Ha Hesi Review

Front 1

Reasons for hypoactive bowel sounds

Back 1

late obstruction

Paritonitis

Front 2

Hyperactive bowel sounds

Back 2

Early abdominal obstruction

diarrhea

gastroenteritis

Front 3

Rebound tenderness

Back 3

Bloombergs = more pain when you let go (not while you're still palpating)

Indicative of paritoneal irritation (apendicitis, paritinitis)

Front 4

murphys sign

Back 4

press over liver

inspatory arrest = positive murphys sign

Notify physician

Thinking gallbladder dz

Front 5

Tactile fremitis
Auscultation (bronchophony, egophany, etc.)

increased

Back 5

palpate "99"

Hearing it better = lung consolidation = pneumonia/ more density.

Empysema and pneumothorax (not tension) = more air, hear sounds worse

Front 6

purpura

Back 6

bruising (more extensive than petichiae)

ask about mads (anticoagulants, aspirrin, heparin, nsaids)

ask about trauma

Front 7

whats one of main reasons to get extensive med hx

Back 7

drug interactions

especially in elderly (polypharmacy)

Front 8

if pt claims allergy

Back 8

ask what actually happens

Front 9

around nail bed inflamed

Back 9

paronchia (water, bar tender)

Front 10

spoon shaped

Back 10

anemia

Front 11

clubbing

Back 11

chronic lack of o2 = larger than 80 degrees

Front 12

vesicles with honey colored drainage, crust

Back 12

impetigo, kids more prone, highly contagious

Front 13

red lesions or more silvery scaley

Back 13

psoriasis, usually family hx of it, not contagious

Front 14

shingles is ex of what

Back 14

zosterform appearance, linear follows a line following a dermatome.

it starts as a vesicle and when it ruptures it forms a scab.

Front 15

bulls eye

Back 15

lyme disease caused by erythema migrans

Front 16

to say officially that there are absent bowel sounds...

Back 16

you have to listen for 5 minutes in each quadrant

Front 17

tinnels

Back 17

tap wrist = burning or tingling = + carpel tunnel

Front 18

phallens

Back 18

test for carpel tunnel. press dorsal part of hands together for 1 min = numbing or pain = carpel tunnel.

Front 19

arterial insufficiency

Back 19

not getting enough blood to the extremity, the temp should be more cold (cool)

the leg would look shiny w/ no or little hair.

color depends on if its acute or chronic (atherosclerosis)

chronic - if you raise leg up = less blood flow = leg will look pallor

if you put it down in a dependant position, blood flow returns and leg turns red or rubor. In chronic insufficiency, pulse will be deminished or absent (note if its a new finding)

Front 20

if you cant feel a pulse in a lower extremity...

Back 20

use doppler

Front 21

acute arterial insufficiency

Back 21

throwing a clot

pt complains of intermittent claudication - hurts when they're active but goes away during rest

as the dz progresses or advances, they will develope rest pain (worse)

Front 22

test for arterial insufficiency

Back 22

ABI - ankle brachial index

capillary refill

Front 23

venous

Back 23

bloods not going back to the right side of heart so you see edema in lower extremities

Front 24

ulcurs or venous stasis cause what color

Back 24

brown
brauny
bronze

because blood is sitting there and breaking down so they release something called hemociteran which turns the color to brown.

more prone to VTE (venous thrombo embolism) aka DVT

can test by doing homans sign.

Front 25

Homan's sign

Back 25

ask pt to dorsiflex and if they have pain = + homan's sign, indicates a venous problem such as DVT.

Front 26

Acute arterial

Back 26

pale, cool, pulses diminishe or absent, paralysis, parasthesia....

but acute has no shiny or hairless appearance.

blue toes could happen in acute or chronic.. very bad.. late sign.

Front 27

neg affects smoking

Back 27

ask ppd

associated w peptic ulcer
Gastric CA
decreased sleep

Front 28

orthopnea, pnd, dyspnea

Back 28

pillows, wake up SOB, SOB

Front 29

when doing infant exam and infant is sleeping what do u do first

Back 29

auscultate heart lungs and abdomen because if infant wakes up theyll cry and u cant hear

do eyes, nose, ears last (most invasive)

Front 30

Tanner stage

Back 30

Know the stages of puberty (male, female)

Front 31

Scoliosis

Back 31

s shape

Front 32

normal lung sound peds`

Back 32

hyperresonance,

heart s3 could be normal in children

Front 33

peds best indicater of nutritional status

Back 33

height weight on growth chart

Front 34

head chest circumferance

Back 34

At birth the head is bigger than chest

check on every visit for the first 2 years of their life. then once a year till they're six.

plot it on growth chart.

by age 2 the head and chest circumference becomes equal

Front 35

serebum

Back 35

wax

elderly has more wax which can lead to hearing obstruction , which is conductive hearing loss vs. sensorineural

Front 36

tympanic membrane

Back 36

pearly grey, pink, cone of light should be either 5 or 7 o clock

Front 37

abnormal finding in ear

Back 37

loss of
perforation
red draining
otitis media = loss of landmarks , no cone of light


external, look at tragus, can be very painful with otitis externum aka swimmers ear

Front 38

PERRLA

Back 38

equal round reactive to light and accommidation

Front 39

accomidation

Back 39

looking distant -= pupil dilated

close = conrtict

Front 40

3,4,6

Back 40

ocular mm

Front 41

6cardinal gaze

Back 41

convergance

Front 42

dirsct consentual

Back 42

both constrict

Front 43

anascoria

Back 43

abnormal pupils

always assess they're baseline for change (their normal)

Front 44

CN 2 ocular

Back 44

perif vision confrontation

Front 45

5 trigeminal

Back 45

chewing

trigeminal neuralgia = pain in face sensation