Phys. Assess. Ch. 9
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| What is a general survey? | a study of the whole person, covering the general health state and any obvious physical charecteristics
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| When does a general survey start? | When you first encounter the person
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| Even as you introduce yourself and shake hands your? | collecting data
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| What 4 areas should you consider when doing a general survey? | physical appearance, body structure, mobility, and behavior
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| What is included in physical appearance? | Age(appear their age?), sex (development), Skin color (color tone), Facial features (are they symetric with movement?)
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| What is A&O x3? | Time, Place, Person, (Event)
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| What is included in body structure? | Statue (height), nutrition (normal weight range), position (sits comforably), body build (Arm span, body length)
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| What is toddler lordosis? | When a standing toddler has a normally protuberant abdomen
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| What is included in mobility? | Gait, range of motion (movement is smooth and cordinated)
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| What is included in behavior? | facial expression (eye contact, express appropriate respone) mood and effect (cooperative), Speech (articulation), Dress (clothing is app. to climate, and culture), Personal hygiene (clean and groomed?)
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| When getting weight you should? | use a standardized balance or electric standing sale
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| When you have to weigh reguraly? | pick same time and same type of clothing
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| To get height you? | use a wall mounted device or a measuring pole
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| What is BMI? | a practical marker of optimal weight for height and an indicator of obesity or protein calorie malnutrition
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| What is the waist to hip ratio? | assesses body fat distribution as an indicator of health risk
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| What is android obesity? | fat in the upper body (abdomen)
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| What is gynoid obesity? | fat in the lower body (hips)
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| What is waist circumfrance be used for? | alone can be used to predict greater health risk
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| What does cellular metabolism require? | a stable core of 37.2 C
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| How does the body maintain a steady temperature? | through a feedback mechanism
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| How is the feedback mechanism regulated? | hypothalamus
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| What is a normal oral temp? | 98.6
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| What is a normal temp influenced by? | diurnal cycle (trough in morning, and peak in the evening), the menstruation cycle, exercise, age (adults lower)
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| The oral temp is? | accurate and convenient
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| Why is oral temp accurate? | oral sublingual site (rich blood supply)
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| What are the advantages of an electric thermometer? | swift and accurate, safe, unbreakable, disposalbe
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| The axillary temp is? | safe and accurate for young ones
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| When is the only reason to take a rectal temp? | only when other routes are not practical
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| What is a tympanic membrane thermometer? | is senses infrared emmisions of the tympanic membrane (eardrum)
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| What are the advantages of tympanic thermometer? | speed, convenience, safety, reduced risk of injury and infection, and noninvasiveness
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| What is the stroke volume? | blood pumped with every beat
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| What is a pulse? | the blood pressure felt against the artery
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| Start your pulse count with? | 0
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| The second pulse felt is? | 2
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| What do you assess about the pulse? | rate, rhythm, force, and elasticity
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| What is the normal adult heart rate? | 60-100 beats
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| Younger age causes heart rate? | to be more rapid
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| Older age causes heart rate to be? | more moderate
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| Females have a ________ heart rate than males? | higher
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| What is bradycardia? | a heart rate less than 60 BPM
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| What is tachycardia? | over 100 BPM
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| The rhythm of the pulse normally has an even? | tempo
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| What is sinus arrhythmia? | the heart rate varies with the respiratory cycle, speeding up at the peak of inspiration and slowing to normal with expiration
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| What does a weak thready pulse reflets? | decrease stroke volume
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| What does a full bounding pulse indicate? | increase stroke volume
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| What is the three point scale for force of heart? | 0 absent
1 weak
2 normal
3 full bounding
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| What is the normal elascity of arteries? | springy, straight, resilient
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| What is a persons normal respirations like? | relaxed, regular, automatic, and silent
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| Do not say that you are? | counting respirations
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| Respiratory rates are usually how in children? | more rapid
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| What is the constant ratio of pulse rate to repiratory rate? | 4:1
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| What is blood pressure? | the force of blood pushing against the side of its container, the vesel wall
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| What is the systolic pressure? | is the maximum pressure felt on the artery during left ventricular contraction
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| What is the diastolic pressure? | is the elestic recoil, or resting, pressure that the blood exerts constantly between each contraction
