Fundamental Concepts of Nursing Practice: Physical Assessment, Lab Values, & Pharmacology Review

Comprehensive vocabulary flashcards covering the Fundamental Concepts of Nursing Practice curriculum, including physical examination techniques, sensory and neurological assessments, cardiopulmonary landmarks and breath sounds, laboratory panels (CMP), electrolyte imbalances (sodium, potassium, phosphorus, calcium), and the twelve cranial nerves.

Pharmacology/Electrolyte Quiz #2

A nursing lab assessment announced by Dr. W covering Vancomycin, Ciprofloxacin, Influenza vaccine, Expectorant, Antihistamines, Sodium Imbalances, and Phosphorus imbalances, administered prior to the midterm practicum.

Inspection

The physical assessment technique of looking to observe size, color, shape, position, and symmetry.

Palpation

The physical assessment technique of feeling to evaluate temperature, turgor (skin spring-back), texture, moisture, and vibrations.

Percussion

The physical assessment technique of tapping body tissues to determine location, shape, size, and density (how solid tissue is).

Auscultation

The physical assessment technique of listening to body sounds to evaluate pitch, loudness, quality, and duration.

General survey

An overall impression that begins at first patient contact and evaluates appearance, behavior, posture, speech, mental state, dress/hygiene, vital signs, height, and weight.

SPICES

An assessment tool for older adults screening for Sleep problems, Problems eating/feeding, Incontinence, Confusion, Evidence of falls, and Skin breakdown.

Cyanosis

A bluish discoloration of the skin indicating reduced oxygenation.

Jaundice

A yellowish discoloration of the skin and sclera resulting from impaired yellow waste (bilirubin) processing.

Ecchymosis

Bruising of the skin caused by bleeding under the surface.

Petechiae

Tiny, pinpoint bleeding spots visible on the skin.

Diaphoresis

Excessive sweating observed during physical assessment.

Edema

Swelling in tissues resulting from excessive fluid accumulation.

Alopecia

Hair loss identified during examination of the skin and scalp.

Hirsutism

Excessive or abnormal hair growth.

PERRLA

A clinical pupillary assessment acronym denoting Pupils equal, round, reactive to light and accommodation.

Clubbing

An abnormal finding marked by bulbous fingertips and a wider nail angle exceeding the expected approximately $160^\circ$ angle.

Snellen chart

A standardized eye chart used to screen distance visual acuity.

Jaeger chart

A handheld assessment tool used to screen near vision.

Cardinal fields of vision

An eye movement examination assessing ocular muscle coordination, alignment, and tracking.

Whisper test

A hearing screening examination performed by testing the patient's recognition of a repeated whispered word.

Broca's aphasia (expressive aphasia)

A language impairment following brain injury characterized by difficulty producing spoken or written words.

Wernicke's aphasia (receptive aphasia)

A language impairment following brain injury characterized by difficulty understanding spoken or written language.

Global aphasia

A severe language impairment following brain injury causing significant deficits in both word production and comprehension.

Stereognosis

The sensory ability to identify a familiar object purely by touch.

Graphesthesia

The sensory ability to recognize letters or numbers traced lightly onto the skin.

Two-point discrimination

The sensory ability to distinguish two distinct points of contact applied simultaneously to the skin.

Point localization

The sensory ability to pinpoint the precise location where a tactile touch was applied.

Extinction (sensory)

A sensory deficit marked by failing to perceive one of two touches applied simultaneously to identical areas on opposite sides of the body.

Abdominal assessment sequence

The mandatory order of abdominal examination: Look (inspect), Listen (auscultate), Tap (percuss), and Feel (palpate), preventing palpation from altering bowel motility and sounds.

Borborygmi

Loud, rumbling or gurgling bowel sounds produced by the movement of gas and fluid through the intestines.

Light palpation

Palpation of the abdomen using the finger pads to a depth of approximately $1\,\text{cm}$ while monitoring the patient for facial clues of pain.

Dysuria

Difficulty, burning, or pain experienced during urination.

