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Exam Prep > Signs and Symptoms Review > Flashcards

Signs and Symptoms Review Flashcards

1
Q

Compensated Shock (Reversible)

A
  • change in LOC (anxious appearance)
  • increased pulse and respirations
  • cool, pale skin
  • normal to slightly increased BP (increase due to initial vasoconstriction)
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2
Q

Uncompensated Shock (Irreversible)

A
  • decrease in LOC, unconscious
  • decreased HR
  • decreased respirations
  • cyanosis (decreased perfusion to tissues)
  • lactic acid build up
  • hypotension
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3
Q

Neurogenic Shock (Spinal Cord Injury)

A
  • warm, dry, flushed skin and capillary refill normal
  • neurologic deficit (paralysis or loss of sensation)
  • change in respiratory pattern (diaphragm breathing)
  • hypothermia (late sign)
  • hypotension (early sign)
  • HR normal or bradycardic
  • cervical vertebrae - most likely fractured (least protected)
  • phrenic nerve (C2-C4) controls chest wall
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4
Q

Anaphylactic Shock (Allergic Reaction)

A
  • itching, flushing, hives
  • swelling of eyelids, lips and tongue
  • tightness in chest (SOB and wheezing)
  • severe dyspnea
  • abdominal cramps
  • nausea and vomiting
  • diarrhea
  • tachycardia, hypotension
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5
Q

Psychogenic Shock

A
  • fainting with no sign of serious injury or illness
  • SOB, anxious, increased HR, respirations and BP
  • respiratory alkalosis due to hyperventilation
  • normal pulse oximetry
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6
Q

Septic Shock

A
  • elevated temp initially (source of infection)
  • decreased temp (late sign)
  • petechiae
  • decreased LOC
  • creeping mottling
  • tachycardia and hypotensive (vasodilation)
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7
Q

Cardiogenic Shock (Heart Failure)

A
  • dyspnea
  • rales (wet lung sounds)
  • tachycardia, decreased BP (ineffective pump)
  • increased respirations, diaphoresis, arrhythmias
  • increased blood volume in lungs and liver due to pump failure (CHF)
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8
Q

Hypovolemic Shock (Bleeding or Dehydration)

A
  • increased HR and respirations
  • decreased BP
  • cyanosis (lack of O2 to tissues)
  • diaphoresis
  • internal or external bleeding
  • LOC changes
  • anxious appearance
  • hypoxia
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9
Q

Cerebral Artery Aneurysm

A
  • severe headache, blurred vision
  • altered LOC
  • s&s of ICP
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10
Q

Thoracic Aortic Aneurysm

A
  • sudden onset
  • pain, ripping or tearing sensation
  • pain may radiate to the neck, back, shoulders or abdomen
  • stridor or hoarseness, dyspnea
  • s&s of hypovolemic shock after rupture
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11
Q

Abdominal Aortic Aneurysm (AAA)

A
  • lower abdominal pain
  • pain may be consistent or intermittent
  • palpable abdominal pulse
  • lower back or flank pain
  • unequal or absent distal pulses
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12
Q

Transient Ischemic Attack (TIA)

A
  • same as CVA but not permanent, resolves between 24-48 hours
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13
Q

Cerebral Vascular Accident (CVA - Stroke)

A
  • headache
  • change in LOC
  • blurred vision
  • unequal pupils
  • hemiplegia (one-sided paralysis)
  • common causes are hypertension and arteriosclerosis
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14
Q

Hypertensive Crisis

A
  • headache
  • dizziness
  • restless
  • blurred vision
  • nose bleed
  • vomiting
  • seizure
  • stupor
  • coma
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15
Q

Acute Myocardial Infarction (Acute MI)

A
  • skin cool, pale, sweaty
  • SOB
  • anxious
  • feeling of impending doom
  • pain that radiates to arm, shoulder, neck, jaw or back
  • nausea or vomiting
  • begins at rest
  • denial
  • may have normal VS in the beginning with NO chest pain
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16
Q

Angina

A
  • induced by exercise, emotion, eating
  • relieved by nitro and rest
  • main symptom of CAD
  • last 3-5 months typically
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17
Q

CHF/ Left-sided Heart Failure

A
  • dyspnea
  • rales
  • tachycardia
  • chronic atrial arrhythmias
  • pink, frothy sputum (pulmonary edema)
  • orthopnea
  • increased BP
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18
Q

Right-sided Heart Failure

A
  • peripheral edema
  • JVD (blood backing up)
  • Ascites (enlarged liver)
  • pt may complain of RUQ pain
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19
Q

