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Health Assesment > Exam 1 Study Guide > Flashcards

Exam 1 Study Guide Flashcards

1
Q

ABCDE

A 
Testing Skin Lesions for Melanoma
A - Asymmetry 
B - Borders
C - Color
D - Diameter (6mm-1/4inch) 
E - Evolution/Elevation
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2
Q

SOAPE Parts

A 
S - Subjective 
O - Objective
A - Assessment
P - Planning
E - Evaluation
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3
Q

Primary Lesions

A

Associated with specific causes on previously unaltered skin.

Macule - Color change and flat
Papule - Can feel, slightly elevated
Nodule - Solid large lump extended into dermis
Wheal - Slightly raised, allergic reaction
Bulla - Larger fluid filled bump
Vesicle - Smaller fluid filled bump
Cyst - Large fluid filled lump
Pustule - Large pus filled lump
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4
Q

Secondary Lesions

A

Modification of primary lesion either by patient themselves of other

Crust - Thickened dried out skin that can be brown, honey, or yellow. (Impetigo, scab)
Scale - Compact flakes of skin.
Fissure - linear crack in skin. (Cheilosis corners of mouth)
Erosion - Scooped out shallow depression. No bleeding, heals without scar.
Ulcer - Deep depression extending into dermis. Irregular shape, bleeds, leaves scar.
Excoriation - due to scratching or self inflicted abrasion

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5
Q

Secondary Lesion (Cont)

A

Scar - Skin lesion after it is repaired. Normal tissue replaced with collagen
Atrophic Scar - Skin level is depressed with loss of tissue and thinning of epidermis (Striae)
Lichenification - Prolonged intense scratching that thickens skin. Looks moss like.
Keloid - Benign excess scar tissue. Looks claw like

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6
Q

Assessment of Skin

A
  • Color
  • Temperature/moisture
  • Texture, Edema, Turgor, Vascularity (Bruising)
  • Lesions
  • Hair and Nails
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7
Q

Assessment of Skin Color

A

Yellow - Jaundice (Liver Disease)
Pallor - Pale and ashen (Vasoconstriction, cold weather, smoking)
Blue - Cyanosis (hypoxia and cardiac arrest)
Redness - Erythema (Excess blood in capillaries, allergic reaction, fever, venous stasis, carbon monoxide poisoning)

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8
Q

Skin Temperature

A

Hypothermia - Cardiac Arrest, Shock, Raynaud’s Disease
Hyperthermia - Increased metabolism, fever, hyperthyroidism
Diaphoresis - Profuse sweating, heart attack, anxiety, pain
Dehydration - Skin feels dry and flaky, dry mucosa, dry membranes, dry and cracked lips

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9
Q

ABC Assessment

A

During Emergency Assessments use ABC
A - Airway
B - Breathing
C - Circulation

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10
Q

Medical Instruments

A

Ophthalmoscope - Visualizes Eye
Otoscope - Examines Ear
Snellen Chart - Screens distant vision
Nasal Speculum - Visualize turbinate’s of nose
Vaginal Speculum - Examine Vagina
Tuning Fork - Auditory
Percussion Hammer - Tests deep tendons and determines tissue density

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11
Q

Order of Assessment

A

Inspection - size, color, shape, position, symmetry
Palpation - temperature, turgor, texture, moisture, vibrations, shape, locate masses
Percussion
Auscultation - Assess sound pitch, loudness, quality, duration

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12
Q

Percussion

A

Flat - Over fatty tissue and bones (Thigh)
Dull - Over Masses and Dense Orders (Liver)
Resonance - Loud sound over air filled sacks (Lungs)
Hyperresonance - Very loud (Air trapped in lungs emphysema)
Tympani - Loud sound over abdominal area. Hollow sound

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13
Q

Order of Physical Assessment

A 
Integumentary
Head and Neck
Thorax and Lungs
Cardiovascular and Peripheral Vascular
Breasts and Axillae
Abdomen
Female and Male Genitalia
Anus, Rectum, Prostate
Musculoskeletal 
Neurological
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14
Q

