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Test 1 Flashcards

1
Q

Health assessment

A

A systematic method of collecting and analyzing data for the purpose of planning patient-centered care

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2
Q

Nursing Process

A
  1. Assessment
  2. Diagnosis
  3. Outcome Identification
  4. Planning
  5. Implementation
  6. Evaluation
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3
Q

Process of Performing a Physical Exam

A
  1. Inspection
  2. Palpation
  3. Percussion
  4. Auscultation
  5. V/S
  6. Labs
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4
Q

Normal temperature

A

98.6

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5
Q

Normal respirations

A

12-20

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6
Q

Normal pulse

A

60-80

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7
Q

Normal BP

A

120/80

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8
Q

Normal O2

A

95-100%

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9
Q

Types of isolation

A
  1. Contact
  2. Airborne
  3. Droplet
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10
Q

Physical Exam Positions

A
  1. Supine
  2. Sims
  3. Prone
  4. Knee-chest
  5. Dorsal recumbent
  6. Standing
  7. Lithotomy
  8. Squatting
  9. Sitting
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11
Q

Characteristics of a pulse

A
  1. Rate
  2. Rhythm
  3. Force
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12
Q

Apical pulse

A

Listen at the apex (bottom right) of the heart for 1 minute

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13
Q

QUESTT (pediatrics)

A
  • Question the child
  • Use pain-rating scales
  • Evaluate behavior and physiologic changes
  • Secure parents’ involvement
  • Take cause of pain into account
  • Take action and evaluate results
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14
Q

Subjective data

A

What the pt tells you

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15
Q

Objective data

A

Physical exam

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16
Q

Phases of an interview

A
  1. Pre-introductory phase
  2. Introductory phase
  3. Discussion/working
  4. Summary
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17
Q

Types of verbal communication

A
  1. Open-ended questions
  2. Closed-ended questions
  3. Laundry list
  4. Rephrasing
  5. Inferring
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18
Q

Cyanosis

A

Bluing of lips caused by lack of oxygen

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19
Q

Clubbing

A

Rounded fingertips, can be normal or show long-term respiratory distress

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20
Q

Other signs of respiratory distress

A
  1. Nasal flaring
  2. Accessory muscle usage
  3. Intercostal retractions (skin goes between ribs)
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21
Q

Egg-shaped or elliptical shaped chest

A

Sign of COPD

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22
Q

What position are COPD patients known for

A

Tripod positioning

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23
Q

What to look for in distressed patient

A

Color, lips, nails, lesions

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24
Q

AP diameter

A

Should be 1:2 ratio.

