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Clin Phys > Hematologic Assessment, Pain, and Fever > Flashcards

Hematologic Assessment, Pain, and Fever Flashcards

1
Q

What is the average normal temperature for adults?

A

97.5-99

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2
Q

What is the average normal temperature for children?

A

99

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3
Q

What is considered a fever in patients that are “older and colder”?

A

1.5 degrees above baseline

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4
Q

What adjustments need to be made for a rectal temperature?

A

subtract 0.5- 1 degree for oral temperature

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5
Q

What adjustments need to be made for axillary temperature?

A

add 0.5-1 degree for oral temperature

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6
Q

What type of temperatures are most accurate?

A

tympanic, temporal, oral

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7
Q

What is the preferred measurement for children 1-3 months?

A

rectal, tympanic

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8
Q

What is the preferred measurement for children 3 months- 5 years?

A

axillary

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9
Q

What is the preferred measurement for adults?

A

oral

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10
Q

When should fever be referred on?

A
  1. 3 months or younger
  2. > 3 months with rectal temp 104
  3. fever > 3 days
  4. rash/ difficult breathing/ severe pain
  5. vomiting >12 hours
  6. diarrhea > 2 days
  7. > 103
  8. cold/flu sx >7 days
  9. recurrent
  10. immunocompromised
  11. pregnant
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11
Q

What is acute pain?

A

</= 1 month

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12
Q

What is subacute pain?

A

1-3 months

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13
Q

What is chronic pain?

A

> 3 months

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14
Q

What are single dimension pain assessments?

A
  1. verbal analog scale (1-10)
  2. visual analog scale (10 cm line)
  3. assessment and frequency (1-3 =mild, 4-6 =moderate)
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15
Q

What are multi dimension pain assessments?

A
  1. pain diary /drawing
  2. McGill Pain Questionnaire
  3. Faces of pain
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16
Q

What are signs of acute pain?

A

tachycardia
tachypnea
sweating
pallor
extreme anxiety

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17
Q

What are the best ways to assess pain in the cognitively impaired?

A

Physiologic indicators
Facial/ body clues
PAINAD (pain assessment in Alzheimer’s disease)

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18
Q

What is the suggested amount of daily caloric intake?

A

25 kcal/kg/day

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19
Q

What is a normal BMI?

A

18.5- 24.9

20
Q

Why is BMI not always accurate?

A

cannot distinguish between weight from adipose, edema, or muscle

21
Q

What body shape is associated with an increased risk of DM, hyperlipidemia, stroke, and CAD?

A

apple-shaped body

22
Q

What waist circumference is at an increased risk of DM, hyperlipidemia, stroke, and CAD?

A

male: >40
female: >35

23
Q

What waist-to-hip ratio is at an increased risk of DM, hyperlipidemia, stroke, and CAD?

A

male: >0.9
female: >0.8

24
Q

What does a total lymphocyte count of 1200-2000 indicate?

A

mild malnutrition

25
Q

What does a total lymphocyte count of 800-1200 indicate?

A

moderate malnutrition

26
Q

What does a total lymphocyte count of <800 indicate?

A

severe malnutrition

27
Q

What is a CBC with differential?

A

differential includes analysis of WBCs

28
Q

What is true for all types of anemias?

A

low RBCs

29
Q

What are RBC indices?

A

assesses size and Hgb content of the RBC

30
Q

What can cause false elevations in MCV (mean cell volume)?

A
  1. reticulocytosis
  2. agglutination of erythrocytes
  3. hyperglycemia
31
Q

What is MCH (mean cell hemoglobin)?

A

percent volume of Hgb per RBC (Hgb/ RBC count)

32
Q

What can cause false elevations of MCH?

A

hyperlipidemia

33
Q

What is used to confirm iron deficiency anemia and disorders of Hgb synthesis?

A

MCHC (mean cell hemoglobin concentration)

34
Q

What can be used to identify drug-induced bone marrow suppression and response to vitamin/iron therapy?

A

reticulocyte counts

35
Q

What indicated variability in RBC width/size?

A

RBC distribution width

36
Q

What are the causes of macrocytic anemia?

A
  1. B12 deficiency
  2. folic acid deficiency
  3. drug-induced
37
Q

What are the symptoms of B12 deficiency?

A

CNS- loss of coordination, tremors, neuropathy
GI- glossitis (inflamed tongue), constipation/D

38
Q

What do labs look like for someone who is B12 deficient?

A

Increased MCV and MCH
Decreased B12

39
Q

How is B12 deficiency treated?

A

IM for 2 months

40
Q

What do labs look like for someone who is folic acid deficient?

A

Increased MCV and MCH
Decreased folic acid

41
Q

What types of drugs can cause macrocytic anemia?

A

Marrow toxicity- alcohol, antineoplastics, AZT (HIV med)
Altered folate metab- anticonvulsants, methotrexate, trimethprim, triamterene
Altered B12- colchicine, neomycin

42
Q

What are causes of Microcytic anemia?

A
  1. iron deficiency
  2. thalassemia (hereditary)
43
Q

What changes in labs are seen with iron deficiency anemia?

A
  1. low serum ferritin
  2. low serum iron
  3. high TIBC
  4. low transferrin saturation
  5. high RDW
44
Q

What are the causes of normochromic anemia?

A
  1. acute blood loss
  2. hemolytic anemia
  3. anemia of chronic disease
45
Q

What medications can cause extrinsic hemolytic anemia?

A

methyldopa
quinine
quinidine
penicillin

46
Q

What lab findings indicate hemolytic anemia?

A

reticulocytosis
increased BUN

47
Q

What lab findings indicate anemia of chronic disease?

A
  1. low serum iron
  2. low TIBC
  3. normal ferritin
  4. micro/normocytic

Clin Phys (15 decks)

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