Systems Review Flashcards
purpose of systems review
identify non-MSK red flags
looking for COMBOS of red flags
what kinds of systems are determined from hx and observation
i.e. aerobic exertion indicating cardio/respiratory
i.e. sx with eating indicating GI
constitutional S&S
fever
chills
seats
weight change
N&V
dixxy/lightheaded
fatigue > 2 wks
weakness
paraesthesias
malaise
cognitive change
functions of urinary system
filter fluid from renal blood flow (remove waste and maintain fluid/solute balance)
stimulate RBC production
BP regulation
convert vit D to active form
Urinary S&S
p! in trunk, flank, and/or pelvic region
discoloration
urinary change (frequency, urgency, bleeding, pus)
dysfunction (flow, initiation, control)
Nocturia (wake up to urinate)
review components for urinary system
mostly from Hx
observation of urine
P! with kidney percussion
P! with bladder palpation/percussion
where is the flank area
costovertebral junction of T12 - L1 area
functions of the reproductive system
produce sex cells and create sex hormones with endocrine system
maintain fertilized egg for development
S&S of reproductive system
P! in pelvis, LB, abdominal regions, and/or sexual organs
sexual/bladder/bowel dysfunction
abnormal menstruation or discharge from sex organs
early and unknown pregnancy indications
polyuria
breast tenderness
fatigue
N&V
heart burn
constipation
abnormal vaginal discharge
review components for reproductive system
most from Hx
observation is unlikely
no other specific assessment
what organs make up the metabolic system
gut, liver, adipose tissue, pancreas, kidney, and muscle
functions of metabolic system
conversion of foods/liquids to energy and building blocks for protein, fat, carbs, etc
elimination of waste
fluid/electrolyte balance which is key for cellular metabolism
characteristics of metabolic S&S
very varied
due to imbalance of fluid, electrolyte, and/or pH
if S&S dont match to a specific system and seem widespread, ots possibly a metabolic condition because an altered metabolism can affect multiple systems
most common fluid and electrolyte imbalances are associated with what
polyuria and/or dehydration
examples of things that can cause polyuria and dehydration
diabetes
kidney dysfunction
malignancy
alcoholism/liver disease
medication side affects
burns
surgery
diarrhea
N&V
what regulates most electrolytes in the body
kidneys
followed by intestines, bone, and parathyroid
how does sodium affect fluid/electrolyte balance
maintains fluid volume and potential between cells for messages to and from CNS
hypoatremia is most frequent electrolyte disorder and contributor to neuro S&S
how does potassium affect fluid/electrolyte balance
maintain fluid volume
hypokalemia related to cardia arrhythmias
hyperkalemia related to muscle dysfunction
how does calcium affect fluid/electrolyte balance
involved in bone health, muscle action, nerve impulses, circulation, and hormones
how does phosphorus affect fluid/electrolyte balance
majority is located in bones/teeth
plays crucial role with metabolism for the growth, maintenance, and repair of all tissues
how does bicarbonate affect fluid/electrolyte balance
works as acid buffer
diarrhea is main reason for loss of bicarb
how does magnesium affect fluid/electrolyte balance
mainly involved in neuromuscular function
how does chloride affect fluid/electrolyte balance
regulates fluid in and out of cells
skin S&S of fluid and electrolyte imbalance
loss of skin elasticity
warm/flushed due to vasodilation from impaired circulation and thermoregulation with metabolic acidosis or diabetes
pale and cool due to vasoconstriction and hypovolemia or dehydration
neuromuscular irritabilities related to fluid and electrolyte imbalance
fatigue
twitching
cramping
tetany
CNS involvement affected by fluid/electrolyte imbalance
memory impairement
depression
delusions/hallucinations
seizures
cardiovascular changes affected by fluid/electrolyte imbalance
tachycardia
postural hypotension
altered respiration
what is normal function for pH balance
pH ideally between 7.35 and 7.45
kidneys remove acids and keep bases
lungs balance the acidic CO2
four classes of pH imbalance
respiratory acidosis
respiratory alkalosis
metabolic acidosis
metabolic alkalosis
S&S that occur with all classes of pH imbalance
confusion and fatigue S&S
what is respiratory acidosis
lowered pH due to hypoventilation and accumulation of acidic CO2 that may occur with:
-disorders that affect respiration
-drugs that supress respiration like opiods/muscle relaxers
-sleep apnea
S&S of respiratory acidosis
HA
anxiety
may progress to
-memory loss/personality changes
-sleep disturbances
-incoordination/tremors
what is respiratory alkalosis
higher pH due to hyperventilation leading to a loss of acidic CO2 that may occur with
-pulmonary conditions
-anxiety
-anemia with less oxygenation
S&S of respiratory alkalosis
SOB is often the ONLY sign
lightheadedness
otherwise highly variable
what is metabolic acidosis
lowered pH
MOST common acid base abnormality
accululation of H+ ions that can occur with:
-diabetes with a build up of ketones/acids (most common)
-diarrhea/dehydration leading to greater acid conc.
-kidney diseases that hold onto too many acids
S&S of metabolic acidosis
long deep breaths with a fruity smell due to ketoacidosis
diabetes cardinal S&S
-frequent urination
-dry mouth
-thirst
-decreased skin turgor
-blurry vision
-weakness/fatigue
what is metabolic alkalosis
higher pH
accumulation of bicarbonate base that can occur with:
-vomitting by loss of stomach acid
-kidney disorders or meds that keep too many bases
-excessive antacid, laxitive, or diuretic meds
-diarrhea
S&S of metabolic alkalosis
HA
neuromuscular excitability
-paresthesias/numbness
-twitching and cramping particular in hands and feet (trousseau sign)
-seizures
muscle alterations due to associated lowering of calcium
-skeletal weakness
-cardiac arrhythmias
what is the most common metabolic condition
diabetes
metabolic review components
Hx
observation
-muscle twitch
-altered respiration
-memory loss
-incoordination
-dry mouth
-fruity breath
weak resisted/MMT
possibly altered sensation with neuro
abdominal assessment, pain with palpation/percussion of
-liver
-pancreas
-kidney
standard vitals
-irregular heart beat
-postural hypotension
-altered respiratory rate
palpation
-loss of skin mobility
-extreme skin temp
