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mski > S1_L5_Obj - 1-2 > Flashcards

S1_L5_Obj - 1-2 Flashcards

1
Q

OBJECTIVE ASSESSMENT (3)

A

● Systems Review
● Physical examination
● Tests and Measures

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2
Q

rate at which the heart beats, or contracts (direct)

A

HR

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3
Q

number of times your arteries create a noticeable “pulse” due to increase
in blood pressure as a result of your heart contracting (indirect)

A

PR

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4
Q

Direct performance of the heart; rhythm

A

HR

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5
Q

Observing the peripheral arteries

A

PR

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6
Q

_ is essentially the HR for normal, healthy heart

A

PR

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7
Q

In CPR pts, There are discrepancies between the HR and the PR. t or.f

A

t

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8
Q

times when HR is higher than PR:

A

obstructions

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9
Q

normal PR:

A

60-100 bpm (resting value for adults)

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10
Q

for healthy pts, HR should be higher than PR t or f

A

f, equal lang dapat

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11
Q

> 100 bpm

A

Tachycardia

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12
Q

<60 bpm

A

bradycardia

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13
Q

<60 bpm for athletes/very active
individuals is considered bardycardia t or f

A

f

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14
Q

Irregular rate is called:

A

dysrhythmia

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15
Q

how to measure HR?

A

use of stethoscope, ECG recording

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16
Q

ECG leads are placed over the _ to get _ activity of the heart

A

chest, electrical

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17
Q

how to measure PR?

A

palpation of pulse, pulse oximeter/pulsemeter

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18
Q

Mobile phones cannot detect PR through sensors
(pulse meters) t or f

A

f, can detect

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19
Q

Pulse oximeter is placed in _

A

fingers

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20
Q

Pulse Strength / Amplitude Grading:

A

0, 1+, 2+, 3+, 4+

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21
Q

pulse strength: absent, not palpable

A

0

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22
Q

pulse strength: Bounding, too strong to obliterate

A

4+

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23
Q

pulse strength: Easily palpable, normal

A

2+

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24
Q

pulse strength: Full pulse, increased strength

A

3+

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25
Q

pulse strength: Pulse diminished, barely palpable; weak, thready

A

1+

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26
Q

2+ of brachial is different from 2+ of popliteal t or f

A

t

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27
Q

Having a _ experience is important for
establishing how to assess what the normal is.

A

baseline

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28
Q

Pulse sites for PR (8):

A

temporal
carotid
brachial
radial
femoral
popliteal
dorsalis pedis
posterior tibial

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29
Q

at the temple

A

temporal

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30
Q

found at the neck

A

carotid

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31
Q

found at the forearm

A

radial

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32
Q

found in the femoral triangle

A

femoral

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33
Q

difficult to palpate;

A

popliteal

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34
Q

deepest among the
others

A

popliteal

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35
Q

popliteal pulse is palplated in what position?

A

palpated in prone c flexed knee

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36
Q

popliteal pulse is found deep in the _

A

popliteal fossa

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37
Q

t or f dorsalis pedis is hard to palpate

A

f, easy to palpate

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38
Q

dorsalis pedis pulse is found where

A

dorsal aspect between 1st and 2nd metatarsal

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39
Q

found behind the medial malleolus

A

posterior tibial

40
Q

Can be documented on either palpation of vital signs
but should be reflected only ONCE

A

PR

41
Q

Assess each pulse for: (4)

A

strength
rate
rhythm
equality

42
Q

check if weak or bounding

A

strength

43
Q

check if normal rate, too fast or slow

A

rate

44
Q

check for regularity or irregularity; skipped beats

A

rhythm

45
Q

how to document rhythm?

A

80 bpm c 2 skipped beats

46
Q

right versus left; should be equal

A

equality

47
Q

Pts with vascular disorders, compare only one side t or f

A

f, Pts with vascular disorders, compare each side since there might be unilateral affectation

48
Q

Apply gentle pressure for all pulse sites t or f

A

f, except for popliteal pulses

49
Q

the more pressure you apply the more you will be able to feel it t or f

A

f, Less pressure you apply the more you will be able to feel it

50
Q

If too hard = will obliterate the flow (push hard, feel less) t or f

A

t

51
Q

If pulses are diminished, use the _ of the stethoscope,
listen for bruit

A

bell

52
Q

Bell of the stethoscope is used for _

A

for low pitch sounds

53
Q

Diaphragm is used for _

A

high pitch sounds

54
Q

Full 60-second count is recommended for
cardiopulmonary patients vs 30-sec multiplied by 2 t or f

A

t

55
Q

HEART RATE (HR) also callled as _

A

apical pulse

56
Q

what is used to get the HR

A

Stethoscope

57
Q

how to locate the HR?

