General Survey & Vital Signs Flashcards
(116 cards)
1
Q
State of Health
A
Is the patient acutely or chronically ill?
2
Q
Alert
A
Lucid and responds to commands
3
Q
Confused
A
Awake but may not respond correctly to stimuli
4
Q
Lethargic
A
drowsy, opens eyes, and follows commands to loud voice
5
Q
Obtundation
A
will awaken to touch but slow to respond, somewhat confused
6
Q
Stupor
A
only arouses to pain
7
Q
Comatose
A
unresponsive
8
Q
Delirious
A
confused, agitated, may be hallucinating
9
Q
Cardiac/Pulmonary Signs of Distress
A
clutching chest, pallor, diaphoresis, labored breathing, wheezing, coughing
10
Q
Pain Signs of Distress
A
wincing, sweating, facial grimace, posture preference
11
Q
Anxiety/Depression signs of distress
A
fidgety movements, cold/moist palms, poor eye contact, flat affect
12
Q
Unkempt appearance may suggest…
A
depression or dementia
13
Q
breath odors can indicate…
A
alcohol use, uremia, liver failure, fruity breath of metabolic acidosis (DKA), ammonia (renal disease or urinary incontinence)
14
Q
Holes in shoes may suggest…
A
gout, bunions, other painful foot conditions, or lower extremity edema
15
Q
Is the patient articulate? If not, think…
A
expressive aphasia, TIA, receptive aphasia, aphonia
16
Q
Proptosis
A
Stare of Hyperthyroidism
17
Q
Myxedema is indicative of…
A
Severe Hypothyroidism
18
Q
Myxedema is…
A
Edema around the eyes does not pit with pressure, dry skin, thinning hair
19
Q
Immobile face is indicative of…
A
Parkinsonism
20
Q
Flat or sad affect is indicative of…
A
Depression
21
Q
A moon face with red cheeks and excessive facial hair growth is indicative of…
A
Cushing’s Syndrome
22
Q
Acromegaly is…
A
increased growth hormone production leads to prominent jaw and brow, enlarged nose, lips, ears
23
Q
Tripod posture indicates…
A
COPD
24
Q
Parkinsonian Gait
A
Shuffle Step
25
Spastic hemiparesis
Pt. with stroke or brain tumor may drag foot
26
Antalgic gait
Painful or limping gait
27
Obvious tremors can secondary to
Liver failure, alcoholism, Parkinson’s
28
Athetosis
Writhing snakelike movements of cerebral palsy
29
Kleinfelter’s
Lacking secondary sexual characteristics in a male
30
Reasons for an abnormally short patient
Turner’s syndrome, achondroplastic and hypopituitary dwarfism
31
Reasons for an abnormally tall patient
Marfan’s syndrome
32
Height loss can be due to...
osteoporosis and vertebral compression fxs
33
Generalized fat
Simple obesity
34
Truncal fat
Cushing's Syndrome
35
Sthenic
Muscular
36
Asthenic
Thin
37
Hypersthenic
Stocky, high fat distribution
38
Cachexia
Wasting
39
BMI
underweight
40
BMI 18.5-24.9
normal
41
BMI 25-29.9
overweight
42
BMI 30-34.9
Obese I
43
BMI 35-39.9
Obese II
44
BMI > 40
Obese III (morbid)
45
Calculation for BMI
Weight (kg)/Height (m2) or (Weight (lbs) x 700)/Height (in)2
46
Width of the BP cuff bladder should be
approx 40% of the upper arm circumference
47
Length of BP cuff bladder should be
approx 80% of upper arm circumference
48
If the BP cuff is too SMALL
will artificially RAISE BP
49
If the BP cuff is too LARGE
will artificially LOWER BP in a small arm and will artificially RAISE BP in a large arm
50
Normal BP
90-120 (systolic) / 60-80 (diastolic) with pulse pressure between 30-40 mmHg
51
Prehypertension
120-139 (systolic) / 80-89 (diastolic)
52
Stage 1 Hypertension
140-159 (systolic) / 90-99 (diastolic)
53
Stage 2 Hypertension
>160 (systolic) / >90 (diastolic)
54
Body temperature is controlled by
Hypothalamus
55
What part of stethoscope should be used for auscultating BP?
Bell
56
An auscultatory gap may be indicative of...
arterial stiffness and atherosclerotic disease
57
Orthostatic Hypotension
Drop in BP 20 mmHg
58
Causes of Orthostatic Hypertension
drugs, moderate or severe blood loss, prolonged bed rest, diseases of ANS
59
Oral Temp Norm
37.0 C / 98.6 F
60
Aural/Rectal/Temporal Temp Norm
37.5 C / 99.6 F
61
Axillary Temp Norm
36.4 C / 97.6 F
62
Convert Celsius to Fahrenheit
(C x 1.8) + 32
63
Convert Fahrenheit to Celsius
(F - 32) x .55
64
Normal Heart Rate
50-90 BPM
65
Respiratory rate controlled by
Medulla Oblongata
66
3 Characteristics of Respiration
Rate, Rhythm, Quality
67
Bradypnea
Slow breathing may be secondary to
| diabetic coma, drug-induced respiratory depression, and increased intracranial pressure.
68
Normal Respiratory Rate
The respiratory rate is about 14–20 per min in normal adults and up to 44 per min in infants.
