the full body assessment

Question 1

ACLS

PALS

Answer 1

advanced cardiovascular life support

pediatric advance life support

Question 2

list the different systems

Answer 2

• cns
• cvs
• respiratory system
• gastrointestinal system
• genitourinary system
• infectious disease

Question 3

CNS sensorium

Answer 3

gives us a basic picture of mental status
recent and older events recalled- memory loss
rational and coherent communication ?

Question 4

CNS med review

Answer 4

intentional and unintentional OD ?
sedation or NMB (neuromuscular blocking) involved ?
-when were meds last given and dose?
can we reverse it ?

Question 5

CNS basic neurologic test

Answer 5

-pain
-gag/cough
-touch
commands
observation

Question 6

CNS assessment tools

Answer 6

physical exam
Glasgow coma scale (1-15)
observation- how patient looks
CT- two dimensional, resembles anatomic slices
x-rays- analyze and compare density and placement of tissue and bone
MRI- Magnetic field produces detailed anatomic images
EEG (electroencephalography)
ICP- intracranial pressure

Question 7

full consciousness

Answer 7

patient is alert and attentive, follows commands, responds promptly to external stimulation if asleep, and once awake remains attentive.

Question 8

lethargy

Answer 8

the patient is drowsy but partially awakens to stimulation, will follow commands slowly and inattentively

Question 9

obtundation

Answer 9

patient is hard to arouse and needs constant stimuli. may verbally response with only one to two words. patient drift back to sleep

Question 10

stupor

Answer 10

only arouses to vigorous and continuous stimuli. typically to pain stimulation. only response is to withdraw from or remove pain

Question 11

coma

Answer 11

patient is not responsive to anything, no movement, only possible by reflex

Question 12

what does Glasgow coma scale measure

Answer 12

• motor response
  -verbal response- poorly suited for patients with impaired verbal response ( aphasia, hearing loss)
  eye opening

Question 13

Glasgow coma scale

Answer 13

scale goes from 1-15
3- deep coma
15- fully awake 
12-15= non icu 
9-12= significant insult
less than 9- severe coma= requires endotracheal intubation

Question 14

CVS history review

Answer 14

hereditary cardiovascular disease ? - does this run in you family
Acute vs chronic

Question 15

CVS med review

Answer 15

chrono tropes- affects heart rate
anti-arrhythmias- controls contractility
anti hypertensive- controls BP

Question 16

assesment of CVS

Answer 16

vital signs- HR,BP
signs- JVD, edema, urine output heart sounds
testing- ecg
lab data- cardiac enzimes, lactate, electrolytes etc

Question 17

PMI (point of maximum impulse)

Answer 17

this is found on the fifth intercoastal space on the left side midclavicular line. this point is created by a healthy left ventricular systole. space is called precordium

Question 18

explain what the S1 sound is

Answer 18

S1 sound is produced by closures AV valves systole

Question 19

S2

Answer 19

sounds produced by closure of semilunar valves during diastole.

Question 20

s3 and s4 sounds

Answer 20

might be audible in patients
with ventricular hypertrophy
this is called a gallop sounds

Question 21

P2

Answer 21

suggestive of pulmonary hypertension and is common in COPD patients with chronic hypoxemia.

Question 22

cardiac murmurs

Answer 22

• systolic murmurs occur when blood passes through narrowed semilunar valves or back flows through incompetent AV valves
• diastolic murmurs occur with stenotic AV valves or incompetent semilunar valves.

Question 23

why are we assessing CVS

Answer 23

picture of patient stability

close correlation with (RS,renal system) CNS system

Question 24

respiratory history

Answer 24

patient/ family interview
reports
chart reviews
actions plans

Question 25

resp; assessment tools

Answer 25

PEFR
Peak flow measured on exhalation for Asthmatic and COPD
Spirometry
More detailed assessment of volumes and flows
V/Q scans
Radioactive radionuclide injected into pt blood then X-ray completed, as well pt breathes in and x-ray done
Done to establish presence of pulmonary emboli compares areas of ventilation and perfusion of the lung
Sputum for C&S(culture and sensitivity), also determine if gram + or -
Cytology (what cells are growing)
AFB (acid fast bacilli) test for TB
Bronchoscopy – procedure where physician enters airway with a bronchoscope to visualize airways and determine any anomalies
Drug levels
Physiologic calculations Qs/Qt – shunt & Vd/Vt - deadspace

Question 26

GI; hx and medications

Answer 26

last meal
chronic vs acute pain (stomach)
nausea, vomiting and diarrhea
GERD( gastroesophageal reflux disease)

Question 27

examination of the abdomen

Answer 27

Performed to inspect and palpate for distention or tenderness
An enlarged or tender abdomen can negatively influence breathing
A large liver is known as hepatomegaly; common in patients with cor pulmonale
An abnormal collection of fluid in the peritoneal cavity is known as ascites

Question 28

GERD

Answer 28

Heartburn and regurgitation
Extraesophageal manifestations
Laryngitis, asthma, chronic and nocturnal dry cough, chest pain, and dental erosion
GER more than twice a week = GERD
Risk factors
Obesity, cigarette smoking, pregnancy

Question 29

why assess GI system

Answer 29

The pts. Nutritional status will directly affect their ability to support ventilation
Aspiration (i.e. - due to distention) may cause a Gm - pneumonia.
GI bleeds (i.e. NG drainage, distention) will decrease Hb and reduce oxygenation

Question 30

urinary hx and med review

Answer 30

hx of transplant or surgery
meds
diuretic
CVS meds

Question 31

why assess renal system ?

Answer 31

Plays a key role in balance of:
circulating fluid volume
waste product elimination
acid/base status

Therefore, it has a huge impact on most major organ functions especially Respiratory & CV

Question 32

infectious disease

Answer 32

History of infections or reoccurring
Antibiotics, Antifungal or Antiviral medication review
Immunocompromised?
Precautions
PPE