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GNUR101 - Health Assessment > Exam 2 - Ch. 7, 9, 10, 11, 15, 16 > Flashcards

Exam 2 - Ch. 7, 9, 10, 11, 15, 16 Flashcards

1
Q

Individual’s response to stress

A

Anxiety

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2
Q

Individual’s perception of and response to stressor

A

Stress

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3
Q

state of mind, relative to how a person is feeling

A

mood and affect

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4
Q

dependence on a substance

A

addiction

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5
Q

mental processing of information and decision making

A

cognition

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6
Q

state of impaired cognitive function

A

psychosis

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7
Q

functional ability is affected by

A

stress, mood and affect, addiction, cognition, anxiety, and psychosis

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8
Q

how is dopamine (DA) associated with mental illness

A

decreased in depression
increased in schizophrenia and mania

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9
Q

how is norepinephrine (NE) associated with mental illness

A

decreased in depression
increased in schizophrenia, mania, and anxiety

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10
Q

how is serotonin (5 HT) associated with mental illness

A

decreased in depression
increased in anxiety

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11
Q

how is histamine associated with mental illness

A

decreased in depression

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12
Q

Depression risk factors

A

gender (women are more likely to develop depression)
age - bad experience in childhood
substance abuse
genetics
psychosocial environment
low self-esteem
sexuality (being lesbian, gay, bisexual, or transgender)
medical history

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13
Q

anxiety risk factors

A

psychosocial environment
genetics
unrelieved stress
other mental health disorders
substance abuse

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14
Q

how to evaluate immediate recall (memory)

A

ask the patient to repeat the names of three unrelated objects that are spoken slowly (such as “dog”, “cloud”, and “apple”)

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15
Q

how to evaluate recent memory

A

give the patient short time to view 4-5 objects and explain you will ask about these objects
after about 10 minutes, ask the patient to name the objects - all objects should be remembered

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16
Q

how to evaluate remote memory

A

ask the patient about his or her mother’s maiden name, high school attended, or subject of common knowledge

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17
Q

alcohol use assessment

A

AUDIT - 10 questions
1 - 3 frequency and quantity
4 - 6 dependence
7 - 10 alcohol related problems

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18
Q

depression - abnormal indications in patient’s level on consciousness and appearance

A

slumped posture, slow movements
soiled clothing, lack of hygiene
speaking in monotone, slow, unexpressive speech patterns
decreased respiratory rate

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19
Q

anxiety - abnormal indications

A

tense muscles, fidgeting, pacing
elevated blood pressure
elevated heart rate
increased respiratory rate

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20
Q

impaired cognition - abnormal findings

A

shuffling, uncoordinated gait
outlandish dress and makeup

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21
Q

reduced consciousness - abnormal findings

A

disorientation to time, place, and person
confusion
sleepiness
lack of response to calling patient’s name, to touch, or pain

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22
Q

substance/alcohol use - abnormal findings

A

changes in pupil size
redness of sclera
glazing of cornea
watering eyes
drooping eyelids
abnormal movements (tremors)

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23
Q

soiled clothing or lack of hygiene may be a symptom of

A

depression or organic brain syndrome

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24
Q

other mental health abnormal findings

A

mania, crying, being withdrawn, rapid rate of speech, high-pitched voice, muscle tension, sweaty palms

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25
Q

Major depression clinical findings

A

depressed mood for at least 2 weeks + at least 5 of the following:
1) depressed mood most of the day
2) diminished interest in almost all activities
3) weight loss
4) psychomotor agitation
5) fatigue or loss of energy
6) feeling of worthlessness
7) decreased ability to think or concentrate
8) recurrent thoughts of death
9) suicide attempt or a specific plan to commit

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26
Q

Bipolar disorder clinical findings

A

recurrent episodes of depression and mania
manic phase - excessive emotional display, euphoria, hyperactivity, decreased ability to concentrate, decreased need for sleep
depressive phase - apathy, feeling of sadness, loneliness, guilt, low self esteem

