HA FINAL Flashcards

Question

RESPIRATORY ASSESSMENT

Answer 1

MUST ASSESS RATE, DEPTH, EFFORT, USE OF ACCESSORY MUSCLES

Answer 2

is a sensation of shortness of breath that awakens the patient, often after 1 or 2 hours of sleep, and is usually relieved in the upright position.

Answer 3

SOB WHEN LYING DOWN

Answer 4

EXCESSIVE SWEATING

Answer 5

4-6 URI PER YEAR CONSIDER NEW FOODS FOR ALLERGIES CHILDPROOF HOME TO STOP INHALATION/CONSUMPTION OF POISONS

Answer 6

DECREASED FUNCTIONAL RESERVE LONGER TO RECOVER FROM ACTIVITY DECREASED VITAL CAPACITY DECREASED SURFACE AREA DECREASED PAIN RESPONSE- RISK FACTOR

Answer 7

HIGH PITCHED POPPING SOUNDS

Answer 8

LONG, LOW PITCHED, COARSE GURGLING SOUNDS

Answer 9

HARSH GRATING SOUND

Answer 10

HIGH PITCHED WHISTLING SOUNDS

Answer 11

RAPID AND SHALLOW BREATHING

Answer 12

SLOW BREATHING

Answer 13

REGULAR BREATHING

Answer 14

CYCLIC GRADUALLY WAX AND WANE IN REGULAR PATTERN PERIODS OF APNEA

Answer 15

INCREASED RATE AND DEPTH

Answer 16

IRREGULAR SHALLOW PATTERN

Answer 17

IRREGULAR PATTERN WITH PERIODS OF APNEA

Answer 18

ON SIDE OF BED OVER BEDSIDE TABLE WITH PILLOWS FOR COPD

Answer 19

is a palpable vibration, produced by the larynx and transmitted through patent bronchi & lung tissue to the chest wall

Answer 20

compression or consolidation of lung tissue. indicates increased density of lung tissue (must have a patent bronchus)

Answer 21

obstruction of vibrations (obstructed bronchus, pleural effusion or thickening, pneumothorax, and emphysema)

Answer 22

results from inflammation of the pleura (visceral or parietal) with decrease in the normal lubricating fluid

Answer 23

anteroposterior-to-transverse diameter is equal (with aging, emphysema, asthma)

Answer 24

“funnel chest”, sunken sternum

Answer 25

“pigeon breast” forward protrusion of sternum

Answer 26

lateral S-shaped curvature of the thoracic and lumber spine

Answer 27

exaggerated posterior curvature of the thoracic spine (humpback)

Answer 28

REACTIVE AIRWAY DISEASE

Answer 29

COLLAPSED LUNG ONE LUNG WILL SOUND DIFFERENT

Answer 30

INFLAMMATION OF THE LINING OF THE BRONCHIAL TUBES

Answer 31

a group of diseases that cause airflow blockage and breathing-related problems. It includes emphysema and chronic bronchitis.

Answer 32

a collection of air outside the lung but within the pleural cavity

Answer 33

have pt. say “99” (increased transmission of voice sound with increased lung density or consolidation)

Answer 34

– have pt. say “ee” (sounds like “a” with consolidation)

Answer 35

Decreased mobility of thorax from calcified cartilage - Decreased muscle strength - Decreased elasticity of lungs - Decreased vital capacity (max exhalation) - Increased residual volume (what’s left over after exhale) - Histologic changes with loss of intra -alveolarseptum & number of alveoli  decreased surface area for gas exchange- Increased risk of dyspnea & pulmonary complications

Answer 36

Restlessness. Headache. Confusion. Anxiety. (tachycardia). (tachypnea). dyspnea barrel chest clubbed fingers cyonosis

Answer 37

picture in power point

Answer 38

- Hemodynamic changes: - Increased systolic BP - Left ventricule (wall) thickens - Heart rate: unchanged at rest - Cardiac output: unchanged at rest * Decreased adaptation to exercise * Dysrhythmias: supraventricular & ventricula rIncreased cardiovascular diseases

Answer 39

angina- onset, charactor, precipitating factors, associated symptoms need to differentiate between cario and noncardio origin dyspnea cough fatigue cyanosis edema nocturia increased fluid absorption/excretion cardiac Hx family cardia Hx

Answer 40

fatigue worse in evening

Answer 41

unilateral or bilateral, dependent edema with heart failure (bilateral, increases in the evening, decreases with elevation of legs)

Answer 42

htn protein in urine edema- feet, legs, face excessive weight gain

Answer 43

1. Pulse and BP 2. Extremities 3. Neck vessels 4. Precordium

Answer 44

(for persons > 40 age or have S/S of CV disease * Bruit: blowing, swishing sound, indicates turbulent blood flow from a local vascular cause; audible when the lumen is occluded by ½ to 2/3 * Use the bell side of the stethoscope for bruits * Absence of bruit does NOT necessarily exclude partial occlusion

Answer 45

* Unilateral distension of external jugular veins indicates local cause (aneurysm or kinking) * Bilateral distension of external jugular veins above 45 degrees indicates increased central venous pressure (CVP) from systemic disorder such as heart failure.

