question

Know indications or purpose for bedside assessments

answer

physical assessment, interview, establishing baseline; opportunity to establish rapport with patient

question

What are the components of bedside assessment

answer

physical exam, chief complaint, history of present illness, past medical history

question

Patient Interview

answer

primary way of obtaining comprehensive information about the patient in order to provide effective patient-centered care

question

Chief Complaint

answer

a concise statement describing the symptom, problem, condition, diagnosis, physician recommended return, or other factor that is the reason for a medical encounter

question

History of Present Illness

answer

a detailed interview prompted by the chief complaint or presenting symptom

question

Past Medical History

answer

narrative or record of past events and circumstances that are or may be relevant to a patient's current state of health

question

Family/Social/Environmental

answer

family medical history, hobbies, occupation, and life happenings such as vacation

question

Dyspnea

answer

a patient perceived shortness of breath

question

Orthopnea

answer

breathing is easier in an upright position

question

Cough

answer

dry, loose, productive, or effective

question

Sputum Production

answer

occurs when the respiratory tract secretions are beyond the ability of the mucociliary mechanism to deal with

question

Hemoptysis

answer

blood in the sputum

question

What is typical of pleuritic chest pain?

answer

locate laterally, sharp and stabbing in nature, and increases with breathing

question

Fever

answer

have a temperature

question

Orientation x 3

answer

time, space-place, person(who they are)

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Confused

answer

slow mental responses, decreased or dulled perception, incoherent thoughts, and exhibits slight decrease in consciousnous

question

Delirious

answer

easily agitated, irritable, and exhibits hallucinations

question

Lethargic

answer

sleepy, arouses easily, and responds appropriately when aroused

question

Obtunded

answer

awakens only with difficulty and responds appropriately when aroused

question

Stuporous

answer

does not awaken completely, has decreased mental and physical activity, responds to pain and exhibits deep tendon reflexes, and responds slowly to verbal stimuli

question

Comatose

answer

unconscious, does not respond to stimuli, does not move voluntarily, exhibits signs of upper motor neuron dysfunction, and loses reflexes with deep or prolonged unconsciousness

question

What are considered vital signs?

answer

temperature, respiratory rate, blood pressure, and heart rate

question

Body Temperature

answer

normal is 37° C

question

Febrile

answer

when the patient has a body temperature that is elevated which is caused by disease

question

Afebrile

answer

when the patient has a body temperature that is normal

question

Hyperthermia

answer

when the patient has a body temperature is above normal

question

Hypothermia

answer

when the patient has a body temperature below normal

question

Pulse Rate

answer

60 - 100 beats per minute

question

Tachycardia

answer

pulse rate over 100 beats per minute

question

Bradycardia

answer

pulse rate under 60 beats per minute

question

Paradoxical Pulse

answer

abnormally large decrease in systolic blood pressure and pulse wave amplitude during inspiration

question

Blood Pressure

answer

the force exerted against the wall of the arteries as the blood moves through them

question

Systole

answer

peak force, contraction of the left ventricle with a normal range of 90 - 140 mmHg

question

Diastole

answer

force in major arteries during relaxation of the ventricle with a normal range of 60 - 90 mmHg

question

Sphygmomanometer

answer

an instrument for measuring blood pressure, typically consisting of an inflatable rubber cuff that is applied to the arm and connected to a column of mercury next to a graduated scale, enabling the determination of systolic and diastolic blood pressure by increasing and gradually releasing the pressure in the cuff

question

Korotkoff Sounds

answer

arterial sounds heard through a stethoscope applied to the brachial artery distal to the cuff of a sphygmomanometer

question

Syncope

answer

temporary loss of consciousness caused by a fall in blood pressure

question

Hypertension

answer

abnormally high blood pressure

question

Hypotension

answer

abnormally low blood pressure

question

Respiratory Rate

answer

normal range is 10 - 20 breaths per minute

question

Tachypnea

answer

abnormally high respiratory rate over 20 breaths per minute caused by exertion, fever, hypoxemia, metabolic acidosis, anxiety, or pain

question

Bradypnea

answer

abnormally low respiratory rate under 10 breaths per minute caused by head injuries, hypothermia, medications, or narcotics

question

Apnea

answer

complete absence of spontaneous respiration

question

Eupnea

answer

normal spontaneous respiration

question

Biot's Respiration

answer

short episodes of rapid, uniformly deep inspirations followed by 10-30 seconds of apnea

question

Hyperpnea

answer

is increased depth of breathing when required to meet metabolic demand of body tissues with or without an increased frequency

question

Hyperventilation

answer

increased alveolar ventilation (decreased PaCO2)

question

Hypoventilation

answer

decreased alveolar ventilation (increased PaCO2)

