NU 650 Final Exam SG Study Guide with Solutions Order of Assessment - Correct Answer Inspection, Palpation, Percussion and Auscultation. EXCEPT with abdomen Comprehensive Health History - Correct Answer chief complaint, reason for visit, ROS, past medical and surgical history, social history and family history Pediatric Body measurements - Correct Answer length, height, weight, head circumference fro birth to 36 months Normal/Hypertension cut off - Correct Answer <130 normal 140+ hypertension Fontanel Closure - Correct Answer posterior 1-2 months, anterior 9mo-2years otoscope - Correct Answer adult-up and back, peds- down and back, using largest speculum that will fit comforably tympanic membrane - Correct Answer Cone of light R-5 l-7 EOM testing - Correct Answer CN III, IV, VI
AP diameter of chest - Correct Answer 1:2 (AP less than transverse)
barrel chest - Correct Answer COPD Flat or Dull percussion - Correct Answer effusion or pneumonia normal resonant percussion - Correct Answer healthy lung Hyperressonance (percussion) - Correct Answer trapped air crackles/rales - Correct Answer high pitched, discontinuous Wheezes - Correct Answer high-pitched whistling or squeaking sounds during inspiration or expiration Rhonchi - Correct Answer snoring, rumbling sounds heard upon auscultation of the chest during respiration-low pitched tactile fremitus - Correct Answer • INCREASED FREMITUS
- Means there is liquid or solid inside the lungs (consolidation such as with pneumonia)
- Remember Liquid or solid transmits vibrations better than air 1 / 2
• DECREASED FREMITUS
Means air trapping such as with emphysema or bronchial obstruction.Bronchophony - Correct Answer the spoken voice sound heard through the stethoscope, which sounds soft, muffled, and indistinct over normal lung tissue, clearer over disease Egophony - Correct Answer abnormal change in tone of voice that is heard when auscultating the lungs EE-->AA UE Arteries - Correct Answer radial-thumb side, ulnar pinky side Pulse grading - Correct Answer 0 absent 1+ weak 2+ normal 3+ increased 4+ bounding palpate bilaterally PMI - Correct Answer point of maximal impulse mid-clavicular and 5th ICS S1 - Correct Answer normal, closure of AV, Start of systole, loudest at Apex, contraction of ventricles S2 - Correct Answer normal, closure of semilunar, end of systole, loudest at base, filling of ventricles S3 - Correct Answer third heart sound (normal in pregnant young adults, and children), gallop S4 - Correct Answer extra heart sound, end of diastole, indicative of disease-AFIB murmur grading scale - Correct Answer I-Barely Audible II-Quiet, Clearly Audible III-moderately Loud IV-loud, thrill V-Very loud, can palpate thrill VI-Very loud, thrill palpable and visible clubbing - Correct Answer bulbous enlargement of distal phalanges of fingers and toes that occurs with chronic cyanotic heart and lung conditions edema scale - Correct Answer 1+ = disappears rapidly. 2+ = last 10-15 seconds. 3+ = lasts more than one minute. 4+ = lasts 2-5 minutes. These are signs used in what scale?
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