question

{Role of Respiratory Therapist} Respiratory Therapist does not actually determine medical diagnosis but may assist physician in selected steps of diagnostic reasoning such as recommending specific assessment _______.

answer

tests

question

{Role of Respiratory Therapist} RT's will make interventions based on patient assessment such as, ___________, ________ _________, or __________ then do assessment of intervention.

answer

- Bronchodilators - Oxygen therapy - Suctioning

question

{Role of Respiratory Therapist} List the seven steps of diagnostic reasoning:

answer

1. Identify the pt. problem 2. Clarify the problem(s) 3. Perform additional assessment procedures 4. Formulate list of potential causes 5. obtain specialized test(s) 6. determine potential solution(s) 7. evaluate solution and monitor pt.

question

{Role of Respiratory Therapist} Define Diagnostic reasoning:

answer

Diagnostic reasoning calls for cognitive skills in communicating, selecting assessment tests, interpreting results, formulating solutions, and evaluating treatment plans.

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Preinteraction Stage~ The majority of pt. encounters begin with a review of the pt. chart to i.d. details such as the:

answer

- Name - Age - Gender - Chief complaints - Hx of present illness - The physician's initial orders

question

{STAGES OF PATIENT - CLINICIAN INTERACTION}~Introductory Stage~ An important part of the introductory phase is the confirmation of ________ ___________.

answer

Patient identification

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Introductory Stage~ What is the two-step approach to verifying patient identity in the conscious patient?

answer

1. Use the patient's name and monitor the response 2. Read the patient's identification bracelet

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Introductory Stage~ The introductory phase is important for _________ yourself to the patient, __________ his/her identification, and beginning to establish a ________.

answer

introducing; confirming; rapport

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Introductory Stage~ Upon entering the pt.'s room the first steps is to:

answer

Introduce yourself to the patient

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Introductory Stage~ Introduce yourself to the patient by stating your ______, _______, and ________ of ________.

answer

- Name - Department - Purpose of visit

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Introductory Stage~ Introductory stage establishes ______ with patient and confirm your concern for patient well being.

answer

rapport

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Initial Assessment Stage~ Take time to note the pt.'s general appearance, _________, and ________ to your statements and questions.

answer

attitude; responses

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Initial Assessment Stage~ Identify the current ______ ________ of the patient and begin a brief _______ and brief __________ ___________.

answer

health status; Brief interview and brief physical examination

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Initial Assessment Stage~ You may begin the initial assessment stage during the __________ stage as you communicate with the patient.

answer

introductory

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Initial Assessment Stage~ Formal assessment of the pt. with a brief _________ regarding ________ ________ at admission can now take place.

answer

interview; chief complaints

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Initial Assessment Stage~ The interview is followed in most cases by a brief _______ ________ to determine the pretreatment status of the patient.

answer

physical examination

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Initial Assessment Stage~ Your goal at this point is to determine the _______ __________ of the pt. and to make sure the prescribed treatment ordered by the MD is appropriate.

answer

baseline condition ~You may need to contact the nurse or physician following your assessment to ask for different therapy~

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Treatment and Monitoring Stage~ During the treatment stage you will need to continue to use your assessment skills to evaluate the _______ of the _________.

answer

effectiveness of the treatment

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Treatment and Monitoring Stage~ The RT must provide the _________ and _______ patient response. Then _______ and ________ whether the pt did or did not benefit from therapy and also if there were there _______ _______ _____ from therapy.

answer

-Treatment and monitor - Identify and document - Unwanted side effects

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Treatment and Monitoring Stage~ Therapy should be stopped immediately when side effects occur and the respiratory care ________, ________ ________, and __________ _________ need to be notified in such cases.

answer

- Supervisor - Head Nurse - Attending Physician

question

{STAGES OF PATIENT - CLINICIAN INTERACTION} ~Follow up Stage consists of communicating with the patient on:

answer

- How the patient feels - If there's anything else he/she needs - Let the patient know when you will return

question

{COMMUNICATING THE ASSESSMENT FINDINGS} Sudden clinical deterioration of the patient must be ___________ in the patients chart and ____________ to the appropriate nurse and physician. A _________ of who was communicated with and when should be also kept.

