Term
| What position is a patient in when he is leaning forward with arms braced on chair arms? What type of pt would this be seen in? |
|
Definition
| Tripod; A person with chronic pulmonary disease. |
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Term
| What is the term for fat concentrated in face, neck, trunk with thin extremities, as in Cushing's Disease? |
|
Definition
| Centripetal (truncal) obesity |
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Term
| What should a patient remove before being weighed? |
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Definition
| Shoes and heavy outer clothing. |
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Term
| If you are taking a sequence of repeated weight measurements, what should you aim for? |
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Definition
| Approximately the same time of day and similar clothing for each measurement. |
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Term
| What is the BMI for someone who is "Underweight"? |
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Definition
|
|
Term
| What is the BMI range for "normal" weight? |
|
Definition
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Term
| A patient has a BMI of 26.5. What BMI range do they fall into? |
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Definition
| Overweight. BMI for overweight is 25-29.9. |
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Term
| If you have a patient who is obese, what numerical range should you expect to find their BMI? |
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Definition
| A BMI between 30-39 for obese people. |
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Term
| What is the BMI number for a pt who is "extremely obese"? |
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Definition
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Term
| You have calculated a BMI of 38 for your patient. What is your next step? |
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Definition
| Show the patient where he falls on the BMI table and show recommended weight ranges for his age group. |
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Term
| Android or upper body obesity is characterized by a waist to hip ratio of what? |
|
Definition
Men: 1 or greater
Women: 0.8 or greater |
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Term
| Android or upper body obesity is characterized by a waist to hip ratio of what? |
|
Definition
Men: 1 or greater
Women: 0.8 or greater |
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Term
| What is the importance in determining someone's waist to hip ratio? |
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Definition
| Waist to hip ratio is useful in determining if a pt is at risk for obesity-related diseases and early mortality. |
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Term
|
Definition
| greater proportion of fat in upper body |
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Term
|
Definition
| Most fat is in hip and thighs |
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Term
| What relevant information can you conclude from a man with a waist circumference of >35 inches or woman with WC > 40 inches? |
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Definition
| These pts have increased risk for cardiovascular disease. |
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Term
| What is the normal "core" or deep body temperature? |
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Definition
|
|
Term
| What is the normal resting temperature range? |
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Definition
| Average is 37 C (98.6F) or range of 35.8 C to 37.3 C (96.4F to 99.1F) |
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Term
| What is the equation for BMI? |
|
Definition
BMI= kg/(m^2)
or
BMI= lbs/(in^2) x 703 |
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Term
| How does the rectal temperature average differ from oral temp? |
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Definition
| Rectal temps are generally .7F to 1F hotter than oral temps. |
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Term
| You take a pt's temp at 6 am and it is 97.2F. When you take the temp again at 9 pm it is 98.7F. How do you rationalize this? |
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Definition
| This is a normal cycle of temperature variation. There is a diurnal cycle in the body and temps in the morning are lower and temps taken in the evening are higher. |
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Term
| Name normal events that can raise temperature. |
|
Definition
1. Exercise
2. Age
3. Menstruation cycle |
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|
Term
| How does age affect temperature? |
|
Definition
There are wider temperature variations in infants and children due to less effective heat control mechanisms.