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27
Q

Bipolar I disorder is defined by

A

manic episodes lasting at least 7 days or being severe enough to require hospitalization
depressive episodes lasting at least 2 weeks

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28
Q

Bipolar II disorder is defined by

A

pattern of depressive and hypomanic episodes (not full-blown manic episodes as seen in Bipolar I)

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29
Q

schizophrenia - clinical findings

A

3 categories (positive, negative, and cognitive symptoms)
positive - hallucinations, delusions, dysfunctional thinking, movement disorders (agitated body movement)
negative - flat affect, reduced feeling of pleasure, difficulty to begin and sustain activities, reduced speaking
cognitive - difficulty understanding information and using it to make decisions, difficulty paying attention, inability to use information right after learning it

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30
Q

generalized anxiety disorder - 4 levels

A

mild, moderate, severe, panic

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31
Q

generalized anxiety disorder MILD - clinical findings

A

heightened awareness to sensory stimuli - hearing more, seeing more, and thinking more logically
occurs in the normal experience of daily life

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32
Q

generalized anxiety disorder MODERATE - clinical findings

A

narrowed field of perception
selective inattention to ignore stimuli and focus on specific concern

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33
Q

generalized anxiety disorder SEVERE - clinical findings

A

reduced perception of stimuli
compulsive mechanisms to avoid anxiety provoking situation
impaired memory, attention, and concentration
difficulty solving problems
unable to focus on events in the environment

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34
Q

generalized anxiety disorder PANIC - clinical findings

A

complete disruption of perceptual field
intense terror, inability to think logically, or make decisions

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35
Q

Obsessive-compulsive disorder (OCD) clinical findings

A

fear of germs or contamination
unwanted thoughts about sex, religion, harm
aggressive toward self or others
excessive cleaning/handwashing
arranging things in particular way
compulsive counting

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36
Q

obsession - definition

A

thoughts, impulses, or images that persist or recur

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37
Q

compulsions - definition

A

ritualistic behaviors that individual feels driven to perform

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38
Q

PTSD clinical findings

A

start within 3 months of traumatic event
must have all of these of at least 1 month:
1) 1 re-experiencing symptom - flashbacks, bad dreams, or frightening thoughts
2) 1 avoidance symptom (staying away from places, events, or objects that are reminders of the experience)
3) 2 arousal and reactivity symptoms - being easily startled, feeling tense, on edge, problems sleeping
4) 2 cognitive/mood symptoms - trouble remembering key features of the event, negative thoughts, distorted feeling (guilt or blame), loss of interest in activities

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39
Q

Delirium vs dementia

A

delirium - disturbance in attention and awareness, develops over short period of time
dementia - chronic, progressive, failing memory, cognitive impairment, behavioral abnormality

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40
Q

Skin cancer - risk factors

A

personal history, family history,
older age
exposure to UV radiation
lifetime sun exposure
severe, blistering sunburns
indoor tanning
fair skin, blonde, or red hair
blue or green eyes

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41
Q

health promotion for those at risk of skin cancer

A

skin should be protected from sun exposure
applying sunscreen (15+)
wearing sunglasses
seeking shade
avoiding sunbathing and indoor tanning

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42
Q

cyanosis - appearance

A

light skin - grayish/blue tone
dark skin - ashen/gray tone

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43
Q

ecchymosis - appearance

A

bruise
light skin - dark red, purple, yellow, or green
dark skin - deeper bluish or black tone

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44
Q

erythema - appearance

A

light skin - reddish tone with raised temp + inflammation
dark skin - deeper brown or purple tone with raised temp + inflammation

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45
Q

jaundice - appearance

A

light skin - yellowish skin color
dark skin - yellowish/greenish skin color

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46
Q

pallor - appearance

A

light skin - pale/white skin color
dark skin - skin tone lighter than normal

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47
Q

petechiae - appearance

A

light skin - small reddish/purple pinpoints
dark skin - difficult to see, evident in buccal mucosa + eyes

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48
Q

rash - appearance

A

light skin - may be visualized and felt
dark skin - cannot be visualized, may be felt