answer

- Documented - Communicated - Record

question

{USE OF SPACE} ~Social Space~ What distance is considered social space?

answer

4 to 12 feet

question

{USE OF SPACE} ~Social Space~ Is used for:

answer

Initial introduction to patient

question

{USE OF SPACE} ~Social Space~ Is the first step in establishing a ________ with the patient.

answer

rapport

question

{USE OF SPACE} ~Social Space~ Allows the practitioner to see the _____ _______.

answer

big picture

question

{USE OF SPACE} ~Social Space~ Do not ask personal questions at the social space because:

answer

Other may overhear

question

{USE OF SPACE} ~Personal Space~ What distance is considered Personal Space?

answer

18 inches to 4 feet

question

{USE OF SPACE} ~Personal Space~ Is most useful for the __________, especially when more personal _________ are being asked.

answer

- Interview - Questions

question

{USE OF SPACE} ~Personal Space~ The Personal space is best entered only after a _______ with the patient has been established in the social space.

answer

rapport

question

{USE OF SPACE} ~Personal Space~ The interview is not only useful for gathering information but also for further development of the _______ between you and the patient.

answer

rapport

question

{USE OF SPACE} ~Personal Space~ The rapport you have with the patient becomes more important when you invade his/her intimate space and when you begin __________ __________.

answer

Therapeutic procedures

question

{USE OF SPACE} ~Personal Space~ Appropriate use of ______ _______ is needed in the personal space because this will increase the patient's trust in you.

answer

eye contact

question

{USE OF SPACE} ~Intimate Space~ At what distance is considered intimate space?

answer

0-18 inches

question

{USE OF SPACE} ~Intimate Space~ Typically invaded only after ______ with the patient has been established and a brief ________ in the personal space.

answer

- Rapport - Interview

question

{USE OF SPACE} ~Intimate Space~ Invasion of the intimate space should be proceeded by a ________ for __________ to do so.

answer

request for permission

question

{USE OF SPACE} ~Intimate Space~ Permission to invade patients intimate space is often obtained simply by requesting permission to ______ to _______ _______ or check ______ _______.

answer

- Listen to breath sounds - Vital signs

question

{USE OF SPACE} ~Intimate Space~ The intimate space is reserved primarily for ________ _________ of the patient and __________ ________.

answer

- Physical exam - Therapeutic procedures

question

{USE OF SPACE} ~Intimate Space~ Minimal or no _____ ______ is used in this space.

answer

eye contact

question

{USE OF SPACE} ~Intimate Space~ Verbal communication with the patient should be limited to _______ ________ or ________ ________.

answer

- Simple questions - Brief commands

question

{USE OF SPACE} ~Intimate Space~ Be aware that some may react negatively to the invasion of their intimate space and be prepared to move more ______ and __________ very carefully in such cases.

answer

slowly and communicate

question

{USE OF SPACE} ~Intimate Space~ What are a few factors that may influence the comfort level of the patient when you enter the intimate space?

answer

- Gender - Age - Race - Physical appearance - Health status - Cultural background

question

{USE OF SPACE} ~Territoriality~ For patient's in a private room the boundary will extend to the _____ of the room.

answer

walls

question

{USE OF SPACE} ~Territoriality~ Removing items from the patient's "territory" should occur only after ________ has been obtained.

answer

permission

question

{USE OF SPACE} ~Territoriality~ Being aware of the territoriality issue will improve your _______ _______ and may avoid _________ a patient.

answer

- Bedside manner - Upsetting

question

✢ What are the ten golden rules of clinical etiquette:

answer

1. Maintain a professional appearance 2. Identify yourself by name and role 3. Do not call adults by their first names 4. Respect and preserve the patient's modesty 5. Do not rest your foot on the bed frame or sit on the patient's bed without permission 6. Do not talk about patients in public places 7. Do not discuss prognosis or other sensitive issues with others in front of the patient 8. Do not argue in front of the patient 9. Do not criticize the actions of other members of the healthcare team with or within earshot of the patient 10. Keep disagreements and criticism out of the patient's chart

question

{Confidentiality} Define the "Privacy Rule":

answer

* The privacy rule establishes regulations for the use and disclosure of the Protected Health Information (PHI) * PHI is any information about health status, provision of health care, or payment for health care that can be linked to an individual * This is interpreted rather broadly and includes any part of the a patient's medical record or payment hx

question

{Expressing Genuine Concern} What are the 5 general techniques commonly used for expressing genuine concern:

answer

1. Face the patient squarely 2. Use appropriate eye contact 3. Maintain an open posture 4. Consider appropriate use of touch 5. Be an active listener

question

{Expressing Genuine Concern} What is one of the most important and powerful techniques for demonstrating true concern for the patient?

