Glasgow Coma Scale (GCS) - Answer Eye-opening response
Spontaneous opening- 4
To verbal stimuli- 3
To pain- 2
None- 1
Most appropriate verbal response
Oriented- 5
Confused- 4
Inappropriate words- 3
Incoherent- 2
None- 1
Most intergrated motor response (arm)
Obeys commands- 6
Localizes pain- 5
Withdraws from pain- 4
Flexion to pain- 3
Extension to pain- 2
None- 1
Orthopnea - Answer ability to breathe only in an upright position (CHF, Heart
problem)
General malaise - Answer Run down feeling, nausea, weakness, fatigue, headache
(electrolyte imbalance)
Dyspnea - Answer Grade 1- occurs after unusual exertion
Grade 2- breathless after going up hills or stairs
Grade 3- while walking at normal speed
Grade 4- slowly walking a short distance
Grade 5- at rest, shaving, dressing, etc.
vasovagal syncope - Answer Common dizziness and fainting, caused by loss of
peripheral venous tone
orthostatic hypotension - Answer Excessive drop in BP when assuming the standing
position
Carotid sinus syncope - Answer Associated with hypertension carotid sinus - more
common in elderly patients
,Cough (tussive) syncope - Answer Transient loss of consciousness following severe
coughing
FUO - Answer fever of unknown origin
heart rate - Answer 60-100 bpm
Respiratory rate - Answer 12-20 breaths per minute
PERRLA - Answer pupils- equal, round, reactive to light and accommodation
Miosis - Answer constricted pupils (pinpoint)
Ptosis - Answer Drooping of the upper eyelid
Diplopia - Answer Blurred or double vision
Nystagmus - Answer involuntary, rapid, rhythmic movement of the eyeball
Peripheral edema - Answer Presence of excess fluid in the tissue.
Caused by CHF, pulmonary hypertension, venous insufficiency and renal failure.
Rated +1,+2,+3,+4; higher numbers indicate more severs swelling.
May be described as "pitting edema"
ascites - Answer abnormal accumulation of fluid in the abdomen, generally caused
by liver failure
Clubbing of fingers - Answer Caused by chronic hypoxemia, suggestive of
pulmonary disease
Eupnea - Answer normal respiratory rate, depth and rhythm
Cheyne Stokes - Answer gradually increasing then decreasing rate and depth in a
cycle lasting from 30-180 seconds, with periods of apnea lasting up to 60 seconds.
,Biot's - Answer increased respiratory rate and depth with irregular periods of apnea.
Each breath has the same depth.
Fines Rales (moist crepitant rales) - Answer alveoli, fluid, patient has CHF/
pulmonary edema, patient needs IPPB, heart drugs, diuretics and oxygen
Wheeze - Answer bronchospasm, patient needs a bronchodilator, unilareral wheeze
indicative of a foreign body obstruction
Stridor (Monophonic inspiratory sound, crowing) - Answer Supraglottic swelling
Subglottic swelling (post extubation)
Foreign body aspiration (solid or fluid)
, Treatment- topical decongestant (racemic epinephrine) for swelling and edema
Suctioning and/or bronchoscopy for secretions and foreign body aspiration
Intubation for marked/severe stridor
Heart Sounds: First Sound (S1) - Answer is created by normal closure of the mitral
valve and tricuspid valves at the beginning of ventricular contraction
Heart Sounds: Second Sound (S2) - Answer is normal and occurs when systole
ends, the ventricles relax and the pulmonic and aortic valves close.
Heart Sounds: Third Sound (S3) - Answer in an adult, the presence of an S3 sound,
is abnormal and may suggest CHF
Heart Sounds: Fourth Sound (S4) - Answer the presence of a fourth sound, S4, is
indicative of a cardiac abnormality such as myocardial infarction of cardiomegaly
Decrease PECO2 or PETCO2% - Answer indicates increase in ventilation or
decreased perfusion (deadspace disease: pulmonary embolism, hypovolemia)
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