question

Cheyne-Stokes Respiration

answer

10 - 30 seconds of apnea followed by a gradual increase in volume and frequency of breathing followed by a gradual decrease in volume of breathing until another apnea occurrence

question

Kussmaul's Respiration

answer

deep and labored breathing pattern often associated with severe metabolic acidosis

question

Nasal Flaring

answer

when the nostrils widen while a person is breathing and is a symptom of difficulty in breathing

question

Cyanosis

answer

a bluish discoloration of the skin resulting from poor circulation or inadequate oxygenation of the blood; normally seen on earlobes, around the mouth, and fingernails

question

Pursed Lip Breathing

answer

used during exhalation to cause back pressure in the small airways which prevents premature collapse

question

Symptoms to look for around the head

answer

nasal flaring, cyanosis, and pursed lip breathing

question

Symptoms to look for around the neck

answer

position of the trachea, suprasternal notch, accessory muscles

question

Position of the Trachea

answer

midline of the neck

question

Positions of the Suprasternal Notch

answer

shifts toward collapse and shifts away increased air-fluid

question

Height of blood column (JVP)

answer

reflects volume and pressure in right side of the heart

question

Internal and External Jugular (JVP)

answer

supine-full; 45° angle 2cm above clavicle

question

What is the most common cause of jugular venous tension?

answer

congestive heart failure in the right of left side

question

Thoracic(chest) Configuration

answer

is the front and back flat with no barrel chest

question

Accessory Muscles

answer

are these being used for respiration; are they overdeveloped

question

Retractions

answer

does suprasternal notch suck in on inspiration

question

Respiratory Rate Ratio

answer

of inspiration to expiration is 1:3

question

What to look at when inspecting the chest area of a patient?

answer

thoracic configuration (is he barrel chested), accessory muscles, retractions, and respiratory rate

question

What do you check during palpation of the chest?

answer

vocal fremitus, thoracic expansion, and skin

question

Vocal Fremitus

answer

check of sound transmitted (vibration) down the tracheobronchial tree and through the lungs

question

Thoracic Expansion

answer

a check of the symmetry of expansion using the thumbs on the back

question

Skin

answer

check for crepitus in the subcutaneous tissues

question

Resonance to percussion

answer

increased is more air (hyperinflation); decreased is consolidation

question

Auscultation

answer

the action of listening to sounds from the heart, lungs, or other organs, typically with a stethoscope, as a part of medical diagnosis

question

Pitch

answer

is it high or low (breath sound component)

question

Amplitude

answer

loudness (breath sound component)

question

Duration

answer

length of inspiration (breath sound component)

question

Tracheal Breath Sounds

answer

normal sounds that has a higher pitch, louder, inspiration and expiration are equal and there is a pause between inspiration and expiration; heard over trachea

question

Bronchovesicular Breath Sounds

answer

normal sounds in the mid-chest area or in the posterior chest between the scapula; found over bronchi

question

Vesicular Breath Sounds

answer

normal sounds heard over the thorax, lower pitched and softer than bronchial breathing; in the periphery and muffled

question

Course Crackles

answer

rhonchi, low vibratory sounds that mean you need to cough

question

Fine Crackles

answer

rales, fluid in alveolus, reopening of alveolus

question

Rales

answer

fine crackles; fluid in the alveolus

question

Wheezes

answer

high pitched, musical sounds due to narrowing of the lumen of the airway

question

Rhonchi

answer

coarse crackles; fluid or mucus in the bronchi

question

Stridor

answer

narrowing of the trachea(upper airway)

question

Diminished

answer

can't hear breath sounds

question

Bronchophony

answer

increased intensity, clarity, and transmission of vocal resonance

question

Whispered Pectoriloquy

answer

an increased loudness of whispering noted during auscultation with a stethoscope on the lung fields on a patient's torso which means consolidation

question

A patient displays the following symptoms: Tracheal deviation to the right, increased vocal fremitus in the right lung field, along with decreased resonance to percussion. The left lung displays normal vocal fremitus and resonance.

answer

right lung atelectasis

question

A patient displays the following symptoms: Tracheal deviation to the left, decreased vocal fremitus in the right lung field along with increased resonance to percussion. The left lung displays normal vocal fremitus and resonance.

answer

right lung pneumothorax

question

A patient displays the following symptoms: Tracheal deviation to the right, normal vocal fremitus in the right lung field along with resonance to percussion. The left lung displays decreased vocal fremitus and increased resonance.

answer

left lung pneumothorax

question

A patient displays the following symptoms: Tracheal deviation to the left, normal vocal fremitus on the right lung field along with normal resonance to percussion. The left lung displays increased vocal fremitus and a decreased resonance to percussion.

answer

left lung atelectasis

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