Answer 46

pallor, coolness, diminished pulse strength unilateral swelling is a local problem, bilateral swelling indicates systemic problem Deep muscle pain, pain with walking aka claudication, thin and shiny skin, absence of hair, necrotic ulcers on toes heels lateral malleolus

Answer 47

brownish discoloration, venous ulcers on medial malleolus-wheeping dull ache, heaviness in lower leg pain, pulses present, thick brawny edematous skin,

Answer 48

* Heave or lift (sustained forceful thrusting of ventricle during systole) – indicates ventricular hypertrophy from increased workload. * Palpate the apical pulse (for the apex beat) and note its normal characteristics: - Location: normally at 4 or 5th intercostal space at or medial to midclavicular line & only occupying one intercostal space - Size: normally 1cm X 2cm - Amplitude: normally a short, gentle tap - Duration: normally occupies only one half of systole

Answer 49

increases its size,displaces it more laterally, increases its duration & amplitude.

Answer 50

a thrill (palpable vibration) *Note its timing if present auscultate or use carotid artery as a guide) * Thrill: generally indicates a significant murmur * Auscultate the precordium using the Z pattern technique from the base of the heart and down

Answer 51

* Second right interspace – aortic valve * Second left interspace – pulmonic valve * Left sternal border – tricuspid valve * Fifth interspace near the left midclavicular line –mitral valve * ALL PIGS EAT TOO MUCH

Answer 52

closure of mitral and tricuspid valves

Answer 53

closure of aortic and pulmonic valves

Answer 54

s3 s4 murmurs

Answer 55

* Result from turbulent blood flow caused by:- Increased velocity- Decreased viscosity- Structural defects

Answer 56

know general ones but also remember picture from powerpoint all pigs eat too much aortic pulmonic erb's point tricuspid mitral

Answer 57

bottom s1>s2

Answer 58

apical- one minute others usually 30 seconds x 2

Answer 59

bruits splits clicks murmurs

Answer 60

drain head and neck

Answer 61

drain breast and upper arm

Answer 62

drains hand and lower arm in the antecubital fossal

Answer 63

drain le, external genitalia, and anterior abdominal wall

Answer 64

use gentle circular motion with your fingerpads start with preauricular

Answer 65

tip patient head toward side being examined

Answer 66

patient to hunch shoulders and elbows forward

Answer 67

abnormal to palpate in adults if palpable note location, size, shape, discrete, matted, mobility, consistency, tenderness

Answer 68

describe all aspects note source they drain refer for follow up pay attention between acute infection and cancer or hiv

Answer 69

normal pathway

Answer 70

alternate route* directly transmit vibrations to inner ear & to CN VIII

Answer 71

1+ Visible just beyond the anterior pillar (normal) 2+ Halfway between tonsillar pillars and uvula 3+ Touching the uvula 4+ Touching each other

Answer 72

note symmetry: asymmetry with central brain lesion, damage to the CN VII (Bell’spalsy

Answer 73

out and down

Answer 74

out and up

Answer 75

normal constriction of the pupils when bright light shines on the retina * Direct light reflex: constriction of that pupil exposed to the bright light* * Consensual light reflex: simultaneous constriction of the other pupil.

Answer 76

refers to the adaptation of the eye from far to near vision - Results from the increased curvature of the lens by movement of the ciliary muscles - Normal finding: convergence of the axis of the eyeball & pupillary constriction

Answer 77

normal vision is 20/20 (you can read at 20 feet what the normal eye could read at 20 feet) * Top number (numerator) notes the distance the person is standing from the chart; the bottom number (denominator) gives the distance at which a normal eye could read that particular line

Answer 78

visual acuity persons over 40 or difficulty reading near vision hold 14 inches from the eye normal is 14/14 move farther away = presbyopia

Answer 79

visual fields * Indication of peripheral field loss: person unable to see the object as the examiner does

Answer 80

corneal light reflex Assess the parallel alignment of the eye axes * Asymmetry of the light reflex indicates deviation in alignment from muscle weakness or paralysis

Answer 81

detects small degrees of deviated alignment * Abnormal finding: eye jumps to fixate on the designated point (indicates muscle weakness).

Answer 82

* Normal response: parallel tracking of the object with both eyes * Abnormal finding: unparallel movement of the eyes (indicates extraocular muscle weakness or dysfunction of the cranial nerve)*

Answer 83

crossed eye, one eye deviates off fixation point, can disconjugate vision.