69
Sighing Respiration
Breathing punctuated by frequent sighs should alert you to the possibility of hyperventilation syndrome—a common cause of dyspnea and dizziness. Occasional sighs are normal.
70
Tachypnea
Rapid shallow breathing has a number of
| causes, including restrictive lung disease, pleuritic chest pain, and an elevated diaphragm.
71
Cheyne-Stokes Breathing
Periods of deep breathing alternate with periods of apnea (no breathing). Children and aging people normally may show this pattern in sleep. Other causes include heart failure, uremia, drug-induced respiratory depression, and brain damage (typically on both sides of the cerebral hemispheres or diencephalon)
72
Obstructive Breathing
In obstructive lung disease, expiration is prolonged because narrowed airways increase the resistance to air flow. Causes include asthma, chronic bronchitis, and COPD.
73
Hyperpnea, Hyperventilation
Rapid deep breathing has several causes, including exercise, anxiety, and metabolic acidosis. In the comatose patient, consider infarction, hypoxia, or hypoglycemia affecting the midbrain or pons.
74
Kussmaul breathing
deep breathing due to metabolic acidosis. It may be fast,
| normal in rate, or slow.
75
Ataxic Breathing (Biot’s Breathing)
characterized by unpredictable irregularity. Breaths may be shallow or deep, and stop for short periods. Causes include respiratory depression and brain damage, typically at the medullary level.
76
Hyperpyrexia
extreme elevation in temperature, above 41.1°C (106°F)
77
hypothermia
Abnormally low temperature, below 35°C (95°F) rectally
78
Fever or Pyrexia
37.4 C, 100F
79
Causes of fever
1. Microbial infection
2. Inflammatory disorders
3. Cancer/malignancy
4. Autoimmune response
5. Drug reactions
6. Fever of unknown origin
7. Trauma/surgery
8. Blood disorders (hemolytic anemia)
80
Heat stroke
Core temp > or = 105F/41C with altered mental status and hot/dry skin (anhydrosis)
81
Difference of BP in both arms should be no more than...
10mmHg
82
If BP is more than 10mmHg different between arms what can be the cause?
Aortic dissection or subclavian steal syndrome
83
Laying down should cause BP to...
Decrease
84
Lower extremities should have ________ BP than upper.
Equal or Higher
85
If lower extremities have lower BP than upper extremities expect...
PAD or Aortic Dissection
86
How should an orthostatic BP be taken?
After resting 3 min measure supine, then within 3 min of standing
87
Hypertension accounts for what percent of MIs and strokes?
35%
88
Hypertension accounts for what percent of heart failures?
49%
89
Hypertension accounts for what percent of premature deaths?
24%
90
Dyspnea
difficulty breathing, use of accessory muscles
91
Apnea
lack of breathing
92
Stridor
“crouping sound” – suggests problem is not with in lungs but with in Upper Airways (May indicate inspiration of Foreign Body in infant)
93
Orthopnea
can breathe OK sitting UPRIGHT, but can’t breathe lying down (supine)
94
Orthopnea is indicative of...
Cardio/Pulmonary disease (i.e. CHF, pulmonary edema)
95
Paroxysmal Nocturnal Dyspnea (PND)
SOB and coughing at night
96
Paroxysmal Nocturnal Dyspnea (PND) is indicative of...
CHF (fluid from extremities begins to pool in lungs when lying)
97
Ataxic Breathing
irregular but without a pattern
98
Ataxic Breathing is indicative of...
Disorder/trauma affecting medulla
99
Prolonged expiration
seen with COPD (takes longer to get air out than to get air in)
100
Tachycardia
>100
101
sinus tachycardia
100-180
102
supraventricular (atrial or nodal) tachycardia
150-250
103
Sporadic (Arrhythmia)
premature or extra beats at random intervals but normal underlying rhythm
104
Regularly Irregular (Arrhythmia)
regular pattern of cadences (i.e. ventricular trigeminy)
105
Irregularly Irregular (Arrhythmia)
No discernible regularity (i.e. a-fib, a-flutter)
106
Pulsus Alterans
strong pulse alternating with weak pulse pulse, regular rhythm.
Cause: Heart failure
107
Bisferiens Pulse
increased arterial pulse w/ double systolic peak
Cause: aortic stenosis, aortic regurgitation
108
Bigeminal Pulse
Irregular rhythm may mimic pulsus alterans.
| Cause: normal beat alternating w/ premature contraction
109
Paradoxial Pulse
rapid fall in systolic BP when pt inspires
Causes: Pericardial Tamponade, pulmonary hypertension, asthma & COPD
110
Large, Bounding Pulses
pulse pressure is increased/feels strong and bounding. Rise & Fall may feel rapid.
Causes: increased stroke volume, hyperthyroidism, aortic regurgitation, patent ductus arteriosis; seen more commonly with elderly patients.
111
Small, Weak pulses
pulse pressure is diminished, feels weak and small.
Causes: decreased stroke volume as in heart failure, PAD, shock, hypovolemia, aortic stenosis
112
Nociceptive (somatic) (Pain)
linked to tissue damage to skin
113
Neuropathic (Pain)
consequence of a lesion or dx affecting the somatosensory system
114
Central Sensitization (Pain)
alteration of CNS processing of sensation leading to amplification of pain signals (i.e. fibromyalgia).
115
Bradycardia
HR
116
BP should be maintained at.... for patients with diabetes or renal failure
