Exam 1 Flashcards

Question

Waddell's signs OVERREACTION

Answer 1

Disproportionate verbalization, facial expression, muscle tension, and tremor, collapsing, or sweating. Client may exhibit any of the following behaviors during the physical examination: guarding, bracing, rubbing, sighing, clenching teeth, or grimacing.

Answer 2

Weakness- cogwheeling or giving way of many muscle groups that cannot be explained on a neurologic basis. Sensory disturbance- diminished sensation fitting a "stocking" rather than a dermatomal pattern.

Answer 3

cutaneous somatic visceral neuropathic referred

Answer 4

C: Have you ever thought you should cut down on your drinking? A: Have you ever been annoyed by criticism of your drinking? G: Have you ever felt guilty about your drinking? E: Do you ever have an eye-opener (a drink or two) in the morning?

Answer 5

Insight/ awareness Metacognition Consider alternatives Simulation Decrease reliance on memory Cognitive forcing strategies Minimize time pressures Accountability Feedback

Answer 6

most people would not have gotten it correct tough situation

Answer 7

technical failures (poor reading or visualization or glitch in technology) organizational failures (PT overbooked, overstressed)

Answer 8

what we can address and refine

Answer 9

predisposition to thinking population is special compared to others for that general presentation

Answer 10

make a decision too early without thinking through the rest of the results

Answer 11

commission-- force something in (if I don't do anything, the patient will get worse) omission-- stay away (I better not do anything or I will make the patient worse)

Answer 12

if you develop a hypothesis during a differential, you will pay attention to everything that supports the dx and ignore the rest seeks to confirm suspicion

Answer 13

predisposed to a certain condition because you know there is a better prognosis // tendency to think pt will have a better outcome (tight pec minor as opposed to cervical rib for thoracic outlet syndrome)

Answer 14

extraordinary belief in yourself

Answer 15

do not finish eliminating or just confirm one thing common in new clinicians

Answer 16

as soon as you find something consistent with one dx, you zone into that and not consider other possibilities

Answer 17

emotionally attached to a procedure or dx that you do not use contrary procedures

Answer 18

ignores how common or uncommon something is

Answer 19

leaning towards the more common things because they are more likely

Answer 20

putting too many links in a chain trying to assign a cause and effect relationship where there might not be one

Answer 21

stereotyping populations or demographics (older people and OA)

Answer 22

not considering clinical patterns and jumping to something at the top of your mind

Answer 23

script is almost there, may be too broad// overrepresentation

Answer 24

hypertension, high cholesterol, smoking

Answer 25

Presence of irregular heartbeat Common descriptors: bump, pound, jump, flop, flutter, racing sensation of the heart Palpations lasting for hours with pain, shortness of breath, fainting or severe lightheadedness require medical evaluation Medical referral if observed with a family Hx of unexplained sudden death

Answer 26

Breathlessness or SOB Could also be secondary to pulmonary pathology, fever, certain meds, allergies, poor physical conditioning, obesity Severity corresponds with severity of disease progression Medical referral if patient: Cannot climb a single flight of stairs without feeling moderately to severely winded Reports waking at night or observes SOB when lying down (either obesity or more serious concern)

Answer 27

fainting due to reduced O2 delivery to brain Observed with arrhythmias, orthostatic hypotension, poor ventricular function, coronary artery disease, vertebral artery insufficiency Syncope without warning of lightheadedness, dizziness, or nausea requires referral

Answer 28

If provoked by minimal exertion, may have a cardiac origin Associated SxS common: dyspnea, chest pain, palpitations, headache Monitor closely if fatigue exceeds normal expectations during or after exercise

Answer 29

Possible cause: Left ventricular dysfunction from mitral valve dysfunction when aggravated by exercise, metabolic stress, supine position, or paroxysmal nocturnal dyspnea Hacking cough with significant frothy, bloody sputum

Answer 30

Bluish discoloration of lips and nailbeds due to inadequate blood-oxygen levels

Answer 31

>/= 3 lb. weight gain or gradual, continuous gain over several days with swelling in ankles, abdomen and hands is a red flag for HF Even more so with presence of SOB, fatigue and dizziness Possible associated SxS: jugular vein distension & cyanosis

Answer 32

leg pain that occurs with PVD Pitting edema & leg pain commonly accompany with vascular disease Immediate MD consult if abrupt onset of ischemic rest pain or sudden worsening of intermittent claudication requires immediate referral