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| What is the pulse pressure? | the difference between the systolic and diastolic and reflects the stroke volume
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| What is the mean artierial pressure? | the pressure forcing blood into the tissues, averaged over the cardiac cycle
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| What affects blood pressure? | age (adult-rise), gender (females-lower), race (black-higher)
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| What is diurnal rhythm? | a daily cycle of a peak and a trough occures: the BP climbs to a high in later afternoon and early evening and then declines to an early morning low
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| How does weight affect BP? | Higher is obese people
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| How does emotions effect BP? | rises with fear, anger, and pain
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| What are the five factors in which BP is determined? | CO, Peripheal vascular resistence, Volume of circulating blood, viscosity,and elasticity of vessel walls
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| Increased CO= | increased pressure
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| Increased PV resistence= | greater pressure
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| Increased volume= | increased pressure
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| Increased viscosity (thickness)= | greater pressure
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| Lower elasticity= | lower pressure
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| What is BP measured with? | stethoscope, sphygmomanometer
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| The bladder of a BP cuff should be around how much of a pt's arm? | 40%
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| The length of a cuff should be? | 80%
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| How many cuff sizes are there? | 6
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| You should take how many BP readings? | 2 seperated by 2 min
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| For each person you should verify BP? | in both arms
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| The arm should be where during BP readings? | heart level
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| When setting during BP reading where should the pt's feet be? | flat on the floor
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| What is the auscultatory gap? | period when korotkoff's sounds disappear during auscultation
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| The fifth korotkoff phase is used to define what? | Diastolic pressure
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| You should take serial measurements of pulse and blood pressure when? | you suspect volume depletion, when the person reports fainting, or if they are hypertensive
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| When you take blood pressures from a person sitting and then a person standing there is? | a slight decrease
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| What is coaractation of the aorta? | congenital form of narrowing
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| If BP in the arm is high you should? | check theigh pressure
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| Theigh pressure is normally ________ than the arm? | higher
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| What is normally higher when getting a theigh pressure? | systolic (10-40 mg)
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| What should you asses with children? | Physical appearance, body structure, mobility, behavior, and parental bonding
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| Were do you weigh an infant? | platform type balance scale
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| When do you start using an upright scale? | 2 or 3
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| How do you measure an infants length? | horizontal measuring board
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| By 2 or 3 your should measure a child how? | a standing platform scale
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| What is the best index of a child's general health? | physical growth
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| Healthy childhood growth is? | continuous but uneven
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| Black children _______ _____ than white? | weigh less
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| How long do you measure head circumference? | at birth and at each visit until 2 and then yearly till 6 years
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| What order should vitals be taken in infants? | respiration, pulse, and temp
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| How long dose it usually take for glass thermometer? | 3-5 min
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| What site do you use to take pulses in infants? | apical
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| The cuff on an infant should? | cover 2/3 of the arm and must completly incircle it
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| What is assessed with aging pt's? | Physical appearance, posture, gait, weight, height (shorter)
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| In elderly what increase? | respirations, and BP
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| What is a pulse oximeter? | a noninvasive method to assess arterial oxygen satruation
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| What is a good oxygen saturation? | 97-98%
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| What is the doppler ultrasonic flowmeter? | pitch is higher-when distance is small
Pitch lowers- as the distance increases
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| The doppler technique is used for? | locating the peripheral pulse site
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| What should you do before usuing doppler technique? | apply gel, turn on, touch to skin, pulsatile woushing sound indiactes artery, inflate cuff, deflate cough
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| What will keep BP under control? | lose weight, no alcohol, regualr aerobic excercise, cut sodium intake, no smoking, reduce dietary saturated fat and cholesterol
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| Why are immigrants usually taller? | better nutrition provided in the US and deceased interference with growth from infectios diseases during the formative years
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| What is hypopituitary dwarfism? | deficiency in growth hormone
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| What is gigantism? | excessive growth hormone
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| What is acromegaly? | excessive growth hormone, overgrowth of bone in face, hands, and feet
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| What is achondroplastic dwarfism? | Congenital skeletal malformation caused by genetic disorder is converting cartilage to bone
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| What is Marfan's syndrome? | thin and tall, but arm length is longer than the body is tall
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