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health assessment > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

What are the identifiers for a nutritional assessment?

A

Obesity
Dietary deficits(malnutrition, under nutrition)
Guidance for health promotion and disease prevention

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2
Q

What is optimal nutritional status?

A

Balance of nutrient intake to meet daily metabolic demands

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3
Q

What can change someone’s metabolic demands?

A

High levels of exercise
Elevated body temperature
Diseases

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4
Q

What can affect nutritional status?

A

Development
Cultural behaviors
Economic status

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5
Q

What do people with optimal nutritional status have?

A

Improved immune systems
More energy for activities
Body heals quicker

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6
Q

Types of malnutrition

A

Undernutrition
Overnutrition

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7
Q

Undernutrition

A

Inadequate nutrient intake or nutritional reserves been depleted

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8
Q

What can cause under nutrition?

A

Certain diseases
Disorders
Lifestyle behaviors

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9
Q

Risk factors of undernutrition

A

Lower socioeconomic status
Long work hours
Poor food choices
Chronic dieting
Chronic diseases
Dental problems
Illness or trauma
Limited access to sufficient foods
Eating disorders

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10
Q

Overnutrition

A

Intake of nutrients exceeds the metabolic needs of the body to maintain normal growth, development, and metabolism

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11
Q

Risk factors for overnutrition

A

Obesity
Cardiovascular disease
Type two diabetes
Hypertension
Cancer
Gallbladder disease
Sleep apnea
Immune system diseases

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12
Q

Things that affect hydration

A

-Exposure to high environmental temperatures
-Lower access to adequate fluids
-High intake of alcohol or diuretic fluids (coffee, soft drinks)
-People with impaired thirst mechanisms
-People taking diuretic medication’s
-Diabetic clients with severe hyperglycemia
-People with high fevers

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13
Q

Optimal hydration

A

Maintains functions, like urination, bowel, elimination, sweating, temperature, regulation, toxin, illumination, metabolism, enzyme, production, nutrient, absorption, immune system, efficiency, calorie burning efficiency, and health of skin, hair and nails

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14
Q

Daily water recommendation

A

Eight , 8oz glasses

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15
Q

Dehydration/underhydration

A

-Dehydration can go unnoticed in normal people under adverse conditions
-Development of a sense of thirst typically after dangerous deficit of fluid

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16
Q

Overhydration

A

-Typically not a problem in a healthy person
-People at risk for overhydration are those with kidney, liver, and cardiac diseases

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17
Q

Components of a nutritional assessment

A

Health history interview
Physical examination
Physical growth and development
Nutritional status
Laboratory tests

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18
Q

What type of data is collected first in a health assessment?

A

Subjective data

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19
Q

Types of objective data

A

Patient diet
Weight loss or gain
Current weight
Patient/family history
Lifestyle and health practices

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20
Q

What do you use when evaluating symptoms?

A

COLDSPA

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21
Q

What is COLDSPA?

A

-C: character
-O: onset
-L: location
-D: duration
-S: severity
-P: pattern
-A: associated factors

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22
Q

What is used for warning signs of poor nutrition?

A

DETERMINE

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23
Q

What is DETERMINE?

A

-D: disease
-E: eating poorly
-T: tooth loss or mouth pain
-E: economic hardship
-R: reduced social contact
-M: multiple medicines
-I: involuntary weight loss or gain
-N: needs assistance
-E: elderly (80yrs or older)

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24
Q

What are signs of foodborne illness?

A

Nausea
Vomiting
Diarrhea
Abdominal cramps

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25
Q

Most common pathogens of foodborne illnesses

A

Norovirus
Salmonella
Clostridium perfringens
Campylobacter

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26
Q

What is a food allergy?

A

A immune response to irritation, or the inability to break down enzymes

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27
Q

What are the most common allergies?

A

Peanuts, tree, nuts, milk, eggs, wheat, soy, fish, shellfish, sesame

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28
Q

How long do symptoms take for allergic reactions?

A

Minutes to hours after ingestion

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29
Q

What type of equipment is needed for an exam?

A

Scale
metric measuring tape
Marking pencil
Calipers

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30
Q

What is a anthropometric measurement?

