Chapter 8 Patient Assessment and Vitals

A ____ is a subjective condition the patient feels and tells you about.

A ____ is an objective condition you can observe about the patient.

Fragile and easily injured areas include the (three things):

The concept of standard precautions assumes that all blood, body fluids (except ____), nonintact skin, and mucous membranes may pose a substantial risk of infection.

When there are multiple patients, you should use the ____ ____ ____, call for additional units, and then begin triage.

A system implemented to manage disasters and mass-casualty incidents in which section chiefs report to the incident commander.

The process of sorting patients based on the severity of each patient’s condition.

To determine if you require additional resources, ask yourself (four things):

The goal of the ____ ____ is to identify and initiate treatment of immediate or potential life threats.

The initial ____ ____ is formed to determine the priority of care and is based on your immediate assessment of the patient.

Five things that make up a general impression:

Conscious with an altered LOC may be due to inadequate ____; can also be caused by medications, drugs, alcohol, or poisoning

The circulation of blood within an organ or tissue.

Assessment of an unconscious patient focuses first on (three things):

To assess for responsiveness, use the mnemonic:

____ tests mental status by checking a patient’s memory and thinking ability.

Orientation evaluates a person’s ability to remember (four things):

The ____ ____ ____ (___) score can be helpful in providing additional information on patients with mental status changes.

The diameter and reactivity to light of the patient’s pupils reflect the status of the brain’s ____, ____, and ____.

A small number of the population exhibit unequal pupils.

____, which are one category of central nervous system depressants, cause the pupils to constrict so significantly, regardless of light, that they become so small as to be described as pinpoint.

Mnemonic to assess pupils

An open airway is:

Consider providing positive-pressure ventilations with an airway adjunct whenr espirations exceed __ breaths/min and when respirations are fewer than __ breaths/min.

A normal respiratory rate varies widely in adults, ranging from:

You can almost always hear a patient’s breath sounds better from the patient’s ____.

Three areas to auscultate the lungs:

A moist crackling, usually on both inspiration and expiration.

Low-pitched, noisy sounds that are most prominent on expiration.

A brassy, crowing sound that is most prominent on inspiration.

Measure of the depth of breathing and is the amount of air in milliliters that is moved into or out of the lungs during one breath.

Condition where a patient can speak only two or three words without pausing to take a breath.

In responsive patients who are older than __ year, you should palpate the radial pulse at the wrist.

In unresponsive patients older than 1 year, you should palpate the:

Palpate the ____ pulse, located at the medial area (inside) of the upper arm, in children younger than 1 year.

If the patient has a pulse but is not breathing, provide ventilations at a rate of at least __  breaths/min for adults and at least __ breaths/min for an infant or a child.

For an adult, the normal resting pulse rate should be between __ and ___ beats/min and could be as much as ___ beats/min in geriatric patients.

You should describe a stronger than normal pulse as:

A pulse that is weak and difficult to feel is described as “weak” or:

Perfusion is assessed by evaluating a patient’s skin (four things):

Poor peripheral circulation will cause the skin to appear:

When the blood is not properly saturated with oxygen, it appears ____.

High blood pressure may cause the skin to be abnormally flushed and ____.

Skin that is wet, moist (often called ____), or excessively dry and hot suggests a problem.

With adequate perfusion, the color in the nail bed should be restored to its normal pink color within __ seconds.

Lifesaving interventions begin with:

Perform a ____ ____ of the patient’s body to identify injuries that must be managed or protected immediately.

Take __ to __ seconds to perform the rapid scan.

The rapid scan assists in determining:

The time from injury to definitive care, during which treatment of shock and traumatic injuries should occur because survival potential is best.

Aim to assess, stabilize, package, and begin transport to the appropriate facility within __ minutes (often referred to as the “____ __”) after arrival on scene.

Use the mnemonic SAMPLE to obtain the following information:

Use the OPQRST mnemonic to assess:

Negative findings that warrant no care or intervention.

The most common cause of confusion:

Use a ____ to function as a hearing aid for the patient.

