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Signs and Symptoms Review Flashcards

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1
Q

Compensated Shock (Reversible)

A
  • change in LOC (anxious appearance)
  • increased pulse and respirations
  • cool, pale skin
  • normal to slightly increased BP (increase due to initial vasoconstriction)
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2
Q

Uncompensated Shock (Irreversible)

A
  • decrease in LOC, unconscious
  • decreased HR
  • decreased respirations
  • cyanosis (decreased perfusion to tissues)
  • lactic acid build up
  • hypotension
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3
Q

Neurogenic Shock (Spinal Cord Injury)

A
  • warm, dry, flushed skin and capillary refill normal
  • neurologic deficit (paralysis or loss of sensation)
  • change in respiratory pattern (diaphragm breathing)
  • hypothermia (late sign)
  • hypotension (early sign)
  • HR normal or bradycardic
  • cervical vertebrae - most likely fractured (least protected)
  • phrenic nerve (C2-C4) controls chest wall
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4
Q

Anaphylactic Shock (Allergic Reaction)

A
  • itching, flushing, hives
  • swelling of eyelids, lips and tongue
  • tightness in chest (SOB and wheezing)
  • severe dyspnea
  • abdominal cramps
  • nausea and vomiting
  • diarrhea
  • tachycardia, hypotension
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5
Q

Psychogenic Shock

A
  • fainting with no sign of serious injury or illness
  • SOB, anxious, increased HR, respirations and BP
  • respiratory alkalosis due to hyperventilation
  • normal pulse oximetry
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6
Q

Septic Shock

A
  • elevated temp initially (source of infection)
  • decreased temp (late sign)
  • petechiae
  • decreased LOC
  • creeping mottling
  • tachycardia and hypotensive (vasodilation)
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7
Q

Cardiogenic Shock (Heart Failure)

A
  • dyspnea
  • rales (wet lung sounds)
  • tachycardia, decreased BP (ineffective pump)
  • increased respirations, diaphoresis, arrhythmias
  • increased blood volume in lungs and liver due to pump failure (CHF)
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8
Q

Hypovolemic Shock (Bleeding or Dehydration)

A
  • increased HR and respirations
  • decreased BP
  • cyanosis (lack of O2 to tissues)
  • diaphoresis
  • internal or external bleeding
  • LOC changes
  • anxious appearance
  • hypoxia
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9
Q

Cerebral Artery Aneurysm

A
  • severe headache, blurred vision
  • altered LOC
  • s&s of ICP
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10
Q

Thoracic Aortic Aneurysm

A
  • sudden onset
  • pain, ripping or tearing sensation
  • pain may radiate to the neck, back, shoulders or abdomen
  • stridor or hoarseness, dyspnea
  • s&s of hypovolemic shock after rupture
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11
Q

Abdominal Aortic Aneurysm (AAA)

A
  • lower abdominal pain
  • pain may be consistent or intermittent
  • palpable abdominal pulse
  • lower back or flank pain
  • unequal or absent distal pulses
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12
Q

Transient Ischemic Attack (TIA)

A
  • same as CVA but not permanent, resolves between 24-48 hours
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13
Q

Cerebral Vascular Accident (CVA - Stroke)

A
  • headache
  • change in LOC
  • blurred vision
  • unequal pupils
  • hemiplegia (one-sided paralysis)
  • common causes are hypertension and arteriosclerosis
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14
Q

Hypertensive Crisis

A
  • headache
  • dizziness
  • restless
  • blurred vision
  • nose bleed
  • vomiting
  • seizure
  • stupor
  • coma
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15
Q

Acute Myocardial Infarction (Acute MI)

A
  • skin cool, pale, sweaty
  • SOB
  • anxious
  • feeling of impending doom
  • pain that radiates to arm, shoulder, neck, jaw or back
  • nausea or vomiting
  • begins at rest
  • denial
  • may have normal VS in the beginning with NO chest pain
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16
Q

Angina

A
  • induced by exercise, emotion, eating
  • relieved by nitro and rest
  • main symptom of CAD
  • last 3-5 months typically
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17
Q