Pericardial Tamponade

A
  • shock
  • dyspnea
  • mechanism of injury
  • weak, rapid pulse
  • equal breath sounds
  • Beck’s triad - muffled heart sounds, JVD, narrowing pulse pressure (hypotension)
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20
Q

Flail Chest

A
  • localized pain at injury site
  • point tenderness
  • pain with increased movement
  • may report a crackling sensation
  • deformity of the chest wall
  • characteristic stance - leaning toward injured site
  • holding hand over injured area
  • paradoxical movement of the chest wall
  • seen w/ rib fractures
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21
Q

Hemothorax

A
  • Vital signs may present like shock
  • no JVD
  • hypo-resonance chest sounds (muffled)
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22
Q

Myocardial Contusion

A
  • sternal bruising
  • chest pain
  • arrhythmias
  • SOB, dyspnea
  • usually seen in MVC - blunt force trauma - chest into steering wheel
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23
Q

Pulmonary Contusion

A
  • often asymptomatic initially
  • monitor for increased respiratory distress
  • monitor for signs and symptoms of hypoxia
  • contusions and abrasions
  • mechanism of injury
  • respiratory distress worsens before improves
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24
Q

Pulmonary Embolism

A
  • sudden onset
  • SOB
  • chest pain
  • increased HR and respiratory rate
  • cool, pale, clammy skin
  • decreased LOC (hypoxia)
  • pink, tinged sputum
  • clear breath sounds initially than rales as PE gets worse
  • bed ridden pt, trauma or surgical pt, prolonged sitting, recent c-section or traumatic delivery, <40 year old taking oral contraceptives, smokers
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25
Q

Sucking Chest Wound (Open Pneumo)

A
  • same as pneumothorax
  • open wound on chest wall
  • may hear sucking sound w/ patients respirations
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26
Q

Pneumothorax - Spontaneous or Traumatic

A
  • spontaneous usually occur in tall, thin pt with coughing episode
  • sudden onset of sharp chest pain
  • SOB
  • decreased or absent breath sounds on affected side/ hyper-resonance
  • tracheal deviation (late sign)
  • displaced heart sounds
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27
Q

Traumatic Asphyxia

A
  • head, neck and shoulders appear dark blue or purple
  • eyes may be blood shot or bulging
  • chest wall appears deformed
  • severe respiratory distress
  • severe shock
  • many are CPR on scene
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28
Q

Closed Head Injury (increased ICP)

A
  • subdural or epidural hematomas
  • change in LOC - 1st indicator
  • personality changes
  • seizures
  • headache
  • aphasia
  • projectile vomiting
  • posturing
  • pupils may be dilated, usually unequal (late sign)
  • irregular respiratory patterns, usually Cheyne-Stokes
  • decreased pulse, increase blood pressure, with irregular respirations = CUSHINGS
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29
Q

Blunt Trauma to the Abdomen

A
  • same as penetrating
  • liver (RLQ), spleen, and pancreas are most commonly injured
  • shock, pain to affected area
  • contusions, abrasions
30
Q

Injuries to the Structures of the Neck

A
  • pain at the injury site
  • dyspnea, stridor
  • difficulty swallowing
  • difficulty speaking
  • swelling, bruising, hematoma
  • obvious spinal deformity
  • subcutaneous air
  • hemoptysis (coughing up blood)
31
Q

Chronic Bronchitis (Blue Bloater)

A
  • hx of smoking
  • persistent productive cough for 3 months and 2 consecutive years
  • overweight
  • cyanotic
  • coarse rhonchi and wheezes that clear with cough
  • normal or slightly increased respiratory rate
  • frequent respiratory infections
  • dyspnea
32
Q

Pulmonary Emphysema (Pink Puffer)

A
  • dyspnea
  • pursed lip breathing
  • wheezing
  • barrelled chest
  • thin
  • cannot complete sentences (SOB)
  • Home O2
  • tripod positioning
  • use of accessory muscles when breathing
  • clubbing of fingers
33
Q

Asthma (acute exacerbation)

A
  • expiratory wheezes
  • use of accessory muscles
  • increased respiratory rate
  • dyspnea
  • increased anxiety
  • tripod positioning
  • air trapping (mucus plugging)
  • long expiratory phase - shark fin on capnography
  • changes in LOC depict degree of respiratory distress
34
Q

Pneumonia

A
  • green and yellow mucus
  • chills and shivering
  • productive cough
  • may show signs and symptoms of respiratory distress
  • tachypnea
  • rales or rhonchi
  • chest pain made worse by coughing
  • fever
  • usually only affects one side
35
Q