PEARRLA

A 
Pupils
Equal - In size and shape
Round 
Reactive to
Light - Eyes get smaller when light is shined
Accommodation - Ability to change focus
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15
Q

General Survey

A 
First initial impression with patient
Physical Appearance
Body Structure
Mobility
Behavior
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16
Q

OLDCART

A 
Assessment of Pain
O - Onset
L - Location
D - Duration
C - Characteristics
A - Aggravating Factors
R - Relieving Factors
T - Time
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17
Q

Order of measuring Children Vital Signs

A

Respiration - Watch abdomen for movement
Pulse - Apical Pulse, after 2 use radial/brachial
Temperature - Rectal higher in infants
Blood Pressure - Check 3 and older y/o.
- Cuff must be 2/3 width of arm
- Height is more correlated with BP than age

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18
Q

Measuring Vitals for aging adults

A

Temperature - Greater risk for hypothermia, less reliable
Pulse - Rhythm may be irregular
Respirations - Decrease in rate and depth
Blood Pressure - Systolic pressure increases leading to wider pulse pressure

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19
Q

ROS for Skin (Subjective)

A 
History (Allergies, Hives, Eczema)
Changes (Skin color, mole size, excessive hair (Hirsutism))
Irritation/Injury
Medications
Environmental/Occupational Hazards
Self-Care Habits
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20
Q

Aging Adult Skin

A
  • History of pruritis (dry skin or systemic disease)
  • Changes you’ve noticed in skin past few years
  • Delay in wound healing
  • Changes in feet
  • Falls resulting in bruises or trauma
  • History of diabetes or peripheral vascular disease (extremities)
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21
Q

Clubbing of Nails

A

Nails appear like clubs and are 180 degrees with profile skin test.
- Caused by interrupted pulmonary condition such as COPD and emphysema.

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22
Q

Review of Systems for Head

A

-Headaches/Migraines
- Head Injury (loss of consciousness)
- Dizziness or Vertigo
Room spinning (Neurological Problem)
- Neck Pain (Limitations to ROM)
- History of lumps/swelling/surgeries

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23
Q

Assessing Head

A
  • Check for size. (normocephalic, macrocephalic, microcephalic)
  • Palpation of temporal artery.
24
Q

Assessing Face

A
  • Appropriate expression on face
  • Symmetrical Features
  • TMJ Disorder (Temporomandibular joint) crepitus or cracking over joint. Tenderness or limited ROM.
25
Q

Assessing Face

A

Pilar Cyst - Swelling in the scalp
Hydrocephalus - Obstruction of drainage from cerebral spinal fluid.
Acromegaly - Excessive secretion of growth hormone from pituitary gland. Elongated head, massive face.

26
Q

Fontanels

A
  • Measured each visit up to 2 years old
  • Measured yearly up to 6 years old
  • Triangular posterior fontanel 1-2 Months
  • Diamond shaped anterior Fontanel 9 months - 2 years.
  • Delayed closure or larger than normal fontanels occur with hydrocephalus, down syndrome, hypothyroidism, or rickets.
  • Depressed fontanels indicate malnutrition/dehydration
  • Bulging indicates increased intracranial pressure
27
Q

Assessing Pallor/Tonic Neck Reflex

A
  • Look at children’s hands to assess pallor
  • Tonic Neck Reflex is assessed with child supine, head turned to 1 side. Reflex should disappear at 3-4 months. 5 months indicates birth defect.
28
Q

Physical Assessment Order

A

Step 1 - Inspect (Head)
Lumps/Lesions/Deformities/Hair Pattern/ Size of Skull/Symmetry/Anxiety/
Step 2 - Inspect (Neck)
Symmetry of Trachea
Step 3 - Palpate (Head)
Deformities/Patterned Hair loss/Lymph nodes
Step 4 - Palpate Thyroid Gland (Neck)
Place hands on sides of neck and ask to swallow
Step 5 - Osculate Thyroid
Notice any bruiting sound (whooshing)

