FINAL SCENARIOS Flashcards
(36 cards)
WHAT IS PQRSTU? WHAT DOES IT STAND FOR?
P - PROVACTIVE (what brings it on? what makes it better?)
Q - QUALITY/QUANTITY (how does it feel? intensity?)
R - REGION/RADIATION (where is it? does it spread?)
S - SEVERITY SCALE (1-10)
T - TIMING (onset? duration? frequency?)
U - UNDERSTAND PATIENT’S PERCEPTION OF PROBLEM
MUSCULOSKELETAL ASSESSMENT - SUBJECTIVE ASSESSMENT
8 questions
HEALTH HISTORY: 1. Back pain? PQRSTU. 2. Stiffness? Swelling? Heat? Redness? 3. Limitations in movement? 4. Deformities of bone or joint? 5. Accidents or trauma to bones? 6. Problems with ADL? 7. Medications? 8 Family history of OA or RA?
MUSCULOSKELETAL (SPINE EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT
ORDER OF ASSESSMENTS (3)
- INSPECTION
- PALPATION
- ROM OF SPINE
MUSCULOSKELETAL (SPINE EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT
INSPECTION (5)
- STRAIGHT SPINOUS PROCESS
- EQUAL HORIZONTAL POSITIONS OF SHOULDERS, SCAPULAE, ILIAC CRESTS, GLUTEAL FOLDS.
- EQUAL SPACES OF ARMS AND LATERAL THORAX
- KNEES AND FEET ALIGN WITH TRUNK, POINT FORWARD
- FROM SIDE, NOTE CURVATURE OF SPINE: CERVICAL (CONCAVE) THORACIC (CONVEX) AND LUMBAR (CONCAVE)
MUSCULOSKELETAL (SPINE EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT
PALPATION (3)
- SPINOUS PROCESSES
- PARAVERTEBRAL MUSCLES
- HIP ROM (TO CHECK FOR CREPITUS)
MUSCULOSKELETAL (SPINE EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT
ROM OF SPINE, ACTIVE (5)
- FLEXION
- EXTENSION
- LATERAL BENDING (RIGHT & LEFT)
- ROTATION (RIGHT & LEFT)
- STRAIGHT LEG RAISING (LASEGUE’S TEST - PAIN = POSITIVE)
MUSCULOSKELETAL (SHOULDER EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT
ORDER OF ASSESSMENTS (4)
- INSPECTION
- PALPATION
- ROM OF SHOULDER (ACTIVE OR PASSIVE)
- MUSCLE TESTING OF SHOULDER
MUSCULOSKELETAL (SHOULDER EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT
INSPECTION (5)
- SIZE
- CONTOUR
- COLOR
- SWELLING
- MASS OR DEFORMITY
MUSCULOSKELETAL (SHOULDER EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT
PALPATION (4)
- TEMPERATURE
- PAIN
- SWELLING OR MASS
- CREPITUS
MUSCULOSKELETAL (SHOULDER EXAM) ASSESSMENT - OBJECTIVE ASSESSMENT
ROM OF SHOULDER (5)
- FLEX, EXTEND & HYPER EXTEND ARMS
- TOUCH HANDS TO SCAPULAE BEHIND BACK
- ABDUCT ARMS ABOVE HEAD PALMS TOGETHER
- BRING ONE ARM DOWN AT A TIME AND SWING ACROSS ABDOMEN
- CLASP BOTH HANDS TOGETHER BEHIND HEAD
MUSCULOSKELETAL ASSESSMENT - OBJECTIVE ASSESSMENT
MUSCLE TESTING OF SHOULDER (3)
- SHRUG THE SHOULDER
- FLEX THEM FORWARD AND UP
- ABDUCT THEM AGAINST RESISTANCE
ABDOMINAL ASSESSMENT - SUBJECTIVE ASSESSMENT
9
- APPETITE (CHANGE OR LOSS OF)
- SWALLOWING (DIFFICULTY)
- FOODS YOU CANNOT TOLERATE
- ABDOMINAL PAIN - PQRSTU
- BM (FREQUENCY OF)
- NAUSEA OR VOMITING
- HISTORY OF GI DISEASE
- MEDICATIONS
- ALL FOOD IN LAST 24 HOURS.
ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT
ORDER OF ASSESSMENTS (4)
- INSPECTION
- AUSCULTATION
- PERCUSSION
- PALPATION
ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT
INSPECTION (8)
- CONTOUR OF ABDOMEN
- GENERAL SYMMETRY
- SKIN COLOUR & CONDITION
- PULSATION & MOVEMENT
- UMBILICUS
- HAIR DISTRIBUTION
- STATE OF HYDRATION & NUTRITION
- FACIAL EXPRESSION & POSITION
ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT
AUSCULTATION (2)
- BOWEL SOUNDS
- NOTE ANY VASCULAR SOUNDS
(AORTIC, RENAL, ILLIAC, INGUINAL/FEMORAL)
ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT
PERCUSSION (3 AREAS, 1 ADDITIONAL)
- PERCUSS ALL 4 Qs
- PERCUSS BORDERS OF LIVER SPAN
- PERCUSS SPLEEN
- IF SUSPECT ASCITES, TEST FLUID WAVE AND SHIFTING DULLNESS
ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT
4 THINGS TO LOOK FOR WITH LIGHT PALPATION:
- MUSCLE WALL
- TENDERNESS
- ENLARGED ORGANS
- MASSES
ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT
7 THINGS TO LOOK FOR WITH DEEP PALPATION:
- MASSES
- CONTOUR OF LIVER
- SPLEEN
- KIDNEYS (DUCK BILL)
- AORTA
- REBOUND TENDERNESS
- CVA TENDERNESS
ABDOMINAL ASSESSMENT - OBJECTIVE ASSESSMENT
ADDITIONAL TESTS IF INDICATED
- INSPIRATORY ARREST (MURPHY’S SIGN)
- ILIOSOAS MUSCLE TEST (STRAIGHT LEG)
- OBTURATOR TEST (LEG BENT AT 90 DEGREES)
NEGATIVE = NO PAIN POSITIVE = PAIN
PERIPHERAL VASCULAR SYSTEM ASSESSMENT - SUBJECTIVE ASSESSMENT
(9 questions)
- Pain? PQRSTU
- Skin changes?
- Skin lesions or sores?
- Swelling?
- Swollen glands?
- Facial skin ever turn blue or ashen?
- Medication?
- Past history of hear/PV disease?
- Family history of heart, PV, disease?
PERIPHERAL VASCULAR SYSTEM ASSESSMENT - OBJECTIVE ASSESSMENT
ORDER OF ASSESSMENTS (4)
- INSPECTION
- PALPATE
- AUSCULTATE
- ADDITIONAL TESTS
PERIPHERAL VASCULAR SYSTEM ASSESSMENT - OBJECTIVE ASSESSMENT
INSPECTION (5)
- COLOUR
- HAIR DISTRIBUTION
- VENOUS PATTERN/VISCOSITIES
- SWELLING OR EDEMA OR ATROPHY - MEASURE CIRCUMFERENCE (R&L)
- SKIN LESIONS OR ULCERS
PERIPHERAL VASCULAR SYSTEM ASSESSMENT - OBJECTIVE ASSESSMENT
PALPATION (5)
- TEMP
- TENDERNESS
- LYMPH NODES
- LOCATE AND GRADE PULSES
- CHECK EDEMA (GRADE PITTING)
PERIPHERAL VASCULAR SYSTEM ASSESSMENT - OBJECTIVE ASSESSMENT
AUSCULTATION (1)
- BRUITS