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7 attributes of a symptom correct answers >> 1. Location- where is it, does it radiate? 2. Quality- what does it feel like? 3. Quantity or Severity- how bad is it? (for pain, how bad is it on a scale of 1 to 10?) 4. Timing: Onset, duration, & frequency- when did it start, how long does it last, how often does it occur? 5. Setting in which it occurs- include environmental factors, personal activities (walking), emotional reactions, and any other contributing factors 6. Factors that aggravate or relief the symptom- what makes it better? what makes it worse? 7. Associated manifestations
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7 attributes of a symptom correct answers >> 1. Location- where is it, does it radiate?
Childhood illness to be assessed on PMH correct answers >> MMR, whooping cough, chickenpox, rheumatic fever, scarlet fever, polio, & any chronic childhood illness 4 categories of adult PMH correct answers >> Medical, surgical, OBGYN, psych,. Health Maintenance correct answers >> UTD on immunizations & screenings? TB test, paps, mammograms, stool tests, colonoscopy, cholesterol. What should be considered for a female born before 1971? correct answers >> exposure to diethylstilbestrol (DES) for maternal use during pregnancy-- linked to cervical carcinoma. 5 steps to generating clinical hypothesis correct answers >> 1. select most specific and critical findings to support hypothesis.
masked HTN office BP correct answers >> <140/90 but elevated daytime BP >135/ nocturnal hypertension correct answers >> dipping occurs in most patients at night when they fall asleep Brachial artery location and BP readings correct answers >> if below heart, readings are high. If above heart, bp readings are low. Office manual or automated blood pressure HTN correct answers >> Based on average of two readings:
or equal to 140/ prehypertension correct answers >> 120-139/80- Stage 1 hypertension correct answers >> For age 18- 60: Systolic 140-159, Diastolic 90- for age >60, 150-159/ Stage 2 htn correct answers >> >160/>
Steps to ensure accurate blood pressure correct answers >> avoid smoking, caffeine, exercise 30 min prior, room quiet and comfortable, pt sit quiet in chair for 5 min w. feet on floor. palpate brachial artery for ensure pulse, roughly level with 4th ICS at junction of sternum. If sitting- arm on table little above waist if standing- support arm at mid chest level. How to estimate systolic pressure correct answers >> palpate radial artery w/one hand, rapidly inflate cuff until radial pulse disappears- note the measurement and add 30 mmHG auscultatory gap correct answers >> a brief period when Korotkoff sounds disappear during auscultation of blood pressure; common with hypertension When to note systolic bp correct answers >> when hear sounds of two consecutive beats identification of diastolic correct answers >> disappearance point, usually 3 mmhg below muffling point