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101 LEC > TEST 3 > Flashcards

TEST 3 Flashcards

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1
Q

What are the subjective data questions you ask for heart?

A

Chest pain?
Dyspnea (trouble breathing)
Orthopnea (diff breathing laying flat)
Cough
Fatique
Cyanosis
Edema
Nocturia
Past history
Risk factors

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2
Q

What is different in IPPA for cardia?

A

No percuss for cardiac

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3
Q

What are we inspecting neck for?

A

Symmetry
Lumps
Pulsations
Jugular venous pulse - normal when laying flat/not normal when sitting up

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4
Q

What does a jugular venous pulse mean when sitting upright?

A

Increased pressure in heart

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5
Q

What does a Brutis mean if you hear it on carotid?

A

Carotid artery narrowing from plaque build up

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6
Q

What are you inspecting on precordium?

A

Shape, abnormalitlies, heave lift

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7
Q

What does it mean if you see heart pounding through chest?

A

Enlargment of heart at R or L ventricle —where ever you see it

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8
Q

Normal heart sounds are what frequency? Murmurs are heard with what frequency?

A

Normal - high - diaphragm
Murmur - low - bell

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9
Q

What are the 5 areas we asculatate heart sounds?

A
  1. Aortic
  2. Pulmonic
  3. Erbs point
  4. Tricuspid
  5. Mitral
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10
Q

What sound is S1?

A

Closure of AV valves
Loudest at apex
Beginning of systole

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11
Q

What sound is S2?

A

Closure of semilunar valves
loudest at base
end of systole

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12
Q

What are murmurs

A

Structural defects in valves or unusual openings in chambers resulting in backwash of blood going backward

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13
Q

When documenting murmurs what do you note?

A

Location - intercostal space, Arotic? mitral? what area

Timing - S1? S2? after?

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14
Q

What is a systolic murmur?

A

AFter S2.
Lubb swish dubb

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15
Q

What is a diastolic murmur?

A

After S2
lubb dubb swich

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16
Q

What are the gradings for murmurs?

A

1 - barely audible
2 - faint
3. Moderate, easy to hear
4. Loud w/ thrill
5. Very loud, can hear with part of stethoscope off chest, thrill
6. Loudest, can hear w/o stethoscpe. Thrill

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17
Q

What are the risk factors for cAD and stroke?

A

African america
High blood pressure
Smoking
High cholesterol
Obesity
diabetes
Decreased activity level

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18
Q

What defines heart failure?

A

Pump failure
Low Cardiac output >4-6l/min
Low BP

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19
Q

What signs are Left sided heart failure?

A

BACK UP IN LUNGS
Pulmonary congestion
Dyspnea
Orthopnea

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20
Q

What signs are Right sided heart failure?

A

BACK UP IN BODY TISSUES
Extremity edema
JVD
Kidneys retain water
**treatment diuretic

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21
Q

What are we assessing when looking at peripheral vascular system
?

A

Vessels transpoting blood, fluid or lumph

*Arteries/veins/lymph

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22
Q

What do arteries do?

A

High pressure system
Supply oxygen and nutrients to tissues

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23
Q

What arteries do we examine?

A

Temporal, carotid
Brachial, Radial
Femoral, popliteal, dorsalis pedis, posterior tibial

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24
Q

What are veins?

A

Parallel to arteries
Low pressure system
- Contracting skeletal muscles milk blood back to heart
- Pressure gradient
_Valves ensure unidirectional flow

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25
Q

What veins do we examin?

A

Jugular, subclavian
Cephalic, basilic, median cubital
Great saphenous, small saphenous

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26
Q

What is the lumphatic system?

A

Retrieves excess fluid from tissue spaces
Propelled by skeletal muscles contract, pressure changes when breathing, valves

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27
Q

What are the 2 main trunks of lymphatic system?

A

Right lymphatic duct - head
Thoracic ducts - left side and rest of body

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28
Q

What is the function of lymphatic system

A

-Conserve fluid and plasma proteins
-Major part of immune system
-Absorbs lipids from intestinal tract

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29
Q

What subjective data do we ask for perpherial vascular?

