Chapters 1, 2, 3, 4, 8, 9, 10, 11, 12, 13 Flashcards
(305 cards)
1
Q
Annular Lesions
A
Description: circular, begins in center & spreads to periphery
Ex. Ringworm
2
Q
Confluent Lesions
A
Description: lesions run together
Ex. Urticaria (hives)
3
Q
Discrete Lesions
A
Description: distinct, individual lesions that remain separate
Ex. Skin tags, acne
4
Q
Gyrate Lesions
A
Description: twisted, coiled, spiral, snakelike
5
Q
Linear Lesions
A
Description: a scratch, a streak, line or stripe
6
Q
Zosteriform Lesions
A
Description: linear arrangement along unilateral nerve route
Ex. Herpes Zoster
7
Q
Grouped Lesions
A
Description: clusters of lesions
Ex/ Vesicles of contact dermatitis
8
Q
Target Lesions
A
Description: resembles iris of eye, concentric rings of color in lesions
Ex. Erythema Multiforme
9
Q
Polycyclic Lesions
A
Description: annular lesions grow together
Ex. psoriasis, lichen planus
10
Q
Macule Lesion
A
Description: soley a color change, flat & circumscribed of less that 1 cm.
Ex. Freckles, petechiae, measles, scarlet fever
11
Q
Papule Lesion
A
Description: solid elevated, circumscribed less than 1 cm.
Ex. Mole or Wart
12
Q
Patch Lesion
A
Description: Macules that are larger than 1 cm.
Ex. mongolian spot, cafe au lait spots, measles rash
13
Q
Nodule Lesions
A
Description: solid elevated, hard or soft, larger than 1 cm.
Ex. xanthoma, fibroma
14
Q
Wheal Lesion
A
Description: superficial raised, transient & erythematous, slightly irregular shape from edema
Ex. Mosquito bite, allergic reaction
15
Q
Urticaria Lesion (Hives)
A
Description: wheals coalesce to form extensive reaction, intensely pruritic
16
Q
Vesicle Lesion
A
Description: elevated cavity containing free fluid, up to 1 cm. “blister”
Ex. Herpes simplex, early varcellia, herpes zoster
17
Q
Bulla Lesion
A
Description: Larger than 1 cm. usually single chambered superficial to epidermis; thin walled & ruptures easily
Ex. Friction blister, burns
18
Q
Cyst Lesion
A
Description: Encapsulated fluid-filled cavity in dermis or subcutaneous layer, tensely elevated
Ex. sebaceous cyst, wen
19
Q
Pustule Lesion
A
Description: turbid fluid (pus) in the cavity. Circumscribed and elevated
Ex. Impentigo, acne
20
Q
Crust Lesion
A
Description: The thickened, dried out exudate left when pustules burst or dry up
Ex. Impetigo (dry-honey color), scab
21
Q
Scale Lesion
A
Description: Compact desiccated flakes of skin dryor greasy, silvery or white from shedding of dead excess keratin cells
Ex. Eczema, psoriasis, ichthyosis, seborrheic dermatitis
22
Q
Fissure Lesion
A
Description: linear crack with abrupt edges, extends into dermis
Ex. Cheilosis (corners of mouth), athlete’s foot
23
Q
Erosion Lesion
A
Description: Scooped out but shallow depression. Superficial; epidermis lost; no bleeding (b/c does not extend to dermis)
24
Q
Ulcer Lesion
A
Description: Deeper depression extending into dermis, irregular shape; may bleed
Ex. Stasis ulcer, pressure injury
25
Excoriation Lesion
Description: self-inflicted abrasion; superficial; scratches from intense itching
Ex. insect bite, scabies, dermatitis
26
Scar Lesion
Description: After a skin lesion is repaired normal tissue is lost and replaced with connective tissue (collagen)
Ex. healed area of surgery, injury, or acne
27
Atrophic Scar Lesion
Description: Skin level is depressed with loss of tissue, thinning of epidermis
Ex. Striae
28
Keloid Lesion
Description: A benign excess of scar tissue beyond sites of original injury. May occur months-years after original trauma. Most common in ages 10-30 Africans, Hispanics, Asians.
