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Health Assessment > Ch. 6 & 9 > Flashcards

Ch. 6 & 9 Flashcards

1
Q

Acute Pain

A

recent onset (less than 6 months), results from tissue damage, is usually self-limiting, and ends when the tissue heals

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2
Q

Persistent (Chronic) Pain

A

intermittent or continuous, lasting more than 6 months

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3
Q

Nociceptive Pain

A

results from activation of essentially normal neural systems that produce somatic or visceral pain

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4
Q

Neuropathic Pain

A

occurs from an abnormal processing of sensory input by the central or peripheral nervous systems

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5
Q

Referred Pain

A

pain in an area away from the tissue injury or disease

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6
Q

Phantom Pain

A

pain that feels like it’s coming from a body part that’s no longer there

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7
Q

Pain Threshold

A

point at which a stimulus is perceived as pain

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8
Q

Pain Tolerance

A

duration or intensity of pain that a person endures or tolerates before responding outwardly

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9
Q

Tissue Integrity

A

structural intactness and physiologic function of tissues and conditions that affect integrity

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10
Q

Primary Lesions

A

expected variations of the skin and include moles, freckles, patches, and comedones (acne) among adolescents and young adults

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11
Q

Secondary Lesions

A

some are considered expected variations; a scar is a common variation caused by injury to the skin

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12
Q

Vascular Lesions

A

many are considered common variations; bruising on a bony prominence is generally considered a common finding secondary to the activities of daily living

Ex: petechiae, purpura, ecchymosis, angioma

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13
Q

Petechiae

A

tiny, flat, reddish-purple, nonblanchable discoloration in skin LESS THAN 0.5 cm in diameter

increased vascular pressure = ruptured capillaries

appears on chest, mouth, nose, cheek

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14
Q

Purpura

A

flat, reddish-purple, nonblanchable discoloration in skin GREATER THAN 0.5 cm in diameter

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15
Q

Ecchymosis

A

bruise; reddish-purple, spot of variable size

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16
Q

Angioma

A

benign tumor consisting of a mass of small blood vessels; can vary in size from very small to large

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17
Q

Pressure Ulcer

A

localized injury to the skin and/or underlying tissue usually over a bony prominence as a result of pressure or pressure in combination with shear and/or friction

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18
Q

Stage 1 Pressure Ulcer

A

intact skin with nonblanchable redness, usually over a bony prominence; area may be painful, firm, soft, warmer, or cooler compared to adjacent tissue

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19
Q

Stage 2 Pressure Ulcer

A

partial-thickness loss of dermis; presents as a shiny or dry shallow open ulcer with pink wound bed without slough or bruising; may also present as an intact or open/ruptured serum-filled blister

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20
Q

Stage 3 Pressure Ulcer

A

full-thickness skin loss involving damage to or necrosis of subcutaneous tissue; subcutaneous fat may be visible, but bone, tendon, or muscles are NOT exposed; slough may be present; wound may include undermining and tunneling; depth varies by location

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21
Q

Stage 4 Pressure Ulcer

A

full-thickness tissue loss with exposed bone, tendon, or muscle; slough or eschar may be present within wound bed; undermining and tunneling often present; depth varies on location

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22
Q

Pallor

A

pale skin color that may appear white

cool/cold

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23
Q

Cyanosis

A

grayish-blue tone, especially in nail beds, earlobes, lips, mucous membranes, palms, and soles of feet

decreased oxygen

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24
Q

Jaundice

A

yellowish color of skin, sclera of eyes, fingernails, palms of hands, and oral mucosa

increased bilirubin

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25
Q

Erythema

A

reddish tone with evidence of increased skin temperature secondary to inflammation

increased inflammation and warmth

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26
Q

Petechiae vs. Purpura

A

Petechiae: less than 0.5 cm; appear as tiny red spots pinpoint to pin head in size

Purpura: more than 0.5 cm

Both: flat, reddish-purple, nonblanchable spots in skin

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27
Q

Vesical vs. Pustule vs. Bulla

A

Vesical: elevated, circumscribed, superficial, not into dermis; filled with serous fluid (clear); less than 1 cm