answer

eye contact

question

{Expressing Genuine Concern} What is another powerful tool used to express genuine concern to the patient, but also is the most difficult technique to use appropriately?

answer

Touch

question

{Expressing Genuine Concern} Touch to communicate empathy should only be used in those patient in which you have established a _______ ______.

answer

solid rapport

question

{Expressing Genuine Concern} Only certain site on a patient are acceptable for you to touch as an empathic gesture. These sites include:

answer

- Hands - Arms - Shoulders

question

{Expressing Genuine Concern} Being an active ________ and carefully _______ to what a patient has to say is another technique used to show genuine concern.

answer

- listener - listening

question

{Expressing Genuine Concern} What are some techniques used to demonstrate active listening:

answer

- Good eye contact - Asking for clarification on certain points - Brief note-taking

question

{Expressing Genuine Concern} ________ ________ can lead to more accurate assessments when all details are noted.

answer

Active listening

question

{Interpreting diagnostic test results} Define True Negative:

answer

Normal results are said to be a true negative if the patient truly lacks the disease.

question

{Interpreting diagnostic test results} Define True Positive:

answer

Abnormal results are said to be a true positive if they are abnormal as a result of the disease.

question

{Interpreting diagnostic test results} Define False Negative:

answer

When a pt. immune system is not strong enough to cause a significant reaction to the test given such as a TB skin test.

question

{Interpreting diagnostic test results} Define False Positive:

answer

A false positive suggest that a certain disease test may be present when in fact it is not.

question

{Interpreting diagnostic test results} Two other important concepts related to interpreting diagnostic tests are:

answer

- Sensitivity - Specificity

question

{Interpreting diagnostic test results} Define Sensitivity:

answer

Sensitivity refers to how good a test is at correctly identifying patients who have the suspected disease.

question

{Interpreting diagnostic test results} A test with a high sensitivity will produce ________ results in most patients with the disease.

answer

positive

question

{Interpreting diagnostic test results} A test with a sensitivity of ____% is never falsely negative (normal) in a person with a suspected disease.

answer

100%

question

{Interpreting diagnostic test results} Unfortunately, some tests with a high sensitivity are not very specific and thus _______ results can be seen in patients who do not have the suspected disease.

answer

positive

question

{Interpreting diagnostic test results} Define Specificity:

answer

Specificity refers to how good a test is at correctly excluding patients who do not have the suspected disease

question

{Interpreting diagnostic test results} A test with a high specificity will rarely produce a _______ result in a patient who does not have the suspected disease.

answer

positive

question

{Interpreting diagnostic test results} A _____% specific test is never positive (abnormal) in a person without the suspected disease.

answer

100%

question

{PATIENT INTERVIEW} Define objective data:

answer

The physical exam provides objective data or that which can be seen, felt, smelled, or heard by the examiner, commonly referred to as signs.

question

{PATIENT INTERVIEW} Define Subjective data:

answer

The review of systems provides subjective data, or that which is evident only to the patient and cannot be perceived by an observer or is no longer present for the observer to see and therefore can only be described by the patient.

question

{PATIENT INTERVIEW} Define symptoms:

answer

Subjective manifestations of disease

question

{PATIENT INTERVIEW} Define pertinent negatives:

answer

Negative responses to important questions asked at anytime during the interview

question

{PATIENT INTERVIEW} Define pertinent positives:

answer

Affirmative responses to important questions asked at anytime during the interview

question

{PATIENT INTERVIEW} Define packs per years:

answer

The term packs per years refers to the number of years the patient has smoked times the number of packs smoked each day. [If a pt. smoked 3 packs a day for 10 years, it would be recorded as a 30 pack year smoke hx]

question

{PATIENT INTERVIEW} The Hx is the __________ of comprehensive assessment- a written picture of the patient's perception of his/her ________ _______, _______ _______, and _________ of __________. It comprises subjective data- those which the patient ________, _______, or _________ that cannot be perceived by an observer.

