Flashcards in Hospital @ Night Deck (8)
What might lead to communication difficulties with a patient?
Hearing aids, dementia, language barrier, unconsciousness, oxygen/ventilation, speech or language difficulties
a) Mercedes Benz
b) Median sternotomy - look where else?
a) Liver transplant
b) CABG, open valve/aneurysm repair (also look in calves for saphenous vein harvest)
a) Before approaching patient, think...?
b) Intensifying sound
c) Differentiating between AS/MR murmur
a) What am I expecting (always expect to hear a murmur), e.g. elderly - AS, MI - MR, endocarditis/Marfan's - AR/MR
b) RILE: Right-sided (inspiration), Left-sided (expiration). Also getting them to stop breathing helps to hear it.
c) Radiation (carotids vs axilla), area, 2nd heart sound often quiet/inaudible with pansystolic but not with ejection systolic
a) Direct vs. indirect inguinal
c) Tests to perform
a) Direct (through weakened abdominal wall), indirect (through inguinal canal, usually into groin)
b) Incisional, inguinal, femoral
c) Cough/sit up, reducible?
a) If fixed flexion - also look for...?
a) Dupuytren's and palmar erythema - alcoholic liver diseases
a) Possible due to SC heparin
a) Ileostomy vs colostomy
b) Assess what?
a) Site (RIF vs LIF), opening (spouted vs flushed), consistency of fluid
b) Health of spout, consistency and volume of fluid, surrounding skin