A

Height and weight
Vital signs
BMI
Mid arm and waist circumference
Skinfold thickness
Mid arm muscle circumference

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31
Q

Different body types

A

Ectomorph
Endomorph
Mesomorph

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32
Q

Ectomorph

A

Small frame
Flat chest
Thin
Lean muscle
Hard to gain weight

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33
Q

Mesomorph

A

Athletic
Hardbody
Strong
Defined muscles
Gaines muscle easily

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34
Q

Endomorph

A

Soft and round body
Gaines muscle, and fat easily
Stocky
Hard to lose fat
Muscles not defined

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35
Q

Visceral fat

A

Inside and around organs

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36
Q

Subcutaneous fat

A

Directly underneath the skin

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37
Q

Abnormal nutrition

A

Marasmus
Kwashiorkor

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38
Q

Marasmus

A

Protein and calorie malnutrition

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39
Q

Kwashiorkor

A

Pro Tien malnutrition

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40
Q

Findings of elderly’s nutritional safety

A

Muscle tone and mass decrease
Loss of subcutaneous fat
Fat is redistributed
Tinting (fluid loss, mount, nutrition, loss of collagen)
Fat moves from face and neck and goes to arms, abdomen and hips

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41
Q

How to communicate interview and assessment findings

A

Validate information collected
Ask additional questions
Compare, objective and subjective data
Document both normal and abnormal findings

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42
Q

Age ranges for TBI risk factors

A

Newborn-4yrs
15-19yrs
Adults over 65 yrs

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43
Q

TBI risk factors

A

Transportation accidents
Violence
Falling
Caregivers

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44
Q

TBI risk factors for infants and toddlers

A

-Environmental
-Lack of parental knowledge of shaken baby syndrome
-Caregivers risk of shaken baby syndrome

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45
Q

TBI risk factors for children and teens

A

-Lack of protective equipment in sports and bicycle use
-Lack of safety practices while driving

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46
Q

TBI risk factors for adults and older adults

A

-Knowledge and use of safety practices for driving
-Impairment of physical or mental stability
-Maltreatment or domestic violence

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47
Q

TBI prevention teachings

A

-Use of child safety seats( car seat, booster)
-Wearing a seatbelt any time any motor vehicle
-Wearing a helmet or protective equipment
-Making living areas safe for elders (tripping hazards, mats and rugs, bar, rails, handrails, proper lighting)
-Never drive under the influence

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48
Q

What is HIT

A

Headache impact test

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49
Q

Questions to ask for HIT

A

-When you have headaches, how often is the pain severe?
-How often do headaches limit your ability to do usual daily activities?
-When you have a headache, how often do you wish you could lie down?
-In the past 4 weeks, how often have you felt too tired to do work or daily activities because if your headaches?
-In the past 4 weeks, how often have you felt fed up or irritated because your headaches?
-In the past 4 weeks, how often did headaches limit your ability to concentrate on work or daily activities?

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50
Q

Sinus headache

A

Deep, constant, throbbing, pain, or pressure, like pain in one specific area of face or head; tender to the touch

Occurs with, or after a cold, acute sinusitis, acute febrile illness

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51
Q

Cluster headache

A

Stabbing pain may be accompanied by tearing eyelid, drooping, redness, or runny nose

Has sudden onset may be precipitated by ingesting alcohol

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52
Q

Tension headache

A

Dull, tight defuse

No prodromal stage may occur with stress, anxiety, or depression

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53
Q

Migraine, headache

A

Accompanied by nausea, vomiting, and sensitivity, to noise or light

May have prodromal stage such as visual disturbances, vertigo, numbness, or tingling in the fingers or toes

May be precipitated by emotional disturbances, anxiety, or ingestion of substances, to which client is sensitive

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54
Q

Tumor related headache

A

Aching, steady, neurologic and mental symptoms, as well as nausea and vomiting

No prodromal stage may be aggravated by coughing, sneezing or sudden movements of the head

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55
Q

How to prepare a client for head and neck examination

A

-Ask them to remove wigs, hat, hair, clips, jewelry, scarves
-Upright position
-Explain the importance of being still
-Explain what you were doing
-Be cautious of any cultural considerations

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56
Q

Tools needed for head and neck exam

A

Small cup of water
Stethoscope
Penlight
Gloves

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57
Q

Techniques for head, examination

A

-Inspect for size shape, and configurations
-Palpate for consistency
-Inspect face for symmetry, movement expression

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58
Q

Where to palpate temporal artery

A

Between top of ear and eye

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59
Q

Where to palpate temporomandibular joint

A

Please finger over front of each ear and have client open and close mouth

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60
Q

Techniques to inspect neck

A

Observe neck that is slightly extended for symmetry, lumps, and masses

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61
Q

Inspect swallowing movement of neck

A

Ask client to swallow a sip of water and observe the movement of the thyroid cartilage

