Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
154 Cards in this Set
- Front
- Back
|
focused physical exam
|
-responsive medical patient
-examine specific area of the body |
|
|
rapid medical assessment
|
-unresponsive patient
-head-to-toe exam -used to discover problems |
|
|
Assessment of Responsive Medical Patient
|
1. Scene Size-up
2. Primary Survey 3. SAMPLE History 4. OPQRST 5. Focused physical exam 6. Vital signs 7. Transport 8. Reassessment |
|
|
Assessment of Unresponsive Medical Patient
|
1. Scene Size-up
2. Primary Survey 3. Rapid medical assessment 4. Vital signs 5. SAMPLE History 6. Transport 7. Reassessment |
|
|
general impression
|
initial ideas about what might be wrong with a patient
|
|
|
Chief Complaint: Abdominal pain
|
-examine abdomen, pelvis
-possible problems: -ectopic preg., spontaneous abortion -heart attack -appendicitis -gallbladder disease -disease of colon, bowel obstruction |
|
|
Chief Complaint: Altered Mental Status
|
-examine head, neck, chest, abdomen, back, extremities
-possible problems: -stroke, seizure -low blood sugar -overdose -temp.-related illness -anaphylaxis, hypoxia, shock |
|
|
Chief Complaint: Arm Complaint
|
-examine head, neck, chest, upper extremities
-possible conditions: -heart-attack -insect stings -musculoskeletal problems |
|
|
Chief Complaint: Back Pain
|
-examine back
-possible conditions: -kidney stone -back strain -aortic aneurysm |
|
|
Chief Complaint: Chest discomfort
|
-examine neck, chest, abdomen, extremities
-possible conditions: -heart attack -respiratory infection -gallbladder disease -anxiety disorder |
|
|
Chief Complaint: Difficulty Breathing/SOB
|
-examine head, neck, chest, lower extremities
-possible conditions: -asthma, emphysema -heart failure, heart attack -anxiety disorder -toxic exposure -pulmonary embolism -anaphylazis |
|
|
Chief Complaint: Dizziness
|
-examine head, chest
-possible conditions: -dehydration -abnormal heart rhythm -viral infection |
|
|
Chief Complaint: Fainting
|
-examine head, chest, injured body parts
-possible conditions: -dehydration -low blood sugar -abnormal heart rhythm |
|
|
Chief Complaint: Headache (3)
|
-examine head, neck
-possible conditions: -stroke -seizure -meningitis |
|
|
Chief Complaint: Leg Complaint (5)
|
-examine head, neck, chest, lower extremities
-possible conditions: -heart failure -bite or sting -blood clot -stroke -peripheral vascular disease |
|
|
Chief Complaint: Naseau/Vomiting (8)
|
-examine chest, abdomen
-possible conditions: -heart attack -bowel obstruct -toxic exposure -anaphylaxis -viral illness -pregnancy -foodborne illness -dehydration |
|
|
Chief Complaint: Neck pain or stiffness
|
-examine head, neck
-possible conditions: -meningitis |
|
|
Chief Complaint: Palpitations
|
-examine neck, chest
-possible conditions: -abnormal heart rhythm -anxiety |
|
|
Chief Complaint: Weakness
|
-examine head, chest
-possible conditions: -shock -abnormal heart rhythm -nervous system disorder -anemia -electrolyte imbalance |
|
|
OPQRST
|
Onset, Provocation/palliation/positioning, Quality, Region/radiating, Severity, Time
|
|
|
DCAP-BTLS
|
Deformities, Abrasions, Contusions, Punctures, Burns, Tenderness, Lacerations, Swelling
|
|
|
tripod position
|
patient prefers to sit up and lean forward; upper body supported by hands on thighs
|
|
|
orthopnea
|
breathlessness when lying flat that is relieved or lessened when the patient sits or stands
|
|
|
paroxysmal nocturnal dyspnea
|
-sudden onset of difficulty breathing occurring at night
-fluid buildup in alveoli |
|
|
bradypnea
|
slow breathing (<12 breaths/min)
|
|
|
tachychardia
|
fast breathing (>20 breaths/min)
|
|
|
tidal volume
|
amount of air inhaled/exhaled each breath
|
|
|
minute volume
|
=tidal volume x respiratory rate
|
|
|
supraclavical retractions
|
sinking in of skin above collar bones
|
|
|
intercostal retractions
|
sinking in of skin between ribs