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49
Q

scar - appearance

A

light skin - narrow scar line
dark skin - has keloid development

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50
Q

early signs of melanoma (ABCDE)

A

A - asymmetry
B - border
C - color
D - diameter
E - evolving

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51
Q

how is skin turgor assessed

A

used to test elasticity and dehydration of the skin: assessed by picking up and slightly pinching the skin

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52
Q

nails - clubbing

A

no space observed between fingers and the nail beds angle away from one another
base of the nail is enlarged and curved

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53
Q

nails - spooning

A

thinning of the nail

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54
Q

nails - leukonychia punctata

A

transverse white bands, result from repeated minor trauma to the nail matrix

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55
Q

skin - macule

A

flat, circumscribed area - freckles, flat moles

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56
Q

skin - papule

A

elevated firm, circumscribed area
wart

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57
Q

skin - plaque

A

elevated, firm, rough, flat
psoriasis, eczema

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58
Q

skin - wheal

A

elevated, irregular shaped area
insect bites

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59
Q

skin - nodule

A

elevated, firm, circumscribed, deep
melanoma

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60
Q

skin - tumor

A

elevated, solid, deep
neoplasms

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61
Q

skin - vesicle

A

elevated, circumscribed, superficial, filled with serous fluid
varicella (chicken pox)

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62
Q

skin - pustule

A

elevated, superficial, filled with purulent fluid
acne, folliculitis

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63
Q

skin - cyst

A

elevated, circumscribed, filled with liquid or semisolid material
cystic acne

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64
Q

skin - scale

A

flaky skin, keratinized cells
eczema, pityriasis rosea

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65
Q

skin - lichenification

A

rough, thickened epidermis
chronic dermatitis, psoriasis

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66
Q

skin - keloid

A

thin-to-thick fibrous tissue
healed wound, or surgical incision

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67
Q

skin - fissure

A

linear crack or break from epidermis to dermis
athlete’s foot, cracked skin

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68
Q

skin - crust

A

dried drainage or blood
scab on abrasions

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69
Q

skin - ulcer

A

loss of epidermis + dermis, concave
pressure injury, stasis ulcers

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70
Q

stages of pressure injuries

A

1) intact skin with non blanchable redness - may be painful, firm, soft, warm, cool
2) partial thickness, loss of dermis
3) full thickness skin loss involving damage or necrosis to subcutaneous tissue
4) full thickness loss with exposed bone, tendon, or muscle

71
Q

unstageable pressure injury

A

full thickness tissue loss in which base of the wound is covered by slough

72
Q

suspected deep tissue presure injury

A

localized area of discolored intact skin or blood-filled blister

73
Q

atopic dermatitis vs contact dermatitis

A

atopic - chronic superficial inflammation of the skin with unknown cause
contact - inflammatory reaction of the skin that develops in response to irritant or allergens

74
Q

herpes simples, herpes varicella, and herpes zoster

A

simplex - chronic, non curable condition transmitted by contact during outbreak
varicella (chicken pox) - viral infection that spreads by droplets
zoster (shingles) - acute inflammation by reactivation Herpes Varicella virus

75
Q

psoriasis, candidiasis, and cellulitis

A

psoriasis - chronic skin disorder, inflammatory process causes lesions
candidiasis - fungal infection caused by candida albicans found on skin, mucous membranes, gastrointestinal tract and vagina
cellulitis - acute infection of the skin caused by strep or staph pathogens

76
Q

scabies

A

skin condition, highly contagious infestation associated with mite sarcoptes scabiei

77
Q

pediculosis (lice)

A

parasites that invade the scalp, body, or pubic hair regions

78
Q

hirsutism

A

increased growth of facial, body, or pubic hair in women

79
Q

alopecia areata

A

chronic inflammatory disease or hair follicles resulting in hair loss on the scalp

80
Q

presyncope, disequilibrium, and vertigo

A

presyncope - feeling of faintness (cardiovascular symptom)
disequilibrium - feeling of falling (vestibular function disorder)
vertigo - sensation of movement, rotational motion (cardinal symptom of vestibular dysfunction)

