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N258 Final Review > Introduction to Physical Assessment and Vital Signs and Health History > Flashcards

Introduction to Physical Assessment and Vital Signs and Health History Flashcards

1
Q

What is the correct order for the skills for the physical examination?

A

Inspection, Palpation, Percussion, Auscultation

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2
Q

What is the back of the hand best for when using palpation?

A

Best for determining temperature

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3
Q

Which hand feature is best for determining texture, swelling, pulsation, and presence of lumps?

A

Fingertips

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4
Q

What three features is percussion best used to determine?

A

Location, Size and Density

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5
Q

What kind of structure with more air produces a louder, deeper, longer sound?

A

The lungs

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6
Q

Example of structure that is dense, more solid with softer, shorter, higher sound? (auscultation)?

A

The liver

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7
Q

What is the diaphragm of stethoscope best used for and how is it used?

A

Best used for high pitch sounds (breath, bowel, heart sounds) - flat shape
Hold diaphragm firmly against person’s skin

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8
Q

What is the bell of stethoscope best used for and how is it used?

A

Best used for low pitch sounds (heart murmurs, extra heart sounds) - cup like shape
Hold it lightly against person’s skin

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9
Q

You should listen through the gown T or F?

A

False

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10
Q

Describe how an examination room should be?

A

Examination room should be warm, comfortable, quiet, private, and well lit

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11
Q

Describe what an otoscope is used for?

A

Funnels light into the ear canal, and onto tympanic membrane

Five specula used (short, broad speculum used for viewing nares, largest one used for ear canal

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12
Q

Describe what an ophthalmoscope is used for?

A

Used to view through pupil at the fundus (background of eye)

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13
Q

When should the mechanical action of hand washing be used?

A

When hands are visibly soiled and when the person is infected with spore forming organisms (C. Diff)

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14
Q

When should you wear gloves?

A

When anticipating contact with blood, infectious materials, mucous membranes, nonintact skin, and infected intact skin

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15
Q

When should you wear a gown?

A

When contacting blood, body fluids, secretions or excretions

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16
Q

When should you wear eye protection?

A

When there is potential splashes, sprays of blood, body fluids, secretions, excretions

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17
Q

When should you wear a mask?

A

when treating persons with transmissable respiratory infections

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18
Q

Describe some important steps for examining infants?

A

Once baby is able to sit without support (around 6 months) examination should be performed on on the caregivers lap

caregiver must be in infants vision at 9-12 months

examination should be done 1-2 hours after feeding in warm environment

use toys for distraction and medical tools for older babies

listen to heart, lung, ab sounds when baby is sleeping and do most invasive and Moro reflex last

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19
Q

Preschoolers like to help with the examination true or false?

A

True

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20
Q

With preschoolers head, eye, ear, nose and throat should be observed first or last?

A

Last

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21
Q

It is important to allow rest periods during examination for older adults true or false?

A

True

22
Q

What is a normal temperature adult temperature?

A

96.8-100.4 degrees Farenheit

23
Q

What is a normal neonate temperature?

A

97.7-99.7 degrees Farenehit

24
Q

What is a normal infant temperature?

A

98.6-99.5 degrees Farenheit

25
Q

What factors affect temperature?

A

age, exercise, heart rhythms, stress and environment

26
Q

When and where is the oral thermometer used?

A

For adolescence underneath the sublingual pocket

27
Q

Rectal temperature?

A

Closest to approx. core temperature (most accurate)

Insert 2.5 cm with lube or 1/2 inch for newborn

28
Q

What three fingers are used to palpate the radial pulse?

A

The pads of your first three fingers

29
Q

What is bradycardia?

A

Heart rate less than 50 beats/min

30
Q

What is a normal pulse?

A

60-95 beats/min

31
Q

What is tachycardia?

A

Over 100 beats per minute

32
Q

What are the different heart rates based on age?

A 
Neonate: 110-160
Infant: 90-160
Toddler: 80-140
Pre K: 70-120
School: 60-110
Adol: 50-100
33
Q

What is a normal respiratory rate?

A

12-20 beats per minute

34
Q

What are the different respiratory rates?

A 
Neonate: 30-60
Infant: 25-30
Toddler: 25-30
pre-ke: 20-25
school: 20-25
Adol: 16-20
35
Q

What is the stroke volume?

A

The amount of blood the heart pumps into the aorta every beat

36
Q

What is a normal blood pressure?

A

120/80

37
Q

What is the systolic blood pressure?

A

peak pressure in arteries when contracting ventricles

38
Q

What is the diastolic blood pressure?

A

peak pressure in the arteries when ventricles are relaxed

39
Q

What is the pulse pressure?

A

The difference between the systolic and diastolic pressure (reflects stroke volume)

40
Q

What factors influence bp?

A 
Age 
Gender
Ethnicity and Genetics (higher bp in AA's)
Stress
Daily Variations
Meds
Activity
Wt
Smoking
41
Q

What are the Kortkoff Sounds?

A

BP with sphygmonanometer 1 inch above brachial artery in the AC fossa

Listening for first and last sounds (1-closure of AV valve, 2-swoosh, 3-knock, 4-muffle, 5-diastolic)

42
Q

What sites are appropriate to take BP on?

A

upper arm, wrist, ankle, thigh
(don’t use near IV site, lymph node removal, dialysis fistula)
Bladder width is 40% , length is 80%

43
Q

Hypertension Stages

A

Elevated: 120-129/80 or less
Stage 1: 130-139/80-89
Stage 2: More than 140/More than 90
Crisis: Over 180/Over 110

44
Q

What is hypotension?

A

Systolic bp less than 90
Orthostatic Hypotension is change in position causes bp to decrease by 20
Pale, cunfused, neuoro change

45
Q

BP’s by age group

A

infant: 64/41
child: 88/44
pre-k: 92/51
school: 100/59
adol: 112/64

46
Q

What is the difference between a sign and a symptom?

A

A symptom is a subjective sensation that the person feels from the disorder

A sign is an objective abnormality that one could detect from a physical examination

Put patient’s exact words in quotation marks with time frame - no diagnostic statement

47
Q

What are the components of the interview phase?

A
  1. Orientation and setting and agenda (private, greet by name, explain purpose)
  2. Working phase and collecting data (Ask questions, listen, attentive)
  3. Termination phase (restate info, patient summarize)
    * Assure confidentiality
48
Q

What is included in demographic information?

A

name, address, phone number, age, date of birth, birthplace, sex, marital status, race, ethnicity, occupation

49
Q

Who is a reliable source for information regarding health history?

A

patient, parents, interpreter, or caseworker (less reliable - relative or friend)

50
Q

What is the chief complaint?

A

Brief spontaneous statement in person’s own words describing reasons for visit

N258 Final Review (9 decks)

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