Final Flashcards
How to set up for a PE?
1) Hand hygiene and PPE (2) Consent before and during (3) Setting comfortable including language (4) Clothing, drape (5) Check equipment
Lateral? Medial? Distal? Proximal?
Lateral away from midline, Medial toward the midline, Distal down toward bottom, Proximal up toward top.
What is systolic and diastolic and normal range for pregnant person
Systolic (TOP) - pressure in the arteries when the hear beats and pushes blood out into the body normal 90-140
Diastolic (BOTTOM) the pressure in teh artiers when the hear rests between beats normal 60-90
Hypertenstion can result from stress, smoking, salt intake.
Worry over 140/90
What are some practical steps around trauma informed care?
- Realizes the widespread impact of trauma and
understands potential paths for recovery; - Recognizes the signs and symptoms of trauma
in clients, families, staff, and others; - Responds by fully integrating knowledge
about trauma into policies, procedures, and
practices; and - Seeks to actively resist retraumatization.
6 principles:
- Safety
- Trustworthiness and transparency
- Peer support
- Collaboration and mutuality
- Empowerment, voice, and choice
- Cultural, historical, and gender issues
What causes a heart murmer and describe some. Where would you hear an S1 murmer? S2?
- valves that are slower to shut / shutting slightly asynchronously
- a septal defect
- a foramen ovale or ductus arteriosus that hasnt closed
Results in a ‘whoosing’ sound at some point of the cardiac cycle, it is not simply lub/dub
S1 murmer - when one of the AV valves mitral/tricuspid valves is off. nearer the apex of the heart at S1 zone
S2 murmer - when one of the semilunar valves (Aortic/Pulmonic) valves are off. nearer the base of the heart
What are the 5 bones of pelvis, joints,
Normal range non-pregnant? HR, BP, Temp, Oxsat?
Heart Rate 60-80 bpm
Blood Pressure 120/80
Resp. Rate 12-16
** Temperature 36.5-37.5
O2 Saturation 95-100%**
Normal range pregnant? HR, BP, Resp rate, Temp, Oxsat?
Heart Rate 60-100 bpm
Resp. Rate 12-20 **
Blood Pressure 90-140
60 – 90
** Temperature 36.5-37.5
O2 Saturation 95-100%
Normal range baby? HR, Temp, Resp, Rate,Oxsat?
Heart Rate 100-160 bpm
Resp. Rate 40-60
** Temperature 36.5-37.5
O2 Saturation 95-100%**
2-3 deep tendon reflexes? What are they testing and how they are measured? How to landmark?
Palpate before you hit!
bicep: flex patient’s arm to 45 degrees at elbow. Palpate the biceps tendon in the antecubital fossa– place thumb over the tendon and fingers under elbow, strike thumb not tendon, contraction of biceps causes visible or palpable flexion of elbow.
patellar: flex patients knee to 90 degrees, lower leg hands loosely. strike patellar tendon just bellow the patella. Contraction of the quadriceps muscle causes extension of the lower leg.
**tricep: **flex patients arm at elbow up to 90 degrees supporting the arm proximal to elbow put. Palpate triceps tendon and strike it directly with the reflex hammer… contraction of triceps muscle causes visible or palpable extension of the elbow.
between 0-5
2+ = normal/healthy reflex, depends a lot person to person.
2-3 skin lesions?
Macule: flat area of altered colour less thatn 1.5 cm in diameter (ex. freckle)
Patch: flat area of altered colour more thatn 1.5 cm in diameter (ex. port-wine birthmark)
Papule a solid raised palpable lesion less than .5 cm in diameter (ex. PUPPS, measles)
What is S1 and S2 heart sound and when and where is it heard?
The “lub” is the first heart sound, commonly termed S1, and is caused by turbulence caused by the closure of mitral and tricuspid valves at the start of systole. APEX AV valves close, semilunar valves open
S1 - S2 is ventricular systole
The second heart sound, “dub” or S2, is caused by the closure of the aortic and pulmonic valves, marking the end of systole. BASE semilunar valves close, AV valves open
Adventitious lung sounds? Listen and understand why.
**stridor **= musical wheezing heard in inspiration from possible obstructed trachea or larynx.
wheezes: high pitches and continuous upon exhale, could be from asthma, chronic bronchitus, pulmonary edema.
crackles: from fluid in lungs heard in late inspiration, could be from congestion, interstitial lung disease, bronchitis, asthma.. sounds are discontinuous and sound like crackling, popping, rice krispy.
How to document normal, ex. heart and lung?
Bilateral air entry, no adventitous lung sounds detected, clear and regular S1S2, no murmers detected.
2-3 lymph zone?
Submental: felt from underneath chin,
submandibular: underneath mandible (jaw), lateral to the trachea and more in line with the ears, axillary (in armpit)
Preauricular- roll your finger in front of the ear, against the maxilla
What are the 2 hip maneuvers and how do you do them? What are we
Both of these are assessing the function of the hip joint and possible instabilities of developmental hip dysplasias.
**Barlow ** IN AND DOWN baby’s thighs are adducted, brought together at midline, and light downward pressure is applied kind to the knee, force is directed posteriorly. IF the hip dislocates posteriorly from the acetabulum (which is palpable), it is a positive test… diagnosis is confirmed by Orotolani’s maneuver. Attempting to dislocate the femoral head.
The Ortolani OUT thigh is lifted upwards, and the hip is abducted fully 90 degrees. Hips are examined one at a time (or together, apparently), flex hips and knees at 90 degrees, thigh is gently abducted bringing femoral head from its dislocated posterior position from the barlow. poditive test is when the femoral head reduces into the acetabulum and there is a palpable and audible clunk as hip reduces.
