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Physical Assessment > Vital Signs And General Physical Assessment > Flashcards

Vital Signs And General Physical Assessment Flashcards

1
Q

What are common and concerning symptoms of a general physical assessment?

A

-Constitutional symptoms (ROS)
Fatigue
Weakness
fever,chills, and night sweats
weight change
pain

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2
Q

What could some of the differential diagnosis of fatigue be?

A

-Depression
-Anxiety
-Infection
-Endocrine disorders
-Heart failure
-Anemia
-Malignancies
-Medications

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3
Q

What are the four ways to determine the areas of involvement?

A

-Proximal
-Distal
-Symmetric
-Asymmetric
1.Focal: Portion of face or extremity
2. Monoparesis: in an extremity
3. Paraparesis: in both extremities
4. Hemiparesis: in one side of the body

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4
Q

What is Progressive fatigue?

A

Subacute onset of distal lower extremities
*Guillain Barre syndrome

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5
Q

What is chronic weakness?

A

gradual onset of weakness in lower extremities
*Can be seen in metastatic cord lesions and lumbar disc disease

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6
Q

What are the two different types of Focal asymmetric weakness?

A

1.Central
-Ischemic
-Thrombotic
-mass lesions
2. Peripheral
-nerve injury
-Neuromuscular junction disorders
- Myopathies

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7
Q

How to identify proximal weakness in the upper and lower extremities?

A

Upper extremities:
-combing hair
-Reaching up to a shelf
Lower extremities
-Getting up out of a chair
-Climbing a high step

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8
Q

What is the bilateral distal weakness?

A

Polyneuropathy
*caused by DM

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9
Q

What should you inquire when someone has fever, chills, and night sweats?

A

-Travel
-Contact with sick people
-Medications
-Illness
-cycle history

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10
Q

How can weight changes happen in the body?

A

-Rapid changes suggest body fluids
*CHF, nephrotic syndrome, liver failure

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11
Q

What are the aspects of weight gain?

A

-Caloric intake exceeds caloric expenditure
-Abnormal accumulation of body fluids

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12
Q

What are the aspects of weight loss?

A

-5% or more loss over 6 month period
-multiple causes

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13
Q

What is the “healthy” BMI

A

18.5 and 24.9

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14
Q

What should be investigated if there is a BMI less than 18.5?

A

-anorexia
-bulimia

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15
Q

What is the four step approach about weight and nutrition

A
  1. Measure BMI and waist circumference
  2. Assess dietary intake
  3. Assess the patient’s motivation
  4. Provide counseling about nutrition and exercise
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16
Q

What are the additional risk factors of weight gain?

A

HTN
High LDL cholesterol
Low HDL cholesterol
High triglycerides
High blood sugar
FH (family history) of premature heart disease
Physical inactivity
Cigarette smoking

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17
Q

What is the recommended sodium intake?

A

USDS recommends 2.3g/day
AHA recommends 1.5g/day

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18
Q

What are reasonable goals for weight loss?

A

-5 to 10% reduces risk of diabetes and other obesity associated health problems
-Actvity 30-60 min per day
-Portion control
-1/2 pound to 2 pound per week
-Monitor calories
-Accountability

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19
Q

At what moment does the general assessment begin?

A

The moment you step into the room

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20
Q

What is being perceived during the general assessment?

A

-State of health
-Deamenor
-Facial affect
-Posture
-Gait

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21
Q

What are the three components of the general assessment?

A
  1. Patient’s general appearance
  2. Height
  3. Weight
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22
Q

What are the observed areas in the GA?

A

-Apparent state of health
-Level of consciousness
-Signs of distress
-Skin color and obvious lesion
-Dress, grooming, and personal hygiene
-Facial expression
-Odors of the body and breath
-Posture, gait, and motor activity
-symmetry
- Height
-Weight

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23
Q

What are the different type of factors that contribute to body habitus (body stature)

A

-socioeconomic status
-nutrition
-genetic make-up
-degree of fitness
- mood state
-early illnesses
-gender
-geographic location
-age cohort

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24
Q

What are the components of mental status?

A

-Speech
-Awareness/consciousness
-Manner
-mood
Orientation

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25
Q

What are the different levels of consciousness?

A

Alert
Lethargic
Obtunded
Stupor
Coma

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26
Q

Describe alertness

A

Patient opens the eyes, looks at you, and responds fully and appropriately to stimuli

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27
Q

Describe lethargic

A

Sleepy,drowsy, or mental sluggishness
*patient requires you to speak with a loud voice, appears drowsy but opens the eyes and looks

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28
Q

Describe obtunded?

A

A result of intoxication, metabolic illness, infection, or neurological catastrophe
*have to shake the patient gently as if awakening a sleeper

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29
Q

Describe stuporous?

A

A state of altered mental status and decreased responsiveness to one’s environment
*needs to be awoken by a sternum rub

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30
Q

Describe a coma

A

A state of unconsciousness from which one cannot be aroused

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31
Q

Signs of distress need to be addressed immediately true or false?

A

True

32
Q

What is the preferred position (posture) of a person with CHF and COPD respectively?

A

Upright with CHF
Leaning forward with arms braced in COPD

33
Q

What is Gait?

A

The manner of walking, how a patient walks

34
Q

What are the five vital signs?

A

Temperature
Pulse
Respiration
Blood pressure
Pain

35
Q

What do vital signs do?