CHF/ Left-sided Heart Failure

A
  • dyspnea
  • rales
  • tachycardia
  • chronic atrial arrhythmias
  • pink, frothy sputum (pulmonary edema)
  • orthopnea
  • increased BP
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18
Q

Right-sided Heart Failure

A
  • peripheral edema
  • JVD (blood backing up)
  • Ascites (enlarged liver)
  • pt may complain of RUQ pain
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19
Q

Pericardial Tamponade

A
  • shock
  • dyspnea
  • mechanism of injury
  • weak, rapid pulse
  • equal breath sounds
  • Beck’s triad - muffled heart sounds, JVD, narrowing pulse pressure (hypotension)
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20
Q

Flail Chest

A
  • localized pain at injury site
  • point tenderness
  • pain with increased movement
  • may report a crackling sensation
  • deformity of the chest wall
  • characteristic stance - leaning toward injured site
  • holding hand over injured area
  • paradoxical movement of the chest wall
  • seen w/ rib fractures
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21
Q

Hemothorax

A
  • Vital signs may present like shock
  • no JVD
  • hypo-resonance chest sounds (muffled)
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22
Q

Myocardial Contusion

A
  • sternal bruising
  • chest pain
  • arrhythmias
  • SOB, dyspnea
  • usually seen in MVC - blunt force trauma - chest into steering wheel
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23
Q

Pulmonary Contusion

A
  • often asymptomatic initially
  • monitor for increased respiratory distress
  • monitor for signs and symptoms of hypoxia
  • contusions and abrasions
  • mechanism of injury
  • respiratory distress worsens before improves
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24
Q