29
Primary Skin Lesions
```
Macule
Papule
Patch
Plaque
Nodule
Wheal
Tumor
Urticaria
Vesicle
Bulla
Cyst
Pustule
```
30
Secondary Skin Lesions
```
Crust
Scale
Fissure
Erosion
Ulcer
Excoriation
Scar
Lichenification
Keloid
Atrophic Scar
```
31
Lichenification Lesion
Description: Prolonged intense scratching eventually thickens skin and produces tightly packed sets of papules
32
Lanugo
The fine downy hair of the newborn infant
33
Vitiligo
The complete absences of meanin pigment in patchy areas.
34
When assessing Skin Lesions what do the ABCDE's stand for?
```
A- Asymmetry
B- Border
C- Color variation
D- Diamete
E- Elevation
```
35
What color occurs on the skin with anemia, shock, arterial insufficiency?
Gray - Dark Skinned
| Pallor - Light Skinned
36
When red-pink tones from oxygenated hemoglobin are lost the skin take on color of ___ tissue
Connective
37
Cyanosis
A blush-ish color from decreased profusion
38
Diaphoresis
Profuse perspiration
39
Diaphoresis accompanies (4 things)
Thyrotoxicosis
Heart Attach
Anxiety
Pain
40
What does the skin feel like during Hyperthyroidism?
Smooth, soft, like velvet
41
What does the skin feel like during Hypothyroidism?
Rough, dry, and flaky
42
Anasarca
Bilateral edema, generalized over whole body (consider central problem. Ex. Heart or Kidney failure)
43
Cherry (Senile) Angiomas
Small, slightly raised red dots that commonly appear on the trunk
44
What integumentary defect occurs when congenital cyanotic heart disease, lung cancer or pulmonary diseases occur?
Clubbing of the nails
45
Mongolain Spot
Hyperpigmenttion in African American, Asian, American Indian, And Latino newborns. Occurs usually around sacrum, or butt, sometimes on abdomen or arms
46
Cafe Au Lait Spots
Large round or oval patch of light brown pigmentation. Usually present at birth
47
What do you consider if you observe 6 or more Cafe Au Lait Spots on a newborn?
Neurofibromatosis
48
Erythema Toxicum
Common rash that appears first 3-4 days of life "Flea-bite rash"
49
Acrocyanosis
Temporary blue-ish color around lips, hands and fingernails in newborn
50
What could persistent Acrocyanosis be a sign of?
CyanoticCongenital Heart Disease
51
Cutis Marmorata
a transient mottling in trunk or extremities
52
What could persistent Cutis Marmorata occur with?
Down Syndrome or Prematurity
53
What are indicators of fetal distress?
Green-brown discoloration of skin, nails, and cord with passing of meconium in utero
54
Milia
tiny white papules on the forehead and eyelids caused by sebum that occludes the opening of the follicles
55
Physiologic Jaundice
Normal in 50% of newborns
| Develops after the 3-4 day of life because of increased number of RBCs
56
What does Jaundice in a 1 day old baby indicate?
Hemolytic Disease
57
What does Jaundice in a 2 week old baby indicate?
Biliary Tract Obstruction
58
What does excessive sweating in children indicate?
Hypoglycemia, Heart Disease, Hyperthyroidism
59
Nevus Simplex or Stork Bite
Flat irregularly shaped red/pink patch on forehead or back of neck in newborns
60
Open Comedones
Blackheads
61
Closed Comedones
Whiteheads
62
Striae
"Stretch marks"
63
Linea Nigra
Brown-ish-Blackline down the midline if abdomen in pregnant women
64
Chloasma
Irregular brown patch of hyperpigmentation on the face of pregnant women
65
Why are Vascular Spider common in pregnant women?
Increase estrogen
66
5 or more spider angioma possibly indicate what in pregnant women?
Liver Disease
67
Senile Lentigines
Common variations of hyperpigmentation in older adults "Liver spots"
68
Keratoses
Raised thickened areas of pigmentation
| Crusty, scaly or warty
69
Seborreic Keratoses
Dark, greasy, and" Stuck on"
| Not cancerous
70
Actinic Keratoses
red-tan scaly plaques that increase in numbers and become raised and rough
Are premalignant
71
What is a healthy capillary refill time?
1.5-2 seconds; 4 seconds MAX
72
Sebaceous Hyperplasia
Raised yellow papule with a central depression
| Occur in older adults
73
Subjective Data
What the person SAYS about him/herself
74
Objective Data
What you OBSERVE about the patient during assessment
75
What 6 Phases are included in the Nursing Process?
