Perfusion - BP, sensorium, temp, urine output, hemodynamics
Tobacco use, smoking status
# packs per day X # of years smoked = pack years
Pysical inspection (IPPA)
Inspection
Palpation
Percussion
Auscaltation
Normal urine output
40mL/hr = 1L/day
Sensible water loss reasons
urine, vomiting
Insensible water loss
Lungs, skin
Affects of intake exceeding output
,Weight gain, electrolyte imbalance, increased hemodynamic pressures, decreased lung
cst
Normal CVP (central venous pressure)
2-6 mmHg
Decreased CVP & indications
< 2 mmHg = hypovolemia = fluid therapy
Increased CVP & indications
> 6 mmHg = diuretics (furosemide aka Lasix)
Orientation x3
Time, Place, Person
Orthopnea is:
difficulty breathing while lying down (CHF)
Dyspnea grades
Grade I: unusual exertion
Grade II: up hills or stairs
Grade III: walking at normal speed
Grade IV: slowly, walking short distance
Grade V: at rest, shaving, dressing, etc.
Proper interviewing techniques
Open-ended questions
Patient education
process of influencing the patient's behavior to effect changes in knowledge, attitudes, &
skills needed to maintain & improve health
Effective education
begins with an assessment of the patient's & family's learning needs to determine what
learning needs to occur & how the learning can best occur.
Peripheral edema causes, locations
CHF, renal failure; arms & ankles
Acites
accumulation of fluid in the abdomen, generally caused by liver failure
Clubbing definition; causes
, When angle of the nail bed & skin increases; chronic hypoxemia caused by COPD,
CHF, CF, pulmonary diseases
Cap refill
Color should return within 3 seconds
JVD
jugular venous distention
CHF (left-sided heart failure)
On exhalation in patients with air trapping (decrease venous return)
Diaphoretic
profuse sweating
heart failure (diuretics, positive inotropics)
fever, infection (antibiotics)
anxiety, nervousness (sedatives)
TB (antitubercular drugs)
Erythema
redness of the skin (flushed, cap congestion, inflammation, infection)
Cyanosis (definition)
5g decrease in hemoglobin
Pectus carinatum
forward protrusion of the sternum
Pectus excavatum
depression of part or all of the sternum
Kyphosis (dowager's hump)
convex curvature of the spine (lean forward)
Scoliosis
a lateral or side-to-side curvature of the spine
Kyphoscoliosis
combination of kyphosis & scolisis
restrictive lung pattern (reduced lung volumes)
barrel chest
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