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TEST 3 Flashcards

1
Q

What are the subjective data questions you ask for heart?

A

Chest pain?
Dyspnea (trouble breathing)
Orthopnea (diff breathing laying flat)
Cough
Fatique
Cyanosis
Edema
Nocturia
Past history
Risk factors

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2
Q

What is different in IPPA for cardia?

A

No percuss for cardiac

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3
Q

What are we inspecting neck for?

A

Symmetry
Lumps
Pulsations
Jugular venous pulse - normal when laying flat/not normal when sitting up

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4
Q

What does a jugular venous pulse mean when sitting upright?

A

Increased pressure in heart

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5
Q

What does a Brutis mean if you hear it on carotid?

A

Carotid artery narrowing from plaque build up

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6
Q

What are you inspecting on precordium?

A

Shape, abnormalitlies, heave lift

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7
Q

What does it mean if you see heart pounding through chest?

A

Enlargment of heart at R or L ventricle —where ever you see it

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8
Q

Normal heart sounds are what frequency? Murmurs are heard with what frequency?

A

Normal - high - diaphragm
Murmur - low - bell

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9
Q

What are the 5 areas we asculatate heart sounds?

A
  1. Aortic
  2. Pulmonic
  3. Erbs point
  4. Tricuspid
  5. Mitral
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10
Q

What sound is S1?

A

Closure of AV valves
Loudest at apex
Beginning of systole

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11
Q

What sound is S2?

A

Closure of semilunar valves
loudest at base
end of systole

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12
Q

What are murmurs

A

Structural defects in valves or unusual openings in chambers resulting in backwash of blood going backward

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13
Q

When documenting murmurs what do you note?

A

Location - intercostal space, Arotic? mitral? what area

Timing - S1? S2? after?

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14
Q

What is a systolic murmur?

A

AFter S2.
Lubb swish dubb

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15
Q

What is a diastolic murmur?

A

After S2
lubb dubb swich

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16
Q

What are the gradings for murmurs?

A

1 - barely audible
2 - faint
3. Moderate, easy to hear
4. Loud w/ thrill
5. Very loud, can hear with part of stethoscope off chest, thrill
6. Loudest, can hear w/o stethoscpe. Thrill

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17
Q

What are the risk factors for cAD and stroke?

A

African america
High blood pressure
Smoking
High cholesterol
Obesity
diabetes
Decreased activity level

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18
Q

What defines heart failure?

A

Pump failure
Low Cardiac output >4-6l/min
Low BP

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19
Q

What signs are Left sided heart failure?

A

BACK UP IN LUNGS
Pulmonary congestion
Dyspnea
Orthopnea

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20
Q

What signs are Right sided heart failure?

A

BACK UP IN BODY TISSUES
Extremity edema
JVD
Kidneys retain water
**treatment diuretic

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21
Q

What are we assessing when looking at peripheral vascular system
?

A

Vessels transpoting blood, fluid or lumph

*Arteries/veins/lymph

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22
Q

What do arteries do?

A

High pressure system
Supply oxygen and nutrients to tissues

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23
Q

What arteries do we examine?

A

Temporal, carotid
Brachial, Radial
Femoral, popliteal, dorsalis pedis, posterior tibial

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24
Q

What are veins?

A

Parallel to arteries
Low pressure system
- Contracting skeletal muscles milk blood back to heart
- Pressure gradient
_Valves ensure unidirectional flow