```
Assessment
Diagnosis
Outcome Identification
Planning
Implementation
Evaluation
```
76
First Level Priority Problems
Life threatening - Emergent
| Ex. ABC's
77
Second Level Priority Problems
Require intervention before further deterioration
| Ex. Mental status, acute pain, abnormal labs, risk of infections
78
Third Level Priority Problems
Require attention but can be attended to after more emergent problems
79
What is focus-centered database?
For limited/short-term problems
| "Mini database"
80
What is a follow-up database?
Evaluated at regular intervals after initial visit
| Used in both acute and chronic problems
81
What is a complete database?
Includes complete health history and full physical exam, both present and past health problems
82
What is an Emergency Database
Urgent rapid collection of crucial info and often compiled concurrently with lifesaving measures
83
Holistic Health
consideration of the whole person
84
Biomedical Theory
Theory of illness causation assumes that all events in life have a cause and effect.
"Germ Theory"
85
Naturalistic Theory
Believe that the forces of nature must be kept in natural balance or harmony
86
The Naturalistic Theory is most common in what 2 cultural groups?
American Indians
| Asians
87
Magicoreligious Perspective
The world depends of supernatural forces for good and evil
| Ex. Voodoo & Witchcraft
88
What does FICA mean?
Faith, Importance/Influence, Community, Address/Action
89
When do you use FICA?
To obtain a spiritual history
90
What does RCOPE questions have in common?
the word "God"
91
When do you use RCOPE?
To understand how a person is coping with loss or illness
92
As the interviewer what 4 internal factors should you be aware of?
Liking Others
Empathy
Ability to Listen
Self-Awareness
93
As the interviewer what 1 external factor should you be aware of?
The physical setting
94
As the interviewer how much space should be between you and the patient?
4-5 feet
95
Equal-Status Seating
Both you and the client should be comfortably seated at eye level with nothing in front of you. Chairs at 90 degrees
96
When do you use an open-ended question?
Begin interview
Introduce new sections of questions
Whenever the patient introduces a topic
97
When do you use closed/direct questions?
To elicit specific information
| To fill in any details the patient may have left out
98
For what ages of a child would you focus more of the caregiver?
1-6
99
What could cause the child to feel threatened?
The interviewer standing above the child
| Maintaining eye contact
100
What kind of words/sentences do you use when speaking to a child?
Short/simple words and sentences
101
Piaget's Stage: Sensorimoter
Birth-2 years
Vocabulary: >200 words (mostly nonverbal communication)
Manipulation of Objects
102
Piaget's Stage: Preoperational
2-6 years
Vocabulary: >10,000 words (grammar and language to communicate)
Symbolic Thinking
103
Piaget's Stage: Concrete Operations
7-11 years
Vocabulary: Passive tense mastery; complex grammar
Logical Thinking; numbers
104
Piaget's Stage: Formal Operations
12+ years
Vocabulary: Near adult-like
Abstract Thinking; futuristic; broad
105
Icebreakers for School-Aged-Childern
Friends, activities, sports, school
106
Adolescence stage begins with ___
Puberty
107
____ is the most important thing you can communicate to an adolescent
Respect
108
True/False: Ask adolescents questions about him/herself before health concern questions.
True. The adolescent wants to talk about him/herself first. Ask open ended questions about friends, schools, activities.
109
What kind of questions do you ask adolescents?
Short and simple
110
True/False: For an adolescent more emotionally charged questions should be asked later in the interview.
True. You have now developed a trust after the first parts of the interview. They are more willing to be truthful with you. Opportunity to discuss interventions. Praise good behaviors
111
Always address an older adult by his/her ____
Surname
112
What kind of questions do you ask older adults?
NOT short or simple; could be perceived as "baby talk"
113
Is it okay to touch the adolescent when beginning interviewing?
No, not before the physical exam
114
Is it okay to touch the older adult before beginning the interview?
Yes, nonverbal communication is important to older adults.
115
When a hearing-impaired patient who prefers lip-reading is being interviewed, What kind of person is best for this task?
A healthcare provider without a beard or mustache and no foreign accent.
116
What are the don't to interviewing a patient who lip reads?
Exaggerating lip movement, shouting
117
What are the do's to interviewing a patient who lip reads?
Slow speech with hand gestures
118
These drugs are CNS depressants
Alcohol, Benzodiazepines, Opioids (Heroin, methadone, Morphine, Oxycodone)
119
What do CNS depressants do?
Slow brain activity, and impair judgement, memory, intellectual performance and motor skills.