answer

- Foundation - Health status - Current problems - Effectiveness of treatment - Reports - Feels - Experiences

question

{PATIENT INTERVIEW} What are the 5 factors that influence communication:

answer

1. Internal Factors 2. Sensory/Emotional Factors 3. Environmental Factors 4. Verbal Expression 5. Nonverbal Expression

question

{PATIENT INTERVIEW} What are the potential effects of Internal Factors that can influence communication:

answer

- Education - Cultural heritage - Religious beliefs - Previous experiences - Self concept - Attitudes, Values - Listening habits - Preoccupation, Feelings

question

{PATIENT INTERVIEW} What are the potential effects of Sensory/Emotional Factors that can influence communication:

answer

- Fear - Stress, Anxiety - Pain - Mental Acuity - Brain damage - Hypoxia - Sight - Hearing - Speech impairment

question

{PATIENT INTERVIEW} What are the potential effects of Environmental Factors that can influence communication:

answer

- Lights - Noise - Privacy - Distance - Temperature

question

{PATIENT INTERVIEW} What are the potential effects of Nonverbal Expression that can influence communication:

answer

• Facial expressions • Body movement • Touch • Eye contact • Send signals of compassion, empathy, professionalism • Body movement • Facial expression • Dress, Professionalism • Warmth, Interest - Non verbal messages can say more than actual words

question

{PATIENT INTERVIEW} What are the potential effects of Verbal Expression that can influence communication:

answer

- Language Barrier - Jargon - Choice of words/questions - Feedback, Voice tone

question

{PATIENT INTERVIEW} What is one of the most common mistake made by the interviewer?

answer

Failing to listen carefully to the patient's answers and questions

question

{Structuring the interview} What are the 4 points to keep in mind to facilitate an effective interaction with the patient:

answer

1. Your ability to project a sense of undivided interest in the patient is the key to a successful interview and patient rapport 2. Introduction establishes your professional role, asks permission to be involved in the pt.'s care, and conveys your interest in the pt. 3. Professional conduct shows your respect for the pt.'s beliefs, attitudes, and rights and enhances pt. rapport 4. A relaxed conversational style on the part of the health care professional with questions and statements that communicate empathy encourages pt.'s to express their concerns.

question

{Questions and Statements used to facilitate conversational interviewing} Using a Conversational style by mixing the types of questions and responses encourages spontaneous descriptions by the patient while giving enough direction to _______, _______, and _______ details.

answer

- Clarify - Quantify - Qualify

question

{Questions and Statements used to facilitate conversational interviewing} What type of questions encourages patients to describe events and priorities as they see them and thereby help bring out concerns and attitudes and promotes understanding?

answer

Open-ended questions

question

{Questions and Statements used to facilitate conversational interviewing} What type of questions such as "When did your last cough start?" or "How long did the pain last?" focus on specific information and to clarify issues and discrepancies in the patient's statements.

answer

Closed questions/Indirect questions ☞Clarify issues - Example: • Are you saying you can breath better now that you are not taking your heart medication ☞Clarify discrepancies- Example: • If I understood you correctly, it is harder for you to breath now than before your treatment

question

{Questions and Statements used to facilitate conversational interviewing} ___________ questions and statements as opposed to leading questions are preferred for all interactions with the pt. Leading questions prompt the pt. to provide a certain answer and therefore may lead to inaccurate information.

answer

Neutral - Example: • What happened next

question

Neutral questions also may give a patient a choice of responses while focusing on the type of _________ _________. - Example: • Would you say there was a teaspoon or a tablespoon

answer

information desired - Example: • Would you say there was a teaspoon or a tablespoon

question

{Questions and Statements used to facilitate conversational interviewing} What type of questioning is better for brief interview such as a follow up on results of therapy?

