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What part of your hand should you use to determine vibration?
ulnar surfaces of hand and fingers
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What part of your hand should you use to determine temperature?
dorsal surface of hand
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What part of your hand should you use to determine texture, size, or crepitus?
palmar surface of fingers and finger pads
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How will the leg BP compare to arm BP in a case of coarctation of the aorta or aortic stenosis?
it will be LOWER (normally is higher)
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Orthostatic HTN: measure BP sitting, then within ___ minutes of standing. If present, systolic will drop > ___ mmHg & diastolic will drop > __ mmHg.
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What kind of pain may be tender, deep, and aching?
bone and soft tissue pain
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What kind of pain may be heavy, throbbing, and aching?
tumor pressing on a cavity
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What kind of pain may be burning, shock like pain?
nerve tissue damage
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What may cramping spasms indicate?
visceral or colic pain
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What may a sustained tachycardia indicate in an infant?
underlying cardiac rhythm disturbance, such as paroxysmal atrial tachycardia
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Normal RR for newborns.
30-80
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Expected newborn BP.
60/30 - 96/62
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In newborns, what could a sustained increase in BP indicate?
- thrombosis after umbilical catheter
- coarctation of aorta
- renal DO
- congenital adrenal hyperplasia
- CNS disease
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What is the PIPP?
- Premature Infant Pain Profile
- used to assess procedural pain in newborns b/w 28-40 wks gestation
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When is the Neonatal Infant Pain Scale used?
to assess procedure pain up to 6 wks of of age
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What is the CRIES scale?
- Crying,
- Requires O2 to keep sat >95
- Increased Vital Signs
- Expression
- Sleeplessness
- -used to evaluate procedure & surgical pain in newborns & infants
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Normal RR for 1 yr old
20-40
-
Normal RR for 6 yr old
16-22
-
Normal RR for 3 yr old
20-30
-
Normal RR for 10 yr old
16-20
-
Normal RR for 17 yr old
12-20
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Normal BP for kids are is designated in what percentile?
< 90th
-
Pre-HTN for kids are is designated in what percentile?
90-95th
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In kids, if systolic is elevated and diastolic is not, what could be the cause?
anxiety
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What is FLACC?
- a Behavioral Pain Assessment Scale for nonverbal children
- Face
- Legs
- Activity
- Cry
- Consolability
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What part of the brain is primarily responsible for a person's mental status?
- cerebrum
- (cerebral cortex = higher mental fxns & is responsible for perception & behavior)
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What part of the brain is responsible for receiving and processing sensory data?
parietal lobe
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What part of the brain contains the motor cortex and is associated with speech formation?
frontal lobe (Broca area)
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What part of the brain is responsible for decision making, problem solving, concentration, and short-term memory?
frontal lobe
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Where do emotions, affect, drive, autonomic responses to emotional states, and awareness of self orginate?
frontal lobe
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What part of the brain is responsible for the perception and interpretation of sounds?
temporal lobe
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What part of the brain allows a person to understand spoken and written language?
Wernicke area within the temporal lobe
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Person disorientation results from?
- cerebral trauma
- seizures
- amnesia
-
Place disorientation occurs with?
- psych DO
- delerium
- cognitive impairment
-
What is the mini-cog?
- measures cognitive fxn
- tell pt three words to remember
- draw clock face (in 3 min)
- repeat the 3 words
-
examples of attention span assessment.
- follow a short set of commands
- say days of week or spell "world" fwd & bkwd
- perform arithmetic calculations
-
Decreased attn span may be r/t?
- fatigue
- depression
- delerium
- toxic or metabolic causes = confusion
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What is circumlocution?
Pantomime or word substitution to avoid revealing that a word was forgotten.
-
What is perseveration?
Repetition of a word, phrase, or gesture
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Meaningless, disconnected word choices.
word salad
-
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Word choice based on sound so that words rhyme in a nonsensical way
clang association
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What is echolalia?
repeating ANOTHER PERSON's words
-
What type of hallucinations are most commonly associated with alcohol withdrawal?
tactile
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What type of hallucinations are associated with psych DO, severe dipression, acute into, delirium, & dementia?
auditory & visual
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Articulation milestones in children b/w 2.5 - 6 yoa may be evaluated with what screening exam?
Denver
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Patients with _____, which has a gradual onset, are likely to appear apathetic and depressed, and often get lost in familiar places.
dementia
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Patients with _______ develop symptoms suddenly and are prone to mood swings.
delirium
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