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Health Assessment > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Orthopenic

A

Propped with pillows

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2
Q

Eupeniec

A

Normal/ quiet breathing

Resting respiratory rate

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3
Q

Tachypneic

A

Fast breathing

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4
Q

Bradypneic

A

Slow/ labored breathing

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5
Q

Ethnicity

A

Belonging to social group with common national or cultural tradition

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6
Q

Acculturation

A

Assimilate a diff culture usually dominant one

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7
Q

Dysphagia

A

Difficulty swallowing

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8
Q

Orthostatic hypotension

A

Decrease in systolic pressure of 20mm/Hg

OR

Decrease in diastolic of 10mm/Hg

Within 3 min standing from sitting or supine

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9
Q

Alcohol naive

A

Preferring alcohol

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10
Q

Subjective

A

SYMPTOM

What patient says

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11
Q

Objective

A

SIGN

What is observed

PHYSICAL APPEARANCE, BODY STRUCTURE, MOBILITY, BEHAVIOR

Self actualization
Esteem
Love/belonging
Safety
Physiological
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12
Q

BP common errors

A

Sitting without back support

Crossed legs

Full bladder

Tobacco use

Elbow unsupported, too high or too low

Talking

Cuff not sized

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13
Q

BP cuff size

A

80% arm circumference

40% width

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14
Q

Radial artery

A

Right side of inner arm

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15
Q

Ulnar artery

A

Left side of inner arm

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16
Q

Brachial artery

A

Inner elbow

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17
Q

Delirium

A

Confusion over time

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18
Q

Dimentia

A

Confusion built over time

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19
Q

Mental assessment

A

Nurses 1st test for consciousness

A-B-C-T

Appearance
Behavior
Cognition
Thought process

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20
Q

Accessing orientation

A

Person, place, time

“Why did you come to the clinic today?”

Attention span
Recent memory: 24-hour diet
Remote memory: past health, bday

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21
Q

Aphasia

A

Loss of ability to speak and write coherently

Inability to give info

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22
Q

MMSC

A

Mini-mental state exam

Cognitive functions to go home

Safe marker

11 questions

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23
Q

Nutrition screening

A

24 hour recall

Food frequency- type and frequency

Food Diary- can be difficult if writing ability

Direct observation- feeding techniques

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24
Q

Stethoscope bell

A

Soft low-pitched sounds

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25
Q

Examination of ear canal

A

Largest that will fit

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26
Q

Orientation

A

Awareness of objective world in relation to the self

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27
Q

Nonciceptive pain

A

Functioning and intact nerve fibers in periphery and CNS are stimulated

Outside events in nervous system (actual or potential tissue damage)

  1. Transduction -stimulus takes place
  2. Transmission- spinal cord to brain
  3. Perception- conscious awareness of pain
  4. Modulation- descending pathways release 3rd set neurotransmitters to produce analgesic effect
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28
Q

Neuropathic pain

A

Caused by lesion or disease of somatosensory nervous system

Abnormal processing of pain message from injury to nerve fibers

Ex. Diabetes, shingles, HIV/AIDS, etc

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29
Q

Visceral pain

A

Originates in larger internal organs

Dull, deep, squeezing, cramping

Direct injury to organ or stretching of organ due to tumor, ischemia, distention, severe contraction

Pain travels to ANS (vomiting, nausea,pallor, diaphoresis)

Ex. Ureteral colic, acute appendicitis,ulcer pain, cholecytitis

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30
Q

Somatic pain

A

Musculoskeletal tissues or body surfaces

ANS: Nausea, sweat, tachycardia, hypertension

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31
Q

Deep somatic pain

A

Blood vessels, joints, tendons, muscles, and bone

Pressure, trauma, ischemia

Aching or throbbing

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32
Q

Cutaneous pain

A

Skin surface and subcutaneous tissues

Superficial, sharp, burning

Cutaneous “cut” knife- sharp

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33
Q

Referred pain

A

Particular site but originates in another location

Both sites innervated by same spinal nerve

Diff for brain to differentiate

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34
Q

Acute pain

A

Short term

Self limiting

After injury, pain gone after healed

Ex. Surgery, trauma, kidney stones

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35
Q

Incident pain

A

Acute pain

Happens with certain movements

Ex. Lower back pain when standing

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36
Q

Chronic (persistent) pain

A

6 months or longer

Malignant or nonmalignant

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37
Q

Malignant pain

A

Cancer related

Tumor cells

Induced by tissue necrosis or stretching of organ by growing tumor

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38
Q

Nonmalignant pain

A

Musculoskeletal conditions

Ex. Arthritis, low back pain, fibromyalgia

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39
Q

Breakthrough pain

A

Spike in pain level

Moderate to severe

End-of-dose medication failure

Treatment: shortening interval between doses or increasing level of dose

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40
Q

Phantom pain

A

Coming from body part that is no longer there

Post amputation phenomenon

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41
Q

Pain assessment

A

To find accurate pharmacologic and nonpharmacologic strategies to interrupt pain

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42
Q

Evidence based practice (EBP)

