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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
pulse strength: Pulse diminished, barely palpable; weak, thready
1+
26
2+ of brachial is different from 2+ of popliteal t or f
t
27
Having a _ experience is important for establishing how to assess what the normal is.
baseline
28
Pulse sites for PR (8):
temporal carotid brachial radial femoral popliteal dorsalis pedis posterior tibial
29
at the temple
temporal
30
found at the neck
carotid
31
found at the forearm
radial
32
found in the femoral triangle
femoral
33
difficult to palpate;
popliteal
34
deepest among the others
popliteal
35
popliteal pulse is palplated in what position?
palpated in prone c flexed knee
36
popliteal pulse is found deep in the _
popliteal fossa
37
t or f dorsalis pedis is hard to palpate
f, easy to palpate
38
dorsalis pedis pulse is found where
dorsal aspect between 1st and 2nd metatarsal
39
found behind the medial malleolus
posterior tibial
40
Can be documented on either palpation of vital signs but should be reflected only ONCE
PR
41
Assess each pulse for: (4)
strength rate rhythm equality
42
check if weak or bounding
strength
43
check if normal rate, too fast or slow
rate
44
check for regularity or irregularity; skipped beats
rhythm
45
how to document rhythm?
80 bpm c 2 skipped beats
46
right versus left; should be equal
equality
47
Pts with vascular disorders, compare only one side t or f
f, Pts with vascular disorders, compare each side since there might be unilateral affectation
48
Apply gentle pressure for all pulse sites t or f
f, except for popliteal pulses
49
the more pressure you apply the more you will be able to feel it t or f
f, Less pressure you apply the more you will be able to feel it
50
If too hard = will obliterate the flow (push hard, feel less) t or f
t
51
If pulses are diminished, use the _ of the stethoscope, listen for bruit
bell
52
Bell of the stethoscope is used for _
for low pitch sounds
53
Diaphragm is used for _
high pitch sounds
54
Full 60-second count is recommended for cardiopulmonary patients vs 30-sec multiplied by 2 t or f
t
55
HEART RATE (HR) also callled as _
apical pulse
56
what is used to get the HR
Stethoscope
57
how to locate the HR?
Locate the site of the apical pulse
58
how to locate the apical pulse?
(~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
Athletes; how to count their HR
15-second count multiplied by 4
60
Cardiovascular patients; how to count their HR
full 60-second count
61
may not be even (esp in CPR patients) hence it must be compared simultaneously
Apical and radial pulse
62
Typically, apical pulses and radial pulses are the different t or f
f, Typically, apical pulses and radial pulses are the same
63
if Apical > Radial, what is it?
Blood pumped from left ventricle doesn’t reach the peripheral site or too weak
64
Every beat of heart, should go to _
pulse sites
65
pulse deficit is the difference betweeen _ and _
apical and radial
66
Procedures for apical-radial pulse
2 Examiners: 1 for apical (stethoscope), 1 for radial (palpation) Count the pulse for 60 seconds Compare results
67
apical radial pulse should be done simultaneously t or f
t
68
HOW TO Document?
O: VS > PR: Apical radial pulse = 2 bpm deficit
69
BP CLASSIFICATION
JNC 8 ACC/AHA 2017
70
JNC 8: Normal BP
<120/<80
71
JNC 8: Pre-Htn
120-129/<80
72
JNC 8: Pre-Htn
130-139/80-89
73
JNC 8: Stage 1 Htn
140-159/90-99
74
JNC 8: Stage 2 Htn
≥160/≥100
75
ACC/AHA: <120/<80
normal BP
76
ACC/AHA: 120-129/<80
elevated BP
77
ACC/AHA: 130-139/80-89
Stage 1 Htn
78
ACC/AHA: 140-159/90-99
Stage 2 Htn
79
ACC/AHA: ≥160/≥100
Stage 2 Htn
80
Only the systolic must be within normal values to be considered as normal t or f
f, Both systolic AND diastolic must be within normal values to be considered as normal
81
Hypertensive Crises (2)
Htn Urgency Htn Emergency
82
>180/>110; no acute end-organ damage
Htn Urgency
83
>180/>110; c acute end-organ damage
Htn Emergency
84
Htn Emergency:
>180/>110; c acute end-organ damage
85
Htn Urgency:
>180/>110; no acute end-organ damage
86
Pt has past medical history of kidney disease: htn urgency or emergency?
htn emergency
87
end-organ damage examples
kidney failure, serious lung/heart problems
88
BP Measurements (2)
Home BP Monitoring 24 Hour Ambulatory BP Monitoring
89
Usual monitoring system we have; we get BP as necessary
Home BP Monitoring
90
BP cuff is attached to pts throughout the day
24 Hour Ambulatory BP Monitoring
91
the BP cuff in 24 hr ambulatory BP monitoring is removed during _
self-care activities
92
24 hour ambulatory BP monitoring is usually seen in _
in-pts / ICU
93
Prior to phase 1, the first sound that we hear is the _
SBP
94
Between phases _ & _, sound disappears, representing the _
4, 5, DBP
95
t or f there is sound before the phase 1 in korotkoff sounds
f, only silence
96
phase 1 is known as the _
tapping sound

mski (28 decks)

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