____ ____ is performed at the scene or in the back of the ambulance en route to the hospital.

The purpose of the ____ ____ is to perform a systematic physical examination of the patient.

The mnemonic DCAP-BTLS reminds you what to look for in a ____ ____:

Measures the oxygen saturation of hemoglobin in the capillary beds.

In most patients, a pulse oximetry reading will fall between:

Several conditions can give false pulse oximetry values (five things):

____ ____, or electronic measurement, is another method of obtaining blood pressure readings.

A noninvasive method that can quickly and efficiently provide information on a patient’s ventilatory status, circulation, and metabolism.

The partial pressure or maximal concentration of CO2 at the end of an exhaled breath.

The normal range for end-tidal CO2 is __ to __ mm Hg, or _% to _% CO2.

The goal of the ____-____ ____ is to identify injuries or causes missed during the primary assessment’s 60- to 90-second rapid scan.

A ____ ____ is performed on patients who have sustained nonsignificant MOIs or on responsive medical patients and is based on the chief complaint.

The goal of a ____ ____ is to focus your attention on the immediate problem.

The purpose of ____ is to identify and treat changes in a patient’s condition.

A patient in unstable condition should be reassessed every __ minutes.

A patient in stable condition should be reassessed every __ minutes.

The primary assessment is performed on all patients. It includes forming an initial ____ ____ of the patient, including the LOC, and identifies any life-threatening conditions to the ABCs.

History taking includes an investigation of the patient’s chief complaint or history of present illness.  A ____ history is generally taken during this step of the assessment process. This information may be obtained from the patient, family, friends, or bystanders.

A systematic head-to-toe examination that is performed during the secondary assessment on a patient who has sustained a significant mechanism of injury, in unconscious, or is in critical condition.

A grating or grinding sensation caused by fractured bone ends or joints rubbing together; also air bubbles under the skin that produce a crackling sound or crinkly feeling.

The delicate membrane that lines the eyelids and covers the exposed surface of the eye.

A step within the patient assessment process that identifies and initiates treatment of immediate and potential life threats.

In patients with deeply pigmented skin, changes in color may be apparent only in certain areas, such as the:

When interviewing a patient, you can show him or her that you understand the situation by:
A. interrupting him or her as needed for clarification.
B. repeating statements back to him or her.
C. using medical terminology whenever possible.
D. maintaining constant eye contact with him or her.

A patient with spontaneous respirations is breathing:
A. at a normal rate.
B. without difficulty.
C. without assistance.
D. with shallow depth.

Which of the following abnormal breath sounds indicates obstruction of the upper airway?
A. rhonchi
B. crackles
C. rales
D. stridor

When assessing motor function in a conscious patient's lower extremities, you should expect the patient to:
A. feel you touching the extremity.
B. note any changes in temperature.
C. identify different types of stimuli.
D. wiggle his or her toes on command.

You are assessing a 72-year-old man with abdominal pain.  The patient is sitting in a chair; he is conscious, alert, and calm.  As you are talking to the patient, your partner discreetly directs your attention to a handgun, which is located on a nearby table.  You should:
A. document the presence of the weapon, including its specific location, and continue your assessment of the patient.
B. immediately cease all patient care, carefully back out of the residence, and request law enforcement assistance.
C. direct your partner to move the gun to a safe area and then advise the patient that his weapon has been secured.
D. position yourself in between the patient and the gun and ask your partner to request law enforcement assistance.

After performing a primary assessment, a rapid scan of the body should be performed in order to:
A. identify less obvious injuries that require immediate transport.
B. determine the need for spinal motion restriction precautions.
C. find and treat injuries or conditions that do not pose a threat to life.
D. look specifically for signs and symptoms of inadequate perfusion.

Upon arriving at the scene of a patient with difficulty breathing, you determine that the scene is safe. You enter the residence and find the patient sitting in a chair in obvious distress. Your first action should be to:
A. introduce yourself to the patient.
B. ask the patient what's wrong.
C. assess the patient's airway status.
D. obtain a set of baseline vital signs