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TEST 2 Flashcards

1
Q

What do we check when taking vital signs?

A

Temp
Pulse
Respiration
BP
Pain
Oxygen saturation

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2
Q

What is the normal range for temp?

A

35.9-38 C
96.7-100.5 F

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3
Q

What is the normal range for pulse?

A

60-100bpm

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4
Q

What is the normal range for respirations?

A

12-20 breathes per min

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5
Q

What is the avg bp?

A

120-80 mmHg

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6
Q

What is the pulse pressure?

A

30-50 mmHg difference between systolic and diastolic

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7
Q

What is the bodys primary source of heat?

A

Metabolism

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8
Q

What is basal metabolic rate?

A

Occurs at rest, heat is still being produced

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9
Q

What are the factors affecting temp?

A

-Elderly - lose muscle & fat
-Males - higher temp due to hormones
-Circadian rythm - temp 1-2 lower in AM & peak in afternoon/early evening
Environmental temps

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10
Q

What is hyperthermia
What is hypothermia

A

hyperthermia -elevated temp
hypothermia - lower temp

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11
Q

What is pyrexia (febrile)
What is afebrile?

A

pyrexia (febrile) - fever
afebrile - no fever

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12
Q

What are the sites we can assess temp?

A

Oral - glass for contact precaution
Axillary
Tympanic
Rectal
Forhead - temporal

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13
Q

What is cardiac output?

A

Volume of blood pumped by heart each minute

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14
Q

How do we calculate the cardiac output?

A

SV X Heart rate = CO

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15
Q

What is the min blood volume available before heart speeds up contractions to make up for it?

A

4-6 liters

Increased volume = heart rate slower
Decreased volume = heart rate faster

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16
Q

What is the pulse rate?

A

number of beats felt in 1 min

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17
Q

What are the numbers for bradycardia and tachycardia?

A

Bradycardia - >60
Tachycardia - <100

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18
Q

What are the sites to check for a pulse?

A

Temporal
Carotid - Emergecy
Apical - 4-5 intercostal space and mid left calvicular
Brachial
Radial
Femoral
Popliteal
Posterior tibial
Dorsalis pedis

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19
Q

What 3 scenarios do you need to check the apical pulse

A

Giving cardiac meds, abnormal heart rythum, history of cardiac issue

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20
Q

Diaphragm pick up what frequency sounds?
Bell picks up?

A

Diaphragm - high frequencey
Bell - low

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21
Q

Characteristics of pulse
Rhythm
Force/strength

A

Rhythm - regular or irregular
(dysrhythmia/arrhythmia)

Force - 0 - no pulse
1+ barely/weak
2+ normal
3+ bounding

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22
Q

What part of the brain controls our respirations?

A

Medulla oblongata - sensitive to opioids

*Regulated by levels of carbon dioxide, oxygen & hydrogen Ion concentration in the blood

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23
Q

What does
Bradypnea
Tachypnea
Apnea
Dyspnea

A

Bradypnea - slow breathing
Tachypnea - fast breathing
Apnea –no breathing
Dyspnea - difficulity breathing

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24
Q

What does the oxygen saturation measure?

