General Survey, Measurement, Vital Signs (Chapter 9 and 10) Flashcards

1
Q

what is a general survey

A

looking/inspecting at the general state of health and obvious physical characteristics of a person

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2
Q

dysarthria

A

difficulty speaking caused by brain damage, which results in an inability to control the muscles used in speech

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3
Q

dysphonia

A

difficulty in speaking due to a physical disorder of the mouth, tongue, throat, or vocal cords

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4
Q

aphasia

A

loss of ability to understand or express speech, caused by brain damage.

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5
Q

global aphasia

A

most severe form of aphasia
all languages modulates are affected
brain damage to multiple language centers

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6
Q

expressive aphasia

A

broca
may eliminate ‘and’ & ‘but’ & speak in short meaningful sentences

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7
Q

receptive aphasia

A

wernickes
able to speak well and use long sentences but what they say do not make sense

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8
Q

what are general survey 4 components

A

physical appearance
body structure
mobility
behavior

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9
Q

what make up physical apperence

A

age
sex
level of consciousness
skin color
facial features

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10
Q

what makes up body structure

A

stature
nutrition
symmetry
posture
position
body build, contour

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11
Q

what make up mobility

A

gait
range of motion

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12
Q

what make up behavior

A

facial expression
mood and affect
speech
dress
personal hygiene

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13
Q

what category does posture belong to

physical appearance
body structure
mobility
behavior

A

body structure

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14
Q

what category does level of consciousness belong to

physical appearance
body structure
mobility
behavior

A

physical appearance

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15
Q

what category does speech belong to

physical appearance
body structure
mobility
behavior

A

behavior

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16
Q

what category does personal hygiene belong to

physical appearance
body structure
mobility
behavior

A

behavior

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17
Q

what category does gait belong to

physical appearance
body structure
mobility
behavior

A

mobility

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18
Q

what category does nutrition belong to

physical appearance
body structure
mobility
behavior

A

body structure

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19
Q

what category does facial expression belong to

physical appearance
body structure
mobility
behavior

A

behavior

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20
Q

what is the normal temp range for adults

A

35.8-37.3 (96.4-99.1)

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21
Q

what routes are appropriate for assessing temp

A

oral, rectal, tympanic, axillary, temporal

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22
Q

is axillary one temp below or above oral

A

below

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23
Q

is rectal one temp higher or lower than oral

A

higher

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24
Q

what is normal stroke volume

A

70 ml

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25
Q

how long should apical pulse be taken

A

1 min

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26
Q

peripheral pulses should be taken for how long if normal

A

30 sec

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27
Q

peripheral pulses should be taken for how long if abnormal

A

1 min

28
Q

when would you listen to apical pulse

A

when peripheral pulses are irregular or abnormal

29
Q

if the site of pulse is not documented it is assumed it is taken where

A

radial artery

30
Q

if the site of temp is not documented it is assumed it is taken where

A

oral

31
Q

the force of pulse is graded on scale from _ to _

A

0-3

32
Q

what number is considered normal for a pulse

A

+2

33
Q

a pulse is weak and thready what number is it

A

+1

34
Q

a pulse is absent what number is it

A

0

35
Q

a pulse is bounding what number is it

A

+3

36
Q

what is contained when reporting a pulse

A

BMP, scale, regular/irregular

37
Q

normal adult pulse rate

A

60-100 bmp

38
Q

what is considered bradycardia

A

<50 bmp

39
Q

what is considered tachycardia

A

> 95-100 bmp

40
Q

would a long distance runner have a high or low heart rate

A

low

41
Q

1 breath consists of
- 1 insipiration
- 1 exhalation
- 1 inspiration and 1 exhalation

A

1 inspiration and 1 exhalation

42
Q

how long do you count respiratory rate if normal

A

30 seconds

43
Q

how long do you count respiratory rate if abnormal

A

1 min

44
Q

do you or do you not let the patient know you are counting respirations

A

do not

45
Q

what is the normal adult respiratory rate

A

10-20/min

46
Q

pulse ox is used to measure what

A

saturation of oxygen

47
Q

what is the normal range for pulse ox

A

97-99%

48
Q

what situations could be affecting oxygen saturation

A

anemia, lung disease, heart disease

49
Q

systolic

A

blood pushing against the vessel wall
maximum pressure felt on artery during left ventricular contraction

50
Q

diastolic

A

resting blood pressure is pressure against the vessel wall between contractions
when heart is resting

51
Q

what phase lasts longer
diastolic or systolic

A

diastole

52
Q

how do you find pulse pressure

A

difference between systolic and diastolic blood pressure

53
Q

adult normal BP

A

<120/80

54
Q

hypertension BP

A

120-129/<80

55
Q

what is orthostatic hypotension

A

drop in blood pressure when standing up

56
Q

what numbers classify orthostatic hypotension

A

systolic drop in >20
diastolic drop in >10

57
Q

if the blood pressure drops in orthostatic pressure what will happen to the pulse/heart rate

A

increase in pulse >20bmp when changing to standing position

58
Q

what is the correct order to take blood pressure with a patient you suspect has orthostatic hypotension

A

lying
sitting
standing

59
Q

what are common causes of orthostatic changes BP

A

fluid loss
aging and related vascular changes
bedrest
changes blood pressure medication

60
Q

is orthostatic hypotension temporary or permanent

A

can be either

61
Q

why would we take blood pressure in leg

A

bilateral mastectomy
lymphdema
fistula
blood clot
amputation

62
Q

what is considered an abnormal difference in limbs for blood pressure

A

30-40

63
Q

what are common errors with blood pressure assessment

A

arm placement
patient holds arm up
legs are crossed
examiner eyes not level with manometer or meniscus
incorrect cuff size
failure to palpate for level of inflation
deflate too fast or too slow
stopping during descent and then reinflating
failure to wait 1-2 mins between reading

64
Q

what is the first korotkoff sound

A

systolic number
first clear audible tapping sound

65
Q

korotkoff V sound

A

diastolic number
silence
last audible is heard before silence