A

Do you any pain in arms or legs?
Any skin changes?
Swelling/edema
lymph node enlargement?

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30
Q

What would pain in arms and legs indicate?

A

Claudication - Part blockage, lack of oxygenated blood flow

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31
Q

What would skin changes indicate in peripheral vascular?

A

Poor circulation

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32
Q

If you touch a patient and they are cold what does it indicate?

A

Problem with circulation

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33
Q

What are the grades for edema?

A

1+ mild, slight indentation
2+ moderate, indent subsides rapidly
3+ deep, remains for short time, leg looks swollen
4+ very deep, indent last long time, leg very swollen

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34
Q

What are the risk factors for venous issues?

A

Prolonged standing or sitting
Prolonged bed rest
Hypercoaguable states
Vein wall trauma - IV’s
Obesity
Later months pregnancy

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35
Q

What are risk factors for arterial disease?

A

Older adults
Hypertension
Smoking
diabetes
INcrease lipid levels
Obesity

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36
Q

What are the differences between Arterial and Venous disease?

A

Arterial
Claudication
Relief w/ rest
Pale, cyanosis, pulseless, cool, atrophic
Ischemic ulcer

Venous
Pain with standing, sitting/end of day = worse
Relief w/ walking
Brown discoloration, red warm swollen - bc of blood pooling
Stasis ulcer

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37
Q

S1 is the closure of what valve?

A

Mitrial and tricuspid

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38
Q

Where does gas exchange take place?

A

Alveoli

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39
Q

The R and L lung have how many sections?

A

R - 3 RUL, RML, RLL
L - 2 LUL, LLL

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40
Q

What is the Visceral pleura?

A

Lining of lungs

41
Q

What is the parietal pleura?

A

Lining of chest wall

42
Q

What is Hemothorax?

A

Blood in intrapleural space

43
Q

What is empyema?

A

Puss in intrapleural space

44
Q

What is pneumothorax?

A

Air in intrapleural space

45
Q

What can happen if the intrapleural space gets filled with air?

A

lungs could collapse

46
Q

What is the subjective data we ask for lungs?

A

Do you have a history of coughing?
Is it productive/nonproductive?
COCA - Sputum?
Any shortness of breath?
What are you doing when you have SOB?
Chest pain?
Smoking?
Environmental exposure?

47
Q

What are you looking for when you inspect the lungs?

A

Shape - front-back should be less than side to side
Level of consciousness - awake/lathargic?
Position of patient -relaxed, upright?
Use of accessory muscles
Location of trachea
Skin color and condition
Respiratory rate

48
Q

What is a barrel chest?

A

Front to back same size as left to right

49
Q

What is scoliosis?

A

Genetic Lateral deviation of spine

50
Q

What is kyphosis?

A

Hunched over, spine toward back
*bad posture

51
Q

What is pectus excavatum?

A

Caved in sternum

52
Q

What is pectus carinatum?

A

Protruding sternum, pigeon chest

53
Q

What is tachypnea?

A

Shallow breathing(not deep) <20bpm

54
Q

What is Bradypnea?

A

Slow >12bpm

55
Q

What is hyperventilation?

A

Deep and fast - losing C02 Fast = alkaline

56
Q

What is Cheyne-stokes?

A

near end of lif, regular-irregular pattern w/ periods of apnea

57
Q

When we are palpating the lungs what are we palpating for?

A

Symmertric expansion - place hands at base t10, thumbs near spine, patient takes deep breath, should be equal

Tactile fremitus - vibration, have patient say 99 then palpiate lungs - vibration should be equal

Note areas of tenderness, lumps or masses

58
Q

What part of IPPA do we not do for lungs?

A

Percuss!

59
Q

How many places do we auscultate on front and back ?

A

10 on front
18 on back

60
Q

How many places do we auscultate on front and back ?

A

10 on front
18 on back

61
Q

What do crackles sound like and what does it mean?

A

Popping/bubbling
Due to fluid, mucus or pus

62
Q

What does wheezing sound like?

A

Like whistling
due to airway constriction/narrowing

63
Q

What does stridor sound like?

