Secondary Patient Assessment Flashcards

Vocabulary flashcards covering the components of secondary patient assessment, vitals, A+O status, pain history, respiratory severity, and stroke assessment based on the lecture notes.

A+O Status

Assessment of orientation determining status from $A+O \times 4$ to $A+O \times 0$ based on four parameters: Person, Place, Time, and Event.

Vitals

Key physiological measurements including HR, BP, $O_2$, L/S, Skin signs, temp, blood sugar, and RR.

Medications (Secondary Ax)

Assessment of prescribed and non-prescribed substances (OTC, Rx, Supp., drug/alc) evaluating Name, Dose/Freq., Last Dose, Directions, Dr., and Compliance.

Pertinent medical Hx

Patient medical history components covering Sx (symptoms), diseases, and hospitalizations.

Pain / C/P Assessment

Evaluation of pain or chest pain consisting of Onset (gradual/sudden), Provocation/Palliation, Quality-describe, Radiate spread, Severity (1-10), and Time.

Severe Respiratory Distress (Talking Tiredness)

Respiratory limitation where the patient can only speak 1-2 words at a time.

Moderate Respiratory Distress (Talking Tiredness)

Respiratory limitation where the patient can speak 2/3-5 words at a time.

Mild Respiratory Distress (Talking Tiredness)

Respiratory limitation where the patient can speak 5-7 words at a time.

Respiratory / SOB Assessment

Evaluation of shortness of breath including Progression (gradual/sudden), Associated CP, Sputum (color, consistency, amount, etc), Talking Tiredness (observe), and Exercise Tolerance (compare 2 baseline).

Stroke / CPSS Assessment

Stroke assessment evaluating Facial drop, Arm drift, Speech, and Time (last seen norm + go).