81
Q

microcephaly vs macrocephaly

A

microcephaly - abnormally small head
macrocephaly - abnormally large head

82
Q

visual acuity test (Snellen eye chart) - how to perfrom

A

place chart 20ft away
have the patient sit at eye level and cover one eye
ask the patient to read the smallest line they can see clearly
record
repeat with other eye
record

83
Q

what may yellow sclera indicate

A

jaundice

84
Q

what does PERRLA in pupils stand for

A

Pupils (are)
Equal (and)
Round (and)
React (to)
Light (and)
Accommodation

85
Q

normal findings for pupil diameter

A

2-6mm, round and equal
dilate in the dark
constrict in light

86
Q

eyes - nystagmus vs strabismus

A

nystagmus - involuntary movement of the eyeball
strabismus - when eyes do not align

87
Q

cataract vs glaucoma - difference and risk factors

A

cataract: opacity of the crystalline lens caused by denaturation of lens protein. Risk: age, trauma, congenital
glaucoma: group of diseases caused by increased intraocular pressure, damages optic nerve.
Risk: age, gender, ethnicity, family history, medication, chronic disease

88
Q

subtle indications of hearing loss

A

patient asks you to repeat questions
misunderstanding questions asked
gargled speech sounds
word distortion
tilts to hear/leans forward
reads lips
speaks in loud monotone voice

89
Q

discharge from ears (color + indication)

A

bloody - head trauma
yellow/green - bacterial infection

90
Q

how to inspect adult ear using otoscope

A

outer+middle ear
1) pull top of the ear upward and toward back of the head
2) hold otoscope vertically or upside down
3) stabilize by resting back of your hand against patient’s temple area

91
Q

normal findings for tympanic membrane

A

color: pearly gray, slightly pink, translucent
light reflex: cone of light
mobility: mobile when tested with pneumatic otoscopy
borders: well-defined visible, no swelling

92
Q

abnormal findings for tympanic membrane and causes

A

yellow/amber: otitis media with effusion
redness: infection
chalky white: infection
blue or deep red: blood behind TM, injury
red streaks: allergy
dullness: repeated infections
white flecks: healed inflammation

93
Q

purpose of Rinne test

A

assessing hearing by comparing air conduction of sound to bone conduction of sound (AC to BC)

94
Q

how is thyroid assessed

A

palpate the thyroid gland for size, consistency, tenderness, and nodules

95
Q

what is a goiter

A

hypertrophy of thyroid gland (increase in size)

96
Q

tension headache, migraine, cluster headache, and posttraumatic headache

A

tension - frontal, temporal, parietal, or occipital area (tight band around head)
migraine - throbbing unilateral distribution
cluster - most painful, intense episodes of unilateral excruciating pain, pain behind the eyes
posttraumatic - secondary to head trauma, dull generalized head pain

97
Q

hydrocephalus - clinical findings

A

enlargement of the head, bulging fontanelle, dilated scalp veins

98
Q

otitis media - clinical findings

A

infection of middle ear
ear pain, fever, vomiting, decreased hearing, inflammation, bulging, discoloration

99
Q

conductive vs sensorineural hearing loss

A

conductive - interference in air conduction, caused by blockage, decreased ability to hear, muffled tones
sensorineural - caused by structural changes, disorders of inner ear, auditory nerve problems, progressive bilateral deafness and loss of high-pitched tones

100
Q

herpes simplex clinical findings

A

groups of vesicular lesions with erythematous base

101
Q

gingivitis clinical findings

A

hyperplasia of the gums, erythema, and bleeding with manipulation

102
Q

tonsillitis clinical findings

A

sore throat, painful swallowing, fever, chills, and tender lymph nodes

103
Q

candidiasis (thrush) clinical findings

A

soft, white plaques on the tongue, buccal mucosa, or posterior pharynx

104
Q

hyperthyroidism clinical findings

A

increased metabolism, enlarged thyroid gland, and exophthalmos, goiter

105
Q

hypothyroidism clinical findings

A

decreased metabolism, patients seem to be “slow motion”