Answer 33

Unexplained fever, nausea, vomiting

Answer 34

Dark urine Asterixis (liver flap) Bilateral carpal tunnel syndrome Palmar erythema (liver palms) Spider angioma Changes in nail beds, skin color Ascites

Answer 35

Angina MI Pericarditis Dissecting aortic aneurysm

Answer 36

hardening of arteries

Answer 37

when a clot forms on plaque that is built up on artery walls

Answer 38

sudden constriction of coronary artery

Answer 39

artery narrows by 75%

Answer 40

acute pain in the chest imbalance between cardiac workload and O2 supply to heart muscle tissue

Answer 41

Occurs at a predictable level of physical or emotional stress Responds quickly to rest or nitroglycerin No pain at rest & location/ duration/ intensity/ frequency of chest pain consistent over time

Answer 42

Abrupt change in the intensity & frequency of symptoms or decreased threshold of stimulus Most common trigger: bursting of a cholesterol-filled plaque in lining of coronary artery Clot forms & partially blocks blood flow Duration > the usual 1 to 5 minutes (may last for up to 20-30 minutes) Pain or discomfort unrelieved by rest or nitroglycerin = risk for MI Immediate MD assessment necessary

Answer 43

Chest pain that occurs at rest in the supine position

Answer 44

Can wake a person from sleep with the same sensation experienced during exertion

Answer 45

Abnormal SxS with physical or emotional exertion (toothache or earache) Subsides with rest or nitroglycerin

Answer 46

Gripping, vise-like feeling of pain or pressure behind the sternum Pain that may radiate to the neck, jaw, back, shoulder, or arms (most often the left arm in men) Toothache Burning indigestion Dyspnea; exercise intolerance Nausea Belching

Answer 47

Frequent use of antacids to relieve symptoms Heartburn wakes the client up at night Acidic or bitter taste in the mouth Burning sensation in the chest Discomfort after eating spicy foods Abdominal bloating and gas Dysphagia

Answer 48

Sudden loss of responsiveness (no response to gentle shaking) No normal breathing (patient doesn’t take a normal breath when observed for several seconds) No signs of circulation No movement or coughing

Answer 49

Prolonged or severe substernal chest pain or squeezing pressure Pain radiating down one or both arms and/or up to the throat, neck, back, jaw, shoulders, or arms Nausea or indigestion Angina >/= 30 min Angina unrelieved by rest, nitroglycerin, or antacids Pain of infarct unrelieved by rest or position change Nausea Sudden dimness or loss of vision or speech Pallor Diaphoresis SOB Weakness, numbness, and feelings of faintness

Answer 50

inflammation of the pericardium if fluid accumulates in the pericardial sac, it may prevent the heart from expanding

Answer 51

Substernal pain Dysphagia Pain relieved by: Leaning forward or sitting upright Holding the breath Pain aggravated by: Movement associated with deep breathing Trunk movements Lying down Fever, chills, weakness Cough Lower extremity edema

Answer 52

Increased fatigue Dependent edema (usually beginning in the ankles) Pitting edema Edema in the sacral area or the back of the thighs Right upper quadrant pain Cyanosis of nail beds

Answer 53

Fatigue and dyspnea after mild physical exertion or exercise Persistent spasmodic cough, especially when lying down, when fluid moves from the extremities to the lungs Paroxysmal nocturnal dyspnea Orthopnea Tachycardia Fatigue and muscle weakness Edema and weight gain Irritability/restlessness Decreased renal function or frequent urination at night

Answer 54

Fatigue and dyspnea after mild physical exertion or exercise Orthopnea Edema and weight gain Jugular vein distention

Answer 55

Hx smoking Known congenital heart disease Sx to repair/ replace aortic valve before age of 70 years Recent infection Atherosclerosis Predisposing genetic conditions Active older adults

Answer 56

Sudden, severe chest pain with a tearing sensation Pain may extend to the neck, shoulders, between the scapulae, low back, or abdomen Pain is not relieved by a change in position Pain may be described as “tearing” or “ripping” Pulsating abdominal mass Other signs: cold, pulseless lower extremities, BP changes (more than 10 mm Hg difference in diastolic BP between arms; systolic BP less than 100 mm Hg) Pulse rate more than 100 bpm Ecchymoses in the flank and perianal area Light-headedness and nausea

Exam 1 Flashcards

(81 cards)