Week 3: Chapters 8, 9, and 10 - NRSE 2122 Baker/Cox

What is the first step in the assessment of each body system?

Inspection

What are the four primary physical examination techniques?

Inspection, palpation, percussion, and auscultation.

What is the purpose of hand hygiene in clinical settings?

To decrease the spread of infection before and after patient care.

What personal protective equipment (PPE) is commonly used in clinical settings?

Gloves, gown, mask, eye protection, or face shield.

What is the definition of palpation in a clinical assessment?

The use of touch to assess various body structures.

What are the three types of palpation techniques?

Light, deep, and bimanual palpation.

What is percussion used for in a physical examination?

To assess underlying structures by tapping the skin.

What are the characteristics of sounds produced by percussion?

Amplitude, pitch, quality, and duration.

What is auscultation and what equipment is typically used?

Listening to sounds produced by the body using a stethoscope.

What is the difference between the diaphragm and bell of a stethoscope?

The diaphragm is used for high-pitched sounds, while the bell is for soft-pitched sounds.

What should be done before beginning a physical examination?

Have the patient change into an examination gown and perform hand hygiene.

What is the significance of maintaining privacy during a clinical examination?

To respect the patient's dignity and comfort.

What should be included in the explanation provided to the patient before an examination?

The purpose of the examination and what to expect during the process.

What is the role of respiratory hygiene in infection control?

To prevent the spread of respiratory infections through education and source control measures.

What is the importance of the fit and quality of a stethoscope?

It affects the ability to hear body sounds clearly by blocking out extraneous noise.

What is the sequence of performing a physical examination?

Typically performed in the order of inspection, palpation, percussion, and auscultation.

What should be done after completing a physical examination?

Summarize findings for the patient.

What is the key factor in decreasing the spread of infection in healthcare settings?

Hand hygiene.

What is the purpose of using isolation precautions?

To prevent the spread of infection from patients who are known to be contagious.

What does the term 'cultivating your senses' refer to in clinical assessment?

Using sight, smell, touch, and hearing to gather information during an examination.

What are the patient considerations during palpation?

To ensure comfort and explain what is being assessed.

What is the significance of developmental care for patients?

To address the specific needs of patients based on their developmental stage.

What are the four areas considered in a general survey?

Physical appearance, body structure, mobility, and behavior.

What is the purpose of a general survey?

To study the whole person, covering general health state and any obvious physical characteristics.

What objective measurements are included in a general survey?

Height, body mass index, and waist circumference.

What are some abnormalities in body weight and proportion?

Dwarfism, hypopituitary dwarfism, achondroplastic dwarfism, gigantism, acromegaly, anorexia nervosa, and endogenous obesity (Cushing's syndrome).

What is the average oral temperature for adults?

98.6°F.

What is the normal range for a resting adult heart rate?

60 to 100 beats per minute (bpm).

What does a heart rate less than 60 bpm indicate?

It is termed bradycardia and occurs normally in well-trained athletes.

What is hyperpyrexia?

A body temperature of 106°F or higher.

What is hypothermia?

A body temperature of 95°F or lower when measured rectally.

How does heart rate vary with the respiratory cycle?

It speeds up at the peak of inspiration and slows down with expiration.

What is the significance of heart rhythm in pulse assessment?

The rhythm of pulse normally has a regular, even tempo, with irregularities commonly found in children and young adults.

What is the relationship between stroke volume and heart rate?

A stronger heart muscle pushes out a larger stroke volume, requiring fewer beats per minute to maintain stable cardiac output.

What factors can affect blood pressure?

Age, weight, physical activity, and emotional state.

What is the mean arterial pressure (MAP)?

The average pressure in a person's arteries during one cardiac cycle.

What is the procedure for assessing normal respirations?

Observe the patient's breathing pattern and count the number of breaths per minute.

What is the significance of using a blood pressure cuff of improper size?

It can lead to inaccurate blood pressure readings.

What is the average rectal temperature for adults?

99.3°F to 99.5°F.

What is the average axillary temperature for adults?

97.6°F.

What is the relationship between heart rate and exercise?

Heart rate increases during exercise to meet the body's demand for increased metabolism.

What is the strength of pulse indicative of?

The strength of the heart's stroke volume.

What is a common irregularity in heart rhythm found in children and young adults?

Sinus arrhythmia.

What are the four qualities considered when assessing the pulse?

Rate, rhythm, amplitude, and procedure.

What does a weak, thready pulse reflect?