A

Helpful in the diagnosis
Provides critical initial information

36
Q

What are the methods of taking temperature?

A

Oral
Rectal
Axillary
Tympanic
Temporal artery

37
Q

What is the device to take oral temperature?

A

Electronic thermometer

38
Q

What can cause inaccurate readings of oral temperature?

A

-hot or cold liquids
-smoking
-rapid respirations
*wait 10-15 minutes before measuring temperature

39
Q

What is the least accurate temperature method?

A

Axillary
*Used for infants and children

40
Q

What is the most commonly used temperature method?

A

Tympanic membrane
*measure core body temperature

41
Q

Definition of fever/pyrexia?

A

Elevated body temperature
*associated with infection and inflammation

42
Q

Definition of hyperpyrexia?

A

Extreme elevation
*106 F

43
Q

Describe hyperthermia?

A

-elevation of body temperature not caused by fever
-inability of body to dissipate heat
- related to medication, drugs, and heat stroke

44
Q

Describe hypothermia

A

-abnormally low temperature
*below 35 F (95 F)

45
Q

Bradycardia bpm

A

<60 bpm

46
Q

Tachycardia bpm

A

> 100bpm

47
Q

Normal bpm

A

60-100bpm

48
Q

What are the causes of bradycardia?

A

-athletic conditioning
-sick sinus syndrome
-increased intracranial pressure
-hypothyroidism
-hypothermia

49
Q

What are the causes of tachycardia?

A

-fever
-hyperthyroidism
-anxiety
-anemia
-exertion
-pulmonary embolism
-fear
-acute coronary syndrome
-drugs

50
Q

List and describe the pulse character

A

0=absent; no palpable
1= weak; diminished amplitude, may have difficulty locating
2=normal; readily palpable
3= strong; increased amplitude, quickly palpable
4=Bounding
*estimation of the amount of blood ejected into the arterial system through left ventricular contraction minus any obstruction of arterial flow

51
Q

What is the term of normal pulse 2?

A

Hemodynamically stable

52
Q

How do you watch for respirations

A

complete while patient is unaware

53
Q

What is the normal respiratory rate?

A

12-20bpm
*Eupena

54
Q

What is Bradypnea?

A

Slow breathing
<12 bpm
*count for full 60 seconds

55
Q

What is Tachypnea?

A

Rapid breathing
*>20 bpm
*Count for full 60 seconds

56
Q

What are causes of abnormal respirations?

A

-apneustic
-obstructive
-restrictive
-hyperpnea
-sighing
-Cheyenne-stokes
-ataxic

57
Q

Describe apneustic

A

Inspiration phase longer than expiratory phase

58
Q

Describe obstructive pattern

A

Expiratory phase longer than inspiratory phase

59
Q

Describe restrictive pattern

A

Shallow inspirations that become rapid with exertion

60
Q

Describe hyperpnea

A

Rapid, deep inspirations

61
Q

Describe sighing

A

Deep inspirations with the breathing pattern

62
Q

Describe Cheyene-stokes

A

Increasing and decreasing amplitude of respirs and periods of apnea

63
Q

Describe ataxic (Biot’s breathing)

A

-irregular, unpredictable pattern with periods of apnea

64
Q

What is blood pressure?

A

Arterial blood pressure is an estimation of the force of blood on the wall of the artery

65
Q

What is systolic blood pressure

A

Pressure of the blood on the arterial wall at the peak of left ventricular contraction

66
Q

What is diastolic blood pressure

A

The resting pressure on the arterial wall

67
Q

What are some office errors leading to inaccurate results of blood pressure?

A

-Observer and measurement error
-Natural physiology fluctuations in blood pressure
-Anxiety
-Presence of “white coat”

68
Q

What is masked hypertension?

A

-Office blood pressure is normal but the ambulatory readings are high

69
Q

What are contraindications of blood pressure?

A

-Physical defects
*injuries to arms
*Fistulas
*Mastectomy
-Therapeutic interventions

70
Q

What is the Palpation systolic pressure?

A

Used to determine how high to raise the cuff pressure

71
Q

What is the auscultation gap

A

Period between systolic and diastolic where the pulse is not audible but returns with continued deflation

72
Q

What is the diagnostic criteria for hypertension

A

Must have 2 or more properly measured elevated readings, with patient seated, on 2 more separate occasions

73
Q

What is the definition of orthostatic hypotension?

A

-Drop in systolic BP of 20mmHg or diastolic BP drops >10mm Hg
-Increase in pulse by 20 bpm from supine to standing

74
Q

What is pulse pressure?

A

Systolic-diastolic=pulse pressure

*low/narrow (less than 25mmHg)
*high/wide (>100mmHg)
75
Q

What are the different types of pain?

A

Somatic
*related to tissue damage, M/S or visceral
Neuropathic pain
*pain resulting from direct injury to somatosensory system
Central sensitization pain
*Alteration of CNS sensation, low pain threshold
Psychogenic pain
*factors that influence the patient’s report of pain
Idiopathic pain
*no identifiable etiology

76
Q

What are the four A’s to monitoring pain outcome?

A
  1. Analgesia
  2. Activities of daily living
  3. Adverse effects
  4. Aberrant drug-related behaviors
77
Q

What are the 7 attributes of symptoms?

A
  1. Location
  2. quality
  3. Quantity or severity
  4. Timing
  5. Setting in which it occurs
  6. Remitting or exacerbating factors
  7. Associated manifestations

Physical Assessment (12 decks)

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