Pustule: elevated, superficial, lesion; filled with purulent fluid (white, yellow, brown)

Bulla: vesicle greater than 1 cm

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28
Q

Macule vs. Papule vs. Patch

A

Macule: flat, circumscribed area that is a change in color of skin; LESS THAN 1 cm

Papule: elevated, firm, circumscribed area less than 1 cm

Patch: flat, nonpalpable, irregular-shaped macule MORE THAN 1 cm

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29
Q

Finger Clubbing

A

no space is observed between the fingers and nail beds angle away from one another

base of nail is enlarged and curved

caused by proliferation of connective tissue, resulting in enlargement of distal fingers

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30
Q

Braden Scale

A

assessment tool for predicting the risk of pressure ulcers

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31
Q

Melanoma (signs of [ABC…])

A

A - asymmetry (not round or oval)
B - border (poorly defined or irregular border)
C - color (uneven, variegated)
D - diameter (usually greater than 6 mm)
E - evolving (skin lesion that looks different from others or is changing in size, shape or color)
F - feeling (itching, tingling, stinging)

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32
Q

Assessment of Skin Turgor

A

picking up and slightly pinching the skin on the forearm or under the clavicle; skin should be elastic and return to place immediately when released (less than 3 seconds)

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33
Q

How often should you ask about pain?

A

frequently

34
Q

Pain Goal

A

where the patient wants to be at for their pain level

Ex: at a 10, want to be at a 4

35
Q

Aspects can pain affect

A

quality of life
interactions with family and friends
sense of well-being and self-esteem
financial resources

36
Q

Acute Pain may cause…

A

increased vital signs (fight/flight)

37
Q

Persistent Pain

A

chronic

may be intermittent (comes and goes) or continuous

38
Q

What meds do you take for nociceptive pain?

A

ibuprofen, Tylenol, opioids

39
Q

Structures that cause nociceptive pain

A

somatic structures: bones, joints, muscle
visceral organs: chest, abdomen, pelvic areas

40
Q

Structures that cause Neuropathic Pain

A

nerve pain; caused by damaged nerves

41
Q

What meds do you take for nociceptive pain?

A

anticonvulsant and antidepressant

42
Q

Factors that Decrease Pain Tolerance

A

movement
fatigue
sleep deprivation
repeated exposures to pain
anger
bored

43
Q

Factors that Increase Pain Tolerance

A

adrenaline
shock
alcohol intake
meds
hypnosis
heating pad/ice
distraction
prayer
meditation

44
Q

Cognitive Factors of Pain Perception

A

attention people give to the pain
expectation or anticipation of pain
appraisal or expression of pain

45
Q

OLDCARTS

A

Onset (when/what happened)
Location (where)
Duration (how long [recent/chronic])
Characteristics (what does it feel like)
Aggravating factors (what causes it)
Related symptoms (any other symptoms)
Treatment by the patient
Severity (scale 0-10)

46
Q

Pain Reassessment: Oral Pain Med

A

30 min - 1 hr

47
Q

Pain Reassessment: IV Pain Med

A

15 min - 30 min

48
Q

FLACC Scale

A

pain assess scale used for nonverbal/preverbal patients

Face
Legs
Activity
Cry
Consolability

49
Q

Pruritis

A

itching

most commonly reported symptom of skin disease

PQRST/ symptom analysis

50
Q

Skin Examination

A

inspection and palpation

51
Q

Inspection Skin Examination Techniques

A

note color, pigmentation, vascularity, bruising, lesions, discolorations, or unusual odors

inspect from head and neck to trunk, arms, legs, and back

52
Q

Localized Variations in Color on Skin

A

Intentional: tattoos, coin patterns, cupping

Normal: pigmented nevi (moles), freckles, patches, striae (stretch marks)

53
Q

Skin Palpation Techniques

A

palpate skin for texture, temp, moisture, mobility, turgor, thickness

the older the age, the thinner the skin

54
Q

Changes in Moles

A

color
shape
texture
tenderness
bleeding
itching

55
Q

Hints to Malignant Melanoma (ABCDEF)

A

Asymmetry
Border Irregularity
Color Variegation
Diameter Greater than 6mm
Evolution (has it changed)
Feeling (itching, tingling, stinging)

56
Q

Diabetic Patients lose nerve sensation in feet and wounds could occur without their knowledge (T or F)

A

True

57
Q

Questions to Ask About Wounds

A

Where is the wound located?
What have you done to treat the wound?
Do you typically have problems with wound healing?