120
These drugs are simulates of the CNS
Cocaine and Amphetamine
121
What do CNS stimulates do?
Cause intense high, agitation, and paranoid behavior
122
These drugs are hallucinogens
LSD, Ketamine, PCP
123
What do hallucinogens do?
Cause bizarre, inappropriate, sometimes violent behavior. Superhuman strength and insensitivity to pain
124
What kind of question do you ask a patient under the influence of drugs?
Nonthreatening questions and manners
125
What do you avoid while interviewing someone under the influence?
Confrontation & turning your back to them
126
What is the top priority when interviewing someone under the influence?
Find out the time the patient took their last drug, how much it was, and what exactly it was
127
What do you do first when interviewing someone who is already angry?
Deal with the angry feelings first before starting the interview.
128
What is the Health History Sequence?
```
Biographic Data
Reason for seeking care
Present health
Past history
Medication reconciliation
Family history
Review of systems
Functional Assessment or ADLs
```
129
What does ADL mean?
Activities of Daily Living
130
Symptom
A SUBJECTIVE sensation that the person feels from the disorder
131
Sign
An OBJECTIVE abnormality that you as the examiner could detect on physical examination or through diagnostic testing
132
Present Health includes:
```
Location
Character/Quality
Quantity/Severity
Timing
Setting
Relieving Factors
Associated Factors
Patient's Perception
```
133
Past Health includes:
```
Childhood Illnesses
Accidents/Injuries
Serious/Chronic Illnesses
Hospitalizations
Operations
Obstetric History
Immunizations
Last Exam Date
Allergies
Current Medications
```
134
Medication Reconciliation
A comparison list of current medications with a previous list. The purpose is to reduce errors and promote patient safety
135
Medications include:
```
Over the counter medication (Especially aspirin)
Vitamins
Birth control
Antacids
Cold Remedies
Herbal Medications
```
136
What are the three purposes fro review of systems?
1. ) To evaluate the past and present health state of each body system
2. ) To double-check in case any significant data was omitted in Present Illness Section
3. ) To evaluate health promotion practices
137
What is the order of system review examination?
Head-to-Toe
138
What is important to mention when reviewing the Musculoskeletal System?
History of arthritis or gout
139
How do you ask about Intimate Partner Violence?
With open-ended questions first. If they feel unsafe, follow up with closed/direct questions
140
How do you ask about Prenatal Status?
Start with open-ended questions. "Tell me about your pregnancy."
141
What are common pediatric allergies?
Cow's milk, eggs, peanuts, tree nuts, soybean, and fish
142
What is the difference between a true allergy and a food intolerance?
True Allergy: Can be life threatening
| Food Intolerance: Causes distress, and illness, non life threatening
143
What motor skills should a school-aged-child posess?
Run, jump, climbs, rides bike, coordinated skills: tie shoe, uses scissors, language skills: tell time, vocabulary
144
What should be recorded when taking a nutritional history of an infant?
```
If the child is breastfed or bottle fed
Nursing frequency, duration
Any supplements
Method of weaning
Formula type
Any problems
Introduction to solid foods
```
145
What should be recorded when taking a nutritional history of a preschool and school-aged-child
```
Appetite
24-hour recall
Vitamins
Junk food
Parent's perception of child's nutrition
```
146
What does HEEADSSS stand for?
```
H -Home Environment
E- Education
E- Eating
A- Activities
D- Drugs
S- Sexuality
S- Suicide/Depression
S- Safety
```
147
How many hours of sleep does a teen need?
9 hours per night
148
When do you use HEEADSSS?
When interviewing an adolescent
149
Palpation
Applies sense of touch while examining a patient
150
What can fingertips feel best when palpating?
Fine tactile discrimination: texture, swelling, pulsation, and lumps
151
What can grasping with finger and thumb feel best when palpating?
Position, shape, and consistency of organ or mass
152
What can the dorsa of the hands and fingers feel best when palpating?
Temperature
153
What can the base of fingers feel best when palpating?
Vibration
154
Percussion
Tapping the person's skin with short, sharp strokes to assess underlying structures
155
Inspection
Concentrated watching
156
What sound would come from normal lung tissue?
Medium/loud, low pitched clear/hollow sound
157
What sound would come from a child's lung or an adult with emphysema?
Louder low pitched booming sound
158
What sound would come from a stomach or intestine?
Loud high pitched musical sound
159
What sound would come from a dense organ?