Chest width from front to back: chest width lengthwise

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25
Barrel chest
AP diameter 1:1, seen in COPD or emphysema
26
Kyphosis
1. Forward curvature of spine 2. Wide chest 3. Abnormal AP diameter 4. Seen in older adults 5. Chest wall becomes stiff and respiratory muscles weaken
27
Pectus carinatum
Pigeon-breast; curves out; doesn't mean there is a disease
28
Pectus excavatum
Funnel-breast; curves in; doesn't mean there is a disease
29
Thoracic cage
Narrow at top; bottom is diaphragm
30
Parts of sternum
1. Manubrium 2. Body 3. Xyphoid process
31
Intercostal spaces
Space between two ribs
32
Costal angle should be
At or less than 90 degrees
33
How many cervical
7
34
How many thoracic
12
35
How many lumbar
5
36
Anterior reference lines
1. Anterior axillary (armpit) 2. Midclavicular line (Middle of clavicle; nipple) 3. Midsternal line (middle of sternum)
37
Posterior reference lines
1. Scapular line (middle of scapula) | 2. Vertebral line (down middle of back)
38
Lateral reference lines
1. Anterior axillary line (front of armpit) 2. Posterior axillary line (Middle of armpit) 3. Midaxillary line
39
Which lobe is lower and why
Left is lower and narrower due to heart
40
Where is there no middle lobe
On left and in back
41
Where is the apex of lungs
3 cm above clavicles
42
Where are lower lobes anteriorly
7th rib
43
Where are lower lobes posteriorly on exhalation
10th rib
44
Where are lower lobes posteriorly on inhalation
12th rib
45
Eupnea
Normal breathing
46
Sigh
Normal sign that means you need to change positions
47
Tachypnea
Fast but regular pattern
48
Bradypnea
Slow, regular pattern
49
Hyperventilation
Fast irregular pattern
50
Hypoventilation
Slow irregular pattern
51
Where do you start with palpation
Start with either front or back then move to the lateral sides
52
Checking for with palpation
1. Chest expansion: symmetry (thumb thing, 5-12 cm of movement) 2. Tenderness 3. Crepitus 4. Presence of tactile fremitus 5. Costal angle 6. Signs of respiratory distress
53
Crepitus
Using pads of fingers when you feel crackling
54
How to check for tactile fremitus
Say 99, use palms, looking for a lot of vibration; sign of fluid, consolidation, mass
55
Predominant sound in lung field
Resonance
56
What to ask patient when auscultating
Breath deeply through mouth
57
Where do you start with auscultating
At the apex
58
Where do you start in elderly
At bottom, listening for pneumonia
59
Predominant sound in lung fields when auscultating
Vesicular
60
Normal breath sounds
1. Bronchial (tracheal) 2. Bronchovesicular (mid-chest) 3. Vescicular (peripheral lung fields)
61
Bronchial sound
High-pitched, loud, harsh, hollow
62
Bronchovescicular sound
Moderately pitched
63
Vesicular sound
Low, soft, rustling
64
Adventitious breath sounds
1. Crackles/rales 2. Pleural friction rub 3. Rhonchi/wheeze 4. Stridor
65
Crackles can be
1. Fine: Water on pan 2. Course: Velcro 3. Atelectic: Rice crispies
66
What are crackles a sign of
1. Adult respiratory distress syndrome 2. Early congestive heart failure 3. Asthma 4. Pulmonary edema
67
Types of pleural friction rub
1. Pericardial rub | 2. Pleural friction rub
68
What causes pleural friction rub
Inflammation of the visceral and parietal pleurae, this makes them dry out and rub together
69
How to distinguish types of pleural friction rub
Have pt hold their breath, rubbing sound means pericardial rub
70
Sonorous wheeze
Snoring, gurgling quality
71
Rhonchi
Low-pitched moan, more prominent on exhale; caused by blockage of airways
72
What causes rhonchi and what might fix it
Pneumonia, chronic bronchitis, and cystic fibrosis; have pt clear throat
73
Sibilant wheeze
High-pitched and shrill sounding breath sounds; occurs when airway becomes narrow
74
What causes sibilant wheeze
Asthma, congestive heart failure, chronic bronchitis, and COPD
75
Stridor
Rare in adults; high pitched musical sound in upper airway, indicates foreign body in trachea or main bronchus
76
When is stridor heard in children
When they have croup
77
Voice sounds (vocal resonance)
Tests to check more for abnormalities; only do in suspicious area 1. Bronchophony 2. Egophony 3. Whispered pectoriloquy
78
Bronchophony
Say 99 and listen with stethoscope, should be muffled, clear is abnormal
79
Egophony
Say EEE, if sounds like short AAA could be consolidation or mass
80
Whispered pectoriloquy
Say 1-2-3, should be almost inaudible, if clear could be consolidation
81
Order of ethnic groups with largest to smallest chest volume
1. Caucasians 2. AA 3. Asians 4. Native Americans
82
Increased risk of respiratory issues, TB. or asthma
Poor or recent mmigrants
83
Where is there higher asthma incidence
AA, urban, poor communities
84
Chronic lung disease signs
1. Barrel chest 2. Club nails 3. Pursed lip breathing 4. Slight tachypnea 5. Tripod position 6. Costal angle greater than 90 degrees 7. Decreased oxygen levels
85
Acute/respiratory distress
More emergent 1. May have sings of chronic resp. problems 2. Tachypnea 3. Shallow respirations 4. Restless (more in elderly) 5. Use of accessory muscles 6. Confusion 7. Decreased oxygen level
86
Healthy people 2020
National health initiative; have pt stop smoking, ask all pt about tobacco use
87
CDC risk factors for cnacer
1. Smoking 2. Second hand smoke 3. Asbestos 4. Marijuana use 5. Personal/family history of cancer 6. Women 7. Air pollution

Health Assessment (3 decks)

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