In older adults, they often have lower body temps than any other age group. |
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|
Term
| What is the average temperature for an older adult? |
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Definition
|
|
Term
| Common conversions temperatures: |
|
Definition
104F = 40 C
98.6F = 37 C
95.0F = 35 C |
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Term
| How long should you wait to take an oral temperature after a pt has had ice-cream or chicken broth? |
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Definition
| Wait 15 minutes after a pt has taken any hot or cold liquid. |
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Term
| How long should you wait to take an oral temperature after a pt has smoked? |
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Definition
|
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Term
|
Definition
| Fever, caused by pyrogens secreted by toxic bacteria from infections or tissue breakdown that follows events such as: surgery, trauma, MI. |
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Term
|
Definition
| Usually accidental, prolonged exposure to cold. |
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Term
| The tympanic membrane temperature is a measure of core body temperature so the reading is expected to be ~1 F higher than an oral reading. Why is the TMT a good measurement of core body temp? |
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Definition
| Because the tympanic membrane shares the same blood supply as the hypothalmus. |
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Term
|
Definition
|
|
Term
| What is stroke volume? And what is normal? |
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Definition
| The amount of blood the heart pumps with every beat. Normal is ~70 ml/beat |
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Term
| What is a pressure wave of blood that can be felt in the periphery? |
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Definition
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Term
| How long should you feel a pulse of someone with a weal and thready pulse? |
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Definition
| For a full minute since this is not a normal finding. |
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Term
| How long should you feel the pulse of a healthy adult male with a pulse of regular rate and rhythm? |
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Definition
| 30 seconds and multiply by 2 for the number of BPM. |
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|
Term
| What descriptions should you include when documenting about the pulse? |
|
Definition
| BPM, rate, rhythm, force, elasticity |
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|
Term
| What number would you give a "weak and thready" pulse? |
|
Definition
|
|
Term
| What number would you give a "full, bounding" pulse? |
|
Definition
|
|
Term
| What number would you give a normal pulse? |
|
Definition
|
|
Term
| A normal artery feels: spongy, springy, resilient and straight. |
|
Definition
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|
Term
| When is the best time to assess a persons respirations? |
|
Definition
| When they are not paying attention! Take the Resp while pretending to take Pulse. This will allow the pt to continue breathing normally. |
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Term
| Why should you not inform a PT that you are going to "take their respirations"? |
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Definition
| Sudden awareness of one's breathing may alter the normal pattern of breathing. |
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Term
|
Definition
| systolic pressure - diastolic pressure |
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Term
| Fairly constant ratio of pulse rate to respiration rate is: |
|
Definition
| 4:1 (pulse to respiration) |
|
|
Term
Normal respiration rates for:
Neonate?
Adult? |
|
Definition
Neonate: 30-40 Breaths/min
Adult: 10-20/ Breaths/min |
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|
Term
| True/False. Incidence of hypertension is twice as high in blacks as whites. |
|
Definition
|
|
Term
| What is a sinus arrhythmia? |
|
Definition
| Commonly found in children and young adults, sinus arrhythmia is when the heart rate varies with the respiratory cycle. (An increased heart rate when the patient breathes in (inspiration)) |
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Term
|
Definition
|
|
Term
| Factors that can affect BP include: |
|
Definition
Weight: Obese pts have a higher BP
Exercise: causes BP to increase.
Emotions: Anger, fear or pain can cause an increase in BP
Stress: BP may be elevated in a person with who is feeling continual tension because of lifestyle, occupational stress, or life problems.
Diurnal rhythm: BP is low in morning and climbs to a high around early evening. |
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Term
| What five physiological factors affect BP? |
|
Definition
1. Cardiac output
2. Vascular resistance
3. Volume (of blood)
4. Viscosity (of blood)
5. Elasticity of arterial walls |
|
|
Term
| What five physiological factors affect BP? |
|
Definition
1. Cardiac output
2. Vascular resistance
3. Volume (of blood)
4. Viscosity (of blood)
5. Elasticity of arterial walls |
|
|
Term
| How is the cardiac output determined? |
|
Definition
CO= HR x SV
Cardiac output= heart rate x stroke volume |
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|
Term
| Would an increased hematocrit cause an increase or decrease in BP? |
|
Definition
| increase. this would increase the blood viscosity. |
|
|
Term
| Would an increased hematocrit cause an increase or decrease in BP? |
|
Definition
| increase. this would increase the blood viscosity. |
|
|
Term
| How does arteriosclerosis increase BP? |
|
Definition
| The artery wall harden and stiffen which causes reduced artery elasticity. This means the heart will pump against greater resistance causing increased BP |
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|
Term
Vasoconstriction causes elevated BP
Vasodilation can cause decreased BP |
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Definition
|
|
Term
| A difference in two arms of more than 10-15 mmHg may indicate arterial obstruction on side with lower reading |
|
Definition
|
|
Term
| What could happen to the BP reading if a pt has his legs crossed? |
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Definition
| The reading may be falsely elevated. |
|
|
Term
| How should a BP cuff fit? |
|
Definition
| No more than 2/3 of the entire upper arm. It should not be too loose or too tight and it should be 1 inch above the antecubital fossa. |
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Term
| You are taking a BP for a new pt. You take BP readings in both arms. The right arm reads: 122/82 and the left arm reads: 118/76. How do you interpret these findings and which BP do you chart? |
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Definition
| This is normal. There can be up to 5-10 mmHg discrepancy in different arms. You should chart the HIGHER of the two BP readings. |
|
|
Term
| How long should you wait until taking a second BP reading on the same pt same arm? |
|
Definition
| 1-2 minutes. If you do not do this, you can have a falsely high reading. |
|
|
Term
| What is the most common reason for inaccurate blood pressure readings? |
|
Definition
|
|
Term
| What could happen if a BP cuff is too small? or too big? |
|
Definition
Too small: falsely elevated
Too big: falsely decreased
Too narrow: falsely elevated
Too loose: falsely elevated |
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Term
|
Definition
| When tapping sounds disappear for 10 to 40 mmHg and then return during a BP reading. (common in those with hypertension) |
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|
Term
Which Korotkoff sound would be used for the diastolic reading?
