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55 Cards in this Set

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The thorax includes:
skin, musculoskeletal,respiratory, urinary (kidneys)
Subjective questions (3) for aging client
1. any sob with daily actv.
2. hx COPD
3. Chestpain w/breathing?
Pleuritic pain is felt ____in older adults than in younger adults
less
Position of patient during thorax assessment
sitting upright
if in bed leaning forward
if in bed-rolled over to l sde
continuous cough throughout day
acute illness i.e. resp infex
afternoon/evening cough
exposure to irritants at work
night cough
postnasal drip,sinusitis
early morning cough
chronic bronchial inflammation (smokers)
chronic bronchitis
hx of produx cough for 3 months of the year for 2 years in a row
white clear mucous
colds, bronchitis, viral infx
yellow or green mucous
bacterial infex
rust colored
tb,pneumococcal pneumonia;
pink, frothy
pulm edema, red medications
hacking cough
mycoplasma pneumonia
dry cough
early heart failure
barking cough
croup
congested cough
colds, bronchitis, pneumonia
orthopnea
difficulty breathing when supine (how many pillows do you need--2-pillow orthopnea)
Paroxysmal Nocturnal Dyspnea
awakening from sleep with shorness of breath and needing to be upright to achieve comfort
Rural Midwest people have risk of:
histoplasmosis exposure
Mexicans have risk of:
coccidioidomycosis
stone cutters etc... have risk of:
silicosis
asymetric chest expansion
occurs with atelectasis or pneumonia, thoracic trauma, fractured ribs, pneumothorax
decreased tactile fremitus
occurs when anything obstructs transmission of vibrations from thickening, pneumothorax, or emphysema
Rhoncal fremitus
palpable with thick bronchial secretions
Pleural frictions fremitus
palpable with inflammation of pleura
crepitus
coarse crackling sensation palpable over the skin surface; subq emphysema
diaphragmatic exursion
tests level of diaphram; higher on right side
bronchial (tracheal)NORMAL breath sounds
high, loud, i<e, harsh hollow tubular found in trachea and larynx
bronchovesicular NORMAL breath sound
moderate pitch and amplitude; i=e, over major bronchi where fewer alveoli are
vesicular breath sounds
low pitch, soft amplitude I>E; rustling, like sound of wind in trees; over peripheral lung fields thru smaller bronchioles
bronchophony
very distinct voice transmission
egophony
E sounds like A
whispered pectoriloquy
disctict and clear (one two three)
full bounding pulse is rated:
3+
normal pulse is rated:
2+
weak and thready pulse is:
1+
no pulse is
0
the first wave felt is:
0
clients do or do not need to remove their watch
do not
Palpatory BP mehtod
either using radial/brachial artery (obliteration of pulse is systolic)
korotkoff I=
systolic
korotkoff V=
diastolic
common error for bp measurement
incorrect cuff size, arm level
auscultatory gap
the temp disappearance of korotkoff sounds during the end of phase I with reappearance of sounds in phase II
auscultatory gap occurs in ___ % of population and is common with ____ due to noncompliant _______system
occurs in 5% of population; common with hypertension due to a noncompliant arterial system
If undetected auscultatory gap, results in
falsly low systolic or falsly high diastolic reading
Normal BP is
120/80
Prehypertension
120-139/80-89
HTN Stage 1:
140-159/90-99
HTN Stage 2:
> or = 160 or > or = 100
HIPPA
Health Insurance Portability and Accountability; access to med records, limits on use of personal med info, confidential comm, complaints
Mental status...inferred functioning due to "A,B,C,T"
appearance, behavior, cognition, thought processes & perceptions
IADL's
housekeeping, shopping, cooking, etc....
Pain assessment PPQRST
Place, Quality, Rate, Symptoms, Time