TEST AND MEASURES Flashcards
Describe the Angina pain scale
- grades the severity of angina
- on a scale of 1-4, 4 being most pain ever experienced
Describe ABI and the test values
- measures systolic blood pressure at the arm and leg to measure peripheral artery disease
1.0 - 1.4 = normal
> 1.4 = rigid arteries
.8 - .99 = mild blockage
.4 - .79 = moderate blockage, may have exercise pain
< .4 = severe blockage, may have resting pain
What are the 5 stages of blood pressure levels in adults?
normal < 120/60
Elevated < 120-129/80
Stage 1 HTN 130-139/80-89
Stage 2 HTN at least 140/90
HTN Crisis greater than 180/120
When auscultating heart sounds, what is the S1 sound?
- the “lub”
- closing of mitral and tricuspid valves at onset of ventricular systole
- high frequency, low pitch and long duration sound
When auscultating heart sounds, what is the S2 sound?
- the “dub”
- closing of aortic and pulmonary valves at the onset of ventricular diastole
- high frequency, with high pitch and shorter duration
What is the S3 heart sound? Why is it problematic?
- vibration of the distended ventricle walls due to passive flow of blood from the atria during the rapid filling phase of diastole
- may be a sign of heart failure
What is the S4 heart sound? Why is it problematic?
- vibration of the ventricular wall with ventricular filling and atrial contraction
- may be associated with HTN, stenosis, hypertensive heart disease, or MI
What are crackles heard during breath sounds?
- abnormal, high pitched popping sound heard more often during inspiration
- wet crackles = the movement of fluid or secretions during inspiration
- dry crackles = sudden opening of closed ariways
What pathologies can cause crackles?
pulmonary edema, atelectasis, pneumonia, bronchiectasis, pulmonary edema
What do pleural friction rub lung sounds present as?
- dry, crackling sound heard during both inspiration and expiration
- occurs when inflamed visceral and parietal pleurae rub together
What do rhonchi breath sounds present like?
- continuous low pitched sounds described as having a snoring or gurgling quality, can be during both inspiration and expiration
What causes rhonchi breath sounds?
air passing through an airway which is obstructed by inflammatory secretions, bronchial spasms, or neoplasms
What is stridor in breath sounds? what does it indicate?
- continuous high pitched wheeze heard with inspiration or expiration
- indicates upper airway obstruction
What can cause wheezing during breath sounds?
- turbulent airflow and vibrations of the walls of small airways due to narrowing
- bronchospasm, edema, collapse, secretions, neoplasms, or foreign body
What causes decreased breath sounds?
severe congestion, emphysema, or hypoventilation
What do normal voice sounds sound like in the lungs?
usually muffled, whispered words are very faint
What do abnormal voice sounds sound like in the lungs? What do they indicate?
- increase in loudness and distinction = consolidation, atalectasis, or fibrosis (they all improve vibration through lung tissue)
List the adult BMI classifications
< 18.5 = underweight
18.5 - 24.9 = normal
25 - 29.9 = overweight
30 - 34.9 = obesity
> 35 = extreme obesity
What is capillary refill time use for? What are the refill parameters?
- indicated impaired perfusion to the extremities
- normal = color returns in < 2 seconds
- abnormal = refill is > 2 seconds
What is claudication? What are the symptoms??
- cardinal symptom of PAD, occurs when skeletal muscle oxygen demand during exercise exceeds blood oxygen supply
- symptoms = pain, aches, cramping, sense of fatigue, or other discomfort in the affected muscle group
What are the grades for the claudication pain test?
grade 1 - definite discomfort or pain, but only of initial or modest levels
grade 2 - moderate discomfort or pain from which the patient’s attention can be diverted
grade 3 - intense pain from which the patient’s attention cannot be diverted
grade 4 - excruciating and unbearable pain
how do you administer the claudication test?
patient walks on a treadmill and time is measured to onset and max pain
what is an ECG used for?
- to assess cardiac rhythm, to diagnose location, extent, and acuteness of myocardial ischemia and infarction, and to evaluate changes with activity
what are exercise stress tests used for?
measure the patients ability to tolerate increasing intensity of exercise while measuring vitals as well as monitoring for signs of ischemia, abnormal conduction, or abnormal signs of exertion
What is homan’s sign and what is it used for?
- passively DF the foot with the knee straight, positive if it produces pain
- used for detecting a DVT
What is mediate lung percussion used for?
tapping the surface of the body to identify areas of altered density
What does a flat or dull sound with mediate percussion indicate?
- sounds like if you percussed the thigh
- neoplasm, atelectasis, or consolidation
what does a resonance sound with mediate percussion indicate?
Normal!!
What does a hyperresonance sound with mediate percussion indicate?
- pulmonary emphysema or pneumothorax
What does tympany sound with mediate percussion indicate?
hollow sound vaguely resembles a drumbeat = usually exclusively a pneumothorax
What does pulmonary function measure? What is the outcome measurement?
- flow of air during inhaltion and expiration, measures for obstructive or restrictive pathology
- FEV1/FVC < 70% = obstructive
- FEV1/FVC is normal or > 80% = restrictive
What are the RHR for adults, children, and infants?
infant = 100-130
Child = 80-100
Adult = 60-100
What are the normal respiratory rates for infants, children and adults?
infant = 25-35
child = 15-20
adult = 12-20
What are the four parameter considerations for measuring respiratory rate?
rate, rhythm, depth, and character
What are the at risk numbers for waist circumference measurement?
> 40 inches for men
35 inches for women
= increased risk for type 2 diabetes, dyslipidemia, hypertension, and cardiovascular disease
What waist to hip ratio # indicates central obesity?
> 1 in males
.85 in women
What is cardiogenic shock?
cardiac problems (such as heart failure or MI) lead to poor perfusion of the organs.
What is hypovolemic shock?
- occurs when severe blood loss causes decreased perfusion to the organs.
- Presents with hypotension, altered mental state, cool and clamm6 skin, rapid pulse, and fatigue.
- usually from severe trauma or fatigue
What is included in a complete blood count test?
RBC count, WBC count, platelets, hemoglobin, and hematocrit
What is a hematocrit test? What does it consist of?
tests the percentage of RBC in the blood. Low hematocrit might = anemia, blood loss, or vitamin and mineral deficiencies. High hematocrit might = dehydration or polycythemia (overproduction of RBCs)
What is pulse pressure?
- the difference between systolic and dyostolic pressure
