26

• Wide pulse pressure: Above 50% of systolic pressure (e.g., 210/100).
• Narrow pulse pressure: Below 25% of systolic pressure.

Question 27

How is orthostatic hypotension assessed?

Answer 27

Measure BP and pulse while supine and standing. A systolic BP drop >20 mmHg or diastolic drop >10 mmHg is abnormal.

Question 28

What are the sizes and reactions of pupils?

Answer 28

• Normal: 2-5 mm in light.
• Dilated: “Mydriasis.”
• Constricted: “Miosis.”
• Pupils should react to light quickly and equally.

Question 29

What are common skin abnormalities?

Answer 29

• Pale: Poor circulation.
• Cyanosis: Lack of oxygen.
• Flushed: Excessive heat or fever.
• Jaundice: Liver disease.
• Mottling: Poor blood flow.

Question 30

What is normal body temperature?

Answer 30

• Average: 98.6°F (37°C).
• Fever: 100.4°F (38°C) rectal, ear, or temporal; 100°F (37.8°C) oral; 99°F (37.2°C) axillary.

Question 31

What is capillary refill?

Answer 31

The time it takes for capillaries to refill after blanching.
- Normal: ≤2 seconds.
- Delayed (>2 seconds): Indicates possible shock.

Question 32

How do you document skin findings?

Answer 32

Examples:
- “Skin warm, pink, dry.”
- “Skin cool, clammy, capillary refill 3 seconds.”