29
Q

Lymph nodes

A 
Preauricular - In front of ear
Postauricular - Behind Ear
Occipital - Base of skull near back of neck/head
Parotid - Next to ear near cheek
Submandibular - Base of mandible
Submental - Under the chin
Superficial Cervical Chain - Upper Neck
Deep Cervical Chain - Under Upper Neck
Posterior Cervical Chain - Behind Neck
Supraclavicular - By clavicle 
Tonsillar - Under Parotid Near base of mandible
30
Q

Review of systems (Nose)

A 
Discharge from nose
Suffer from frequent colds/sinusitis
History of trauma or recreational drug
Epistaxis (nose bleeds)
Allergies
History of altered smell
31
Q

Review of Systems (nose/throat)

A

History of sores/lesions/bleeding gums/toothaches

  • Smoke/Alcohol
  • Brush, floss, dentist regularly
32
Q

Physical Assessment of Nose

A 
Step 1 - Outer
- Symmetric, midline, proportional
- Deformities, inflammation, lesions
- Palpate for any pain
- Have patient breathe in through each nostril
Step 2 - Nasal Cavity
- Color/texture of mucosa (pinkish red)
- Swelling/discharge
- Deviated Septum
- Color of discharge
(red/yellow - rhinitis or sinusitis)
(Gray or pale mucosa - allergies)
33
Q

Physical Assessment Sinuses

A
  • Palpate Sinuses with thumbs

Tenderness/pressure may indicate sinusitis or allergies

34
Q

Assessing Mouth

A
  • Use Tongue Blade
  • Assess color/texture (moisture or lesions)
  • Mucosa should be pink
    (Cyanosis - Hypoxia, Cherry-lips - Carbon monoxide poisoning or ketoacidosis, Pallor - Shock/Anemia)
    = Teeth Color, Gums, Tongue (Pink)
35
Q

Assessing Buccal Mucosa

Inner Cheeks/Lips

A
  • Should be Pink
    Leukoedema - Grey/bluish area
    Koplik Spots - Small white spots (measles)
    Candidiasis - Yeast cottage cheese looking
    Fordyce granules - Small isolated white/yellow papules on cheek/tongue/lips.
36
Q

Assessing Palates

A
  • Assess Hard Palate should appear white
  • Assess Soft Palate - Should be pink
  • Observe uvula. When patient says ahh uvula and soft palate should rise in midline.
37
Q

Assessing Tonsils

A
  • Color and texture should be pink with indentations/crypts.
  • White spots/exudates show infection.
  • White membrane over tonsils may be mononucleosis or leukemia
38
Q

Tonsil Grading

A 
0 - 0% of oropharynx
1 - less than 25%
2 - 26-50%
3 - 51-75%
4 - 75%
39
Q

Nose/Mouth/Throat Assessment Order

A

Nose
- Check for symmetry.
- Use Speculum and check for deviations
- Look for boils and obstructions in nose
- Pallor should be pink and smooth
Lips
- Dryness/Color (Pink) Pallor means dehydration/anemia
- Red Lips (Erythema) (Carbon Monoxide Poisoning)
- Blue Lips (Cyanosis) (Hypoxia)
- Pallor Lips (White) (Anemia/Dehydration)

40
Q

Nose/Mouth/Throat Assessment (cont)

A
  • Check mouth color with penlight (pink)
  • Check Teeth for cavities/yellow/brown
    Yellow - Caffeine/Smoking
    Brown - Too much fluoride in toothpaste
  • Gums should be pink
    Grey - Chronic Allergies
  • Assess Tonsils
    (White streaks may mean Fungal Infection)
  • Assess tongue
    Cranial Nerve 12 - Moving tongue side to side
  • Smoothness of tongue B12 Deficiency
41
Q

