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Kettering TMC- Patient Assessment
Terms in this set (116)
four life functions
Out of the 4 life functions, what is the most common probelm?
What is a Sign?
Objective information, those things that you can see or measure
*color, pulse, edema, bp)
What are symptoms?
Subjective information, those, things that the patient must tell you.
*dyspnea, pain, nausea, muscle weakness
What is the 50/50 rule?
PaCo2 50 or greater & PaO2 50 or below = Respiratory failure, patient needs ventilation
What is an advance directive?
Set of instructions documenting what treatment a patient would want if he/she was unable to make medical decisions
Advance Directive documents should be...?
Dated, signed, witnessed and notarized.
Types of advance directives?
*Do Not Resuscitate (DNR)
*Do Not Intubate (DNI)
*Durable Power of Attorney
Normal urine output?
40 mL/hr (1 liter per day)
What does obtunded mean?
Drowsy state, may have decreased cough or gag reflex, risk of asppiration
Activities of daily living (ADL)
1. Bathing with sponge, bath or shower
4. Toilet Use
6. Urine and bowel continence
Peripheral Edema is caused by what?
Congestive Heart Failure (CHF) and Renal Failure
Clubbing of the fingers is caused by?
Chronic Hypoxemia. Presence of this is suggestive of pulmonary disease.
What is Jaundice?
Increased bilirubin level in the blood and tissue.
What is Erythem?
Redness of the skin. Caused by capillary congestion, inflammation or infection, flushed
What is Cyanosis?
Blue or blue-grey discoloration of skin and mucous membranes. Caused by hypoxia from increased amount of reduced hemoglobin.
What is barrel chest?
A result of air trapping in the lungs for a long period of time
2. Increased A-P Diameter
What is Flail Chest
three or more adjacent ribs fractured at 2 points, causing paradoxical inward movt of the flail segment w/ inspiration
Increased respiratory rate. Greater than 20 respirations per minute
an abnormally slow rate of respiration usually of less than 12 breaths per minute
cessation of breathing
Increased respiratory rate, increased depth, regular rhythm
Causes: Metabolic disorders/CNS disorders
gradually increasing then decreasing rate and depth in a cycle lasting from 30-180 seconds, with periods of apnea
Increased Respiratory Rate/Depth w/ Irregular periods of Apnea
ie: CNS Problems
Increased RR (>20 breaths/min), increased depth, irregular rhythm, breathing sounds labored
Cause: Diabetic ketoacidosis
prolonged inspiratory phase with shortened expiratory phase
Cause: problem with resp center, trauma, or tumor
shallow or slow breathing
Normal heart rate
> 100 bpm, indicates hypoxemia, anxiety, stress
recommend o2 therapy
< 60 bpm, indicates heart failure, shock, code/emergency
Normal value for ICP?
5-10 mm Hg
When would you recommend to initiate treatment of icp?
>| 20 mmhg
What is a therapy to reduce ICP
Hyperventilation, target PaCO2 equals 25 to 30 torr
What is a osmotic agent to remove fluid from the brain
A decrease in FEno suggest a decrease in what
Normal value for RBC
male: 4.5-6.0 mill/mm3 female: 4.0-5.5 mill/mm3
Normal value of hemoglobin
12-16 gm/100 mL blood
Normal value of hematocrit
Normal value for WBC
What does increased WBC indicate
Indicates bacterial infection
What does a decreased WBC indicate
Indicates a viral infection also called leukopenia
What are the four main electrolytes
Potassium, sodium, chlorine, bicarb
What is the major intracellular cation?
What is the normal range for potassium
3.5 to 4.5 mEq/L
What is the major extracellular cation controlled by the kidneys
What is the normal range for sodium
What is the major extracellular anion
What is the normal range for chloride
What is the total CO2 content
What is the normal range for bicarbonate
What electrolyte is excreted by the kidneys
What is the normal value for creatinine
What is the normal value for blood urea nitrogen (BUN)
What does mucoid sputum color mean
Chronic bronchitis, white/gray color
What does yellow sputum color mean
Presence of WBC, bacterial infection
What does green sputum color mean
Stagnant sputum, Graham negative bacteria, bronchiectasis/Pseudomonas
What does brown/dark color sputum mean
Old blood, anaerobic lung infection
What does bright red sputum mean
Hemostasis, bleeding tumor, TB
What does pink frothy sputum mean
What does sinus tachycardia mean
What is the recommended treatment for sinus tachycardia
What is sinus bradycardia?
What is the treatment recommendation for sinus bradycardia
What is the treatment for PVC
Oxygen, lidocaine, consider other causes (hypoxemia, electrolyte imbalance)
What does ventricular tachycardia mean
V-Tach, ventricular rhythm with rate greater than 100
What is the recommended treatment for ventricular tachycardia
Pulse present (Stable VT) cardiovert
Pulse absent(Unstable VT) defibrillate, CPR, epinephrine, amiodarone
Term infant is defined as
born b/w 38 to 42 weeks
Preterm infants is defined as
Less than 38 weeks of gestational age
What does APGAR stand for?
appearance, pulse, grimace, activity, respiration
What action for a 0 to 3 Apgar score
What action for a 4 to 6 Apgar score
Support, stimulate, warm, administer 02
What action based on 7 to 10 Apgar score
What is normal temperature for an infant
What is a normal heart rate for a term infant
110 to 160 bpm
What is a normal respiratory rate for an infant
What is a normal blood pressure for a term infant
What is A normal blood pressure for a preterm infants
What is average term infant weight
> 3000 g
What is capnography?
A noninvasive way of measuring exhaled CO2 content using infrared absorption; (ECO2, ETCO2, PetCO2)
Normal range for SpO2
If there is a sudden fall in readings without a change in patient condition and then there is a possible malfunction of the probe, what needs to happen
The probe may need to be changed or reattached
What are Co-oximeter /hemoximeter used for
Used to diagnose carbon monoxide poisoning
What is normal range for COHB
0 to 1%
normal COhb for smokers
Percentage for CO poisoning
What is hemodynamics?
monitoring of blood pressure
what are the 3 factors that control blood pressure?
1) The Heart: Changes in the HR and contractility will affect the BP directly
3) Vessels: Vessel dilation-decrease in BP (septic shock, Anaphylactic shock)
Device used to convert one form of energy into another
The pressure transducer should be at what level
same level as the tip of the catheter
if the transducer is above the catheter readings are _____ than actual
if transducer is below the catheter , readings are _____ than actual
Normal Mean arterial pressure (MAP)
(SBP + 2DBP)/3
Cardiac index normal
2.5-4.0 for patients of all sizes
cardiac index equation
Normal for lungs
White pattern, solid, fluid
Normal for bones, organs
Any ill-defined radiodensity
Solid white area
Extra pulmonary air
COPD, asthma attack, pneumothorax
Lymphatics, vessels, lung tissue
Increased with CHF
Absent with pneumothorax
to spread throughout
crowded pulmonary vessels
crowded air bronchograms
ground glass appearance, honeycomb pattern, diffuse bilateral radiopacity
Blunting of costophrenic angle, Basilar infiltrates with meniscus, Concave superior interface/border
Peripheral wedge-shaped infiltrate
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