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126 Cards in this Set
- Front
- Back
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Vesticular Lung Sounds
(normal) |
Sounds are soft breezy, and low pitched. Inspiratory phase is 3 times longer than expiratory phase.
Location: Best heard of lung's periphery Origin: Created by air moving through smaller airways |
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Bronchiovascular
(Normal) |
Blowing sounds thare are medium pitched and ofmedium intensity. Inspiratory phase is equal to expiratory phase.
Origin: Air Moving over large airways |
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Bronchial
(normal) |
Heard only over trachea
Orgin: Created by air moving through trachea close to chest wall. |
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Crackles
Adventitious |
Random, Sudden reinflation of groups of alveoli, disrupitve passage of air through small airways
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Fine Crackles
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high pitched and fine, short, interrupted crackinling sounds heard during end of inspiration, not cleared with coughing
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Medium Crackles
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lower more mosite sounds heard during the middle of inspiration not cleared with coughing
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Coarse crackles
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loud bubbly sounds heard during inspiration, not cleared with coughing
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Rhonchi (Sonorus wheeze)
Adventitious Causes |
Cause: Muscular spasum Fluid, or mucus in larger airways, new growth or external pressure causing turbulance
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Rhonchi (Sonorus wheeze)
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Loud Low pitched rumbling, coarse sounds heard either during inspiration or expiration sometimes cleared by couhing
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Wheezes (sibilant wheeze) Cause
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High velocity air flow thrugh severly narrowed or obstructed air way
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Wheezes (sibilant wheeze)
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High-pitched, continuious musical sounds, like a squeak heard continuously during inspiration or expiration, usuaullly louder on expiration
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Pleural friction rub
Cause |
Inflamed pleura, parietal pleura rubbing against visceral pleura
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Pleaural Friction Rub
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Has dry rubbing or grating quality heard during inspiration or expiration does not clear with coughing, heard loudest over lateral anterior surface.
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S1 Heart Sounds
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"Lub" Closure of the mitral and tricupid valves, causes the first heart sound S1
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S2 Heart Sound
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Closing of the aortic and pulmonic valves, creating the "Dub" sound
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PMI
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Point of Maximum Impulse, or apical pulse.
the 4th to 5th intracostal space, left of the midclavicular line |
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Anatomical Sites for assesment of Cardiac Function
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Aortic, Pulmonic, Erbs Point, Tricuspid, and Mitral
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Pallor (decrease in color)
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reduced amount of oxyhemoglibn resulting in decreased blood flow
Causes: Anemia Location: face, conjunctiva, nail beds, palms of hands |
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Loss of pigmentaition
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Vitilligo
Congenital or auto immune condition causing lack of pigment Location: Patchy areas on skin over face, hands arms |
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Jaundince
(Yellow- Orange) |
Increased deposit of billiruben in tissues, liver disease destruction of red blood cells,
Location: Sclera, mucous membranes |
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Wheezes (sibilant wheeze)
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High-pitched, continuious musical sounds, like a squeak heard continuously during inspiration or expiration, usuaullly louder on expiration
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Pleural friction rub
Cause |
Inflamed pleura, parietal pleura rubbing against visceral pleura
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Pleaural Friction Rub
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Has dry rubbing or grating quality heard during inspiration or expiration does not clear with coughing, heard loudest over lateral anterior surface.
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S1 Heart Sounds
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"Lub" Closure of the mitral and tricupid valves, causes the first heart sound S1
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S2 Heart Sound
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Closing of the aortic and pulmonic valves, creating the "Dub" sound
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PMI
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Point of Maximum Impulse, or apical pulse.
the 4th to 5th intracostal space, left of the midclavicular line |
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Anatomical Sites for assesment of Cardiac Function
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Aortic, Pulmonic, Erbs Point, Tricuspid, and Mitral
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Pallor (decrease in color)
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reduced amount of oxyhemoglibn resulting in decreased blood flow
Causes: Anemia Location: face, conjunctiva, nail beds, palms of hands |
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Loss of pigmentaition
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Vitilligo
Congenital or auto immune condition causing lack of pigment Location: Patchy areas on skin over face, hands arms |
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Jaundince
(Yellow- Orange) |
Increased deposit of billiruben in tissues, liver disease destruction of red blood cells,
Location: Sclera, mucous membranes |
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Red (Erythema)
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Increased visibility of oxyhemoglobin, caused by dialation
Caused by Fever, direct trauma, blushing, alcohol intake Location: Face, area of trauma, etc |
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Tan- brown
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Increased amout of melain, causes: suntan, pregnancy
Location: areas of exposure to sun |
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Increased skin temp
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often accompanies localized erythmia or redness of teh skin
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Decreased Skin temp
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Caused by a decrease in blood flow
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Turgor
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is the skins elastisity, edema or dehydration deminish turgor, to asses the skin turgor grasp a fold of skin on the back of the forearm or sternal area with the fingertips and release, normal skin turgor snaps back immediately
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Macule
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Flat non palpaple change in skin color
hint; freckle |
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Papule
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palpable, circuscribed solid elevation in the skin smaller than 1cm
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Nodule
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Elevated solid mass deeper and firmer than a papule
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tumor
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solid mass that extends deep through the sub cutanious tissue larger than 1-2 cm
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wheal
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irregularly shaped elevated area or superficial localized edema varries in size
hint; hive or mosquito bite |
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Vesicle
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cirucmscribed elevation of skin filled with serous fluid, smaller than 1 cm.
