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Patient Ass L1
Patient Ass T1
| Question | Answer |
|---|---|
| How should you explain the rationale for a physical assessment to a patient? | Clearly explain why the assessment is being performed, use lay terms, speak slowly, keep explanations concise/easy to understand, and encourage questions. |
| What should you explain to the patient before beginning an assessment? | They may need to expose specific body regions or assume different positions; they should report changes in symptoms during/after the exam; and the assessment may temporarily increase symptoms, but they should subside shortly. |
| When does visual observation of the patient begin, and what are you looking for? | As soon as you see the patient. Observe facial expression, symmetrical/compensatory motion, posture, muscle contours/body proportions, and skin color/condition/creases. |
| What can asymmetry or malalignment of bone/soft tissue structures indicate? | Fractures/dislocations, edema, congenital variations, muscle hypertrophy, muscle/soft-tissue tightness, muscle atrophy, muscle weakness, or muscle/ligament laxity. |
| What do cyanosis, pallor, erythema, and yellow skin indicate? | Cyanosis = blue discoloration from lack of oxygen; pallor = decreased blood flow or hemoglobin; erythema = localized redness indicating inflammation/infection; yellow skin = may indicate liver disease. |
| What should you observe when inspecting an incision? | Location/condition, intact staples or stitches, redness, drainage and its characteristics, and foul odor. |
| What are common anthropometric measurements and what can they assess? | Height, weight, BMI, leg length, volumetric measurements, and circumferential measurements. Circumference can assess joint effusion, edema, muscle hypertrophy, and atrophy; volumetric measurements can assess hands/feet using displaced water volume. |
| How is leg length measured? | ASIS → medial malleolus. |
| What is palpation and what information can it provide? | Examination of the body surface by touch to assess bony/soft-tissue contours, consistency, temperature, texture, bony landmarks, muscle contractions, tenderness, and tissue irregularities. |
| What are the key rules for proper palpation technique? | Keep pt comfortable, support body part; visually inspect first; use pads of index/middle fingers w short nails; palpate directly through skin if poss; use sensitive but firm touch without prodding; have pt contract isomet against resistance and relax prn |
| What are the main objective measurements used during assessment? | ROM, muscle testing/MMT, grip strength with a dynamometer, girth/circumferential measurements, and special tests. |
| What is kinematics? | The study of movement, focusing on bone movement in space. |
| What is the difference between AROM and PROM? | AROM = patient voluntarily moves the body part. PROM = an external force moves the body part. |
| What is the assessment sequence IN ORDER? | History & pain assessment → Vitals → Inspection/observation → AROM → PROM → Muscle strength → Muscle length → Functional status. |
| When should vitals be assessed? | At rest before exercise after 5 minutes of rest, following exercise/activity, and when symptoms occur during/after activity |
| Why are baseline vitals important? | To ensure the patient is medically stable for treatment and determine their response to physical activity/exercise. |
| Which patients especially need baseline vitals? | Elderly >65, sedentary individuals, patients with previous/current cardiac issues, and patients recovering from surgery or trauma. |
| What factors can influence vital signs? | Physical activity, environmental temperature, age, emotional status, and physiologic status such as illness, disease, trauma, or medications. |
| What are adverse responses to activity? | Mental confusion, fatigue/exhaustion, lethargy, slow/decreased reaction, nausea, syncope, vertigo, diaphoresis, change in appearance such as pallor/erythema, decreased BP, pupil constriction, and loss of consciousness. |
| What is the normal body temperature range and average? | Normal = 96.8–99.3°F; average = 98.6°F. |
| What sites can be used to assess body temperature, and which is most accurate? | Oral cavity, rectum (most accurate), axilla, ear canal, forehead/temporal lobe, and inguinal fold. |
| What factors affect body temperature? | Physical activity, environmental temperature, age, emotional status, illness/disease, and medications. |
| What does pulse/heart rate indirectly measure? | Contraction of the left ventricle and blood movement in an artery. |
| What are normal HR values by age? | Adult = 60–100 bpm; newborn = 100–130 bpm; child age 1–7 = 80–120 bpm. |
| What are the pulse assessment sites, and which is most common? | Temporal, carotid, brachial, radial (most common), femoral, popliteal, pedal, and posterior tibial arteries. |
| What three characteristics of a pulse are assessed? | Rate, rhythm, and volume. |
| What are tachycardia and bradycardia? | Tachycardia = >100 bpm; bradycardia = <60 bpm. |
| What does a pulse oximeter measure, what is normal SpO₂, and when is hypoxemia suspected? | Measures blood oxygen and pulse rate. Normal = 95–100%; below 90% = hypoxemia suspected. |
| What are the types of pulse oximeters? | Stationary digital, handheld, and finger pulse oximeters. |
| What equipment is used to measure blood pressure? | Sphygmomanometer and stethoscope. |
| What do systolic and diastolic BP represent? | Systolic = top number, contraction of left ventricle, Korotkoff Level I sound. Diastolic = bottom number, rest period of heart, Korotkoff Level IV sound. |
| What BP values should you know? | Normal = <120/80 mmHg; hypertension = systolic >140 or diastolic >80–90; hypotension = systolic <100 mmHg. |
| What factors can affect BP? | Age, physical activity, emotional status, meds, artery size, arm position, muscle contrac, blood vol, dehy, CO, measurement site, obesity, phys inactivity, nicotine/alcohol/salt, arteriosclerosis, diabetes mellitus, oral contraceptives, and advanced age. |
| What is the common artery used for BP assessment? | Brachial artery. |
| What are the two components of pulmonary ventilation? | Inspiration = inflow of air; expiration = outflow of air. |
| What are normal respiration rates? | Adults = 12–20 respirations/min; infants = 30–50 respirations/min. |
| What four things are assessed during respiration? | Rate, rhythm, depth, and character. |
| Define apnea, dyspnea, orthopnea, rale, SOB, and wheezes | Apnea = absence of breathing; dyspnea = labored breathing; orthopnea = easier breathing when seated/standing; rale = abnormal discontinuous crackle; SOB = difficulty breathing; wheezes = restricted-airway sound during expiration. |
| What is pain? | An unpleasant sensory and emotional experience associated with tissue damage or potential damage. |
| What is the most reliable indicator of pain? | Patient self-report. |
| What components should be included in a pain assessment? | Location, intensity 0–10, duration, aggravating/relieving factors, effects on activities/sleep, and psychosocial effects. |
| What should a clinician document about pain? | Onset, pattern, exact location, radiation, description, best/worst ratings, constant vs intermittent, factors affecting it, time-of-day variations, and effects on work/social activities. |
| What are nonverbal indicators of pain? | Vocalizations, facial grimaces, bracing, restlessness, and rubbing. |
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