Physical Diagnosis Exam 1

what is the normal range for temperature

97.2 to 99.9

what does temperature do throughout the day

varies throughout a 24 hour cycle

what types of thermometers are easy and accurate

oral, tympanic, forehead/infrared

what types of thermometers are accurate but not the true core temperature

rectal, axillary

what type of thermometer is appropriate for infants and inconvenient for most outpatient offices

rectal

what type of thermometer is not appropriate for those with muscular deficits and respiratory diseases

oral

what type of thermometer is not appropriate for infants and inconvenient for most outpatient offices

axillary

what type of thermometer infers temperature from thermal radiation of the tympanic membrane

tympanic

what type of thermometer infers temperature from thermal radiation of the temporal artery

forehead/infrared

when is temperature normally the lowest during the day

early morning

in what conditions could temperature rise 1 degree Fahrenheit

-throughout menses peaking at ovulation

-exercise more specifically on a hot day

what oral temperature is considered a fever

above 100.4 Fahrenheit

what rectoral or aural temperature is considered a fever

above 101 Fahrenheit

what category of fever is when temperature elevates and falls to normal every day

intermittent

what is the pattern of a intermittent fever

the spike can occur the same time each day, every other day, or every few days

what are some diseases that you would have an intermittent fever with

-cholangitis (charcot)

-TB

-malaria

-septicemia

what category of fever is when temperature elevates and falls every day, but not to normal

remittent

what infectious diseases are remittent fever often associated with

-infective endocarditis

-rickettsiae infections

-brucellosis

what category of fever is where the temperature peaks and troughs is by 1.4 degrees Celsius or more

hectic fever

what would be suggested if someone were to have a hectic fever

-the individual has an abscess or pyogenic infection

-also seen with TB, hypernephromas, lymphomas, and drug reactionswhat

what are the types of pyogenic infections could someone with hectic fever have

pyelonephritis and ascending cholangitis

what category of fever has a pattern with negligible change (0.3 degrees Celsius or less) in a 24 hour period

continuous (sustained)

what is a continuous (sustained) fever associated with

-chill or rigor

-typhoid fever or typhus

-bacterial endocarditis, TB, fungal disease, and bacterial pneumonia

what category of fever is spiking separated by days or weeks of intervening normal temps

relapsing

in what cases can relapsing fever be seen

-rat-bite

-malaria, cholangitis

-infections with borrelia recurrentis

-Hodgkin's disease

what is the most common periodic fever condition in children

PFAPA

what is a temperature greater than 105 degrees Fahrenheit or 40.6 degrees Celsius

hyperpyrexia

what is hyperpyrexia usually caused by

injury to the brains thermoregulating centers

when can hyperpyrexia be observed in an individual

-stroke, heat stroke

-cerebral anoxia

-encephalitis meningitis

what is a temperature of less than 95 degrees Fahrenheit or 35 degrees Celsius

hypothermia

what is when the body dissipates more heat than it absorbs or creates, leaving the body unable to generate sufficient heat to maintain homeostasis and proper bodily function

accidental hypothermia

what is secondary hypothermia caused by

-central line failure

-peripheral failure

-endocrine and energy failures

for every degree in Celsius the body increases in an adult or child how much will the pulse rate increase

-adult = ~10 bpm

-child = ~12 bpm

what is a pulse rate under 60 bpm

bradycardia

what is a pulse rate over 100

tachycardia

what is a respiration rate under 12 breaths per minute

bradypnea

what is a respiration rate over 20 breaths per minute

tachypnea

what is true or normal breathing

eupnea

what is slow, shallow irregular respiration due to anoxic brain injury

agonal

what is when upright breathing necessary and is most commonly due to heart failure

orthopnea

what is the sensation (subjective) difficulty breathing

dyspnea

what is a decreased respiratory rate for an individuals age

bradypnea

what is a increased respiratory rate for an individuals age

tachypnea

what is an involuntary inspiration 1.5 to 2 times greater than normal tidal volume