Soft high pitched muffled sound
160
What sound would come from a location where no air is present? (Muscle/Bone)
Very soft high pitched sound with a dead stop/dullness
161
What 4 characteristics are assessed when performing percussion?
Amplitude
Pitch
Quality
Duration
162
What sounds are heard best by the diaphragm?
Breath, bowel, and normal heart sounds
163
What sounds are heard best by the bell?
Extra heart sounds or murmurs
164
What lighting is best for an examination room?
Tangenital Lighting
165
True/False: The Otoscope can be use to inspect the ear and nose
True.
166
Opthalmascope
illuminates the internal eye structures
167
Which microorganisms are antibiotic resistant and difficult to treat?
MRSA, VRE, and tuberculosis
168
Which microorganism are most effectively rid by alcohol?
Mycobacterium tuberculosis, Hepatitis B & C, and HIV
169
When examining a patient what should you start with? (So they don't feel a threat?
Vital Signs (Make small talk), then examine hands (skin)
170
What is the major task of the infant?
Establishing trust
171
When should an examination occur for an infant?
1-2 hour AFTER feeding
172
True/False: It is okay to examine a baby while it is sleeping
True.
173
What should you do when the infant is fussy?
Offer brightly colored toys
174
Should you keep eye contact with an infant while examining?
Yes.
175
What should you use when performing invasive steps on an infant?
A pacifier
176
What do you perform at the end of the examination with an infant?
The Moro "Startle" reflex
177
What is the major task of a toddler?
Developing Autonomy
178
Where should the toddler be sitting when the examination is performed?
The caregiver's lap
179
Who should undress the toddler for examination?
The caregiver
180
What is the major task for a preschool child?
Developing initiative
181
What age will a child feel comfortable of the exam table?
4 or 5 years old
182
How can you reduce the fears of a preschool child?
Let him/her play with equipment first
183
What should you provide when examining a preschool & adolescent child?
Reassurance and Praise
184
What should you examine first when examining a preschool child?
Thorax, abdomen, extremities, and genitals
185
What should you examine first when examining an adolescent?
Head-to-toe assessment - Genital last
186
What is the major task of an adolescent?
Developing self-identity
187
What is the major task of a school-aged-child
Developing industry
188
When can a child decide whether a caregiver can stay in the examination room?
Age 11 or 12
189
What is the major task of an older adult?
Developing the meaning of life and one's own existence
190
Should the adolescent be examined with a caregiver in the room?
No
191
When a patient is exhibiting a Tripod position it can be an indicator of ____
Chronic Pulmonary Disease
192
A toddler usually exhibits ___ regarding posture
"Toddler Lordosis"
193
Gait
Feet approximately shoulder width apart; foot placement is accurate (Normal)
194
When a patient is sitting straight up and resist laying down this can be an indicator of ____
Heart Failure
195
When a patient is curled up in the fetal position this can be an indicator of ____
Acute Abdominal Pain
196
Propulsion
difficulty stoping after ambulation (Abnormal)
197
ROM
Range of Motion
198
How can you help people how appear anxious?
Smile
199
Velcro fasteners instead of buttons on clothing may be an indicator of ____
Motor Disfunction
200
Short-term illnesses associated with unexplained weight loss
Fever
Infection
Disease of the mouth or throat
201
Long-term illnesses associated with unexplained weight loss
```
Endocrine diseases
Malignancy
Depression
Anorexia Nervosa
Bulimia
```
202
Unexplained weight gain is associated with what?
Heart Failure
203
BMI can be calculated by:
lb./in. X 703 OR kg./meter2 (squared)
204
What one thing can cause a false BMI?
Gain or loss of muscle mass
205
What is the normal BMI range?
18.5-24.9
206
A patient with a 17.9 BMI is classified as what?
Underweight
207
A patient with 25.1 BMI is classified as what?
Overweight
208
A patient with 34.5 BMI is classified as what?
Class 1 Obesity
209
A patient with 37.2 BMI is classified as what?
Class 2 Obesity
210
A patient with 41.1 BMI is classified as what?
Extreme Obesity (Class 3)
211
What biological marker would you use to place a measuring tape when measuring waist circumference?
The top of the iliac crest (hip bone)
212
Normal waist circumference in women:
Less than or equal to 35 in.
213
Normal waist circumference in men:
Less than or equal to 40 in.