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62
Q

Inspect cervical vertebrae

A

Ask the client to flex the neck chin to chest

63
Q

Inspect ROM

A

Turn head right to left, touch ear to shoulder, chin to chest, Chin to ceiling

64
Q

Palpate trachea

A

Place finger on sternal notch, feel each one and palpate tracheal rings

65
Q

Palpate lymph nodes

A

Preauricular
Postauricular
Occipital
Submandibular
Submental
Tonsillar

66
Q

FAST- signs of stroke

A

Face drooping
Arm weakness
Speech difficulties
Time to call

67
Q

Signs and symptoms of hypothyroidism

A

Increased sensitivity to cold
Constipation
Depression
Fatigue
Pale dry skin
Heavy periods
Thin hair or nails
Weakness
Unintentional weight gain

68
Q

Abnormal findings of head and neck

A

Hyperthyroidism
Hypothyroidism
Headaches
Stroke
TBI
Acromegaly
Cushing syndrome
Scleroderma
Bell palsy

69
Q

Hyperthyroidism(thyrotoxicosis)

A

Bulging eyes

70
Q

Hypothyroidism(myxedema)

A

Dull, puffy face
Edema around the eyes
Dry, course, and sparse hair

71
Q

Headaches

A
72
Q

Stroke

A

FAST

73
Q

TBI

A

Traumatic brain injury

74
Q

Acromegaly

A

Enlargement of the facial features(eyes, nose), hands and feet

75
Q

Cushing syndrome

A

Moon shaped face
Reddened cheeks
Increased facial hair

76
Q

Scleroderma

A

Tightened hard face with thinning facial skin

77
Q

Bell palsy

A

Begins suddenly and reaches a peek within 48 hours
Twitching
Weakness
Paralysis
Drooping eyelids or corner of the mouth
Drooling
Dry eye
Dry mouth
Decreased taste
Facial distortion

78
Q

What do older client to have arthritis or osteoporosis experience?

A

Neck pain, and a decreased range of motion

79
Q

Why are facial wrinkles more prominent in older clients?

A

Subcutaneous fat decreases in age
Lower face may shrink in the mouth may be drawn inward

80
Q

What happens to the strength of pulsation in the temporal artery is an older clients?

A

It may decrease

81
Q

Why would cervical curvature increasing in older clients?

A

Because of kyphosis of the spine

82
Q

Dowager’s hump

A

Fat accumulation around the cervical vertebrae(especially in women)

83
Q

What do older clients thyroid feel like?

A

More nodular or irregular, because of fibrotic changes that occur with aging

Thyroid could also be felt lower due to structural changes because of age

84
Q

Cataracts

A

Often preventable
Leading cause of blindness
Develop slowly, and are often found in people over 65 years of age

Clouding of the eye lids causing a person to see as though looking through a frosty or foggy window with vision, even more affected at night

85
Q

Symptoms of cataracts

A

Feeding or yellowing of colors
Sensitivity to light or glare
Seeing halos around lights
Double vision in one eye
Frequent prescription changes

86
Q

Risk factors for Cataracts

A

Increasing age
Diabetes
Excessive exposure to sunlight
Smoking
Obesity
HPT
Previous eye injury or surgery
Prolonged use of corticoidsteroid medication
Excessive amounts of alcohol

87
Q

Preventing Cataracts

A

-Have regular eye examinations(yearly, or twice a year at 65 years of age)
-Where is sunglasses that block ultraviolet be raise
-Protect eyes, if exposed to radiation sources
-Avoid or stop smoking
-Avoid access alcohol intake
-Maintain healthy weight
-eat a well-rounded diet
-Supplements to prevent cataracts
-Seek medical attention for prolonged eye inflammation

88
Q

Who has the poorest visual acuity in the United States?