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25
What veins do we examin?
Jugular, subclavian Cephalic, basilic, median cubital Great saphenous, small saphenous
26
What is the lumphatic system?
Retrieves excess fluid from tissue spaces Propelled by skeletal muscles contract, pressure changes when breathing, valves
27
What are the 2 main trunks of lymphatic system?
Right lymphatic duct - head Thoracic ducts - left side and rest of body
28
What is the function of lymphatic system
-Conserve fluid and plasma proteins -Major part of immune system -Absorbs lipids from intestinal tract
29
What subjective data do we ask for perpherial vascular?
Do you any pain in arms or legs? Any skin changes? Swelling/edema lymph node enlargement?
30
What would pain in arms and legs indicate?
Claudication - Part blockage, lack of oxygenated blood flow
31
What would skin changes indicate in peripheral vascular?
Poor circulation
32
If you touch a patient and they are cold what does it indicate?
Problem with circulation
33
What are the grades for edema?
1+ mild, slight indentation 2+ moderate, indent subsides rapidly 3+ deep, remains for short time, leg looks swollen 4+ very deep, indent last long time, leg very swollen
34
What are the risk factors for venous issues?
Prolonged standing or sitting Prolonged bed rest Hypercoaguable states Vein wall trauma - IV's Obesity Later months pregnancy
35
What are risk factors for arterial disease?
Older adults Hypertension Smoking diabetes INcrease lipid levels Obesity
36
What are the differences between Arterial and Venous disease?
Arterial Claudication Relief w/ rest Pale, cyanosis, pulseless, cool, atrophic Ischemic ulcer Venous Pain with standing, sitting/end of day = worse Relief w/ walking Brown discoloration, red warm swollen - bc of blood pooling Stasis ulcer
37
S1 is the closure of what valve?
Mitrial and tricuspid
38
Where does gas exchange take place?
Alveoli
39
The R and L lung have how many sections?
R - 3 RUL, RML, RLL L - 2 LUL, LLL
40
What is the Visceral pleura?
Lining of lungs
41
What is the parietal pleura?
Lining of chest wall
42
What is Hemothorax?
Blood in intrapleural space
43
What is empyema?
Puss in intrapleural space
44
What is pneumothorax?
Air in intrapleural space
45
What can happen if the intrapleural space gets filled with air?
lungs could collapse
46
What is the subjective data we ask for lungs?
Do you have a history of coughing? Is it productive/nonproductive? COCA - Sputum? Any shortness of breath? What are you doing when you have SOB? Chest pain? Smoking? Environmental exposure?
47
What are you looking for when you inspect the lungs?
Shape - front-back should be less than side to side Level of consciousness - awake/lathargic? Position of patient -relaxed, upright? Use of accessory muscles Location of trachea Skin color and condition Respiratory rate
48
What is a barrel chest?
Front to back same size as left to right
49
What is scoliosis?
Genetic Lateral deviation of spine
50
What is kyphosis?
Hunched over, spine toward back *bad posture
51
What is pectus excavatum?
Caved in sternum
52
What is pectus carinatum?
Protruding sternum, pigeon chest
53
What is tachypnea?
Shallow breathing(not deep) <20bpm
54
What is Bradypnea?
Slow >12bpm
55
What is hyperventilation?
Deep and fast - losing C02 Fast = alkaline
56
What is Cheyne-stokes?
near end of lif, regular-irregular pattern w/ periods of apnea
57
When we are palpating the lungs what are we palpating for?
Symmertric expansion - place hands at base t10, thumbs near spine, patient takes deep breath, should be equal Tactile fremitus - vibration, have patient say 99 then palpiate lungs - vibration should be equal Note areas of tenderness, lumps or masses
58
What part of IPPA do we not do for lungs?
Percuss!
59
How many places do we auscultate on front and back ?
10 on front 18 on back
60
How many places do we auscultate on front and back ?
10 on front 18 on back
61
What do crackles sound like and what does it mean?
Popping/bubbling Due to fluid, mucus or pus
62
What does wheezing sound like?
Like whistling due to airway constriction/narrowing
63
What does stridor sound like?
Its in trachea High pitched whistle during inspiration Due to obstruction of upper airway
64
What does Ronchi sound like?
Like snoring Due to airway narrowing and secretion
65
What is Atelectasis?
Collapse of aveloi *postop // treatement is deep breathing
66
What are the 2 areas of COPD?
Chronic bronchitis - ,mucus Emphysema - avleoli problem/lose elasticity
67
What is Asthma?
Presents like bronchitis but some have mucous some dont
68
What is pleural effusion?
Something is in intrapleural space
69
What is pleural effusion caused by heart failure?
Blood backs up into intrapleural space
70
What is hemothorax?
Bleeding into intrapleural space from trauma
71
What is Pneumothorax?
Collapsed lung --Cynaosis, tachy, tracheal deviation, decreased breath sounds
72
What are the signs of tuberculosis?
Rust colored sputum Fever Night sweats *need to wear N95
73
What are clubbed fingers and who gets them?
Patients with prolonged hypoxia and its a distortion of fingertips
74
What organs are on RIGHT side top to bottom?
Liver Gallbladder Appendix
75
What organ is on left side of body
Spleen
76
What organ is middle pelvis?
Bladder
77
What are the quadrants of abdomin? 3 top to bottom
Epigastric Umbilical Hypogastric
78
WHat subjective questions do you ask for abdominial assessment?
Hows appetite? Any dysphagia - difficulty swallowing Ab pain? Medications? Bowel habits? STool? COCA? past ab history
79
What is different about IPPA for abdomin?
IAPP
80
Why do we do Palpation last for abs?
To prevent pain and guarding
81
What do we inspect for ab?
Even skin tone Symmetry Umbilicus No pulsations **DONT touch any PULSATIONS! Hair distribution
82
What could pulsation on AB be?
Anersym
83
What are the 4 ways to document the ab section on a patient laying down?
Flat Scaphoid - sinking inward Rounded - slight puff Protuberant - like pregnant looking
84
What is peristalsis?
Waves that move fecal material through colon Water is absorbed into capillaries
85
What is constipation? What is diarrhea? What is Colostomy?
Constipation - feces stays in large intestine for long time Diarrhea - feces moves quickly Colostomy - obstruction/damage/disease
86
What do we ausculte for on AB?
Bowel sounds - 5-30 sounds per min **if absent bowel sounds for 5 mins call provider 911
87
Where do we ausculte bruits on AB?
Aorta (middle) R&L Renal artery R&L iliac artery R&L femoral artery*
88
How do we percus on AB?
Place middle finger firmly then tap on finger --should hear hollw sound - tympany
89
What do we palpate for on AB?
Mass or tenderness Rebound tenderness- pain apon release of pressure - appendicitis **Keep area of pain for last
90
What would a bluish-purple periumbilical indicate?
Bleeding in GI Cullens signs
91
What are the signs of cholecystitis? (murphys signs)
Pain in upper right quad/ inflammation of gallbladder
92
Where am I looking for blood in AB assess?
Stool, gums, urine, skin color
93
Where is the pain in a patient with pancreatitis
Epigastric area
94
What do gallstones do?
Block ducts from releasing bile. STool will then look gray, white, clay Bile will also back up into the liver and create jaundice in patients bile helps absorb fat
95
What is Mcburneys point?
Right Lower Quad Rebound of tissues = pain appenditis
96
Where is bile produced? where is it stored?
Produced in liver stored in gallbladder
97
If Bile doesnt come out of the gallbladder what happens?
backs up into the liver and gets into the system creating jaundice
98
Pancreatitis?
Pancreasis located in epigastric area

101 LEC (15 decks)

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