answer

Direct questions • Example: - Did the oxygen help - How long did the pain last after the last pain med

question

{Questions and Statements used to facilitate conversational interviewing} Reflecting (echoing) is:

answer

Repeating words, thoughts or feelings that the patient has just stated

question

{Questions and Statements used to facilitate conversational interviewing} Reflecting phrases show _______ and lets the patient know that you are ________.

answer

-Interest -Listening

question

{Questions and Statements used to facilitate conversational interviewing} Reflecting phrases are used to _______ and ________ the patient to elaborate on a particular point.

answer

clarify and stimulate • Example: - You are disappointed that your shortness of breath is not getting to be any less

question

What are some alternative sources for obtaining a patient's history?

answer

- Family members - Friends - Works associates - Previous Physicians - Past medical records

question

A patient interview, whether a short assessment of therapy or an extended history, must allow the patient to feel secure and free to discuss personal things. Name 5 things that can be done to help obtain a good rapport with a patient:

answer

1. Dress and act professionally 2. Project a sense of undivided interest 3. Use a relaxed conversational style 4. Respect the patient's beliefs and attitudes 5. Remember the patient's conversation with you and the medical record are confidential

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Systemic disease processes many times is seen as abnormalities of the ____________ system

answer

cardiopulmonary

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Cardiopulmonary disease states may affect other body systems, so it is important that the Respiratory Therapist be aware of the ______ _______- history and complaints

answer

entire patient

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Hx recorded in emergency situations are usually limited to describing events surrounding the pt.'s immediate condition, with hours and sometimes days before a _______, much less a ________ ________, can be obtained.

answer

Name; complete Hx

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Nursing Hx emphasize the effect of the symptoms on ______ of ______ ______ and ________ ________ needs of the pt. and family.

answer

ADL's and emotional support

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Hx performed by a physician emphasize making a ___________.

answer

Diagnosis

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Since diagnosis and initial treatment may be done before there is time to dictate the Hx, the experienced MD may record data obtained from:

answer

- The Hx - Physical exam - Lab tests - X-ray films

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Although variations in recording styles do exist, all histories contain the following same types of information:

answer

• General background information • Screening information • Description of present health status or illness

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Define Background information:

answer

Background information tells the interviewer who the pt. is and what types of diseases are likely to develop.

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Background information also provides a basic understanding of the pt.'s previous experiences with illness and health care and the pt.'s current life situation, including the effects of _______, _______, ________, and _______ on health.

answer

• Culture • Attitudes • Relationships • Finances

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Define Screening information:

answer

Screening information is designed to uncover problem areas the pt. forgot to mention or omitted.

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Screening information is classically obtained by a _____-to-______ review of all body systems but may also be obtained by a review of common ________ or from a description of ________ _________.

answer

- Head-to-Toe - Diseases - Body functions

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} A Description of Present Health Status or Illness is included even in the briefest ______.

answer

Histories

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} What are the most commonly used headings, even though Reason for Visit and Current Health Status may be seen in some outpatient records.

answer

• Chief Complaint (CC) • Hx of Present Illness (HPI)

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} _______ _______ and _____ of ______ _______is the information that most concerns the patient, the interview and recording of the Hx begins with this information:

answer

• Chief Complaint (CC) • Hx of Present Illness (HPI)

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Define Review of Systems (ROS):

answer

Review of Systems is a recording of past and present information that may be related to the present problem but might otherwise have been overlooked.

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} The Review of Systems is grouped by _______ or ________ systems. to guarantee completeness and to assist the examiner in arriving at a diagnosis.

answer

body or physiologic systems

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} The Review of Systems is grouped by body or physiologic systems to guarantee __________ and to ______ the examiner in arriving at a diagnosis.

answer

completeness and to assist

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} The Review of Systems provides for recording both ______ and ______ responses so that when the documentation is later reviewed, there's no doubt as to which questions were asked.

answer

Positive and Negative

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} When documenting ROS and experienced MD usually elicit the ROS information in conjunction with the ______-by-______ physical exam; however, the two must not be confused.

answer

System-by-System

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Define Chief Complaint (CC):

answer

The CC is a brief notation explaining why the pt. sought health care

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} The Chief Complaint is the answer to such _____-_____ questions such as "What caused you to come to the hospital?"

