1. DIAGNOSTIC PROCEDURES & PHARMACOLOGY ICBS 130

2. BASIC EXAMS §Vital Signs l Temperature, normal value is 98.6 F/37.0 C Oral is taken by mouth Aural/Tympanic is taken in the ear Axillary is taken under the arm Rectal is taken in the anal/rectal cavity l Pulse, pressure against the walls of an artery which is caused by the heart contracting. Normal value for an adult is 60-100 bpm. An infant’s pulse will be greater- 130 - 160 bpm.

3. Can be taken in various locations on the body –Temporal - above the ear and to the side of the eye –Carotid - artery in your neck, on either side –Brachial - in the fold of your arm by elbow –Radial - by your wrist –Femoral - in the groin –Popliteal - behind your knee –Posterior tibial - behind your ankle –Dorsal pedis - on the top of your foot l Respirations are the number of breaths taken in a minute, normal values for an adult are 10 - 20 Bpm (breaths per minute)

4. l Blood Pressure is taken with a blood pressure cuff (sphygmomanometer) and a stethoscope. It is recorded in even numbers as systolic ( 1st beat heard) and diastolic (last beat heard). Normal range for an adult is 120/80.

5. l Pain is a subjective value and is rated by the patient. Some offices have a pain scale or pictures in which the patient may use to indicate their pain level.

6. l Auscultation means to listen to with a stethoscope. Different organs make certain sounds when healthy and working properly. Respiratory sounds gives information about your lungs, how well you are breathing. Normal breaths sounds are like air moving through a tube or straw.Abnormal breaths sounds can vary from wheezes which have a musical quality to them, to rales which sound like a crackling noise or bubbling sound.

7. Heart sounds have 2 very distinct sounds. –1) Lubb sound is the first sound heard and is the sound of the tricuspid and mitral valves closing. –2) Dubb sound is heard 2nd and has a shorter and higher sounding pitch to it. This sound comes from the semilunar valves along with the aorta and pulmonary arteries closing as the blood pumps through them –Bruit is a musical sound that can be heard in an artery or vein that might possibly have a blockage or aneurysm –Heart Murmur is kind of a swishy-whistling sound. It may indicate a septal or valve problem

8. Abdominal sounds indicate how the intestinal tract is working. If there are no sounds it can indicate a blockage or anesthesia still present in the system. They can also be described as hyperactive or hypoactive. l Palpation and Percussion is used to feel the texture, size, consistency and location of certain body parts such as the liver, bladder, ovaries and lungs.

9. Types of Instruments Used During Examinations §Ophthalmoscope is used to visually examine the eye. §Otoscope is used to visually examine the ear, ear canal and tympanic membrane. §Speculum is a device used to enlarge an opening so that the interior can be examined such as a vaginal speculum. §Stethoscope is an ear piece that is used for listening.

10. §PERRLA is a common abbreviation meaning pupils are equal, round, responsive to light and accommodation. If the pupils are acting abnormally, this may indicate a head injury,death, stroke or drug use.

11. Examination Positions §Recumbent is when the patient is lying on their back, front or either side. l Decubitus also means the act of lying down §Prone is when the patient is lying on their belly with their face down. §Supine or horizontal recumbent is when the patient is lying on their back with their face up.

13. §The Sims’ position is when the patient is lying on their left side with their knee and thigh drawn up towards the body and the left arm is placed along side of the back. §Knee-Chest is when the patient is lying face down with their knees bent and on the table. The rectal area is up in the air. §Lithotomy is when the patient is lying on their back, face up and their feet and legs

14. §Are raised up with supports such as stirrups. §Trendelenburg is when the patient is lying on their back or belly and the head is lower than the rest of the body.

15. LAB TESTS §Blood tests can be obtained through an artery, vein or capillary. l Typical Blood Tests: ESR - erythrocyte sedimentation rate can indicate if there is an inflammatory process going on in the body. HCT - hematocrit is the % of red blood cells and can indicate blood loss (anemia) or too many red blood cells (polycythemia). RBC - red blood cell count indicates how many red blood cells are in the blood. It can indicate blood loss over the past 24 hours.

16. WBC - white blood cell count measures the number of white blood cells found in the blood. It can indicate an infection or inflammation process. BUN - blood urea nitrogen tells how well the kidneys are functioning. Lipids - lipid panel measures your total cholesterol, HDL and LDL and triglycerides. PT - prothrombin or pro time indicates how well you clot or the lack of clotting ability.

17. §Urine Tests l Urinalysis is a physical and chemical examination of the urine Microscopic examination can indicate an infection or kidney disease. Specific gravity is the amount of mineral, solids and wastes. –Low SG can indicate diabetes –High SG can indicate shock, liver failure or dehydration. Drug screening can be obtained from urine.