Module 5-6 exam review

what are signs and symptoms of HF?

Ascites, fluid in abdomen, lower extremities (legs)
crackles in lungs
JVD

what is it called when a patent reports SOB while walking?

dyspnea

what is it called when a patent reports SOB while lying down?

orthopnea

where do you hear bruits?

Carotid

palpate carotid at ___ times

different

what side of the stethoscope do you use to hear carotid ?

bell

Aortic

2nd ICS RSB

Pulmonic

2nd ICS LSB

Erb's Point

3rd ICS LSB

Tricuspid

4th ICS LLSB

Mitral "apical"

5th ICS L MCL (Midclavicular line )

where would you palpate the apical pulse?

5th ICS, point of maximum impulse

what is S1 ?

systole: ventricles contract

What is S2 ?

Diastole: ventricles relax

Where is S2 louder?

S2 will be louder than S1 over the Aortic and Pulmonic valves

What does ABC's mean ?

airway, breathing, circulation

What is associated with a patient who is experiencing nausea, diaphoresis, midsternal chest pain/pressure?

Myocardial infraction (heart attack)

what valve makes up for S2 ?

semilunar valve

what is the purpose of valves ?

to help prevent backflow of blood

why do we hear murmurs ?

due to backflow of blood

If a patient is having a valve procedure, how would you describe in a therapeutic way ?

draw a picture to keep simple

what is a thrill?

a palpable rushing vibration

where do you listen to apices of the lung ?

top portion of the lung, 2-4 cm above clavicle

if you are auscultating patients lung and hear a high pitched, musical sound what is. it?

wheezing

what is it called when a someone coughs up blood-tinged sputum ?

hemoptysis

hematemesis (vomiting blood) indicates?

GI bleeding

what causes crackles?

back up fluid, pneumonia (alveoli leaks), HF

you may hear wheezing in which type of patient?

Asthma pt

If you're having a hard time hearing breath sounds what do you do?

ask patient to take a deep breath in slowly while their mouth is open

lateral lung/side ?

axillary area

bradypnea

>12

tachypnea

what is a sign of COPD?

clubbing

what is the normal respiration rate

12-20

majority of lung field?

vesicular

kyphosis

increase in thoracic convexity (can impair breathing if severe)

scoliosis

lateral curvature (can impair lung function)

pectus carinatum (pigeon chest)

upper portion of chest sternum displaced outward
usually no problems

pectus excavatum (funnel chest)

lower portion of sternum displaced inward
can cause compression of heart and lungs

barrel chest

1:1 ratio, related to COPD

in what kind of pattern do you listen to to a patients lung ?

zig zag, left to right

what are signs of respiratory distress ?

dyspnea (SOB), accessory muscle use, retraction of intercostal, nasal flaring, tripod ( copd postion )

check carotid 1 side a time because __

it can profuse brain

what do you do if you cant feel pedal pulse ?

use a doppler or palpate the next artery

in a patient with atrial insufficiency in lower extremities what do you asses ?

iliac and femoral artery

what is Intermittent claudication ?

cramping in leg due to low blood flow through leg
can get better with rest (arterial)
leg pain when walking, no pain at rest

abdomens has how many sections?

4

your liver is in which quadrant ?

RUQ

where is your spleen ?

LUQ

what is the function of the spleen ?

immune function, stores WBC/antibodies, removed dead blood cells

what do you before you can say bowel sounds are absent ?

hear for at least 1 minute in all 4 quadrants for a total of 4 minutes before describing them

how would you describe a stoma ?

red, pink, moist

what is the diet of someone who is post operative illus

NPO, abdomen will look distended

you should educate a patient to do a breast self exam at least ?

once a month

you should not perform a breast exam when ?

during menstrual cycle do to hormones

how many quadrants are in a breast ?

4 with tail

which one is missed alot ?

the tail (axially area), cancer goes undetected

Gynecomastia

extra breast tissue in males caused by abnormal hormone imbalance

what are changes in breast during pregnancy ?

increase in size, areolas are darker/darker, nippled are erratic/prominent

bronchial sounds

normal over/above trachea and larynx
high, loud, and coarse

bronchovesicular sounds

normal over major bronchi
medium pitch
2nd ics and 4th thoracic posterior

vesicular sounds

heard over peripheral lung fields
soft low, breezy, rustling quality, higher pitch

which arteries do you auscultate in abdomen for bruits, venous hums?

aorta, renal, iliac, and femoral arteries