A

% of hemoglobin bound to oxygen in arteries

**how saturated your hemoglobin is with oxygen

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25
What is COPD?
Lacking in o2 molecules/ normal is lower 80-90's
26
What can result in abnormal results for oxygen saturation?
Anemia -lacking in hempglobin Nail polish Impeding blood flow while taking BP
27
What does the BP meausre?
amount of force by blood against walls of artery
28
What does systolic and diastolic pressure measure?
Systolic - period of heart muscle contraction Diastolic - period of heart muscle relaxation
29
What are the risks for hypertension
Family history Obesity Smoking heavy alcohol High sodium Sedentary lifestyle stress diabetes Elderly african amerian high cholestrol
30
WHat are the metrics for stage 2 hypertension?
Systolic => 140 Diastolic => 90
31
What are the ranges in normal that determines orthostatic hypotension?
Systolic decrease >20mm HG when changing positions Diastolic decreased > 10 mm Hg when changing positions HR increase 10% when changing positions
32
What are the risk factors for orthostatic hypotension?
Volume depletion Dehydration anemia prolonged bedrest anti-hypertensive meds
33
What is transduction?
Nociceptors stimulated and release chemicals
34
What is transmission?
Pain impulses travel from peripheral nerve fibers
35
What is perception?
Brain interprets pain
36
WHat is modulation?
Inhibition of pain impulse by neuromodular compounds
37
What is nociceptive pain?
Normal due to injury
38
WHat is Cutaneous Somatic Visceral pain?
Cutaneous - superficial, paper cut, laceration Somatic - deep tissue, muscle bone Visceral - internal organs
39
What is neuropathic pain?
Abnormal/ no obvious injury *diabetic neuropathy
40
What is idiopathic pain?
No idea whats causing it
41
What is PQRSTU
Provactive? Quality Region Severity Timing Understand; any other symptoms
42
What are non-pharmacological pain relief options?
Relaxation, distraction, excerise, biofeedback, cutaneous stimulation
43
What is the clincal judgement model?
Recognize Cues Analyze cues Prioritize hypotheses Generate solutions Take action evalute outcomes
44
What is a Initial assessment Focused assessment Time lapsed assessment
Initial assessment - 1st & thorough Focused assessment - 1 area, complaint Time lapsed assessment - pain level assessemnt, wound assess, follow up
45
What is the physical assessment technique?
I- Inspection - look at area P - Palpation - touch P - Percussion - tapping A - Auscultation - listen with stetho
46
How is the abdominal IPPA different?
I - inspect A - Auscultation P - Percusion P - palpate *last to not create false sounds or pain
47
What is the proper format to write a nursing diagnosis?
Diagnosis label, related to, AEB
48
What are the 3 types of nursing diagnosis?
Actual Risk Readiness for enchanced (health promotion/wellness)
49
How to develop an outcome statement?
Specific - patient will Measureable - #'s details Attainable Realistic Time-bound - when to accomplish goal
50
For breast assessment what do you do first?
Ask subjective data 1. Pain 2. Lumps? Discharge? Swelling? 3. Surgery? Trauma/injury 4. History of disease? 5. Do you practice self-checking?
51
When you inspect the breasts what are you looking for?
Symmetry - (left will be slightly bigger) Color/lesions Peau d orange Venous networks - both breasts Dimpling, retracting
52
Where are most cancerous tumors found in the breast
Tail of spence
53
What do you write when demonstrating breast masses?
Location - quad & cm from the nipple Size - length & width, cm Tenderness - discomfort Mobility - fixed or movable Retraction - which quad
54
The frontal lobe is associated with?
Personality & behavior Emotions & intellectual function Motor cortex - voluntary movement *brocas area - Motor speech area
55
What is expressive aphasia?
Cannot talk or talk clearly
56
What is the parietal lobe responsible for?
Process data from -touch, sight, smell, hearing, taste *Proprioception
57
What is proprioception?
Body positioning, awareness of body parts w/out looking
58
What is the occipital lobe responsible for?
Vision center
59
What is the temporal lobe responsible for?
Auditory reception center
60
What is receptive aphasia
Cant understand what people are saying or writing
61
What is the cerebellum responsible for?
Coordinates movement, equilibrium, muscle tone, balance and posture
62
What is the first thing you ask on a neurological assessment?
Subjective data Past history Headache & injury Dizziness, Seizure, Tremors, weakness Loss of coordination, numbness difficultly swallowing
63
What are the 5 parts of the neurological assessment after subjective?
1. Mental status 2. Cranial nerves 3. Proprioception & cerebellar function 4. Sensory function 5. Reflexes
64
how do you assess mental status?
-Awake & alert? -Orientated to person, place and time? -Clear speech
65
What number on the glasgow coma scale is a coma?
7 or >
66
How do you test the olfactory nerve?
Patient close eyes Close one nostril & present a smell to see if they can identify it -do same on other nostril
67
How do you test cranial nerve 2 - optic nerve?
Cover one eye and move your finger to test peripheral 50, 90 and 70 degrees
68
How do you test cranial nerves 3,4,5
PERRLA - find pupils and watch as you shine a light *pupils equal round reactive to light and accommodation -Accommodation - hold an object and bring it closer to patient
69
How do you do a corneal light reflex
Shine a light in center of head and see the reflection in both eyes
70
How do you test the cranial nerve 5 motor function?
Palpate temporal & masseter muscles as person clenches teeth and try to separate jaw by pushing down on chin
71
How do you test cranial nerve 5 sensory function?
Have patient close eyes & get a cotton ball and test all 3 areas of nerve Ophthalmic, Maxillary, Mandibular Tell patient to tell you "now" when they feel it
72
How do you test the cranial nerve 7?
Have patient Smile Frown Close eyes tightly lift eye brows show teeth Puff cheeks *check for mobility & symmetry
73
How do you test the cranial nerve 8?
Test hearing in 1 ear at a time, shield your lips Stand 1-2feet from patients ear and wispher 2 syllable words: Armchair, baseball Have patient repeat word
74
How to test cranial nerve IX and X
Depress tounge, have patient say ahhhh Note pharyngeal movement -Uvula & soft palate should rise in midline -Tonsillar pillars should move medially
75
How to test cranial nerve 11?
Examine sternomastoid & trapezius muscles for equal size -patient rotate head against resistance -Patient shrug shoulders against resistence
76
How to assess cranial nerve 12?
Patient stick out tounge, inspect tongue for tremors Ask patient to say "light tight and dynamite"
77
How to test balance?
Have patient walk 10-20 ft, turn and return Have patient walk heel-to-toe Romberg test- feet together & hold for 20 sec
78
What is the romberg test?
Have patient start with feet together and arms at sides for 20 secs with eyes closed
79
How do you test for coordination and killed movements?
1. rapid alternating movements 2. Alternating fingers 3. Finger to finger 4. Finger to nose 5. Heel to shin
80
How to test the sensory system?
Eyes closed -Test symmetry -Sharp/dull -Light touch -Vibration -Kinesthesia -Stereognosis - id object w/ eyes closed -Graphesthesia - id what was written on hand
81
How do you test the plantar reflex?
With reflex hammer light stroke up lateral side of sole _flexion - abnormal -inversion - normal
82
How to test bicep reflex?
Support patients forarm, place your thumb on bicep tendon and strike a blow
83
How to test triceps?
hold patients arm as it goes limp, strike triceps tendon -Normal = extensions of forearm/elbow
84
How to test brachioradialis reflex?
Hold patients thumb to suspend forarm Strike forearm -normal = flexion and supination
85
How to test quadriceps reflex?
Strike tendon directly below patella Normal = extension
86
How to test achilles reflex?
Hold foot and strike achille tendon -normal = flex
87
What are the disorders of CNS?
Seizure Cerebrovascular accident abnormal positioning
88
What are the 2 abnormal positioning?
decorticate rigidity - cerebral cortex decerebrate rigidity - brainstem damage
89
What is the abnormal positioning with arms at chest
Decorticate
90
What is the abnormal positioning with arms at sides?
Decerebrate
91
What are the disorders of the PNS?
Trigeminal Neuralgia Bells palsy Peripherl neuropathy

101 LEC (15 decks)

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