Pulmonary Embolism

A
  • sudden onset
  • SOB
  • chest pain
  • increased HR and respiratory rate
  • cool, pale, clammy skin
  • decreased LOC (hypoxia)
  • pink, tinged sputum
  • clear breath sounds initially than rales as PE gets worse
  • bed ridden pt, trauma or surgical pt, prolonged sitting, recent c-section or traumatic delivery, <40 year old taking oral contraceptives, smokers
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25
Sucking Chest Wound (Open Pneumo)
- same as pneumothorax - open wound on chest wall - may hear sucking sound w/ patients respirations
26
Pneumothorax - Spontaneous or Traumatic
- spontaneous usually occur in tall, thin pt with coughing episode - sudden onset of sharp chest pain - SOB - decreased or absent breath sounds on affected side/ hyper-resonance - tracheal deviation (late sign) - displaced heart sounds
27
Traumatic Asphyxia
- head, neck and shoulders appear dark blue or purple - eyes may be blood shot or bulging - chest wall appears deformed - severe respiratory distress - severe shock - many are CPR on scene
28
Closed Head Injury (increased ICP)
- subdural or epidural hematomas - change in LOC - 1st indicator - personality changes - seizures - headache - aphasia - projectile vomiting - posturing - pupils may be dilated, usually unequal (late sign) - irregular respiratory patterns, usually Cheyne-Stokes - decreased pulse, increase blood pressure, with irregular respirations = CUSHINGS
29
Blunt Trauma to the Abdomen
- same as penetrating - liver (RLQ), spleen, and pancreas are most commonly injured - shock, pain to affected area - contusions, abrasions
30
Injuries to the Structures of the Neck
- pain at the injury site - dyspnea, stridor - difficulty swallowing - difficulty speaking - swelling, bruising, hematoma - obvious spinal deformity - subcutaneous air - hemoptysis (coughing up blood)
31
Chronic Bronchitis (Blue Bloater)
- hx of smoking - persistent productive cough for 3 months and 2 consecutive years - overweight - cyanotic - coarse rhonchi and wheezes that clear with cough - normal or slightly increased respiratory rate - frequent respiratory infections - dyspnea
32
Pulmonary Emphysema (Pink Puffer)
- dyspnea - pursed lip breathing - wheezing - barrelled chest - thin - cannot complete sentences (SOB) - Home O2 - tripod positioning - use of accessory muscles when breathing - clubbing of fingers
33
Asthma (acute exacerbation)
- expiratory wheezes - use of accessory muscles - increased respiratory rate - dyspnea - increased anxiety - tripod positioning - air trapping (mucus plugging) - long expiratory phase - shark fin on capnography - changes in LOC depict degree of respiratory distress
34
Pneumonia
- green and yellow mucus - chills and shivering - productive cough - may show signs and symptoms of respiratory distress - tachypnea - rales or rhonchi - chest pain made worse by coughing - fever - usually only affects one side
35
Foreign Body Aspiration
- sudden onset of respiratory distress w/ no history of infection - dyspnea - stridor - localized wheezing - coughing
36
Hyperventilation
- carpal pedal spasms (cramping in fingers due to acid build up) - good colour (normal pulse ox) - clear breath sounds - numbness and tingling of fingers and extremities - tachypnea
37
Acute Respiratory Failure
- cyanosis - decreased LOC - bradycardia - laboured or poor respiratory effort
38
Peritonsillar Abscess
- sore throat - fever - difficulty swallowing - leaning over to breathe (open mouth breathing) - droolinh - neck swelling - foul smelling breath
39
Hypoglycemia
- sudden onset (usually 2 hours or less) - dilated pupils - tachycardia - decreased LOC - diaphoretic, cool, clammy skin - headache - weakness, dizziness - tremors - hx of diabetes
40
Hyperglycemia (DKA)
- polyphagia (increased hunger) - polyuria (increased urination) - polydipsia (increased thirst) - blurred vision - weight loss - dry mouth - dry, itchy, warm skin - poor wound healing - Kussmaul respirations - fruity breath - gradual onset (3 days to 2 weeks)
41
Sickle Cell Crisis
- severe chest, abdomen, muscular or bone pain - fatigue - tachycardia - priaprism - fever
42
Hyperglycemic Hyperosmolar Nonketotic Syndrome (HHNS)
- mimics DKA without increased ketones (dry, low BP) - no Kussmaul respirations or fruity breath, no nausea or vomiting
43
Acute Renal Failure
- decreased urine output - hypertension - altered LOC - nausea and vomiting - diarrhea - dialysis / electrolyte imbalances
44
Chronic Renal Failure
- decreased urine output - hypertension - fatigue - weakness - congestive heart failure - acidosis - uremia - CNS changes - seizure - coma - edema - death
45
Kidney Stone (Renal Calculi)
- severe flank pain - radiation of pain to groin
46
Gastrointestinal Emergencies
- distention of the abdomen - tender rigid abdomen, guarding - increased pulse - shallow increased respirations
47
Liver Injury
- RUQ tenderness, involuntary guarding - abdominal distention - referred pain to the right shoulder - bruising/abrasions on the RUQ - alcoholics (clotting problem - esophageal varicies) - hepatitis/ yellow sclera (jaundice) - rib fracture or hemothorax on the right chest - unexplained tachycardia/hypotension