ROS Ears

A 
History of 
Otalgia - Ear Pain
Discharge - Ear infection or Perforated Eardrum
Presbycusis - Hearing Loss
Tinnitus - Ringing in Ear
Vertigo
History of working in loud environments
Self Care Habits
42
Q

Physical Assessment of External Ear

A

Microtia - Small Ears
Macrotia - Large Ears
Palpate for tenderness
Edema/Redness in outer ear

43
Q

Physical Assessment Middle Ear

A

Use otoscope to look at middle ear.
- Age over 3 pullup pinna
Temporal Membrane should be shiny, translucent, and pearly grey with some earwax.
Cone of Light from otoscope should be 5 o’clock in right ear and 7 o’clock in left ear. (Variations abnormality)

44
Q

Rinne and Webber Test

A

Rinne Test - Place tuning fork at base of skull, then once they cannot feel it, move it to the ear until they stop hearing it. Air conduction is longer than bone conduction.
Weber Test - Place fork on top of head, patient should hear the sound equally in both ears.

45
Q

Ears Assessment Order

A
  • Inspection (Symmetry, size, shape)
  • Note for lesions or lumps
  • Palpate for tenderness
  • Watery Drainage from ear (skull fracture)
  • Blood (Trauma or Ear Infection)
  • First do Weber Test
  • Next do Rinne Test
  • Next do whisper voice test
  • Next inspect inner ear
    (5 o clock right side, 7 o clock left side)
46
Q

ROS Eyes

A 
Difficulty seeing
Pain, redness, swelling in eyes
Allergies affect eyes
History of glaucoma
History of surgery
Use of glasses/contacts
Date of most recent vision test
Smoking
47
Q

ROS Eyes

A 
Strabismus - Cross Eyed
Diplopia - Double Vision
Photophobia - Intolerance to Light
Conjunctivitis - Redness in eyes
Glaucoma - Floaters or halos around lights
Cataracts - Caused by smoking
48
Q

Snellen Eye Chart

A

Assess visual acuity
- The larger the denominator the worse the patients vision is.
20/40
You can read from 20 feet what everyone else can read from 40 feet

49
Q

Confrontation Test/Abnormalities

A

Confrontation Test - Tests peripheral vision
Presbyopia - Decrease in accommodation with aging
Peripheral Loss - First sign of glaucoma, retinal disease, and stroke

50
Q

Corneal Light Reflex

A
  • Shining light into patients eyes. Light should reflect in the same place in both eyes.
51
Q

Cover Test

A 
Cover 1 eye test. 
Esotropia - Inward turning of eye
Exotropia - Outward turning of eye
Phoria - Mild weakness
Tropia - Severe weakness
52
Q

Cardinal Gaze Test

A

Also known as diagnostic position test
- Assess muscles of cranial nerves
- Have patient follow finger with their eyes. Eyes should be parallel while following your finger
ABNORMAL
Oscillations in the iris (nystagmus), possible multiple sclerosis or brain lesions.

53
Q

External Structures of Eyes

A

Periorbital Edema - Puffing or swelling of eyelids. Heart failure, renal failure, allergies
Ptosis - Droopy eyelids, neuromuscular weakness
Exophthalmos - Protruding Eyes
Enothalmos - Sunken Eyes
Scleral Icterus - Yellowing of sclera

54
Q

PERRLA

A 
P - Pupils
E - Equal
R - Round
R - Reactive to 
L - Light
A - Accommodation
55
Q

Red Reflex

A

Eyes make a red glow when light passes through pupil and is reflected back off the retina
Inspect Ocular Fundus
- Look for creamy yellow-orange to pink and a round or oval shape
Retinal Vessels
Look for macula and a general background color of light red to dark brown/red
- Used with ophthalmoscope

56
Q

Eye Diseases

A

Hemorrhage - Occurs with macular degeneration

Health Assesment (14 decks)

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