|
|
|
subcostal retractions
|
sinking in of skin below the rib cage
|
|
|
Causes of decreased respiratory rate
|
-drug overdose
-respiratory distress -respiratory failure -head injury -hypothermia |
|
|
Causes of increased respiratory rate
|
-fever
-pain -anxiety -respiratory distress -respiratory failure -certain drugs -increased metabolic rate -hypoxia -trauma -diabetic ketoacidosis |
|
|
crackles (rales)
|
-short popping/crackling
-usually inhalation more than exhalation -caused of air through moisture or fluid |
|
|
rhonchi
|
-"rattling" or "rumbling" sounds
-movement of air through passages narrowed by mucus or fluid |
|
|
wheezes
|
-high or low-pitched whistling sounds
-end of inhalation or exhalation -movement through narrowed lower airways |
|
|
nasal flaring
|
-widening of nostrils when patient brings in
-common in children |
|
|
head bobbing
|
-indicator of increased work of breathing in infants
-baby breathes out falls forward, head comes up when baby breathes in |
|
|
Differences in pediatric respiratory anatomy
|
-nose breathers (newborns)
-smaller passages -large, floppy epiglottis -soft, flexible trachea -underdeveloped respitory muscles |
|
|
seesaw breathing
|
abdominal muscles move opposite direction of chest wall
|
|
|
dyspnea
|
sensation of shortness of breath or difficulty breathing
|
|
|
Croup: Age
|
6 mos - 3 years
|
|
|
Croup: Cause
|
Viral
|
|
|
Croup: Onset
|
gradual
|
|
|
Croup: Signs/Symptoms
|
-stridor
-barking cough -hoarse voice -low-grade fever |
|
|
Epiglottitis: Age
|
3-7 years
|
|
|
Epiglottitis: Cause
|
Bacterial
|
|
|
Epiglottitis: Onset
|
Sudden
|
|
|
Epiglottitis: Signs/Symptoms
|
-stridor
-restlessness -sore throat, drooling -muffled voice -high fever -tripod position -difficulty swallowing -dyspnea |
|
|
Pertussis + Signs/symptoms
|
-"whooping cough"
-bacterial infection -runny nose -sneezing -low fever -severe coughing -gagging -whooping or crowing -vomiting |
|
|
Cystic fibrosis + Signs/symptoms
|
-inherited disease
-appears in early childhood -nasal congestion -salty-tasting skin -respiratory infections -coughing -accessory muscles for respiration -wheezing -dyspnea -increased respiratory rate -cyanosis -poor growth/weight gain -abdominal distention -abdominal pain/discomfort -thin extremities -clubbing of fingers and toes -diarrhea or frequent greasy, foul-smelling, bulky stools |
|
|
Asthma
|
-"reactive airway disease"
-widespread, temporary narrowing of air passages -allergic & nonallergic -bronchospasm and narrowed air passages |
|
|
Asthma Triggers
|
-allergens: dust, cockroaches, pollen, mold, pet dander, shellfish, meds
-enviro irritants: smoke, fumes, smog, aerosols -weather extremes -exercise -colds, flu, sore throat, sinus infection -emotional stress |
|
|
Asthma Signs/Symptoms
|
-wheezing
-restlessness -dry cough -dyspnea -chest tightness -rapid breathing -increased HR -retractions -use of accessory muscles |
|
|
barotrauma
|
injury to tissue caused by excess pressure
|
|
|
breath stacking
|
-series of breaths w/out adequate exhalation
-can lead to excessive inflation, tension pneumothorax, and low BP |
|
|
Chronic bronchitis + signs/symptoms
|
-sputum production 3 months/year for 2 years
-productive cough -cyanosis -labored breathing -accessory muscle use -increased resp. rate -peripheral edema -unable to speak complete sentences |
|
|
COPD
|
-chronic obstructive pulmonary disorder
-mostly emphysema and chronic bronchitis |
|
|
Emphysema + signs/symptoms
|
-irreversible enlargement of space near terminal bronchioles
-destruction of alveolar walls -barrel chest -accessory muscle use -pursed-lip breathing -chronic cough -prolonged exhalation -increased resp. rate -dyspnea w/exertion |
|
|
Pneumonia + signs/symptoms
|
-infection affecting gas exchange in lung
-fever -chills -increased resp. rate -increased HR -possible cough -dsypnea -malaise -possible pleuritic (sharp, stabbing) chest pain |
