Chapter 10- Systematically Assess the Patient- Secondary Assessment

Question 1

What is the goal of secondary assessment?

Answer 1

To identify hidden injuries or identify causes that may not have been identified during the 60-90 second exam that took place during the primary assessment

Question 2

Name the three categories of patients who should receive this type of assessment?

Answer 2

Any patient who sustained a significant MOI

Unconscious patient

Critical condition patient

Question 3

An unconscious patient is unable to tell you what is wrong, therefore this secondary type of examination can ___________

Answer 3

give you clues to identify the problem

Question 4

The secondary survey may seem like repetition, but why is it still necessary?

Answer 4

It is very easy to miss significant physical findings on the rapid first assessment

Question 5

There are _____ steps to secondary assessment.

Answer 5

23

Question 6

Start by looking at the face for ________

Answer 6

Obvious lacerations, bruises, and deformities

Question 7

inspect the area around the ______ and ________

Answer 7

Eyes and Eyelids

Question 8

Examine the eyes for ______ and for _______

Answer 8

Redness and Contact Lenses

Question 9

Assess the ______ using a penlight

Answer 9

pupils

Question 10

Look behind the patients ears to assess for

Answer 10

Battle sign (bruising)

Question 11

Use the penlight to look for drainage of ______ or _______ in the ears

Answer 11

spinal fluid
blood

Question 12

Look for ______ and _______ about the head. Palpate for _____

Answer 12

brushing and lacerations

tenderness, depressions, deformities

Question 13

Palpate the ______ for tenderness or instability

Answer 13

Zygomas (cheekbones/eyesocket)

Question 14

Palpate the _______

Answer 14

maxillae

Question 15

Check the _______ for blood and drainage

Answer 15

nose

Question 16

Palpate the _______

Answer 16

mandible

Question 17

Assess the mouth and nose for ______

Answer 17

cyanosis, foreign bodies (teeth, dentures), bleeding, lacerations, and deformities

Question 18

Check for unusual ____

Answer 18

odors on the patients breath

Question 19

Check the neck for obvious lacerations, bruises, and deformities and most importantly observe for ___________

Answer 19

jugular vein distention (bulging of major veins in the neck)

Question 20

Then, palpate the ______ for tenderness

Answer 20

Back of the neck

Question 21

Look at the ____ for obvious signs of injury before you begin to palpate.

Answer 21

chest
Also watch for movement of chest with respirations

Question 22

Gently palpate over _____ to elicit tenderness. Avoid pressing over obvious _______ and _______

Answer 22

the ribs
bruises and fractures

Question 23

Listen for breath sounds over the _____ and _________ lines

Answer 23

Midaxillary and midclavicular lines

Question 24

Also listen to breath sounds posteriorly at the _____ and ______ of the lungs

Answer 24

Bases and Apices of the lungs

Question 25

Look at the _____ and ______ for obvious lacerations, bruises, and deformities.

Answer 25

abdomen and pelvis

Question 26

Gently palpate the abdomen for tenderness. If the abdomen is unusually tense, describe the abdomen as _____

Answer 26

rigid

Question 27

When assessing the pelvis for tenderness, compress from the ______

Answer 27

sides

Question 28

Gently press the _____ crests to elicit instability, tenderness, and crepitus (creaky joints)

Answer 28

illiac

Question 29

Inspect all ___ extremities for lacerations, bruises, swelling, deformities, and ________

Answer 29

4
medical alert anklets or bracelets

Question 30

Also assess _____ pulses and ____ and _____ function in all four extremities

Answer 30

Distal pulses
motor and sensory function

Question 31

Assess the back for tenderness and deformities. If you suspect a spinal injury, then you should ________

Answer 31

maintain spinal motion restriction and log roll the patient