Answer 84

Normal response= 1. pupillary constriction and 2. convergence of the axis of the eyes 3. * Abnormal finding: absence of constriction or convergence, asymmetric response 4. * Record normal response as PERRLA

Answer 85

(Pupils Equal, Round, React to Light and Accommodation)

Answer 86

Direct the beam of light through the pupil to illuminate the inner structures  Match sides with patient (ex. use your right eye for viewing pt’s right eye  Start at 10 inches away from pt. at an angle 15% lateral to the pt’s person’s line of vision  Note the red reflex filling the pt’s pupil and steadily move closer to the eye, keeping sight of the red reflex

Answer 87

Limited eye movement at birth but peripheral vision is intact; iris less pigmented- Macula is absent at birth; developing byage 4 months & mature by 8 months - Binocularity and the ability to fixate on asingle object by 3-4 months - Eyeball is adult size by age 8

Answer 88

Lacrimal glands involute - Arcus senilis: infiltration of degenerative lipid material around the limbus - Pupil size decreases- Loss of elasticity of the lens - Common causes of decreased visual functioning in the aged adult:- Presbyopia: - senile cataract - floaters - glaucoma - md

Answer 89

the lens decreased ability to change shape in order to accommodate for near vision.

Answer 90

: lens opacity, fibers of the lens thickens & yellows (nuclear sclerosis)

Answer 91

from debris accumulating in the vitreous

Answer 92

increased ocular pressure

Answer 93

loss of central vision (area of clearest vision); inability to read fineprint; peripheral vision is unchanged * Most common cause of blindness (greater incidence in woman)

Answer 94

flat scaphoid rounded distended protuberant

Answer 95

bulging outward

Answer 96

bulging or convex

Answer 97

Use indirect fist percussion to vibrate over the 12th at the costovertebral angle (CVA) * Hold one hand over the CVA, then thump hand with the ulnar edge of your other fist * * Normal finding: patient feels only the thud but no pain * * Sharp pain (costovertebral angletenderness) indicates inflammation of the kidney or paranephric region

Answer 98

any difficulty swallowing painful

Answer 99

inspection auscultation percussion palpation

Answer 100

- Located on posterolateral region of the abdominal cavity beneath the diaphragm, from the 9th to 11th rib lateral to the midaxillary line (approximately 7 cm in length) * Normally not palpable

Answer 101

Palpable only if it is 3 times its normal size* Do not continue to palpate an enlarged spleen as it is friable (bleeds easily) & can rupture * Note how many centimeters it extend sbelow the left costal margin

Answer 102

olfactory smell

Answer 103

optic how well you see

Answer 104

oculomotor 3,4,6 make the eyes do tricks adjusts and coordinates eyes during movement

Answer 105

trochlear look down or to nose 3, 4, 6 make eyes do tricks

Answer 106

trigeminal hree-part nerve in your head that provides sensation. forehead, cheek, chin

Answer 107

abducens 3, 4, 6 make eyes do tricks makes eye move out look to the side

Answer 108

facial nerve facial expression smile lift eyebrows puff cheeks

Answer 109

acoustic hearing

Answer 110

glossopharyngeal swallow moves pharynx/larynx say ahh gag reflex

Answer 111

vagus coughing, sneezing, vomitting gag

Answer 112

spinal accessory nerve push shoulders or head against pressure

Answer 113

hypoglossal tongue movement

Answer 114

glasgow coma scale review chart in ppt mild 13-15 moderate 9-12 severe 3-8

Answer 115

cerebellar function

Answer 116

gait- regular walking tandem walk- heel to toe romberg test- close eyes and maintain balance for 60 seconds hop in place/shallow knee bends

Answer 117

rapid alternating movements ram thumb to finger test finger to finger test finger to nose test heel to shin test

Answer 118

Rapid alternating movements (RAM) of the hands test several aspects of coordination. When a patient has cerebellar disease, one movement cannot be quickly followed by its opposite and movements are slow, irregular, and clumsy.

Answer 119

. The patient is asked to touch the tips of the index finger of each hand together. A, A truly blind patient can easily perform this task. B, A patient with nonorganic visual loss may demonstrate the inability to touch the fingers together.

Answer 120

Finger to nose & finger to finger test. Ask patient to fully extend arm then touch nose or ask them to touch their nose then fully extend to touch your finger. detecting disorders in the cerebellar region and neural circuits involving the cerebellum. It has also been used to detect disorders related to cerebellar function.

Answer 121

For the lower extremities, the examiner asks the patient to move their heel across the shin in a proximal to distal motion. In a hemispheric cerebellar lesion, the patient will not be able to trace the shin in a straight line and will move the heel from side to side.

HA FINAL Flashcards

(154 cards)