106
Q

routine lung assessment

A

inspect patient (visually)
count respirations
observe breathing patterns
inspect nails, skin, lips
inspect the thorax
auscultate thorax

107
Q

special circumstances - lung assessments

A

palpate thoracic muscles, wall, trachea

108
Q

risk factors for lung cancer

A

tobacco smoking
second-hand smoke
environmental exposure
personal + family history

109
Q

risk factors for tuberculosis

A

contact with someone with TB
recent travelers
people with HIV
cigarette smokers
drug abusers

110
Q

how is tobacco use recorded

A

pack-years
number of years x number of packs smoked per day
ex: 1/2 pack a day x 40 years = 20 pack/year

111
Q

abnormal breathing patterns

A

bradypnea - less than 12 bpm
tachypnea - more than 20 bpm
hyperventilation - more than 20 bpm (deep)
sighing - frequently interspersed deep breath
air trapping - difficulty getting breath out
Cheyene strokes - varying periods of increased depth with apnea
Kussmaul - rapid, deep, labored
Biot - irreg interspersed periods of apnea and disorganized breaths
ataxic - disorganization with irregular and varying depths

112
Q

abnormal findings for nail color and angle

A

cyanosis or pallor (inadequate oxygenation)
yellow discoloration (cigarette smoking)
clubbing (chronic hypoxia)

113
Q

adventitious breath sounds and what condition is it related to

A

Crackles: fine, high pitched crackling and popping (pneumonia, heart failure, restrictive pulmonary disease)
Wheeze: high pitched squeak (asthma)
Rhonchi: low pitched, coarse, loud snoring or moaning (bronchitis, COPD)
Pleural friction rub: superficial, low pitched, coarse rubbing or grating sound (pleurisy, pericarditis)

114
Q

Barrel chest - what is it and what is it caused by

A

horizontal ribs, coastal angle, greater than 90 degrees
caused by emphysema

115
Q

what is funnel chest

A

sternum is indented above xiphoid

116
Q

what is fremitus

A

provides information about the density of underlying lung tissue and thorax

117
Q

what is vocal fremitus

A

vibrations resulting from verbalization

118
Q

normal appearance of the trachea

A

palpable, midline, slightly movable

119
Q

what is tracheal deviation

A

displacement of the trachea
caused by medical conditions, large masses, tension pneumothorax, lung collapse

120
Q

what is pneumonia

A

infection of terminal bronchioles and alveoli

121
Q

what is asthma

A

hyperactive airway disease
bronchoconstriction, airway obstruction, and inflammation

122
Q

what is tuberculosis

A

contagious, bacterial infection caused by mycobacterium tuberculosis
transmitted by airborne droplets

123
Q

what is pleural effusion

A

accumulation of serous fluid in the pleural space between visceral and parietal pleurae

124
Q

what is emphysema

A

permanent abnormal enlargement of the air spaces caused by destruction of alveolar walls

125
Q

what is chronic bronchitis

A

hypersecretion of mucus by the goblet cells of the trachea and bronchi

126
Q

pneumothorax - what is it + 3 types

A

air in the pleural spaces
3 types: closed, open, tension

127
Q

hemothorax

A

blood in the pleural spaces

128
Q

what is atelectasis + 2 types

A

collapsed alveoli caused by external pressure
types: compression, absorption

129
Q

clinical findings of lung cancer

A

persistent cough, pain in chest, shoulder, or back, wheezing, loss of appetite, weight loss, fatigue

130
Q

functions of upper airway

A

air conduction, filtration, protection, humidification, warming, smell, speech, swallowing