214
A larger waist circumference in either men or women could put them at a higher risk for __ ___ ___ ___
Type 2 Diabetes
Dyslipisemia
Hypertension
Cardiac Vascular Disease (CVD)
215
Signs of child abuse are:
Child avoids eye contact
Exhibits no separation anxiety
Parent is disgusted by child's odor, sounds, drooling, or stools
216
What do you weigh an infant on?
Platform-type Scale (weigh to the nearest 1/2 oz.)
217
When do you use am upright scale to take a child's weight?
2-3 years
218
When would you stop measuring a child's height in a supine position?
At 2 years of age
219
What biological marker do you use to measure head circumference?
The eyebrows
220
If the head is irregularly large for child's age it can be an indicator of ____
Intracranial Pressure
221
What biological marker do you use to measure chest circumference?
The Nipple Line
222
Kyphosis
Humpback appearance common in the very old and those with osteoporosis
223
What is different about older adult's gait?
It is usually wider base to compensate for diminished balance
224
What 3 things contribute to older adult's height shrinkage?
Thinning of vertebral disks
Postural changes (Kyphosis)
Slight flexion of knees and hips
225
Hypopituitary Dwarfism is a deficiency of what hormone at what stage of life?
Growth Hormone in childhood
226
Gigantism is excessive secretion of which hormone and at which stage of life?
Growth Hormone in childhood
227
Where is growth hormone secreted from?
Anterior Pituitary Gland
228
What are signs of gigantism?
Increased height and weight and delayed sexual development
229
Acromegaly is also called ____
Hyperpituitarism
230
Acromegaly is excessive OR deficiency of growth hormone secretion in what stage of life?
Excessive secretion in the adult years
231
What are signs of Acromegaly?
Overgrowth of bones in face, hands, and feet (Not height)
232
What complication can be a cause from Acromegaly?
```
Enlarged internal organs (Cardiomegaly)
Metabolic Disorders (Diabetes Mellitus)
```
233
Achondroplastic Dwarfism is what kind of disorder?
Genetic
234
Achondroplastic Dwarfism signs
```
Normal trunk size
Short arms & legs
Short Stature
Large head with frontal bossing
Midface hypoplasia
Thoracic Kyphosis
Lumbar Lordosis
Abdominal Protrusion
```
235
Anorexia Nervosa is what kind of disorder?
Mental
236
Cushing Syndrome is an excessive production of which hormone?
Adrenocorticotropin (ACTH)
237
ACTH stimulate the adrenal cortex to produce ____
Cortisol
238
Cushing Syndrome signs
```
Weight gain
Edema
Obesity
Buffalo Hump
Muscle wasting
Weakness
Reduced height
Bruising
Acne
```
239
You can get Marfan's Syndrome by ____
Heredity
240
Marfan's Syndrome signs
```
Tall; thin stature
Arachnodactyly (Long thin fingers)
Hyperextenible joints
Arm span greater than height
Pectus Excavatum (Sternal deformity)
High arched narrow palate
Narrow Face
Pes Planus (Flat feet)
```
241
What can occur in a patient with Marfan's Syndrome
Cardiovascular complications
| Leading to early mortality rates
242
What is the normal oral temp range?
96.4-99.1
243
What is the temperature regulator of the body?
Hypothalamus
244
Do older adult have normal deep temperature readings?
No. Older adult's temperature are usually lower (97.2)
245
What temp is considered to be Hypothermia?
Below 96.8 degrees
246
What temp is considered to be Hyperthermia?
Greater than 100.4
247
Normal heart rates are higher in infants OR adults?
Infants- resting heart rate range is 100-180 (adults resting heart rate range is 55-90)
248
Bradycardia is common in patients experiencing ___
Heart Disease
249
What is a common symptom of fever, sepsis, pneumonia, myocardial infarction, and pancreatitis?
Tachycardia
250
What does weak thready pulse reflect?
Decrease Stroke volume
251
A patient with a 0 pulse force recording has what kind of pulse?
None
252
A patient with a 1+ pulse force has what kind of pulse?
Weak and thready
253
A patient with a 3+ pulse force has what kind of pulse?
Full and bounding
254
Normal Respiratory rate for 0-1 year old
24-38
255
Normal Respiratory rate for 1-3 year old
22-30
256
Normal Respiratory rate for 4-6 year old
20-24
257
Normal Respiratory rate for 7-9 year old
18-24
258
Normal Respiratory rate for 10-14 year old
16-22
259
Normal Respiratory rate for 15-18
14-20
260
Normal Respiratory rate for adult
10-20
261
What mean arterial pressure (MAP) is needed to maintain adequate tissue and organ profusion?