answer

Open-ended

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Chief Complaint~ Each Symptom is recorded separately with its _______ or ______ of initial occurrence.

answer

- Duration - Date

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Chief Complaint~ Ideally, symptom descriptions are written in the pt.'s _______ _______. They should not be ________ ________, someone else's ________, or _______ generalities.

answer

- Own words - Diagnostic statements - Opinion - Vague

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Pt.'s with cardiopulmonary problems may also have any of the so-called constitutional symptoms, which are those commonly occurring with problems in any of the ______ systems.

answer

body

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Constitutional symptoms include:

answer

• Chills • Fever • Excessive sweating • Loss of appetite (anorexia) • Nausea • Vomiting • Weight loss • Weakness • Exercise intolerance • Altered sleep patterns • Fatigue • Hay fever • Allergies • Acute sinusitis • Postnasal drip •Frequent bouts with cold and flu

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Symptoms commonly associated with cardiopulmonary problems include:

answer

• Cough - productive and non productive • Dyspnea • Wheezing • Hoarseness • Dizziness • Headache • Ankle swelling • Chest pain • Hemoptysis • Voice changes • Syncope • Altered mental status

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} When the pt.'s description and the interviewer's clarifying questions are complete, the following information should be gathered for each symptom listed in the CC and each symptom identified during the interview:

answer

- Onset - when and type - Setting - circumstances surrounding onset - Location (where on the body does the symptom occur - example chest pain) - Severity - Quantity - Quality - Frequency - Duration - Course - Associated symptoms - Aggravating factors - Alleviating factors

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} Information recorded in the Past Hx includes a Chronological listing of the following:

answer

- Illness and development since birth - Surgeries and hospitalizations - Injuries and accidents - Immunizations - Allergies - include description of allergic events and effective treatment - Medications - prescribed and OTC, vitamins and home remedies - Names of physicians and sources and types of previous health care - Habits- diet, sleep, exercise, coffee, tea, tobacco, illicit drugs - Description of general health

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Disease and procedure history~ Frequency and treatment of respiratory related diseases are questions to ask a patient with cardiopulmonary complaints such as:

answer

- Pneumonia - Pleurisy - Fungal diseases - Tuberculosis - Colds - Sinus infections - Bronchiectasis - Asthma - Allergies - Pneumothorax - Bronchitis - Emphysema

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Disease and procedure history~ Cardiac and Pulmonary disease are many times closely related, so when getting a history on a patient with pulmonary disease also ask about history of:

answer

- Heart attack - Hypertension - Heart failure - Congenital heart disease

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Drug and Smoking history~ Smoking history closely predicts certain lung diseases and problems. What are the types of questions asked to obtain this information:

answer

- Use the term pack years • Number of years smoked x packs per day - Age when smoking began - Smoke anything other than tobacco - Does anyone smoke in your presence

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Family history~ Some diseases have strong familial or genetic relationships such as:

answer

- Cystic Fibrosis - Asthma - Allergies - Lung cancer - Alpha1 Antitrypsin Deficiency - Neuromuscular Disorders - Kyphosis - Scoliosis - Sleep disturbances - Sleep Apnea -Collagen-Vascular Diseases (such as Lupus Erythematosus) - Cardiovascular disorders (such as hypertension, heart attack, heart failure, and congenital abnormalities) - Diabetes - Obesity

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Occupational and Environmental History~ Reactions to inhaled toxic substances may occur within:

answer

minutes or may take days or week

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Occupational and Environmental History~ Hypersensitivity reactions may be _____ or _____ and often occur in patterns.

answer

• Acute • Delayed

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Occupational and Environmental History~ Shortness of Breath, wheezes, or flulike symptoms usually occur within ___ to ___ hours of exposure.

answer

4 to 8

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Occupational and Environmental History~ Rapid toxic reaction to inhaled fumes causes upper airway irritation warning workers of immediate danger these gases include:

answer

• Ammonia • Chlorine • Sulfur dioxide

question

{CARDIOPULMONARY HISTORY AND COMPREHENSIVE HEALTH HISTORY} ~Occupational and Environmental History~ Gasses that take longer for airways to react include:

answer

• Phosgene • Nitrogen dioxide

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