Retractions

Visible inward pulling of the skin around the ribs and sternum during respiration, signaling labored breathing effort.

Barrel chest

An abnormal chest deformity characterized by an increased anteroposterior (AP)-to-lateral ratio relative to the expected $1:2$ dimension.

Crepitus (pulmonary)

A crackly or crinkly sensation felt on chest palpation caused by air leaking into subcutaneous tissue.

Vesicular breath sounds

Soft, low-pitched breath sounds heard over most peripheral lung fields where inspiration is longer than expiration.

Bronchovesicular breath sounds

Medium-pitched breath sounds heard over main bronchi where inspiration and expiration durations are approximately equal.

Bronchial breath sounds

Loud, high-pitched breath sounds expected when auscultating directly over the trachea.

Crackles (rales)

Short popping or bubbling lung sounds generated when collapsed or fluid-filled alveoli suddenly pop open.

Wheezes

High-pitched, musical whistling lung sounds caused by airflow passing through narrowed or constricted airways.

Rhonchi

Low-pitched, snoring or rattling sounds caused by secretions in large airways that frequently clear or change with coughing.

Stridor

A harsh, high-pitched breath sound heard on inspiration indicating potential upper-airway obstruction.

Pleural friction rub

A grating or rubbing adventitious breath sound produced when inflamed pleural layers rub together.

Point of maximal impulse (PMI)

The apical cardiac impulse located at the left 5th intercostal space at the midclavicular line.

Aortic listening area

The cardiac auscultation landmark located at the 2nd intercostal space at the right sternal border.

Pulmonic listening area

The cardiac auscultation landmark located at the 2nd intercostal space at the left sternal border.

Tricuspid listening area

The cardiac auscultation landmark located at the 4th intercostal space at the left sternal border.

Mitral (apical) listening area

The cardiac auscultation landmark located at the 5th intercostal space at the left midclavicular line.

S1 (Lub)

The first heart sound, created by the closure of the atrioventricular (AV) valves between the upper and lower cardiac chambers.

S2 (Dub)

The second heart sound, created by the closure of the semilunar valves at the exits of the ventricles.

Murmur

An extra heart sound generated by turbulent blood flow across cardiac valves.

Bruit

An abnormal whooshing vascular sound heard on auscultation over an artery caused by turbulent blood flow.

Thrill

A palpable vibration felt over a heart valve or blood vessel indicating turbulent flow.

G.E.K.L.

A mnemonic denoting the four functional metabolic areas evaluated on a Comprehensive Metabolic Panel: Glucose, Electrolytes, Kidneys, and Liver.

Albumin

A liver-produced protein with a course reference range of $3.4\text{--}5.1\,\text{g/dL}$ that supports oncotic pressure and fluid retention within blood vessels.

Blood Urea Nitrogen (BUN)

A waste indicator of protein breakdown with a course reference range of $8\text{--}21\,\text{mg/dL}$, used to evaluate renal function and dehydration.

Creatinine

A waste indicator of kidney filtration efficiency with a course reference range of $0.5\text{--}1.2\,\text{mg/dL}$ (slide 6) or $0.7\text{--}1.2\,\text{mg/dL}$ (slide 23).

Estimated Glomerular Filtration Rate (eGFR)

An estimate of kidney filtration rate flagged as abnormal when $<60\,\text{mL/min}$, with values $<15\,\text{mL/min}$ indicating severe reduction.

Ascites

Accumulation of fluid in the peritoneal abdominal cavity, frequently secondary to cirrhosis and reduced serum albumin.

Hepatic encephalopathy

Altered brain function, confusion, or cognitive decline resulting from the liver's failure to clear metabolic wastes from circulation.

Cirrhosis

Severe, irreversible scarring and structural breakdown of the liver.

Hyponatremia

A serum sodium level $<135\,\text{mEq/L}$ representing excessive water relative to salt, causing water to shift into cells and provoke neurological symptoms like confusion and seizures.