|
|
Pulmonary embolus
|
-result of clot in pulmonary circulation
-sudden onset dyspnea -apprehension, restlessness -increased resp. rate -increased HR -possible symptoms: -cough -pleuritic chest pain -blood-tinged sputum -hypotension |
|
|
Pulmonary edema + signs/symptoms
|
-fluid build-up in lungs
-commonly caused by heart failure -restlessness, anxiety -dyspnea on exertion -orthopnea -paroxysmal nocturnal dyspnea -frothy, blood-tinged sputum -cool, moist skin -accessory muscle use -jugular venous distention -wheezing -crackles -rapid, labored breathing -increased HR -altered BP |
|
|
pneumothorax
|
collection of air/gas btwn lung and chest wall
|
|
|
spontaneous pneumothorax + signs/symptoms
|
-doesn't involve trauma to lung
-primary: no history of lung disease -sudden onset of chest pain on affected side -shortness of breath -increased resp. rate -cough -secondary: complication of lung disease |
|
|
Functions of circulatory system
|
-transport
-maintenance of body temp -protection |
|
|
AV Valves
|
-"atrioventricular valves"
-between atria and ventricles -tricuspid valve (RA/RV) -mitral valve (LA/LV) |
|
|
Semilunar valves
|
-between ventricles and arteries
-aortic valve (LV/Aorta) -pulmonic valve (RV/Pulmonary Artery) |
|
|
automaticity
|
property of heart in which the cells can produce an electrical impulse without stimulation from another source
|
|
|
SA node
|
-"sinoatrial node"
-heart's primary pacemaker -atria contract as sends impulse to AV node |
|
|
AV node
|
-"atrioventricular node"
-ventricles contract as goes through Bundle of His and Purkinje |
|
|
Superior Vena Cava
|
receives blood from areas above the diaphragm and delivers to right atrium
|
|
|
Inferior Vena Cava
|
returns blood to the heart from areas below the diaphragm
|
|
|
Pulmonary veins
|
deliver oxygen-rich blood from the lungs to the heart
|
|
|
Carotid artery
|
supplies the head with blood
|
|
|
aorta
|
largest artery of the body; originates from left ventricle
|
|
|
pulmonary arteries
|
carry blood low in oxygen from the right ventricle to the lungs
|
|
|
brachial artery
|
supplies blood to upper arm
|
|
|
radial artery
|
supplies blood to lower arm
|
|
|
femoral artery
|
supplies the lower extremity with blood
|
|
|
posterior tibial artery
|
supplies the lower leg with blood
|
|
|
dorsalis pedis
|
supplies blood to the foot
|
|
|
Perfusion
|
circulation of lood through an organ or a part of the body
|
|
|
shock + signs/symptoms
|
-hypoperfusion
-restlessness, anxiety, or altered mental status -pale, cyanotic, cool, clammy skin -rapid, weak pulse -rapid, shallow breathing -nausea and vomiting -reduction in total blood volume -low or decreasing blood pressure |
|
|
diaphoretic
|
excessive sweating
|
|
|
cardiovascular disease
|
disease of the heart and blood vessels
|
|
|
Coronary heart disease
|
disease of the coronary arteries and the complications that result, such as angina pectoris or heart attack
|
|
|
Coronary artery disease
|
diseases that slow or stop blood flow through the arteries that supply the heart muscle with blood
|
|
|
Acute coronary syndromes
|
conditions caused by temporary or permanent blockage of a coronary artery as a result of CAD
|
|
|
Arteriosclerosis
|
-hardening of the walls of the arteries; lose elasticity
-begins early and worsens w/age |
|
|
Atherosclerosis
|
-inner lining of the walls of large and medium-size arteries narrow and thicken
-due to plaque build-up |
|
|
Peripheral artery disease
|
-atherosclerosis affets arteries that supply the arms, legs, and feet
|
|
|
modifiable risk factors (6)
|
-factors that influence person's chance of disease that can be controlled
-diabetes mellitus -high blood pressure -elevated cholesterol -smoking -lack of exercise -obseity |
|
|
nonmodifiable risk factors
|
-factors that influence person's chance of disease that cannot be controlled
-family history -gender -race -increasing age |