Foreign Body Aspiration

A
  • sudden onset of respiratory distress w/ no history of infection
  • dyspnea
  • stridor
  • localized wheezing
  • coughing
36
Q

Hyperventilation

A
  • carpal pedal spasms (cramping in fingers due to acid build up)
  • good colour (normal pulse ox)
  • clear breath sounds
  • numbness and tingling of fingers and extremities
  • tachypnea
37
Q

Acute Respiratory Failure

A
  • cyanosis
  • decreased LOC
  • bradycardia
  • laboured or poor respiratory effort
38
Q

Peritonsillar Abscess

A
  • sore throat
  • fever
  • difficulty swallowing
  • leaning over to breathe (open mouth breathing)
  • droolinh
  • neck swelling
  • foul smelling breath
39
Q

Hypoglycemia

A
  • sudden onset (usually 2 hours or less)
  • dilated pupils
  • tachycardia
  • decreased LOC
  • diaphoretic, cool, clammy skin
  • headache
  • weakness, dizziness
  • tremors
  • hx of diabetes
40
Q

Hyperglycemia (DKA)

A
  • polyphagia (increased hunger)
  • polyuria (increased urination)
  • polydipsia (increased thirst)
  • blurred vision
  • weight loss
  • dry mouth
  • dry, itchy, warm skin
  • poor wound healing
  • Kussmaul respirations
  • fruity breath
  • gradual onset (3 days to 2 weeks)
41
Q

Sickle Cell Crisis

A
  • severe chest, abdomen, muscular or bone pain
  • fatigue
  • tachycardia
  • priaprism
  • fever
42
Q

Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)

A
  • mimics DKA without increased ketones (dry, low BP)
  • no Kussmaul respirations or fruity breath, no nausea or vomiting
43
Q

Acute Renal Failure

A
  • decreased urine output
  • hypertension
  • altered LOC
  • nausea and vomiting
  • diarrhea
  • dialysis / electrolyte imbalances
44
Q

Chronic Renal Failure

A
  • decreased urine output
  • hypertension
  • fatigue
  • weakness
  • congestive heart failure
  • acidosis
  • uremia
  • CNS changes
  • seizure
  • coma
  • edema
  • death
45
Q

Kidney Stone (Renal Calculi)

A
  • severe flank pain
  • radiation of pain to groin
46
Q

Gastrointestinal Emergencies

A
  • distention of the abdomen
  • tender rigid abdomen, guarding
  • increased pulse
  • shallow increased respirations
47
Q

Liver Injury

A
  • RUQ tenderness, involuntary guarding
  • abdominal distention
  • referred pain to the right shoulder
  • bruising/abrasions on the RUQ
  • alcoholics (clotting problem - esophageal varicies)
  • hepatitis/ yellow sclera (jaundice)
  • rib fracture or hemothorax on the right chest
  • unexplained tachycardia/hypotension
48
Q

Stomach Injury

A
  • tenderness
  • guarding
  • rigidity
  • distention
49
Q

Spleen Injury (Solid Organ)

A
  • fracture of the 8-10th ribs on the left side
  • unexplained tachycardia/hypotension
  • abdominal tenderness/ guarding/heat
  • pain radiating to left shoulder
50
Q

Gallbladder Injury (Hollow Organ)

A
  • intermittent, cramping pain
  • fullness in RUQ after meals, pain or discomfort
  • nausea and vomiting
51
Q

Pancreas Injury

A
  • more susceptible in alcoholics
  • acute onset of severe epigastric pain that may radiate to neck
  • attacks occur a few hours after a large meal, heavy alcohol intake, spicy foods
  • nausea and vomiting
  • abdominal tenderness, rigitidy, or distention
52
Q

Gastric Ulcers

A
  • burning pain in the epigastric area or LUQ
  • pain usually begins about 2 hours after meals and is relieved by eating antacids
  • sudden onset of intense, constant, generalized abdo pain
  • abdominal rigitidy, tenderness, guarding
  • black, tarry stools
  • s&s of shock
  • pale, waxy white skin (hemorrhage)
  • initially pain may be localized around the umbilicus and then move to RLQ
  • nausea and vomiting
  • fever
53
Q

Bladder Injury

A
  • blood in urine
  • urinary frequency and burning
  • painful urination
  • lower abdo pain
  • hematuria
54
Q

Kidney Injury (Solid Organ)