Hypernatremia

A serum sodium level $>145\,\text{mEq/L}$ representing water deficit or sodium excess, leading to cellular dehydration, intense thirst, and neurological changes.

Antidiuretic hormone (ADH)

A hormone ('Adds Da H2O') instructing the renal tubules to reabsorb existing water into the blood, reducing urine volume.

Aldosterone

An adrenal mineralocorticoid hormone that acts as a 'salt-saving bodyguard' by retaining sodium and water while promoting renal potassium excretion.

Hypokalemia

A serum potassium level $<3.5\,\text{mEq/L}$ marked by flattened T waves, prominent U waves, constipation/ileus, muscle weakness, and increased digoxin toxicity risk.

Hyperkalemia

A serum potassium level $>5.0\,\text{mEq/L}$ characterized by peaked T waves, conduction changes, ascending weakness, and risk of fatal arrhythmias.

Sodium polystyrene sulfonate

An oral or rectal gastrointestinal medication that binds potassium and excretes it out of the body through the stool.

Regular insulin + dextrose

An ordered intravenous therapy for hyperkalemia that shifts potassium from the bloodstream into cells without immediately removing total-body potassium.

Calcium gluconate

An intravenous therapy administered in severe hyperkalemia to provide cardiac membrane stabilization, rather than removing potassium.

Phosphate binder

A prescribed oral medication (e.g., calcium acetate [PhosLo] or sevelamer) taken with meals to attach to dietary phosphate in the intestine and eliminate it in stool.

Hypocalcemia

A serum calcium level $<8.5\,\text{mg/dL}$ (or $<8.2\,\text{mg/dL}$ on CMP) leading to excessive neuromuscular excitability, circumoral tingling, tetany, laryngospasm, and prolonged QT interval.

Hypercalcemia

A serum calcium level $>10.5\,\text{mg/dL}$ (or $>10.2\,\text{mg/dL}$ on CMP) resulting in depressed neuromuscular reflexes, lethargy, constipation, kidney stones, and shortened QT interval.

Trousseau sign

A carpopedal hand/wrist spasm elicited by inflating a blood pressure cuff above systolic blood pressure, indicating hypocalcemia and tetany.

Chvostek sign

A unilateral facial twitch elicited by tapping over the facial nerve in front of the ear, indicating hypocalcemia and neuromuscular excitability.

Parathyroid hormone (PTH)

A parathyroid gland hormone that elevates serum calcium levels by stimulating bone release, renal retention, and intestinal absorption.

Calcitonin

A thyroid hormone that lowers blood calcium levels by inhibiting bone breakdown.

Cranial Nerve I (Olfactory)

A sensory cranial nerve responsible for smell.

Cranial Nerve II (Optic)

A sensory cranial nerve responsible for vision.

Cranial Nerve III (Oculomotor)

A motor cranial nerve responsible for most extrinsic eye movements, pupillary constriction, and eyelid elevation.

Cranial Nerve IV (Trochlear)

A motor cranial nerve responsible for downward and inward eye movement.

Cranial Nerve V (Trigeminal)

A mixed sensory and motor cranial nerve responsible for facial sensation and chewing (muscles of mastication).

Cranial Nerve VI (Abducens)

A motor cranial nerve responsible for outward (lateral) eye movement.

Cranial Nerve VII (Facial)

A mixed sensory and motor cranial nerve responsible for facial expressions and taste.

Cranial Nerve VIII (Vestibulocochlear)

A sensory cranial nerve responsible for hearing and balance.

Cranial Nerve IX (Glossopharyngeal)

A mixed sensory and motor cranial nerve responsible for swallowing and taste.

Cranial Nerve X (Vagus)

A mixed sensory and motor cranial nerve responsible for swallowing, vocalization, coughing, and visceral parasympathetic control.

Cranial Nerve XI (Spinal accessory)

A motor cranial nerve responsible for shoulder shrugging and head turning strength.

Cranial Nerve XII (Hypoglossal)

A motor cranial nerve responsible for tongue movement and protrusion.