58
Q

Hyperkeratosis

A

thickening of the outer layer of skin (made of keratin)

Clavus (corn)

59
Q

Dermatitis

A

common skin irritation

60
Q

Atopic Dermatitis

A

superficial inflammation

61
Q

Contact Dermatitis

A

inflammatory reaction to irritant or allergen

localized erythema
may weep, ooze or crust

62
Q

Seborrheic Dermatitis

A

chronic inflammation

scaly, white, or yellowish skin on scalp, eyebrows, eyelids, nasolabial folds, ears, axillae, chest or back

63
Q

Stasis Dermatitis

A

inflammation seen mostly on lower legs of older adults

areas of scaling, petechiae, brown pigmentation

64
Q

Psoriasis

A

usually develops by age 20 years

slightly raised erythematous plaques with silvery scales

mostly on elbows, knees, buttocks, lower back, and scalp

65
Q

Rosacea

A

chronic inflammatory skin disorder

66
Q

Lesions caused by viral infection

A

warts - caused by HPV
herpes simplex - group of 8 DNA viruses
herpes varicella - chickenpox
herpes zoster - shingles

67
Q

Lesions caused by fungal infection

A

tinea corporis - ringworm
tinea cruris - “jock itch”
tinea capitis - scaling and balding
tinea pedis - “athlete’s foot”

candidiasis: affect superficial layers of skin and mucous membranes

68
Q

Lesions caused by bacterial infection

A

cellulitis: acute streptococcal or staphylococcal infection of the skin and subcutaneous tissue

impetigo: highly contagious Group A streptococcal infection (generally occurs on face, around mouth, and nose)

folliculitis: inflammation of hair follicles

furuncle (abscess or boil): staphylococcal infection

69
Q

Lesions caused by anthropods

A

scabies: highly contagious mite Sarcoptes scabiei

lyme disease: tick infected with borrelia burgdorferi

spider bites: majority from black widow or brown recluse spiders

70
Q

Wheal vs. Nodule vs. Plaque

A

Wheal: hives, elevated, pruritic, red

Nodule: slightly elevated lesions, greater than 5 mm in diameter

Plaque: elevated, solid, superficial lesion, greater than 1 cm

71
Q

Hemangioma vs. Telangiectasias

A

hemangioma: bright red birthmark that shows up at birth or in first or second week of life

telangiectasis: dilated or broken blood vessels located near the surface of the skin or mucous membranes

72
Q

When to use the face scale?

A

for children

73
Q

When to use FLACC assessment?

A

for children/ nonverbal or preverbal patients

74
Q

When to use sliding analog pain scale?

A

for children?

75
Q

How to describe lesions

A

location, size, color
shape and borders
elevation
characteristics
pattern

76
Q

Unstagable Pressure Ulcers

A

eschar or slough may cover the entire wound bed; thus, it is unstagable

77
Q

Eschar

A

dead skin (black)

78
Q

Slough

A

yellowish tissue (newly dead)

79
Q

Inspect hair for the following

A

color
distribution (patches)
quantity

palpate hair for texture

80
Q

Common Problems and Conditions: Hair

A

pediculosis (lice): lice on body called pediculosis corporis; pubic lice are called pediculosis pubis

alopecia areata: chronic inflammatory disease of fair follicles resulting in hair loss on scalp

hirsutism: increase in growth of facial, body, or pubic hair in women

81
Q

Inspect nails for the following

A

pigmentation of nails and beds
length
symmetry
ridging, beading, pitting, peeling

82
Q

Clubbed nails

A

abnormal, rounded shape of nail bed

caused by respiratory disease/cardiovascular disease

Health Assessment (10 decks)

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