A

Japanese and Chinese Americans

89
Q

Who has the second poorest corrected visual acuity in the United States

A

African-Americans and Hispanics

90
Q

Who has the best corrected visual acuity in the United States

A

Native Americans and whites

91
Q

Presbyopia

A

Common in clients over 45

Gradual loss of eyes ability to focus on nearby objects

92
Q

Entropion/Ectropion

A

Eyelid turns in and causes eyelashes to rub against the cornea

93
Q

Pinguecula

A

Yellowish nodules on bulbar conjunctiva

94
Q

Arcus senilis

A

Half circle of gray, white or yellow deposits in the outer edge of the cornea

Made of fat and cholesterol deposits

95
Q

Chart used to test sight

A

Amsler chart

96
Q

How to prep client for eye exam

A

Explain the need to be close to the patients face with a ophthalmoscope to view retina

97
Q

Equipment used for eye exam

A

Snellen chart/ E chart
Penlight
Opaque cards
Ophthalmoscope
Gloves

98
Q

Abnormal findings of external eye

A

Conjunctivitis
Exophthalmos

99
Q

Conjunctivitis

A

Inflammation of the conjunctiva

100
Q

Symptoms of conjunctivitis

A

Redness in one of those eyes
Itchiness in one or both eyes
A gritty feeling
Discharging one or both eyes
Formation of crust
Tearing

101
Q

Abnormal findings of the extraocular muscles

A

Psuedostrabismus
Esotropia
Exotropia
Phoria
Paralytic strabismus

102
Q

Pseudostrabismus

A

Normal in young children
The pupils will appear at the inner canthus

103
Q

Esotropia

A

Eye turns inward

104
Q

Extropia

A

Eye turns outward

105
Q

Ptosis

A

Drooping eye

106
Q

Ectropion

A

Outwardly turned lower lid

107
Q

Physical assessment of the eye (trauma)

A

Foreign body
Perforated globe
Blood in eye
Swollen lid
White cornea
Irregular shaped pupil

108
Q

Risk factors for hearing loss

A

Ototoxic meds
Childcare
Bottlefeeding, while lying down
Fall and winter seasons
Poor air quality
Family history
Cleft palate
Down syndrome
Ethnicity
Enlarged adenoids
Smoking
Premature birth

109
Q

Education to avoid hearing loss

A

-Avoid loud sound exposure
-Avoid activities that involve loud sounds, or risks to had an ear injury
-Avoid listening to loud music for long periods of time
-We are ear protectors, and take breaks from loud noises
-Have your hearing checked periodically
-Avoid tools the remove wax

110
Q

Subjective data for ears and hearing

A

Changes in hearing
Personal health history
Family history
Lifestyle and health practices
Other symptoms

111
Q

Equipment needed for an ear exam

A

Watch
Tuning fork
Weber test
Rinne test
Otoscope

112
Q

Weber test

A

Placed the base of the tuning fork on the bridge of the forehead, nose, or teeth

113
Q

Rinne Test

A

Place the piece of the tuning fork on the mastoid bone behind the ear. Have the patient indicate one sound is no longer heard.

114
Q

Inspecting the auricle, tragus, and lobule

A

Inspect size, shape, and position

115
Q

Palpation of auricle and mastoid process

A

Firm, non tender
No bumps or lesions

116
Q

Whisper test

A

Stand 2 feet behind patient on one side, and whisper a word, and see if they can tell you what you whispered

117
Q

Romberg test

A

Tests the clients equilibrium
Ask the client to stand with her feet together, arms at side and eyes open and then with eyes closed
Can maintain position for 20 seconds without swaying or minimal swaying

118
Q

Otoscope

A

Flashlight that is used to visualize the eardrum and external ear canal

119
Q

How to use otoscope

A

Using thumb and fingers grasp a clients auricle firmly pull out of and back

120
Q

Abnormal findings of the external ear

A

Malignant lesion
Otitis externa
Cerumen buildup (earwax)
Polyp
Exostosis
Microtia
Tophi

121
Q

Polyp

A

Growth inside ear canal due to chronic ear infections or skin cyst

122
Q

Exostosis

A

Known as surfers ear
Abnormal bone growth within the ear canal due to chronic irritation , hereditary, and unknown reasons

123
Q

Microtia

A

Congenital abnormality, where the external ear does not fully develop

124
Q

Tophi

A

Hard, external or natural associated with deposits of uric acid crystals in advanced gout

125
Q

Abnormal findings of the tympanic membrane

A

Acute otitis media
Blue/dark red tympanic membrane
Perforated tympanic membrane
Serious otitis media
Scarred tympanic membrane
Retracted tympanic membrane
Chronic suppurative otitis media with cholesteatoma