|
|
contributing risk factors
|
-factors that are part of cause of person's risk of heart disease
-stress -depression -heavy alcohol intake |
|
|
ischemia
|
reduced blood supply to an organ or tissue
|
|
|
Angina pectoris
|
-chest pain
-hearts need for oxygen exceeds its supply -stable vs. unstable |
|
|
stable angina pectoris
|
symptoms of relatively constant and predictable
|
|
|
unstable angina pectoris
|
progressively worsening, occurs at rest, or brought on by minimal physical exertion
|
|
|
actue myocardial infarction
|
-heart attack
-coronary artery becomes severely narrowed or completely blocked -usually blood clot |
|
|
Possible Angina triggers
|
-physical exertion
-emotional upset -eating heavy metal -exposure to extreme hot or cold temperatures -cigarette smoking -sexual activity -stimulants (caffeine, cocaine) |
|
|
infarction
|
death of tissue due to lack of oxygen
|
|
|
palpitations
|
-abnormal awareness of one's heartbeat
-sign of heart attack |
|
|
palpitations
|
-abnormal awareness of one's heartbeat
-sign of heart attack |
|
|
syncope
|
-fainting
-sign of heart attack |
|
|
syncope
|
-fainting
-sign of heart attack |
|
|
Heart Attack Signs/Symptoms
|
-pressure or chest pain
-radiating pain to arms (often left), back, neck, jaw, or stomach -anxiety, dizziness, irritability -abnormal pulse -abnormal BP -nausea, vomiting -lightheadedness -fainting -diaphoresis (cold sweat) -weakness -dyspnea -palpitations -feeling of impending doom |
|
|
Heart Attack Signs/Symptoms (13)
|
-pressure or chest pain
-radiating pain to arms (often left), back, neck, jaw, or stomach -anxiety, dizziness, irritability -abnormal pulse -abnormal BP -nausea, vomiting -lightheadedness -fainting -diaphoresis (cold sweat) -weakness -dyspnea -palpitations -feeling of impending doom |
|
|
angioplasty
|
balloon-tipped catheter is inserted into partially blocked coronary artery, balloon inflated pushing plaque against walls and improving blood flow
|
|
|
angioplasty
|
balloon-tipped catheter is inserted into partially blocked coronary artery, balloon inflated pushing plaque against walls and improving blood flow
|
|
|
stent
|
small plastic/metal tube inserted into vessel or duct to maintain flow through it
|
|
|
stent
|
small plastic/metal tube inserted into vessel or duct to maintain flow through it
|
|
|
coronary artery bypass graft
|
graft from a healthy vessel used to reroute blood around diseased coronary artery
|
|
|
coronary artery bypass graft
|
graft from a healthy vessel used to reroute blood around diseased coronary artery
|
|
|
Possible Acute Coronary Syndrome Signs/Symptoms in Older Adults
|
-worsened difficulty breathing
-unexplained nausea, vomiting -sweating -unexplained tiredness -change in mental status -weakness -fainting -abdominal discomfort |
|
|
Possible Acute Coronary Syndrome Signs/Symptoms in Older Adults (8)
|
-worsened difficulty breathing
-unexplained nausea, vomiting -sweating -unexplained tiredness -change in mental status -weakness -fainting -abdominal discomfort |
|
|
Possible Acute Coronary Syndrome Signs/Symptoms in Diabetics (5)
|
-change in mental status
-weakness -fainting -lightheadedness -shoulder/back pain |
|
|
Possible Acute Coronary Syndrome Signs/Symptoms in Diabetics
|
-change in mental status
-weakness -fainting -lightheadedness -shoulder/back pain |
|
|
Possible Acute Coronary Syndrome Signs/Symptoms in Women
|
-pain or discomfort in chest, arms, back, shoulders, neck, jaw
-anxiety, dizziness -shortness of breath -unusual tiredness -weakness -cold sweats -nausea, vomiting -numbness, tingling in extremities |
|
|
Possible Acute Coronary Syndrome Signs/Symptoms in Women (8)
|
-pain or discomfort in chest, arms, back, shoulders, neck, jaw
-anxiety, dizziness -shortness of breath -unusual tiredness -weakness -cold sweats -nausea, vomiting -numbness, tingling in extremities |
|
|
Congestive heart failure
