Vitals

Question 1

What types of reactions can a latex allergy form?

Answer 1

Contact dermatitis or systemic reactions

Question 2

What are the components of the physical exam?

Answer 2

Inspection, palpation, percussion, auscultation

Question 3

What are the components of inspection?

Answer 3

observation, lighting, exposure of body parts (general health, body habitus, posture, affect, motor activity, gait, dress/grooming, personal hygeine, odor of body/breath, facial expression, skin color/state, level of awareness)

Question 4

What is the best type of lighting in the PE?

Answer 4

Tangential

Question 5

Should you exam someone through their clothes? What’s this called?

Answer 5

NO - peek-a-boo exams

Question 6

How is palpation properly done?

Answer 6

Using the palmar surface of fingers and finger pads in a rolling or rocking motion

Question 7

When do you use the back of your hands for palpation?

Answer 7

To assess temperature

Question 8

What is normal temperature in F and C?

Answer 8

98.6/37

Question 9

How is tactile fremitus assessed?

Answer 9

Using the ulnar aspect of your hands

Question 10

What are the 5 sounds you hear with percussion?

Answer 10

Tympany, hyperresonance, resonance, dullness, flatness

Question 11

What is tympany and where would you hear it?

Answer 11

sounds like a drum, over an empty stomach

Question 12

When would you expect to hear resonance/hyperresonance?

Answer 12

in the lungs due to air pressure

Question 13

When would you hear flat sounds?

Answer 13

palpation over fluids or solids

Question 14

When would you hear dull sounds?

Answer 14

palpation over a visceral organ, solids, constipation

Question 15

What joint is percussed over during direct percussion?

Answer 15

DIP

Question 16

What are you listening for in auscultation?

Answer 16

intensity, pitch, duration, quality

Question 17

What is the diaphragm of the stethoscope used for?

Answer 17

listening to high-pitched sounds (S1/S2)

Question 18

What is the bell of the stethoscope used for?

Answer 18

listening to low-pitched sounds (S3/S4 gallop or murmur)

Question 19

What should be avoided 30 minutes before vital signs are collected?

Answer 19

EtOH, caffeine, tobacco, exercise

Question 20

What 3 components are checked with pulse?

Answer 20

Location, character, rhythm

Question 21

What are the locations to gather pulse?

Answer 21

radial, brachial, carotid

Question 22

What characters are associated with pulse?

Answer 22

Bounding, normal, weak

Question 23

What rhythms are associated with pulse?

Answer 23

regular, regularly irregular, irregularly irregular

Question 24

What is the normal pulse?

Answer 24

60-100

Question 25

What does lack of symmetrical BP indicate?

Answer 25

pathology/stenosis

Question 26

What happens to BP if the cuff is too small/big?

Answer 26

Big: lower BP, Small: high BP

Question 27

What do you do if you get someones pulse for 15 seconds and it is irregular?

Answer 27

Do it for a full minute

Question 28

What is the auscultatory gap?

Answer 28

period at which Kortkoff sounds indicating true systolic pressure fade away and reappear at a lower pressure point

Question 29

What can the auscultatory gap result in if you don't avoid it?

Answer 29

low systolic BP

Question 30

How do you avoid the auscultatory gap?

Answer 30

pump cuff up until no radial pulse is present (this is the systolic palpable pressure) then pump the cuff 30 mm Hg above this

Question 31

What vital signs are postural?

Answer 31

BP and pulse

Question 32

What are BP and pulse used to assess?

Answer 32

volume status and autonomic function

Question 33

During orthostatic BP, if the patient has autonomic dsfunction and they are standing, what will HR and BP be like?

Answer 33

Both low

Question 34

If a normal person stands up and you take their BP and pulse, what would it be like?

Answer 34

high HR, low BP

Question 35

What is a positive orthostatic vital sign?

Answer 35

increase in the pulse over 10 bpm (means its autonomic) and a 20/10 (either) difference in BP from sitting to standing

Question 36

What is considered normal BP?

Answer 36

\<120/80

Question 37

What is considered preHTN?

Answer 37

120-139/80-89

Question 38

What is considered stage 1 HTN?

Answer 38

140-159/90-99

Question 39

What is considered stage 2 HTN?

Answer 39

\>160/100

Question 40

What is considered HOTN?

Answer 40

SBP \< 90

Question 41

What can be assumed if a patient has a radial pulse?

Answer 41

SBP is at least 80

Question 42

What is considered relative HOTN?

Answer 42

Patient with normally elevated BP the a lower reading (110/70)

Question 43

Define tachpnea

Answer 43

rapid, shallow breathing

Question 44

Define hyperpnea

Answer 44

rapid, deep breathing (hyperventilation)

Question 45

Define bradypnea

Answer 45

slow breathing

Question 46

Define apnea

Answer 46

no breathing

Question 47

Define Cheyne-Stokes

Answer 47

Apnea alternation with hyperpnea

Question 48

What can cause Cheyne-stokes?

Answer 48

CHF, drugs, uremia, brain damage

Question 49

Define ataxic - biots

Answer 49

unpredictably irregular breathing associated with respiratory depression or brain damage

Question 50

Where can you measure temperature with a glass or digital thermometer?

Answer 50

oral, rectal, axillary

Question 51

Where can you measure T with "temp strips"

Answer 51

cutaneous (forehead)

Question 52

What is normal axillary T?

Answer 52

97.6

Question 53

What is normal rectal T?

Answer 53

99.4

Question 54

What is normal aural T?

Answer 54

99.6

Question 55

Which T is most/least accurate?

Answer 55

Rectal/axillary

Question 56

What is the normal number of respirations per minute?

Answer 56

14-20

Question 57

What is considered a fever? (C and F)

Answer 57

38/100.5

Question 58

What is the 5th vital sign?

Answer 58

weight

Question 59

How many cm are per inch?

Answer 59

2.54

Question 60

What is the 1, 5 and 10 year avg SBP?

Answer 60

80, 90, 97

Question 61

NAD

Answer 61

No apparent distress

Question 62

What should O2 saturation be above?

Answer 62

95

Question 63

What toxin can cause falsely appear as normal O2 saturation?

Answer 63

carbon monoxide poisoning

Question 64

What should a fetus HR be at 8 mos gestation?

Answer 64

160

Question 65

5 reasons for good documentation?

Answer 65

communication/continuity, legal, quality assurance, billing, compliance

Question 66

Is it OK to document beliefs/health goals, assessment of cognitive status in the HPI?

Answer 66

yes

Question 67

When is it OK to document normal or WNL?

Answer 67

Never in PE! For labs and SOAP notes if available in chart elsewhere

Question 68

Where are sOAP notes used?

Answer 68

F/u, progress notes, observation units

Question 69

Where does PE go in SOAP notes?

Answer 69

"O"

Question 70

When do new order sets need to be written?

Answer 70

when a pt is being transferred to a different level of care

Question 71

What should discharge orders include?

Answer 71

f/u care instructions and all things necessary to care for the pt, never PRN

Question 72

What tense is used when writing write-ups?

Answer 72

present

Question 73

What words are prohibited in PE?

Answer 73

NORMAL (and use intact sparingly)