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saraherin
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Techniques of physical assessment:
- Inspection
- Palpation
- Percussion
- Auscultation
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Aspects of inspection include:
- lighting
- look for size, shape, color, symmetry, position, and abnormality.
- check for symmetry
- Validate findings with patient
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Aspects of palpation:
- start with light - move to deep
- use differing parts of the hand to detect different characteristics.
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What can percussion help you to determine?
size and density of structures
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During auscultation what portion of the stethoscope would you use for low sounds?
Bell for low
murmurs or carotid artery
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What is a bruit?
pronounced "brew-ee' - abnormal sound made by blood flowing through a narrowed artery
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General survey entails:
assessment of: appearance, vial signs, height & weight
- Grooming
- personal care
- breathe smell
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Skin assessment entails what techniques?
inspection & palpation
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What details are included in a skin assessment?
Color: pigmentation and color
- Moisture
- Temperature
- Texture
- Turgor / hydration
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Cyanosis =
bluing of the skin, may indicate low oxygenation
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Jaundice =
Yellowing of the skin or sclera, may indicate poor kidney function
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Erythema =
Redness, may indicate circulation changes.
Can be seen in the scrum, heels, hips
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What does ABCD stand for when using in skin assessment?
- Asymmetry
- Border irregularity
- Color
- Diameter
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Where and how would you assess for edema?
ankles, instep, calf
palpate to determine mobility, consistency, and tenderness.
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Turgor refers to:
elasticity of the skin.
edema or dehydration may affect turgor
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Hearing is associated with which cranial nerve?
- 8th
- vestibulocochlear nerve -
- inner ear to the brain - balance
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Hearing acuity can be tested by what 3 methods?
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What is ototoxicity?
injury to the auditory nerve due to antibiotic use
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What should a healthy tympanic membrane look like?
pearly gray / cone of light
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Describe a normal bronchovesicular sound:
blowing, medium in pitch, medium intensity, inspiratory is equal to expiratory
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Where is best to hear bronchovesicular sounds?
anterior over bronchioles, lateral to the sternum at intercostal spaces 1 and 2
posterior between scapulae
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What side of the stethoscope would you use to listen to a child?
bell
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Normal Vesicular sounds can be described as :
soft, breezy, and low pitched.
Inspiration lasts 3 X longer than expiration
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Rails or crackles can indicate what in the lungs?
random, sudden re-inflation of aveoli - fluid
may be cleared with coughing
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Rhonchi may indicate what in the lungs?
Fluid, mucus in the larger airways
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Wheeze heard in the lungs may indicate what?
narrowed airways due to inflammation
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Where would you assess PMI?
Point of Maximal Impulse
intercostal space 5 - medial to the midclavicular line
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Closing of the bicuspid or mitral valve is called what?
S1
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At what location would you hear the closure of the tricuspid valve?
- Apex - this would be S1 or "lub"
- 5th intercostal space
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When the aortic and pulmonic valves close, what do you hear?
"dub" or S2
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What heart sound can you hear at the Left ICS 2 ?
Pulmonic valve
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