Vital Signs
Range of normal adult respiratory rate
What is 30-60
Order of Assessment (not abdomen)
What is Inspection, Percussion, Palpitation, and Auscultation.
Harsh, high-pitched sound in trachea
Stridor
Location of apical pulse-landmarks
What is 5th intercostal space, midline clavicular?
Round, hunched backed appearance, upper thoracic spine
What is Kyphosis?
When is this an expected finding?
unresponsive to verbal and painful stimuli
What is comatose?
Bradycardia
What is less than 60?
Tachycardia?
Pulse sites that can be assessed bilaterally & Simultaneously
What is Radial, Femoral, Brachial. Dorsalis Pedis?
If you cannot palpate a pulse, what is your next step?
high-pitched musical sounds during inspiration and expiration
What is Wheeze?
Mostly on expiration but also occur on inspiration
Sound make by air passing through narrowed bronchioles
Expected with Asthma
I am located at the 3rd intercostal space, left sternal border
What is Erb's point?
No valve at this location
Side to side curvature of the spine
What is Scoliosis?
Unable to stay awake without verbal or tactile stimuli but drowsy and confused when awake
What is Obtunded?
Lowest normal O2 sat?
What is 95%
Risk Factors of Peripheral Vascular Disease
What is Smoking, Diabetes, Hypertension, Hyperlipidemia?
Fine, high-pitched crunching sounds that do not clear with coughing
What are crackles?
popping sounds during inspiration
often heard in Pneumonia
I am the first valve you listen too
What is Aortic Valve?
2nd Intercostal Space, RIGHT sternal border
Inward cure of the spine, arched lower back
What is Lordosis?
Unresponsive to verbal stimuli but responds to painful stimuli
What is Stupor?
BP is concerning when it is above?
What is 140/90?
Parts of the General Survey
What is:
Health-appears healthy
No signs of distress
Physical Appearance-looks stated age,
Hygiene-no odor, dressed appropriately for weather. well groomed
Level of Consciousness
Mobility- Gait, Posture, use of assistive devices, ROM
Low pitched sonorous wheeze
What is Rhonchi
Location of the pulmonic valve
What is 2nd Intercostal Space, Left sternal border?
Movement of an arm or leg toward the body
What is adduction?
Piece of equipment needed to assess pupil size and consensual response
What is a penlight?
Range of normal adult oral temperature
What is 97.5 -99.5?
Order of Head to Toe Assessment
Place these in the correct order of assessment
Abdomen
Chest
General Survey
Head and Neck
Lower Extremities
Vital Signs
What is General Survey, Head & Neck, Chest, Abdomen, Lower extremities
Sitting with elbows on knees or leaning over the overbed table
What is Tripod position?
location of Tricuspid valve
What is 4th intercostal space, left sternal bborder?
Movement of an arm or leg away from the body
What is Abduction?
You expect this response when you assess the Achilles reflex
What is Plantar Flexion?