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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
Erythema
reddish tone with evidence of increased skin temperature secondary to inflammation increased inflammation and warmth
26
Petechiae vs. Purpura
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
27
Vesical vs. Pustule vs. Bulla
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
28
Macule vs. Papule vs. Patch
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
29
Finger Clubbing
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
30
Braden Scale
assessment tool for predicting the risk of pressure ulcers
31
Melanoma (signs of [ABC...])
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)
32
Assessment of Skin Turgor
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)
33
How often should you ask about pain?
frequently
34
Pain Goal
where the patient wants to be at for their pain level Ex: at a 10, want to be at a 4
35
Aspects can pain affect
quality of life interactions with family and friends sense of well-being and self-esteem financial resources
36
Acute Pain may cause...
increased vital signs (fight/flight)
37
Persistent Pain
chronic may be intermittent (comes and goes) or continuous
38
What meds do you take for nociceptive pain?
ibuprofen, Tylenol, opioids
39
Structures that cause nociceptive pain
somatic structures: bones, joints, muscle visceral organs: chest, abdomen, pelvic areas
40
Structures that cause Neuropathic Pain
nerve pain; caused by damaged nerves
41
What meds do you take for nociceptive pain?
anticonvulsant and antidepressant
42
Factors that Decrease Pain Tolerance
movement fatigue sleep deprivation repeated exposures to pain anger bored
43
Factors that Increase Pain Tolerance
adrenaline shock alcohol intake meds hypnosis heating pad/ice distraction prayer meditation
44
Cognitive Factors of Pain Perception
attention people give to the pain expectation or anticipation of pain appraisal or expression of pain
45
OLDCARTS
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
Pain Reassessment: Oral Pain Med
30 min - 1 hr
47
Pain Reassessment: IV Pain Med
15 min - 30 min
48
FLACC Scale
pain assess scale used for nonverbal/preverbal patients Face Legs Activity Cry Consolability
49
Pruritis
itching most commonly reported symptom of skin disease PQRST/ symptom analysis
50
Skin Examination
inspection and palpation
51
Inspection Skin Examination Techniques
note color, pigmentation, vascularity, bruising, lesions, discolorations, or unusual odors inspect from head and neck to trunk, arms, legs, and back
52
Localized Variations in Color on Skin
Intentional: tattoos, coin patterns, cupping Normal: pigmented nevi (moles), freckles, patches, striae (stretch marks)
53
Skin Palpation Techniques
palpate skin for texture, temp, moisture, mobility, turgor, thickness the older the age, the thinner the skin
54
Changes in Moles
color shape texture tenderness bleeding itching
55
Hints to Malignant Melanoma (ABCDEF)
Asymmetry Border Irregularity Color Variegation Diameter Greater than 6mm Evolution (has it changed) Feeling (itching, tingling, stinging)
56
Diabetic Patients lose nerve sensation in feet and wounds could occur without their knowledge (T or F)
True
57
Questions to Ask About Wounds
Where is the wound located? What have you done to treat the wound? Do you typically have problems with wound healing?
58
Hyperkeratosis
thickening of the outer layer of skin (made of keratin) Clavus (corn)
59
Dermatitis
common skin irritation
60
Atopic Dermatitis
superficial inflammation
61
Contact Dermatitis
inflammatory reaction to irritant or allergen localized erythema may weep, ooze or crust
62
Seborrheic Dermatitis
chronic inflammation scaly, white, or yellowish skin on scalp, eyebrows, eyelids, nasolabial folds, ears, axillae, chest or back
63
Stasis Dermatitis
inflammation seen mostly on lower legs of older adults areas of scaling, petechiae, brown pigmentation
64
Psoriasis
usually develops by age 20 years slightly raised erythematous plaques with silvery scales mostly on elbows, knees, buttocks, lower back, and scalp
65
Rosacea
chronic inflammatory skin disorder
66
Lesions caused by viral infection
warts - caused by HPV herpes simplex - group of 8 DNA viruses herpes varicella - chickenpox herpes zoster - shingles
67
Lesions caused by fungal infection
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
Lesions caused by bacterial infection
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
Lesions caused by anthropods
scabies: highly contagious mite Sarcoptes scabiei lyme disease: tick infected with borrelia burgdorferi spider bites: majority from black widow or brown recluse spiders
70
Wheal vs. Nodule vs. Plaque
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
Hemangioma vs. Telangiectasias
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
When to use the face scale?
for children
73
When to use FLACC assessment?
for children/ nonverbal or preverbal patients
74
When to use sliding analog pain scale?
for children?
75
How to describe lesions
location, size, color shape and borders elevation characteristics pattern
76
Unstagable Pressure Ulcers
eschar or slough may cover the entire wound bed; thus, it is unstagable
77
Eschar
dead skin (black)
78
Slough
yellowish tissue (newly dead)
79
Inspect hair for the following
color distribution (patches) quantity palpate hair for texture
80
Common Problems and Conditions: Hair
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
Inspect nails for the following
pigmentation of nails and beds length symmetry ridging, beading, pitting, peeling
82
Clubbed nails
abnormal, rounded shape of nail bed caused by respiratory disease/cardiovascular disease

Health Assessment (10 decks)

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