ex; herpes simplex, chicken pox |
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pustule
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cirucmscribed elevation of skin similar to a vessicle but filled with puss, varries in size.
hint, acne |
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ulcer
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Deep loss of skin surface that extends to dermis and frequently bleeds and scars varries in size
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atrophy
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thinning fo skin, with loss of normal skin furrow, with skin appearing shiney and translucent
hint, SCAR! |
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Basal Cell Carcinoma
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crusted lesion that is flat or rased and has a rolled somewhat scaly border, frequently there are underlying widly dialted blood vessels that appear with in the lesion
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Squamous Cell Carcinoma
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Occours more often on mucousal surfaces and non exposed areas of skin, comared with a basal cell.
Frequently grows more rapidly than a basal cell |
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Melanoma
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brown, flat lesion that appears on sun-exposed or non exposed areas of skin. Variegated pigmemtation, irregular borders and indisticnt margins
Ulceration, recent growth, or recent changes in long standing moles are ominous signs. |
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Sitting Position
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Head, neck, back, posterior thorax, lungs, anteror thorax, breast axillae, heart, vital signs, and upper extremities
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Supine
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Head and neck, anterior thorax and lungs, breast and abdomen, extremities and pulses
PROVIDES EASY ACCESS TO PULSE SITES, NORMALLY A RELAXED POSITON |
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Dorsal recumbant
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Postion for abdominal assesment because it pomotes relaxation of abdominal muscles.
On back, knees up |
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Lithotomy Position
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Used to examine the femail genitalia and genenital tract
This position provides maximum exposure of genitialia and facilicates insertion of vaginal speculum |
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Sims
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Used for assesment of rectum and vagina.
Flexion of hip and knee improves exposure of rectal area |
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Prone
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Used for assesment of musculoskeletal system.
This positon is for assessing extension of hip joint skin and buttox |
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Lateral recumbant
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Assess the heart,
this position aids in detecting murmurs |
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Knee chest position
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Rectum, this position provides maximum exposure of the rectal area
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5 techniques for physical assment
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Inspection
Paplation Percussion Ascultation Olfaction |
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Inspection
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The use of vision and hearing to distinguish normal from abnormal findings
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Palpation
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involves the use of the hands to touch body parts to make sensetive assesments
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Percussion
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Involves tapping the body with fingertips to produce a vibration that travels through the body tissues
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Ascultation
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Involves listening to sounds the body makes to detect varations from normal
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Olfaction
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Olfaction helps to detect abormalities that you can not recognize by any other means
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PERRLA
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Pupils
Equal Round Reactive to light and Accomodation |
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Glaucoma
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Intraoccular structural damage resulting from eleavated intraoccular pressure
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Hyperopia
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farsightedness, persons are able to see clearly distant objects but not clear objects
(like dad) |
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Myopia
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near sightedness, persons are able to see clearly close objects but not distant objects
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presbyopia
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impared near vision in middle age and older age adults, caused by the losss of the elasticity of the lens and associated with the aging process
like mom |
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Retinopathy
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non inflamitory eye disorder resulting from changes in retinal blood vessels, leading cause of blindness
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Strabismus
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conditon in which eyes do not focus on an object simultaniously, eyes appear crossed
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Cataracts
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increased opacity of the lens, which blocks rays from entering the eyes, sometimes develop slowly or progressivly after age 35
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macular degeneration
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blurred central vision often occuring suddenly caused by progressive degenration of the center retina
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Abdomen Assesment
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Inspection- observe the patient for posture and look for evidence of abdominal pain
Palpation-Detects areas of abdominal tenderness Ascultation- listening for bowel sounds it takes 5 min of continuous listening to determine if bowel sounds are absent |
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Airborne Precautions
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Used for chicken pox, pulmonary or laryngeal TB
private room, negative pressure air flow of at least 6-12 air exchanges per hour, with HEPA filtration N95 mask |
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Droplet Precacations
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Droplets that can be transfered farther than 3 feet from the client , private room with a mask glove gown
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Contact Precautions
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direct or enviromental contact private room, gloves and gowns
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protective enviroment
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allogenic hematopatic stem cell transplants,
Private room positive pressure room with 12 ore more air exhcanges per hour, respirator mask, gloves, and gowns |
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MMSE
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Mini Mental State Exam
