Initial Assessment of the Critically Ill Patient - Examination - Circulation
9 important questions on Initial Assessment of the Critically Ill Patient - Examination - Circulation
What can cause a weak peripheral pulse?
What causes a pulsus deficiens?
What is a pulsus paradoxus and what can be the cause? (5)
It can occur with deep hypovolemia, constrictive pericarditis, cardiac tamponade, asthma and COPD.
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What can you observe during inspection in C?
- Increased CVP
- Reduced peripheral perfusion (pallor)
- Hemorrhage (obvious or concealed)
- Clubbed fingernails
- Splinter hemorrhages
- Altered lever of consciousness
- Decreased urine output
What must be noted in the palpitation of the abdomen?
- Abdominal tenderness
- Palpable masses
- Organ megaly
- Rigidity, distension, "prikkelbaar"
If possible: flanks and back
What must be considered in all women of childbearing age?
What must be noted in the physical examination in C?
- Precordial cardiac pulsation
- Central and peripheral pulses (rate, quality, regularity, symmetry)
- Cool extremities
What can cause precordial pulsations?
- LVH
- Congestive heart failure
- Cardiac enlargement
- Severe mitral regurgitation
- Severe aortic regurgitation
What causes circulatory inadequacy?
Secondary: drugsy, hypoxia, electrolyte disturbances, dehydration, sepsis, anemia
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