Term
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Definition
| during interview phase of health assessment |
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Term
|
Definition
| important indicators of the patients physiological status and response to the environment |
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Term
| indicators of an acute situation |
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Definition
extreme anxiety
acute distress
pallor
cyanosis
change in mental status |
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Term
| interventions in acute situations... |
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Definition
| begin while continuing the assessment |
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Term
| rapid response may be called for... |
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Definition
an acute change in mental status
stridor
respirations less than 10 or greater than 32 times per minute
increased effort to breathe
oxygen saturation <92%
pulse <55 or >120
systolic <100 or >170
temp <35C or >39.5C
new onset of chest pain
agitation or restlessness |
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Term
| before taking vital signs |
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Definition
have pt rest for at least 5 mins
ensure no smoking, eating or drinking for last 30 mins
remove constrictive clothin from upper arm |
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Term
|
Definition
begins with first moment of patient encounter and continues throughtout health jistory
is the first component of the assessment
helps to form global impression of person
note physical appearance, body structure, mobility, and behavior |
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Term
| in general survey, assess: |
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Definition
overall appearance
hygeine and dress
skin color
body structure and development
behavior
facial expression
level of conciousness
speech
motility
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Term
| anthropometric measurements |
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Definition
height
weight
calculation of BMI |
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Term
|
Definition
reflect overall health status, cardiopumonnary function, and overall body function
need to assess pt medications first
frequency
baseline |
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Term
|
Definition
normal range depends on route of measurement
rectal and temporal slightly higher (<1F) than oral
axillary slightly lower (<1F)
Diurnal cycle
electronic thermometers
documentation
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Term
|
Definition
arterial pulse points
rate
rythym
pulse deficit
amplitude
elasticity
assessment
documentation
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Term
|
Definition
inspiration
expiration
resp rate
eupnea
documentation |
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Term
|
Definition
norma is 95-100%
85-89% may be acceptable for certain chronic illnesses like emphysema
documentation
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Term
|
Definition
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