A

Locate the site of the apical pulse

58
Q

how to locate the apical pulse?

A

(~3.5 inches to the left of mid-sternum, in the 5th ICS, within an inch
of the midclavicular line drawn parallel to sternum)

59
Q

Athletes; how to count their HR

A

15-second count multiplied by 4

60
Q

Cardiovascular patients; how to count their HR

A

full 60-second count

61
Q

may not be even (esp in CPR patients) hence it must
be compared simultaneously

A

Apical and radial pulse

62
Q

Typically, apical pulses and radial pulses are the different t or f

A

f, Typically, apical pulses and radial pulses are the same

63
Q

if Apical > Radial, what is it?

A

Blood pumped from left ventricle doesn’t reach the peripheral site or too weak

64
Q

Every beat of heart, should go to _

A

pulse sites

65
Q

pulse deficit is the difference betweeen _ and _

A

apical and radial

66
Q

Procedures for apical-radial pulse

A

2 Examiners: 1 for apical (stethoscope), 1 for radial (palpation)
Count the pulse for 60 seconds
Compare results

67
Q

apical radial pulse should be done simultaneously t or f

A

t

68
Q

HOW TO Document?

A

O: VS > PR: Apical radial pulse = 2 bpm deficit

69
Q

BP CLASSIFICATION

A

JNC 8
ACC/AHA 2017

70
Q

JNC 8: Normal BP

A

<120/<80

71
Q

JNC 8: Pre-Htn

A

120-129/<80

72
Q

JNC 8: Pre-Htn

A

130-139/80-89

73
Q

JNC 8: Stage 1 Htn

A

140-159/90-99

74
Q

JNC 8: Stage 2 Htn

A

≥160/≥100

75
Q

ACC/AHA: <120/<80

A

normal BP

76
Q

ACC/AHA: 120-129/<80

A

elevated BP

77
Q

ACC/AHA: 130-139/80-89

A

Stage 1 Htn

78
Q

ACC/AHA: 140-159/90-99

A

Stage 2 Htn

79
Q

ACC/AHA: ≥160/≥100

A

Stage 2 Htn

80
Q

Only the systolic must be within normal values to be
considered as normal t or f

A

f, Both systolic AND diastolic must be within normal values
to be considered as normal

81
Q

Hypertensive Crises (2)

A

Htn Urgency
Htn Emergency

82
Q

> 180/>110; no acute end-organ damage

A

Htn Urgency

83
Q

> 180/>110; c acute end-organ damage

A

Htn Emergency

84
Q

Htn Emergency:

A

> 180/>110; c acute end-organ damage

85
Q

Htn Urgency:

A

> 180/>110; no acute end-organ damage

86
Q

Pt has past medical history of kidney disease: htn urgency or emergency?

A

htn emergency

87
Q

end-organ damage examples

A

kidney failure, serious lung/heart problems

88
Q

BP Measurements (2)

A

Home BP Monitoring
24 Hour Ambulatory BP Monitoring

89
Q

Usual monitoring system we have; we get BP as necessary

A

Home BP Monitoring

90
Q

BP cuff is attached to pts throughout the day

A

24 Hour Ambulatory BP Monitoring

91
Q

the BP cuff in 24 hr ambulatory BP monitoring is removed during _

A

self-care activities

92
Q

24 hour ambulatory BP monitoring is usually seen in _

A

in-pts / ICU

93
Q

Prior to phase 1, the first sound that we hear is the _

A

SBP

94
Q

Between phases _ & _, sound disappears, representing
the _

A

4, 5, DBP

95
Q

t or f there is sound before the phase 1 in korotkoff sounds

A

f, only silence

96
Q

phase 1 is known as the _

A

tapping sound

mski (28 decks)

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