48
Stomach Injury
- tenderness - guarding - rigidity - distention
49
Spleen Injury (Solid Organ)
- fracture of the 8-10th ribs on the left side - unexplained tachycardia/hypotension - abdominal tenderness/ guarding/heat - pain radiating to left shoulder
50
Gallbladder Injury (Hollow Organ)
- intermittent, cramping pain - fullness in RUQ after meals, pain or discomfort - nausea and vomiting
51
Pancreas Injury
- more susceptible in alcoholics - acute onset of severe epigastric pain that may radiate to neck - attacks occur a few hours after a large meal, heavy alcohol intake, spicy foods - nausea and vomiting - abdominal tenderness, rigitidy, or distention
52
Gastric Ulcers
- burning pain in the epigastric area or LUQ - pain usually begins about 2 hours after meals and is relieved by eating antacids - sudden onset of intense, constant, generalized abdo pain - abdominal rigitidy, tenderness, guarding - black, tarry stools - s&s of shock - pale, waxy white skin (hemorrhage) - initially pain may be localized around the umbilicus and then move to RLQ - nausea and vomiting - fever
53
Bladder Injury
- blood in urine - urinary frequency and burning - painful urination - lower abdo pain - hematuria
54
Kidney Injury (Solid Organ)
- rib fractures involving 10-12th ribs - back or flank pain - bruising/swelling over back/flank areas - s&s of shock - dysuria - hematuria
55
Pediatric Shock
- changes in LOC - tachycardia - pale, cool. mottled skin - especially in extremities - increased capillary refill - sunken frontanelle - tachypnea
56
Pediatric w/ Asthma or Bronchitis
- dyspnea, tachypnea - expiratory grunting and/or prolonged expiration - wheezing (lower airways, high pitched) - retractions (use of accessory muscles) - nasal flaring - tachycardia
57
Croup
- gradual onset - seal bark (cough before bed), high pitched (upper airway), hoarseness - stridor (upper airway) - low grade temperature (<101) - tachypnea
58
Pediatric Meningitis
- rapid onset often preceded by an upper airway infection - fever (with seizures) - changes in LOC - decreased appetite - photophobia - stiff neck, nuchal rigitidy - fontanels full (or bulging) - nausea/vomiting - headache (noted in older children)
59
Normal Labour & Delivery - Impending Childbirth
Early Labour: - vaginal discharge, "mucous plug" or bloody stool - back pain, mild to moderate contractions Active Labour: - regular contractions lasting 1 minute, getting closer together - pain of contractions increase, may be felt in back and abdomen - cervix dilates - crowning - cord protruding from vagina - goal is to relieve pressure off the cord
60
Breech Presentation
- hx of previous breech delivery - fetal heart tones heard best in upper abdomen - feet, buttock, arms crown before head
61
Meconium Stained Amniotic Fluid
- usually past due date - greenish to brown colour to amniotic fluid - Suction ASAP - mouth then nose
62
Abruptio Placenta
- minimal vaginal bleeding - rigid abdomen - severe abdominal cramping - pain does not cease
63
Placenta Previa
- painless - heavy bleeding - bright red blood - occurs without warning
64
Pelvic Inflammatory Disease (PID)
- low abdominal pain with walking or movement - vaginal discharge - fever - nausea & vomiting - generalized weakness
65
Ectopic Pregnancy
- presence of pregnancy symptoms - hx of PID, tubal ligation, fertility drugs - abnormal menstrual cycles - spotting may or may not occur - shoulder pain - abdominal tenderness/rigidity - shock (if hemorrhaging) - guarding
66
Heat Exhaustion
- pt will be awake or slightly decreased LOC, light headedness, headache or irritable - normal or decreased BP - increased respirations - tachycardia - temperature normal or slightly increased - skin pale with excessive sweating - nausea & vomiting - heat cramps
67
Heat Stroke
- Early: dizziness, headache followed by psychotic behaviours, seizures, and coma - blood pressure may be elevated - tachycardia with bounding pulse - increased respirations - temperature is extremely elevated - skin is usually hot, red, dry
68
Frostbite - Local
- initially red - inflamed skin with stinging or burning sensations, parathesis, numbness - Later: skin turns grey, mottled, white, then waxy white and frozen with complete loss of sensation and dexterity - burning sensation is a good sign that the tissue is viable
69
Systemic Hypothermia
Early: - pt is conscious but slow to respond - shivering - increased metabolic rate - impaired judgement - poor coordination - vasoconstriction - cold, pale skin Late: - stuporous or unconscious with core temp < 84 - pupils are unresponsive - skin is ice cold to touch, pale and most likely will have rigid muscle tone - pulse, respirations, and BP will be decreased or absent - ECG may show a-fib, v-fib, or asystole
70
Basal Skull Fracture
- otorrhea - rinorrhea - mastoid bruising - periorbital ecchymosis
71
Epidural Bleed
- confusion - dizziness - drowsiness - unequal pupils - head trauma with LOC - nausea and vomiting
72
Subdural Bleed
- slower onset - headache that keeps getting worse - personality changes - drowsy - confusion

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