PSD - Physical Assessment Notes

What are the four traditional vital signs?

Temperature, blood pressure, heart rate/pulse, respiratory rate.

Define respiratory rate (RR).

Number of breaths taken per minute (rpm).

What is normal adult RR?

12–20 respirations per minute.

Define tachypnea.

Fast RR > 20 rpm.

Define bradypnea.

Slow RR < 12 rpm.

Why shouldn’t the patient know you’re counting their RR?

They may unconsciously change their breathing rate.

Name causes of tachypnea.

COPD, asthma, pneumonia, pulmonary embolism, pain, stress, anxiety.

Name causes of bradypnea.

Opioids, drug overdose, ethanol toxicity, head injury.

Define cyanosis.

Blue discoloration of skin/nails/mucosa due to lack of oxygen.

Define dyspnea.

Difficulty breathing.

What assessment technique uses sight?

Insepection

What assessment technique uses touch?

Palpation.

What assessment technique uses a stethoscope to hear lung sounds?

Auscultation.

What assessment technique involves tapping to hear sound differences?

Percussion.

Define heart rate (HR).

Number of heartbeats per minute (bpm).

Normal adult HR?

60–100 bpm.

Tachycardia definition.

HR > 100 bpm.

Bradycardia definition.

HR < 60 bpm.

Define pulse.

Pressure wave felt in a peripheral artery each time the heart contracts.

Radial artery location & use.

Wrist under thumb; used to assess HR.

Brachial artery location & use.

Above elbow crease toward body; used for BP measurement.

Define systole.

Ventricular contraction.

Define diastole.

Ventricular relaxation/filling.

Systolic BP is…

Pressure during ventricular contraction (top number).

Diastolic BP is…

Pressure during ventricular relaxation (bottom number).

Things that increase BP/HR?

Caffeine, nicotine, pseudoephedrine, stimulants, albuterol, NSAIDs, estrogen-containing contraceptives.

Examples of low BP causes?

Dehydration, blood loss, heart failure.

Medications that decrease HR?

Beta blockers, non-DHP CCBs (verapamil, diltiazem).

Define core body temperature.

Temperature of blood around the hypothalamus.

Normal oral temperature range.

97.5°F–99°F.

Two normal sources of temperature fluctuation?

Diurnal cycle and age.

Causes of ↑ body temp?

Exercise, infection, hyperthyroidism, progesterone, meds.

Causes of ↓ body temp?

Cold exposure, alcohol, hypothyroidism, antipyretics.

Antipyretic examples.

Acetaminophen, aspirin, ibuprofen, naproxen.

5 temperature measurement routes.

Oral, rectal, axillary, tympanic, temporal.

Rectal temp compared to oral?

~1°F higher.

Axillary temp compared to oral?

~1°F lower.

Pain is sometimes referred to as the…

5th vital sign.

Pain assessment mnemonic?

PQRST (Palliative/Provocative, Quality, Radiation, Severity, Timing).

Subjective pain behaviors?

Complaints, reports of meds, ROS findings.

Objective pain behaviors?

Grimacing, guarding, crying, pacing, rubbing area.

Purpose of general assessment?

Form overall impression of patient’s health.

Components included in general assessment?

Age, skin, facial features, LOC, distress, nutrition, body structure, grooming, behavior, mobility.

What are the four assessment techniques?

Inspection, palpation, percussion, auscultation.

What sense is used in inspection?

Sight.

What sense is used in palpation?

Touch.

What sense is used in percussion?

Hearing (sound from tapping).

What sense is used in auscultation?

Hearing (via stethoscope).

Which physical assessment technique do pharmacists use most?

Inspection.