A
  • rib fractures involving 10-12th ribs
  • back or flank pain
  • bruising/swelling over back/flank areas
  • s&s of shock
  • dysuria
  • hematuria
55
Q

Pediatric Shock

A
  • changes in LOC
  • tachycardia
  • pale, cool. mottled skin - especially in extremities
  • increased capillary refill
  • sunken frontanelle
  • tachypnea
56
Q

Pediatric w/ Asthma or Bronchitis

A
  • dyspnea, tachypnea
  • expiratory grunting and/or prolonged expiration
  • wheezing (lower airways, high pitched)
  • retractions (use of accessory muscles)
  • nasal flaring
  • tachycardia
57
Q

Croup

A
  • gradual onset
  • seal bark (cough before bed), high pitched (upper airway), hoarseness
  • stridor (upper airway)
  • low grade temperature (<101)
  • tachypnea
58
Q

Pediatric Meningitis

A
  • rapid onset often preceded by an upper airway infection
  • fever (with seizures)
  • changes in LOC
  • decreased appetite
  • photophobia
  • stiff neck, nuchal rigitidy
  • fontanels full (or bulging)
  • nausea/vomiting
  • headache (noted in older children)
59
Q

Normal Labour & Delivery - Impending Childbirth

A

Early Labour:
- vaginal discharge, “mucous plug” or bloody stool
- back pain, mild to moderate contractions
Active Labour:
- regular contractions lasting 1 minute, getting closer together
- pain of contractions increase, may be felt in back and abdomen
- cervix dilates
- crowning
- cord protruding from vagina - goal is to relieve pressure off the cord

60
Q

Breech Presentation

A
  • hx of previous breech delivery
  • fetal heart tones heard best in upper abdomen
  • feet, buttock, arms crown before head
61
Q

Meconium Stained Amniotic Fluid

A
  • usually past due date
  • greenish to brown colour to amniotic fluid
  • Suction ASAP - mouth then nose
62
Q

Abruptio Placenta

A
  • minimal vaginal bleeding
  • rigid abdomen
  • severe abdominal cramping
  • pain does not cease
63
Q

Placenta Previa

A
  • painless
  • heavy bleeding
  • bright red blood
  • occurs without warning
64
Q

Pelvic Inflammatory Disease (PID)

A
  • low abdominal pain with walking or movement
  • vaginal discharge
  • fever
  • nausea & vomiting
  • generalized weakness
65
Q

Ectopic Pregnancy

A
  • presence of pregnancy symptoms
  • hx of PID, tubal ligation, fertility drugs
  • abnormal menstrual cycles
  • spotting may or may not occur
  • shoulder pain
  • abdominal tenderness/rigidity
  • shock (if hemorrhaging)
  • guarding
66
Q

Heat Exhaustion

A
  • pt will be awake or slightly decreased LOC, light headedness, headache or irritable
  • normal or decreased BP
  • increased respirations
  • tachycardia
  • temperature normal or slightly increased
  • skin pale with excessive sweating
  • nausea & vomiting
  • heat cramps
67
Q

Heat Stroke

A
  • Early: dizziness, headache followed by psychotic behaviours, seizures, and coma
  • blood pressure may be elevated
  • tachycardia with bounding pulse
  • increased respirations
  • temperature is extremely elevated
  • skin is usually hot, red, dry
68
Q

Frostbite - Local

A
  • initially red
  • inflamed skin with stinging or burning sensations, parathesis, numbness
  • Later: skin turns grey, mottled, white, then waxy white and frozen with complete loss of sensation and dexterity
  • burning sensation is a good sign that the tissue is viable
69
Q

Systemic Hypothermia

A

Early:
- pt is conscious but slow to respond
- shivering
- increased metabolic rate
- impaired judgement
- poor coordination
- vasoconstriction - cold, pale skin
Late:
- stuporous or unconscious with core temp < 84
- pupils are unresponsive
- skin is ice cold to touch, pale and most likely will have rigid muscle tone
- pulse, respirations, and BP will be decreased or absent
- ECG may show a-fib, v-fib, or asystole

70
Q

Basal Skull Fracture

A
  • otorrhea
  • rinorrhea
  • mastoid bruising
  • periorbital ecchymosis
71
Q

Epidural Bleed

A
  • confusion
  • dizziness
  • drowsiness
  • unequal pupils
  • head trauma with LOC
  • nausea and vomiting
72
Q

Subdural Bleed

A
  • slower onset
  • headache that keeps getting worse
  • personality changes
  • drowsy
  • confusion

Exam Prep (10 decks)

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