Exam 1 Flashcards
nonverbal communication
body language is important; gestures, facial expression, affect, posture, eye contact
proxemics
study of distance zones between people during communication
Validating
restating the words as you heard them
reflection
repeating what the person said or describing the persons implied feelings
clarifying
trying to understand what was said
directing/focusing
asking for elaboration on a topic
sequencing
making sure you understand the steps in a process
general leads
encouraging the patient to continue talking
silence
therapeutic listening: maintaining eye contact, not being closed off, eye level
interview guidelines
begin with open-ended questions, use closed ended questions to seek info and clarification
communicating with children
responsive to nonverbal communication, talk at eye level, be gentle/calm, use understandable language, structured play
communicating with critically ill patients
assume they can hear you, state what you are doing (be clear direct ad simple), provide cues about day/time (help to avoid delirium), nonverbal communication is particularly meaningful, keep call bell within reach
communicating with older adults
dont assume they can hear everything said, dont assume they can see all body actions, be gentle and calm, restate and clarify, use understandable language, talk normally but clearly
communicating with hearing impaired
orient pt to your presence, face pt while talking to them, talk clearly not loudly, dont chew gum/eat while talking, increase non-verbal cues, write/communicate in another format, ensure hearing aid devices on and working
somatic sensory
body sense; afferent: touch, pressure, temperature, vibration of body, muscles stretching, balance
visceral sensory
organ senses; afferent; stretch, pain, temperature in organs, nausea, hunger, cramps, smooth muscles
somatic motor
body movement; efferent; voluntary contraction of skeletal muscles
visceral motor
organ movement; efferent; contraction of smooth muscle, glands, and organs
afferent nerve
neurons send signals from the senses, skin, muscles, and internal organs to CNS
efferent nerves
neurons that transmit commands from the CNS to the muscles, glands, and organs
sensory cranial nerves (afferent)
I olfactory, II optic nerve, VIII vestibulocochlear nerve
motor cranial nerve (efferent)
III oculomotor nerve, IV trochlear nerve, VI abducent nerve, XI accessory nerve, XII hypoglossal nerve
mixed nerves (sensory and motor)
V trigeminal nerve, VII facial nerve, IX glossopharyngeal nerve, X vagus nerve
I. olfactory nerve
modality- special sensory; function- smell
II. optic nerve
Afferent: transmits visual info from the retina to brain
III. oculomotor nerve
efferent: innervates majority of the extra-ocular muscles; move eyeball and upper eyelid; somatic motor- eye movement and visceral motor- pupil dilation
IV. trochlear nerve
efferent: innervates superior oblique muscle; turns eye down and inward
V. trigeminal nerve
mixed: sensory and motor; sensation in the face and motor function such as biting/chewing; largest of the cranial nerves
VI. Abducens nerve
efferent: controls movement of lateral rectus which is responsible for outward gaze; damage to this nerve would cause double vision (diplopia)
VII. facial nerve
mixed: controls muscle of facial expression and sensory taste sensation
VIII. vestibulocochlear
afferent: transmits sound and equilibrium (balance) from inner ear to brain
IX. glossopharyngeal nerve
mixed: sensory- innervates oropharynx, carotid body and sinus, posterior 1/3 of tongue, middle ear cavity, eustachian tube, special sensory- provides tastes to posterior 1/3 of tongue, parasympathetic- provides parasympathetic innervation to parotid gland, motor- innervates stylopharyngeus muscle of pharynx
X. vagus nerve
mixed: sensory- innervates skin of acoustic meatus and internal surfaces of laryngopharynx and larynx; provides visceral sensation to hear and abdominal viscera, special sensory- provides taste sensation to epiglottis and root of tongue, motor- provides motor innervation to majority of the muscles of the pharynx, soft palate, and larynx, parasympathetic- innervates smooth muscle of the trachea, bronchi, and GI tract and regulates heart rhythm
XI. accessory nerve
efferent: supplies motor function to sternocleidomastoid and trapezius muscles
XII. hypoglossal nerve
efferent: motor control of the extrinsic muscles of tongue
general cardiovascuar exam guidelines
pt must be in gown and undressed, tangential lighting (allows pulsations and movements to be visible), room must be quiet, stethoscope and room must be warm, general sequence is inspection palpation auscultation
precordium
portion of body over the hear and lower thorax
Inspection
precordium: check for any pulsation, masses, edema; neck: check for jugular vein distention (pt at 45 degree angle)
JVD
indicative of heart or circulatory issue
palpation
precordium; feeling for any pulsations, vibrations, masses, swelling (should not feel any pulses or vibrations); heart: notice size, duration, force or pulse at PMI; palpate carotid arteries (one at a time), palpate rest of the pulse for adequacy of circulation, check cap. refill (<3sec)
if cannot feel PMI…
turn pt onto left lateral side to allow heart to rest up against thoracic wall
auscultate
apical area for 1 minute to determine pulse rate, rhythm (reg. or irreg.); auscultate each of 5 areas for rate, rhythm (reg. or irreg.), S1 (lub), S2 (dub), S3/S4, or extra heart sounds
S3 heart sound
blood flow into the ventricles; can be normal finding in children
S4 heart sound
atrial contraction
heart murmurs
abnormalities that can be asymptomatic or symptomatic and are created by turbulent blood flow
Palpable pulses
Temporal, tympanic, carotid, apical, brachial, radial, ulnar, femoral/groin, popliteal, dorsalis pedis, posterior tibialis
5 auscultative heart locations
Aortic- 2nd intercostal RSB, Pulmonic- 2nd intercostal LSB, Erb’s point- 3rd intercostal LST, tricuspid- 4th intercostal LSB, mitral (apical)- 5th intercostal mid clavicular