A

Its in trachea
High pitched whistle during inspiration
Due to obstruction of upper airway

64
Q

What does Ronchi sound like?

A

Like snoring
Due to airway narrowing and secretion

65
Q

What is Atelectasis?

A

Collapse of aveloi
*postop // treatement is deep breathing

66
Q

What are the 2 areas of COPD?

A

Chronic bronchitis - ,mucus
Emphysema - avleoli problem/lose elasticity

67
Q

What is Asthma?

A

Presents like bronchitis but some have mucous some dont

68
Q

What is pleural effusion?

A

Something is in intrapleural space

69
Q

What is pleural effusion caused by heart failure?

A

Blood backs up into intrapleural space

70
Q

What is hemothorax?

A

Bleeding into intrapleural space from trauma

71
Q

What is Pneumothorax?

A

Collapsed lung
–Cynaosis, tachy, tracheal deviation, decreased breath sounds

72
Q

What are the signs of tuberculosis?

A

Rust colored sputum
Fever
Night sweats

*need to wear N95

73
Q

What are clubbed fingers and who gets them?

A

Patients with prolonged hypoxia and its a distortion of fingertips

74
Q

What organs are on RIGHT side top to bottom?

A

Liver
Gallbladder
Appendix

75
Q

What organ is on left side of body

A

Spleen

76
Q

What organ is middle pelvis?

A

Bladder

77
Q

What are the quadrants of abdomin? 3 top to bottom

A

Epigastric
Umbilical
Hypogastric

78
Q

WHat subjective questions do you ask for abdominial assessment?

A

Hows appetite?
Any dysphagia - difficulty swallowing
Ab pain?
Medications?
Bowel habits?
STool? COCA?
past ab history

79
Q

What is different about IPPA for abdomin?

A

IAPP

80
Q

Why do we do Palpation last for abs?

A

To prevent pain and guarding

81
Q

What do we inspect for ab?

A

Even skin tone
Symmetry
Umbilicus
No pulsations **DONT touch any PULSATIONS!
Hair distribution

82
Q

What could pulsation on AB be?

A

Anersym

83
Q

What are the 4 ways to document the ab section on a patient laying down?

A

Flat
Scaphoid - sinking inward
Rounded - slight puff
Protuberant - like pregnant looking

84
Q

What is peristalsis?

A

Waves that move fecal material through colon
Water is absorbed into capillaries

85
Q

What is constipation?
What is diarrhea?
What is Colostomy?

A

Constipation - feces stays in large intestine for long time
Diarrhea - feces moves quickly
Colostomy - obstruction/damage/disease

86
Q

What do we ausculte for on AB?

A

Bowel sounds - 5-30 sounds per min

**if absent bowel sounds for 5 mins call provider 911

87
Q

Where do we ausculte bruits on AB?

A

Aorta (middle)
R&L Renal artery
R&L iliac artery
R&L femoral artery*

88
Q

How do we percus on AB?

A

Place middle finger firmly then tap on finger –should hear hollw sound - tympany

89
Q

What do we palpate for on AB?

A

Mass or tenderness
Rebound tenderness- pain apon release of pressure - appendicitis
**Keep area of pain for last

90
Q

What would a bluish-purple periumbilical indicate?

A

Bleeding in GI
Cullens signs

91
Q

What are the signs of cholecystitis? (murphys signs)

A

Pain in upper right quad/ inflammation of gallbladder

92
Q

Where am I looking for blood in AB assess?

A

Stool, gums, urine, skin color

93
Q

Where is the pain in a patient with pancreatitis

A

Epigastric area

94
Q

What do gallstones do?

A

Block ducts from releasing bile. STool will then look gray, white, clay
Bile will also back up into the liver and create jaundice in patients
bile helps absorb fat

95
Q

What is Mcburneys point?

A

Right Lower Quad
Rebound of tissues = pain
appenditis

96
Q

Where is bile produced? where is it stored?

A

Produced in liver
stored in gallbladder

97
Q

If Bile doesnt come out of the gallbladder what happens?

A

backs up into the liver and gets into the system creating jaundice

98
Q

Pancreatitis?

A

Pancreasis located in epigastric area

101 LEC (15 decks)

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