sighing

what is the absence of breathing and is life threating

apnea

what is over ventilation with decreased PaCO2 and respiratory alkalosis

hyperventilation

what is under ventilation with increased PaCO2

hypoventilation

what is increased volume with or without increased rate (O2 and CO2 are normal)

hyperpnea

what is decreased volume with decreased rate (O2 and CO2 are normal)

hypopnea

what are attacks of severe SOB that wake the patient and are most commonly seen in heart failure

paroxysmal nocturnal dyspnea

what is deep, sighing respirations (hyperventilation/air hunger with or without increased rate) observed in diabetic ketoacidosis

Kussmaul

what results from stimulation of the brain stem by low blood pH which compensates for metabolic acidosis

kussmaul 2

what are the causes for kussmaul 2

-lactic or ketoacidosis

-salicylate toxicity, uremia, alcohol

what are regular deep respirations with periods of apnea

biot

what are the causes of biot

-brain stem injury due to stroke

-trauma or herniation

what are regular deep inspirations with inadequate expirations that are due to pons injury from stroke or trauma or temporarily induced by ketamine

apneustic

what is a persistent hyperventilation due to head trauma, brain hypoxia, reduced cerebral perfusion

central neurogenic

what Korotkoff phase first appears faint, repetitive, clear tapping sounds that gradually increase in intensity for at least 2 consecutive beats

Phase 1

what is phase 1 also known as

systolic blood pressure (ventricular contraction)

what Korotkoff phase is a brief period where the sounds soften and acquire a swishing quality

Phase 2

what could occur during Korotkoff phase 2

auscultatory gap

what is it called when in some patients the Korotkoff sounds may disappear altogether for a short time

auscultatory gap

what Korotkoff phase is when sharper sounds return and become crisper to regain, or even exceed, the intensity of phase 1 sounds

Phase 3

what Korotkoff phase is when they become distinct muffling sounds, soft and blowing in quality

Phase 4

what phase is also known as the mid-diastolic pressure/first diastolic sound

Phase 4

what Korotkoff phase is the point at which all sounds finally disappear completely

Phase 5

what phase is the diastolic blood pressure also known as end-diastolic pressure/second diastolic sound/ventricular relaxation

Phase 5

what is considered a normal blood pressure

-systolic = less than 120

-diastolic = less than 80

what is considered to be a elevated blood pressure

-systolic = 120-129

-diastolic = less than 80

what is considered a high blood pressure / hypertension stage 1

-systolic = 130-139

-diastolic = 80-89

what is considered high blood pressure / hypertension stage 2

-systolic = 140 or higher

-diastolic = 90 or higher

what is considered a hypertensive crisis

-systolic = higher than 180

-diastolic = higher than 120

when taking a blood pressure how much do you inflate the cuff above palpatory systole

20-40 mmHg

what is white coat hypertension (persons blood pressure is high at doctors)(

what is masked hypertension (persons blood pressure is normal when at the doctors)

what is it called when pressure is less than 90/60

hypotensive

how do you calculate pulse pressure

systole (phase 1) - end diastolic (phase 5)

according to the 2017 ACC/AHA guidelines the patient should avoid caffeine, exercise, and smoking for at least __________________ before measurement

30 minutes

according to the 2017 ACC/AHA guidelines the blood pressure cuff should cover ______ % of the patients arm

80

according to the 2017 ACC/AHA guidelines how much should u inflate the blood pressure cuff above the palpatory systole to take a patients blood pressure

20 - 30 mmHg

according to the 2017 ACC/AHA guidelines how many mmHg per second should you deflate the blood pressure cuff

2

what can be caused by a drop in blood pressure and oxygen to the brain

vasovagal syncope or hypoxia

according to the 2017 ACC/AHA guidelines how many standard drinks a day can a male have

2

according to the 2017 ACC/AHA guidelines how many standard drinks a day can a women have

1