Orientation to time Registration Naming Reading |
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Orientation to time
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What is todays date
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Registration
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listen carefully i am going to say three words, you say them back to me after i stop
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naming
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"what is this"
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Reading
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Please read this and do what it says
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Glasgow Coma Scale
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Total Score 15
eyes open Spontaneously-4 To Speech-3 to pain-2 none-1 Best verbal responce Orientated- 5 Inappropriate words-4 Incomprehensible Sounds-2 None-1 Best Motor Responce Obeys commands-6 localized pain-5 flexion withdrawl-4 abnormal flexation-3 Abnormal Extension-2 Flaccid-1 |
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Adult Enema Volume
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750 to 150 ml
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Adolecent Enema Volume
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500 to 700 ml
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School Aged Child Enema Volume
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300 to 500 ml
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Toddler Enema Volume
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250 to 350 ml
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Infant Enema Volume
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150 to 250 ml
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Rectal tube adult size
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22 to 30 Fr
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Rectal Tube Child size
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12 to 18 fr
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Enema incertation length Adult
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7.5 to 10cm
3-4 inches |
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Enema incertation length
Adolecent |
7.5 to 10 cm
3-4 inches |
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Enema incertation length
child |
5 to 7.5 cm
2-3 inches |
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Enema incertation length
infant |
2.5 to 3.75 cm
1- 1.5 inches |
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High Enema
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12 to 18 inches
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Regular Enema
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12 inches
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Low Enema
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3 inches
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Nasal Canula
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Simple effective comfortable device used for delivering oxygen
1 L/min 24% 2 L/min28% 3L/min 32% 4 L/min36% 5 L/min 40% 6L/min44% |
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Oxygen Mask
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simple face mask for short term oxygen therapy
Delivers O2 concentrations from 30 to 60% |
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Venturi Mask
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4 L/min 24-28%
8 L/min 35-40% 12 L/min 50-60% Mask with the dail on the bottom |
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Partial non breather-
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bag should always remain partially inflated
6 L/min 60% 7 Lmin 70% 8 L min80% 9 L min 90% 10 L min 95% |
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Non rebreather
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6-15 L/min 60-100%
Valve closes during expiration so exhaled air does not enter resivor and mix with inhaled air |
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Face Tent
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8-12 L/min 28-100%
Alternative to aresol mask |
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Oxygen hood/tent
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usually for pediatric use
5-8 L/min 28-40% 8-12 l/min 49-85% |
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Intradermal Injections
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Use a small syringe with short needle (3/8-5/8 inch)
Fine Guage (25-27) injected at 5-15 degrees |
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Types of Insulin
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Rapid Acting (clear)
Short Acting (clear) Immediate Acting (cloudy) Combination Insulins (cloudy) Long Acting (Clear) |
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Insulin Injections
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1 to 3 ml syringe
25-27 guage needle 3/8-5/8 inch |
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IM Injection
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20-25 guage needle- aqueous solutions
18-25 guage needles oil based solutions |
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Venrtogleuteal Site
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Gluteus mediaus and minimus
The "V" |
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Vastus Lateralis
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preferd site for childrens immunizations
upper thigh |
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Deltoid
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Upper Arm
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Blood Glucose Norms
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70/110 mg/dl
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Red Blood Cells
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4.7-6.1 for males
4.2-5.4 Females |
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Hemocrit- HCT
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42-52% males
37-47% females |
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Hemoglobin-HGB
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14-18g/dl males
12-16g/dl females |
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White Blood Cells- WBC
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5,000-10,000/mm
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Platelets
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150,000-400,000/mm
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Chloride
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98-106mEq/L
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Potassium
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3.5-5.0 mEq/L
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Sodium
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136-425mEq/L
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Calcium
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9.0-10.5 mg/dL
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Magnesium
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1.3-2.1mEq/L
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BUN- Blood Urea Nitrogen
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10-20mg/dL
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Urine Specific Gravity
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1.005-1.030
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Glycosulated Hemoglobin HbATc
non diabetic |
4-5.9%
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Glycosulated Hemoglobin HbATc
Good control diabetic |
<7%
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Glycosulated Hemoglobin HbATc
Fair control diabetic |
8-9%
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Glycosulated Hemoglobin HbATc
Poor Control Diabetic |
>9%
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