126
Q

Acute otitis media

A

Red, bulging membrane, decreased, or absent light reflects

127
Q

Blue or dark red tympanic membrane

A

Indicates blood behind the eardrum due to trauma

128
Q

Perforated tympanic membrane

A

Perforation results from rupture caused by increased pressure

129
Q

Serous otitis media

A

Yellowish bulging membrane with bubbles behind it

130
Q

Scarred, tympanic membrane

A

White spots in streaks indicate scarring from infection

131
Q

Retracted tympanic membrane

A

Prominent landmarks are caused by negative air pressure due to obstructed tube or chronic otitis media

132
Q

What to document after ear assessment

A

Biographic data
Reason for seeking care
History or present health concerns
Personal health history
Family history
Lifestyle and health practices
Physical examination findings

133
Q

Risk factors for oral cancer

A

Tobacco use
Alcohol consumption
Prolong skin exposure
HPV virus
Men more than women
Fair skin
Age over 45
Poor oral hygiene
Poor diet
Weakened immune system
Marijuana use
Chewing betel nut(south, and south east Asia)

134
Q

Reducing risks of oral cancer

A

Avoid smoking cigarettes or using tobacco
Avoid excessive alcohol use
Avoid chewing betel nuts
Avoid infection with HPV (oral sex)
Avoid excessive sun exposure
Eat a well-rounded diet
Practice oral hygiene
Avoid smoking marijuana

135
Q

Client in preparation for examination of the mouth, throat, nose, and sinuses

A

Sitting position with their head at eye level
Explain procedure
Remove dentures, retainers, or rubber bands on braces

136
Q

Equipment needed for mouth, throat and nose assessment

A

Non-latex gloves
Gauze pad
Penlight
Tongue depressor
Nasal speculum

137
Q

Examination of mouth

A

Lips
Teeth
Buccal mucosa
Inspect and palpate tongue
Check strength of tongue

138
Q

Inspection of nose

A

Inspect and healthy external nose
Check patency of airflow through nostrils
Inspect internal nose

139
Q

Inspection of sinuses

A

Palpate sinuses
Percuss sinuses

140
Q

Abnormal findings of mouth and throat

A

Herpes Simplex type one(cold sores)
Cheilosis of lips
Carcinoma of the lip
Leukoplakia
Hairy leukoplakia
Candida albicans infection
Black hairy tongue
Carcinoma of the tongue
Canker sore
Gingivitis
Receding gums
Kaposi sarcoma lesions
Acute tonsillitis
Strep

141
Q

Abnormal findings of sinuses

A

Nasal polyp
Perforated septum
Deviated septum

142
Q

Age related changes of the mouth, throat, nose, and sinuses

A

Ability to smell and taste decreases
Gums recede
Difficulty with oral hygiene
Oral mucosa is often dryer and more fragile

143
Q

Preparation of client for abdominal assessment

A

Have client empty their bladder
Remove clothes and put on a gown
Lie down and supine position
Arms folded across chest or resting by sides

144
Q

Equipment for abdominal assessment

A

Centimeter ruler
Small pillow
Marking pen
Stethoscope

145
Q

Order of abdomen examination

A

Inspection
Auscultation
Percussion
Palpation

146
Q

Abnormal abdominal findings

A

Abdominal edema, or swelling
Abdominal masses
Unusual pulsations
Pain associated with appendicitis
Discoloration
Nonhealing wounds
Inflammation

147
Q

Normal abdominal findings

A

Proper skin color
Stretch marks
Scars
Lesion free
Rash free
Flat or round it abdomen

148
Q

4 signs for assessing appendicitis

A

Psoas
Obturator
Hypersensitivity
Blumberg

149
Q

Psoas sign

A

Pain in RLQ when leg is hyperextended

Irritation of the iliopsoas due to appendicitis

150
Q

Obturator sign

A

Pain in the RLQ when hip and knee are flexed, and leg is rotated, internally and externally

Irritation of the up to return muscle, due to appendicitis or a perforated appendix

151
Q

Blumberg sign

A

Abdominal pain or tenderness experience when examiner test for a rebound tenderness

Peritoneal irritation

152
Q

Hypersensitivity

A

Performed with a sharp object such as a broken cotton tip, applicator or tongue blade

Stroke the abdomen with said object, client should feel no pain and no exaggerated sensation

Is pain is indicated it may indicate appendicitis

153
Q

Murphy sign

A

Pressure is applied under the liver border at the right costal margin, and client inhales deeply

Indicates inflammation of the gallbladder

health assessment (1 decks)

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