A decreased stroke volume.

What does a full, bounding pulse denote?

An increased stroke volume.

How is pulse force recorded?

Using a three-point scale: 3+, 2+, 1+, 0.

What should be observed in respiration assessment?

Rate, rhythm, depth, and effort of breathing.

What are some abnormalities in the rate and rhythm of breathing?

Rapid shallow breathing, slow breathing, slow shallow breathing, rapid deep breathing, and Cheyne-Stokes breathing.

What should blood pressure (BP) be less than?

90-140 / 60-90 mmHg.

What should a patient avoid 30 minutes before blood pressure measurement?

Caffeine.

What should the room conditions be for accurate blood pressure readings?

The room should be quiet and comfortable.

How long should a patient sit quietly before measuring blood pressure?

At least 5 minutes.

What factors can affect blood pressure readings?

Age, gender, race, cuff size, and arm position.

What should be noted in infants and children's vital signs?

Measure vital signs with the same purpose and frequency as in adults, but in reverse order: respiration, pulse, and temperature.

What changes occur in the aging adult's physical appearance?

Body contour becomes sharper with more angular facial features and redistributed body proportions.

What happens to weight in the aging adult?

Weight decreases during the 80s and 90s, more evident in males due to greater muscle shrinkage.

What is the risk associated with temperature in the aging adult?

Increased risk of hypothermia.

How does pulse rhythm change in the aging adult?

It may be slightly irregular.

What happens to respiratory rate in the aging adult?

Decreased vital capacity and decreased respiratory rate.

How do arteries change with age?

Arteries stiffen and blood pressure increases, leading to widened pulse pressure.

What are some lifestyle modifications for hypertension?

Weight loss, limiting alcohol use, increasing aerobic exercise, reducing sodium intake, maintaining dietary potassium, calcium, and magnesium, smoking cessation, and reducing saturated fats and cholesterol.

What should be considered when measuring blood pressure?

Always consider the patient's baseline.

What is the recommended cuff size for accurate blood pressure measurement?

Cuff size should be appropriate for the patient's arm size.

What is the significance of parental bonding in child assessments?

It reflects the child's interactions with parents and the quality of physical care provided.

What is the recommended method for taking a rectal temperature in infants?

It may cause the infant to cry, masking normal resting values.

What is the recommended order for measuring vital signs in infants?

Respiration, pulse, and temperature.

At what age can children typically have their temperature measured orally?

Usually age 5 or 6; some 4-year-olds can also.

What should be noted about parental bonding during a general survey of infants and children?

The child's interactions with parents and the parent's provision of appropriate physical care and promotion of new learning.

What changes in physical appearance are observed in aging adults?

Body contour becomes sharper with more angular facial features and redistributed body proportions.

What happens to posture in aging adults by the 8th or 9th decade?

General postural changes occur.

How does weight change in aging adults during the 80s and 90s?

Weight decreases, more evident in males due to greater muscle shrinkage.

What changes occur in fat distribution for aging adults?

Subcutaneous fat is lost from the face and periphery, while additional fat is deposited on the abdomen and hips.

What is a potential risk regarding temperature in aging adults?

Increased risk of hypothermia.

How does pulse rhythm change in aging adults?

It may be slightly irregular.

What respiratory changes occur in aging adults?

Decreased vital capacity and increased respiratory rate.

What happens to arteries as people age?

Arteries become stiffer with age.

What happens to blood pressure in aging adults?

Systolic pressure increases, leading to widened pulse pressure.

What lifestyle modifications are recommended for hypertension management?

Weight loss, limiting alcohol use, increasing aerobic exercise, reducing sodium intake, maintaining dietary potassium, calcium, and magnesium, smoking cessation, and reducing saturated fats and cholesterol.

What should be done prior to a quiz/exam according to the notes?

Read chapters, complete the lab manual, compare PPT notes with readings, engage in lab, and attend SI or office hours with questions.

What is the significance of cuff size in blood pressure measurement?

Cuff size affects the accuracy of blood pressure readings.

What is the importance of calibration in blood pressure measurement?

Calibration ensures accurate blood pressure readings.

What should be noted about the behavior of children during a general survey?

Their response to stimuli and level of alertness appropriate for their age.

What is the impact of aging on gait?

Aging adults may experience balance issues.

What is the purpose of measuring vital signs in infants and children?

To assess health status with the same purpose and frequency as in adults.

What is a common challenge when taking rectal temperatures in infants?

It may cause the infant to cry, masking normal resting values.