PAAM EXAM STUDY GUIDE
Patient Assessment - ANSWER • Structured process of gathering information used
to make a diagnostic opinion of the patient
• A problem-oriented evaluation of the patient
Indications of respiratory distress - ANSWER - Dyspnea
- Mild Cyanosis
- SpO2 greater than 96% on supplemental oxygen
Indications of respiratory failure - ANSWER - Altered mental status
- Retractions, tracheal tugging, nasal flaring, use of
accessory muscles
- Cyanosis or pallor
- Audible sounds
- Abnormal rate or pattern, one to two-syllable dyspnea
- SpO2 less than 96% on supplemental oxygen
sounds of partial airway obstruction - ANSWER - Snoring
- Gurgling
- Crowing
- Stridor
Assessing medical (responsive) - ANSWER • SAMPLE history
• Focused medial assessment
- Based on chief complaint
• Baseline vital signs
,Assessing medical (unresponsive) - ANSWER • Rapid Medical Exam
- Head-to-toe
- Searching for cause
• Baseline vital signs
• SAMPLE history for family / friends / co-workers
Assessing trauma (no significant MOI) - ANSWER • Focused trauma assessment
- Focused on injury site
• Reevaluate mechanism of injury
• Baseline vital signs
• SAMPLE history
Assessing trauma (significant MOI/unconscious) - ANSWER • Rapid Trauma
Assessment
- Head-to-toe
• Baseline vital signs
• SAMPLE history from family/witnesses / bystanders
OPQRST-ASPN - ANSWER to further evaluate purpose of
examination / chief complaint
Psychosocial History - ANSWER • Living condition / Lifestyle
- Home situation and significant others
- Dating experiences
• Daily life
• Important experiences
• Religious beliefs
• The patient's outlook
,Measurement of Vital signs - ANSWER • Level of Consciousness
• Pulse
• Blood Pressure
• Respirations
- Respiratory patterns
• Temperature
• Pupils
• Skin and tissues
Normal Pattern - ANSWER • "Eupnea"
Cheyne-Stokes
Respirations - ANSWER • Cyclic wax and wane
• Usually involves periods of
apnea
• Seen in:
- Stroke, head injury, CHF
Kussmaul's Respirations - ANSWER • Deep, rapid respirations
• Seen in:
- Metabolic disease
Central Neurogenic
Hyperventilation - ANSWER • Rapid respirations
• Seen in:
- Cerebral injury
- Increased intracerebral
, pressure
Ataxic (Biot's)
Respirations - ANSWER • Irregular rate and depth
• Seen in:
- CNS dysfunction
- Increased intracerebral
pressure
Apneustic Respirations - ANSWER • Deep, gasping inhalation
with long slow exhalation
• Brief periods of apnea
• Seen in:
- Pons damage
- Brain stem stroke
Skin - ANSWER • The largest organ of the human body
• Makes up 15% of our total body weight
• Consists of 2 layers that lie atop the subcutaneous
fat
- Dermis
- Epidermis
Bronchial - ANSWER - loud, high pitched lung sounds
- expiatory phase usually
longer
Patient Assessment - ANSWER • Structured process of gathering information used
to make a diagnostic opinion of the patient
• A problem-oriented evaluation of the patient
Indications of respiratory distress - ANSWER - Dyspnea
- Mild Cyanosis
- SpO2 greater than 96% on supplemental oxygen
Indications of respiratory failure - ANSWER - Altered mental status
- Retractions, tracheal tugging, nasal flaring, use of
accessory muscles
- Cyanosis or pallor
- Audible sounds
- Abnormal rate or pattern, one to two-syllable dyspnea
- SpO2 less than 96% on supplemental oxygen
sounds of partial airway obstruction - ANSWER - Snoring
- Gurgling
- Crowing
- Stridor
Assessing medical (responsive) - ANSWER • SAMPLE history
• Focused medial assessment
- Based on chief complaint
• Baseline vital signs
,Assessing medical (unresponsive) - ANSWER • Rapid Medical Exam
- Head-to-toe
- Searching for cause
• Baseline vital signs
• SAMPLE history for family / friends / co-workers
Assessing trauma (no significant MOI) - ANSWER • Focused trauma assessment
- Focused on injury site
• Reevaluate mechanism of injury
• Baseline vital signs
• SAMPLE history
Assessing trauma (significant MOI/unconscious) - ANSWER • Rapid Trauma
Assessment
- Head-to-toe
• Baseline vital signs
• SAMPLE history from family/witnesses / bystanders
OPQRST-ASPN - ANSWER to further evaluate purpose of
examination / chief complaint
Psychosocial History - ANSWER • Living condition / Lifestyle
- Home situation and significant others
- Dating experiences
• Daily life
• Important experiences
• Religious beliefs
• The patient's outlook
,Measurement of Vital signs - ANSWER • Level of Consciousness
• Pulse
• Blood Pressure
• Respirations
- Respiratory patterns
• Temperature
• Pupils
• Skin and tissues
Normal Pattern - ANSWER • "Eupnea"
Cheyne-Stokes
Respirations - ANSWER • Cyclic wax and wane
• Usually involves periods of
apnea
• Seen in:
- Stroke, head injury, CHF
Kussmaul's Respirations - ANSWER • Deep, rapid respirations
• Seen in:
- Metabolic disease
Central Neurogenic
Hyperventilation - ANSWER • Rapid respirations
• Seen in:
- Cerebral injury
- Increased intracerebral
, pressure
Ataxic (Biot's)
Respirations - ANSWER • Irregular rate and depth
• Seen in:
- CNS dysfunction
- Increased intracerebral
pressure
Apneustic Respirations - ANSWER • Deep, gasping inhalation
with long slow exhalation
• Brief periods of apnea
• Seen in:
- Pons damage
- Brain stem stroke
Skin - ANSWER • The largest organ of the human body
• Makes up 15% of our total body weight
• Consists of 2 layers that lie atop the subcutaneous
fat
- Dermis
- Epidermis
Bronchial - ANSWER - loud, high pitched lung sounds
- expiatory phase usually
longer