A

Patients preference is valued

  1. Best evidence to date RESEARCH
  2. Clinicians experience
  3. Patients preferences PRINCIPLES
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43
Q

Primary prevention

A

Aims to prevent disease or injury before it occurs

Preventing exposures to hazards, altering unhealthy or unsafe behaviors and increasing resistance to disease or injury

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44
Q

Secondary prevention

A

Aims to reduce impact of disease or injury that has already occurred

Detecting and treating disease or injury as soon as possible to halt or slow process

Ex. Regulatory exams, screening tests, rehabilitation programs

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45
Q

Tertiary prevention

A

Soften impact of ongoing illness or injury with long lasting effects

Helping with managing long term health problems and injuries

Ex. Rehabilitation, support groups

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46
Q

Religion

A

Organized system of beliefs

Cause, nature, and purpose of the universe

Creators and rulers of universe

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47
Q

Spirituality

A

Individuals unique life experiences

personal efforts to find purpose to meaning of life

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48
Q

Pulse oximetry

A

Monitors oxygen saturation in blood

95-100%

49
Q

3 unrelated words

A

Recall at 5 min, 10 min, 30 min

50
Q

Cultural assessment

A

Patients have right to cultural beliefs, values, and practices

51
Q

If unable to find radial pulse

A

Search for apical pulse

52
Q

Pulse characteristics

A

Rhythm

53
Q

Intermittent pulse

A

Dropping of beats

Irregular

Too weak to open semilunar valves

54
Q

Heritage assessment tool

A

Necessary for building cultural competence

55
Q

General survey

A

Study of whole person

General health state

Physical characteristics , first impressions

Ex. How person walks in

56
Q

Pain

A

5th vital sign

Not associated with old age

57
Q

Acute pain: Nonverbal

A

Guarding

Moaning

58
Q

Chronic pain: nonverbal

A

“Learn to love without pain”

Increased risk of under-detection

Increasing sleep

59
Q

SOAP charting

A

Subjective

Objective

Assessment

Plan

60
Q

Wong-Baker scale of pain

A

Facial expressions

Ages 4-5

61
Q

Cultural competence

A

Access own beliefs before patients

Environment change =cultural change DYNAMIC

62
Q

Illness belief across culture

A

Loss of balance

63
Q

Disparity?

Reduces this risk?

A

Poverty

Receiving diff care

ER: takes in all ppl

64
Q

Successful interview characteristics

A

Father complete and accurate data

Establish report and trust

Teach about healthy state

65
Q

Interview contract

A

What’s expected

  • purpose
  • time
  • presence of others?

Interview goal

66
Q

Internal factors of communication

A

Empathy

Liking others

Ability to listen

67
Q

External factors of communication

A

Environment

Ensuring privacy

Refuse interruptions

Dress

Note taking- lacks eye contact

Tape and video recording

68
Q

Working phase of interview

A

Data gathering

69
Q

Culturally congruent care

A

Provide care across culture

Now federal mandate

Caring is an enabling process!

70
Q

Health literacy

A

Able to read and write but not associated with health

71
Q

History present illness (HPI)

A

Location

Quality

Quantity

Timing

Setting

72
Q

Pain: PQRSTU

A

Palliating/precipitating factors
-what makes pain better/worse?

Quality/quantity
-describe pain?

Region/radiation
-does pain move around or stay in same place?

Severity
-Scale 0-10

Timing
-Is pain constant or intermittent?

Understanding patients perception
-What do you think it means?

73
Q

Adolescents: HEEADSS

A

Home

Education/employment

Eating

Activities

Drugs and alcohol

Sexuality

Suicide

74
Q

Abdominal examination sequence

A

Inspection

Palpation

Percussion

Ausculation

75
Q

Inspection

A

Using eyes

Always doing

Always comes 1st

76
Q

Palpation

A

Texture, temp, moisture, pain, organ size

Fingertips

Fingertips and thumb

Dorsa(outside of hand) and fingers -determining temp

77
Q

Auscultation

A

Doesn’t magnify sounds

Goal: recognize normal sounds

78
Q

Don

A

Put on

79
Q

When to take vital signs?