Greater than 60 mmHg
262
The level of BP is determine by which 5 factors?
```
Cardiac Output
Vascular Resistance
Volume
Viscosity
Elesticity of Arteriole Walls
```
263
What does the BP do if cardiac out increases?
BP increases
264
What does BP do if blood viscosity increases?
BP increases
265
What is the auscultatory gap?
a period when Korotkoff sounds disappear during auscultation
266
What is the interval between Orthostatic Vital Signs positions?
3 minutes
267
In a patient with coarctation of the aorta where do you take BP?
Thigh
268
Why do you take BP in the thigh of a patient with coarctation of the aorta?
The blood supply to the thigh is not effected by the constriction. The arm is therefore the BP will be falsely high
269
Nociceptors
Detect painful sensations from the periphery and transmit them to the CNS
270
What two primary sensory fibers are part of Nociceptors
AS & C fibers
271
AS fibers
Myelinated; large in diameter; transmit more rapid
272
C fibers
Unmyelinated; smaller; transmit more slowly
| Associated with sensations of diffused, aching and long lasting
273
Nociceptive 4 Phases
1. ) Transduction
2. ) Transmission
3. ) Perception
4. ) Modulation
274
What happened on a molecular lever during transduction?
Injured tissues release a variety of chemicals, including substance P, histamine, prostaglandins, serotonin, and bradykinin
275
Where does the pain impulse move from and to during Transmission?
From the spinal cord to the brain (Thalamus to higher cortical areas)
276
What is perception?
Signifies the conscious awareness of a painful sensation
277
What part of the brain usually interprets is perception of pain?
Limbic System
278
What does modulation do?
Inhibit pain signals (stop/slow down)
279
Neurotransmitters that produce an analgesic effect:
Serotonin, Norepinephrine, Neurotensin, GABA, Endorphines, Enkephalins, Dynorphins
280
Examples of Nociceptive pain:
Skinned knee, menstrual cramps, kidney stones, venipuncture, joint pain
281
True/False Nociceptive pain can turn into Neuropathic pain over time.
True. B/c constant irritation and inflammation can alter nerve cells
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Neuropathic pain
Abnormal processing of pain message
283
Conditions that cause Neuropathic pain:
Diabetes mellitus
Herpes Zoster
HIV/AIDS
Chemotherapy
284
What device can you use to identify pain?
fMRI - Functional MRI
285
Visceral Pain
Originates from larger internal organs
286
What is visceral pain described as?
Dull, deep, squeezing, cramping
287
Somatic Pain
Originated from musculoskeletal tissues or body surface
288
Deep Somatic Pain
Comes from sources such as the blood vessels, joints, tendons, muscles, and bone
289
Cutaneous Pain
Derived from skin surface and subcutaneous tissues
290
What is deep somatic pain described as?
Aching or Throbbing
291
What is cutaneous pain described as?
Superficial, sharp, or burning
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What is somatic pain described as?
Sharp or dull
293
What symptoms can accompany somatic pain?
Nausea, sweating, vomiting, tachycardia, hypertension (Like Visceral Pain)
294
Acute Pain
Short-term
| Dissipates after injury heals
295
Chronic Pain
When pain continues for 6 months or longer
296
What chronic nonmalignant pain associated with?
Musculoskeletal conditions (Arthritis, Low back pain, Fibromyalgia)
297
Breakthrough Pain
A transient spike in pain level in an otherwise controlled pain syndrome. (End-of-dose medication failure)
298
Referred Pain
Pain felt at a particular sire but originates from another location
299
When should pain rating scales be introduced?
4 or 5 years old
300
What are some acute pain behaviors?
Guarding, Grimacing, vocalization (moaning), agitation, restlessness, stillness, diaphoresis, change in vital signs
301
What are some chronic pain behaviors?
Bracing, rubbing, diminished activity, and change in appetite
302
What does the CRIES pain tool measure?
Physiologic and behavior indicators of neonates on a 3 point scale
303
What is FLACC?
A nonverbal assessment tool for infants and young children under 3 years old
304
What 5 things does FLACC assess?
Facial expression, Leg movement, Activity level, Cry, and Consolability
305
Hoe do people with dementia communicate pain?
Agitation, pacing, repetitive yelling