|
-heart fails to pump efficiently
-leads to edema (pulmonary, feet/ankles) |
|
|
Signs/Systems of CHF
|
-fatigue
-nausea -palpitations -feet/ankle swelling -sacral swelling -unexplained weight gain -shortness of breath -dyspnea w/exertion -paroxsymal nocturnal dyspnea -orthopnea -jugular venous distention -pulmonary edema |
|
|
hypertension
|
-sustained elevation of systolic or diastolic BP
-systolic >140 mmHg -diastolic >90 mmHg |
|
|
prehypertension
|
-120 < systolic < 139
- 80 < diastolic < 89 |
|
|
essential/primary hypertension
|
w/out identifiable cause
|
|
|
secondary hypertension
|
w/identifiable cause
|
|
|
Possible causes of secondary hypertension
|
-anxiety
-appetite suppressants -atherosclerosis or arteriosclerosis -birth control pills -cocaine -diabetes -kidney disease -migraine medications -obesity -pregnancy |
|
|
hypertensive emergencies
|
-situations that require rapid lowering of blood pressure to prevent organ damage
|
|
|
Signs/Symptoms of Hypertensive Emergency
|
-altered mental status
-strong, bounding pulse -range of skin temp/color -headache -ringing in ears (tinnitus) -nausea or vomiting -dizziness -shortness of breath -paroxysmal nocturnal dyspnea -orthopnea -nosebleed (epistaxis) -seizures |
|
|
cardiogenic shock
|
-heart fails to function effectively as a pump
-not enough pumped blood to maintain adequate perfusion |
|
|
Signs/symptoms of Cardiogenic shock
|
-altered mental status
-jugular venous distention -labored breathing -tachycardia -hypotension -crackles -pale, cool, clammy skin -pulmonary edema |
|
|
MONA
|
-pneumonic used to recall initial treatment for acute coronary syndrome
-Morphine -Oxygen -Nitroglycerin -Aspirin |
|
|
cardiac arrest
|
heart stops beating
|
|
|
Possible causes of cardiac arrest (11)
|
-heart attack/stroke
-chocking/respiratory arrest -seizures -diabetic emergency -severe allergic rxn -electrical shock -poison/drug overdose -drowning -suffocation -trauma -severe bleeding |
|
|
CPR
|
-cardiopulmonary resuscitation
-rescue breathing and external chest compressions -provides only 1/3 of blood to heart/brain |
|
|
sudden cardiac death
|
unexpected death from cardiac causes early after symptom onset or w/out symptoms
|
|
|
chain of survival
|
-ideal series of events that should take place after recognition of injury/illness
1. Early access (call 9-1-1) 2. Early CPR 3. Early defibrillation 4. Early Advanced care |
|
|
Vfib
|
electrical impulses of the heart are completely disorganized, preventing the heart from pumping effectively
|
|
|
defibrillator
|
device that delivers an electrical shock to a patient's heart to stop an abnormal heart rhythm
|
|
|
manual defibrillator
|
-rescuer analyzes heart rhythm
-applies paddles/shock if needed |
|
|
implantable cardioverter-defibrillator
|
device surgically implanted below skin that recognizes abnormal rhythms and delivers shock
|
|
|
Adult Rescue Breathing
|
-10-12 breaths/min
-1 breath/5-6 secs |
|
|
Child Rescue Breathing
|
-12-20 breaths/min
-1 breath/3-5 secs |
|
|
Infant Rescue Breathing
|
-12-20 breaths/min
-1 breath/3-5 secs |
|
|
Adult Pulse Check
|
Carotid
|
|
|
Child Pulse Check
|
Carotid
|
|
|
Infant Pulse Check
|
Brachial
|
|
|
Adult Rate/Depth/Method of Chest Compressions
|
-100/min
-1.5-2inch -heel of hand, other hand on top |
|
|
Child Rate/Depth of Chest Compressions
|
-100/min
-1/3-1/2 depth of chest --heel of 1 hand, or same as adult |
|
|
Infant Rate/Depth of Chest Compressions
|
-100/min
-1/3-1/2 depth of chest -2 fingers (1 rescuer) or 2 thumbs (2 rescuer) |
|
|
AED
|
-automated external defibrillator
-computer programmed to recognize heart rhythms that need shocks |
|
|
SAED
|
-semiautomated external defibrillator
-advises on steps to take based on heart rhythm |
|
|
Adult age for CPR
|
>12-14 years old
|
|
|
Child age for CPR
|
between 1 and 12-14 years old
|
|
|
Infant age for CPR
|
less than 1 year
|