A

Upon admission

Any changes in health status

80
Q

Body temp factors

A

Age

Circadian rhythms

Exercise

Hormones

Stress

Environment

81
Q

Pulse rate

A

60-100bpm

Apical: most accurate

82
Q

Cyanosis

A

Lack of oxygen

Blue/grey

Seen before pallor

83
Q

Obstetric history

A

Gravidity: # pregnancies (Grav 3)

Term: full term or pre term (Term 2) (pre term 1)

Incomplete pregnancies: miscarriages or abortions (Ab 0)

Living: Number of children living (living 3)

84
Q

Medication reconciliation

A

Comparison of list of current medications to previous list

Purpose: reduce errors and promote patient safety

Name, dose, schedule

85
Q

Nociceptors

A

Detect painful sensations from periphery and transmit them to CNS

Located in skin, joints, CT, muscle, and thoracic, abdominal, pelvic viscera

Direct: Mechanical or thermal trauma

Secondarily: chemical mediators released from site of tissue damage

86
Q

Pain assessment tool

A

Based on purpose, time invoked in administration, patients ability to comprehend and complete tool

87
Q

Overall pain assessment tool

A

Most useful

Detect chronic pain conditions or acute problems

Ex. Initial pain assessment, brief pain inventory, McGill Pain Questionnaire

88
Q

Initial pain assessment

A

8 questions

Location

Duration

Quality

Intensity

Aggravating / relieving factors

89
Q

Brief pain inventory

A

Rate pain within 24 hours

Mood, walking ability, sleep

90
Q

McGill Pain Questionnaire

A

Patient to rank list of descriptors of intensity and give overall intensity rating

91
Q

CRIES

A

pain perception for infant

Crying: high pitched (1) inconsolable (2)

Requires O2: Saturation below 95%

Increased vital signs

Expression: Grimace present

Sleeplessness: pain ⬆️unable to sleep

92
Q

FLACC Scale

A

Objective assessment of pain

Young children

Face: smile, frown, or clenched jaw
Legs: relaxed, tense, or kicking 
Activity: lying or restless
Cry
Consolability: content or dicomfort
93
Q

PAINAD Scale

A

Dementia patients pain scale

Breathing independent of vocalization: normal or noisy

Negative vocalization: groaning

Facial expression

Body language: relaxed or clenched

Consolability: console or distracted

94
Q

Allodynia

A

Experience of pain after normally non painful tactile

Ex. From clothing

95
Q

Oral temperature

A

Posterior lingual pocket lateral to midline

96
Q

Tympanic temperature adult

A

Pull pinna back and upward

97
Q

Rectal temperature

A

1.5 in (3.5 cm)

Position against blood vessels

98
Q

Reflection

A

Echoing patients words

99
Q

Clarification

A

Use when persons words are ambiguous or confusing

Asking for agreement

Person can confirm or deny your understanding

100
Q

Confrontation

A

Frame of reference shifts from patients perspective to yours

Focus attention on patients feeling or statement

Honest feedback

101
Q

Interpretation

A

Based on inference or conclusion

Patient can correct

102
Q

Developmental competence

A

Interviewing the caregiver

Communicating with diff age differences (infants, school age, adolescents)

103
Q

Overcoming communication barriers

A

Working with and without interpreters

Nonverbal cross cultural communication

Touch- comprehensive assessment and cross-culture

104
Q

Diagnostic reading

A

Analyzing data

Drawing conclusions

Diagnosis identification

Verifying all data

105
Q

Critical thinking

A

Assessing

Diagnosing

Planning

Implementing

Evaluating

106
Q

Collecting data

A

Complete

Focused problem

Follow up

Emergency database

107
Q

First and landmark standard

A

Organizations ensure patients receive effective, understandable, and respectful care

Cultural health beliefs and practices and preferred language

108
Q

Cultural and linguistic competence

A

Congruent behaviors

Attitudes

Policies

Enables work in cross-cultural situations

109
Q

VI Civil rights act

A

Service las cannot be denied to ppl of limited English proficiency

110
Q

Culture characteristics

A

Learned

Shared

Adapted

Dynamic

111
Q

Assimilation

A

Developing a new cultural identity and becoming like members of dominant culture

112
Q

Biculturalism

A

Dual pattern of identification and often divided by loyalty

113
Q

Naturalistic of holistic theory

A

Yin and yang

Hot and cold

114
Q

Pain pathway

A

Site of injury

Spinal cord

Brain stem

Cerebrum

115
Q

Psychogenic pain

A

Pain related to mental disorder

116
Q

Pain assessment

A

Where is pain?

When did it start?

What does it feel like?

How much pain do you have right now?

117
Q

Brief pain inventory

A

24 hours

0-10 Scale

Mood, sleep, walk changes

118
Q

Puncher Scale

A

6 pictures

Diff expressions of pain

0-5 Scale

119
Q

CAGE Test

A

Have you ever thought to CUT down on drinking?

Have you ever been ANNOYED of criticism?

Have you ever felt GUILTY?

Do you drink in morning, EYE opener?

Health Assessment (11 decks)

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