Systolic? |
|
Definition
Korotkoff V (diastolic)
Korotkoff I (systolic) |
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|
Term
| Would you expect the thigh BP to be higher or lower than the arm BP? |
|
Definition
| Higher. Normal thigh systolic can be 10-40 mmHg higher in the thigh. |
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|
Term
| Why might a nurse take a thigh BP on a young adult? |
|
Definition
| When a arm BP is extremely high to check for "coarctation" (which is a congenital form of aorta narrowing) |
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|
Term
| When might a Nurse take orthostatic vitals? |
|
Definition
| If you suspect volume depletion; the pt is normally hypertensive and is taking antihypertensive meds; person reports fainting or syncope. |
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|
Term
| What would you expect to find in a person who has orthostatic hypotension? |
|
Definition
| A drop in systolic BP of more than 20 mmHg or pulse increase of 20 bpm or more. |
|
|
Term
| When might a pt experience orthostatic hypotension? |
|
Definition
| When they have had prolonged bed rest, are old, hypovolemia, and some meds. |
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|
Term
| In a pt with coarctation of the aorta will the thigh BP be lower or higher? |
|
Definition
| Lower. (normally a thigh BP is higher but with this congenital narrowing of the aorta you can expect a lower BP. Why? the blood supply to the thigh is below the constriction. |
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|
Term
| What are some signs of child abuse? |
|
Definition
| Child avoids eye contact; no separation anxiety from parent; parent is disgusted by child's odor, drooling, stools. |
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|
Term
| Enlarged head circumference occurs with increased intracranial pressure. |
|
Definition
|
|
Term
| Take an infants VS in the following order: |
|
Definition
1. Respiration
2. Pulse
3. Temp
Taking the temp may make the infant cry thus falsely elevating the other VS |
|
|
Term
| Where should you take the pulse on a child under 2 years of age? |
|
Definition
Apical (1 min)
(after 2 years of age you can use the radial pulse) |
|
|
Term
| T/F. In children, height is better correlated with BP than age. |
|
Definition
|
|
Term
| The aging adult may have a "stooped" appearance, kyphosis, steps may be shorter and uneven, and walk with a wider base to make up for diminished balance. |
|
Definition
|
|
Term
| Why do old people appear shorter than they used to be? |
|
Definition
| Because there is shortening in the spinal column and thinning of vertebral disks. |
|
|
Term
| The aorta and major arteries harden and stiffen with age, causing a increase in systolic pressure and increased pulse pressure. |
|
Definition
|
|
Term
| Aging causes a decrease in vital capacity. You may note shallow inspirations and increased respiratory rate. |
|
Definition
|
|
Term
| If a pt with a SaO2 reading of 86% requires continuous pulse oximeter monitoring, where should the probe be placed? |
|
Definition
| Earlobe. It is more accurate and less affected by peripheral vasoconstriction. |
|
|
Term
| What is the foundation of hypertension control? |
|
Definition
|
|
Term
| In what disease would you see the characteristic "moon face" and "buffalo hump"? |
|
Definition
| Cushing's Syndrome. Causes endogenous obesity. Caused by excessive ACTH which stimulates adrenal cortex to create cortisol. |
|
|
Term
| What is the name of the disease characterized by tall, thin stature, long skinny fingers, and a wing span longer than one is tall? |
|
Definition
|
|
Term
| What is Acromegaly (hyperpituitarism)? |
|
Definition
| Excessive growth hormone in adulthood. Causes increase in size of bone in face, hands, feet, and organs but not height (because this occurs after closure of epiphyses) |
|
|
Term
|
Definition
| Excessive growth hormone before puberty. Causes overgrowth of entire body. Occurs in childhood before closure of epiphyses in puberty leading to increased height and weight. Delays sexual development. |
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