131
Q

where does gas exchange take place in the body

A

mostly in alveoli

132
Q

Cranial Nerve I

A

Olfactory

133
Q

Cranial Nerve I function

A

smell - sensory

134
Q

Cranial Nerve II

A

Optic

135
Q

Optic Nerve function

A

vision - sensory input

136
Q

Cranial Nerve III

A

Oculomotor

137
Q

Oculomotor function

A

eve movement - motor

138
Q

Cranial nerve IV

A

Trochlear

139
Q

Trochlear nerve function

A

eve movement up and down - motor

140
Q

cranial nerve V

A

trigeminal

141
Q

trigeminal nerve function

A

jaw, mastication - sensory and motor

142
Q

cranial nerve VI

A

abducens

143
Q

abducens nerve function

A

lateral movement of the eye - motor

144
Q

cranial nerve VII

A

facial

145
Q

facial nerve function

A

movement of facial muscles and taste in first 2/3 of tongue - sensory and motor

146
Q

cranial nerve VIII

A

vestibulochlear

147
Q

Vestibulocochlear nerve function

A

hearing and equilibrium - sensory

148
Q

cranial nerve IX

A

glossopharyngeal

149
Q

glossopharyngeal nerve function

A

taste in posterior 1/3 of tongue and tongue movement - sensory and motor

150
Q

cranial nerve X

A

vagus

151
Q

vagus nerve function

A

respiration, digestion, and heart rate - sensory and motor

152
Q

cranial nerve XI

A

accesory

153
Q

accessory nerve function

A

movement of shoulders - motor

154
Q

cranial nerve XII

A

hypoglossal

155
Q

hypoglossal nerve function

A

tongue movement - motor

156
Q

motor cranial nerves

A

III - Oculomotor
IV - trochlear
VI - abducens
XI - accessory
XII - hypoglossal

157
Q

sensory cranial nerves

A

I - olfactory
II - optic
VIII - vestibulochlear

158
Q

cranial nerves names 1-12

A

olfactory
optic
oculomotor
trochlear
trigeminal
abducens
facial
vestibulochlear
glossopharyngeal
vagus
accessory
hypoglossal

159
Q

Nerves that are both sensory and motor

A

V. Trigeminal
VII. Facial
IX. Glossopharyngeal
X. Vagus

160
Q

cerebrovascular (stroke) risk factors

A

age, genetics, family history, race, tobacco, alcohol use, physical inactivity, high blood pressure, high cholesterol, diabetes, obesity, heart disease

161
Q

What does Romberg test assess, how to perform it

A

to assess balance and body’s ability to sense its position in space
have patient stand feet together, arms at side, eyes open and then eyes closed
watch for balance

162
Q

Babinski reflex - how to assess, what does it assess

A

meaning: plantar flexion of all toes
use the reflex hammer, stroke the lateral aspect of the foot - heel to ball, curving medially

163
Q

describe Glasgow coma scale

A

tool to assess person’s level of consciousness
1) eye opening (1-4 points)
2) verbal response (1-5 points)
3) motor response (1-6 points)
total score 3-15 points, lower score indicates lower level of consciousness

164
Q

clinical findings of meningitis

A

severe headache, fever, nausea, vomiting, stiff neck

165
Q

encephalitis - clinical findings

A

fever, headache, nausea, vomiting, changes in mental status, possible coma

166
Q

Parkinson’s disease - clinical findings

A

tremors, bradykinesia, limb rigidity, gait and balance problems
chronic and progressive movement disorder

167
Q

stroke (CVA) clinical findings

A

impairment of motor function, bowel and bladder elimination, intellectual function, spatial-perceptual alterations, personality, sensations, swallowing, and communication
occurs when brain cells die from ischemia

168
Q

Myasthenia Gravis clinical findings

A

chronic autoimmune neuromuscular disease
ocular - muscle weakness in the eye causing ptosis and diplopia
weakness of the face, arms, hands, legs, trunk, thorax

169
Q

clinical findings of Guilian-Barre syndrome

A

acute, widespread demyelination of the motor nerves
ascending paralysis that begins with weakness, paresthesia in lower extremities

170
Q

risk factors for breast cancer

A

gender (females)
age (more than 45, peak 65-84)
genetics (mutations BRCA1 or BRCA 2)
family history
long menstrual history
first pregnancy after 30
increased breast density
estrogen replacement therapy
physical inactivity
alcohol intake
obesity

171
Q

describe the methods for breast palpation

A

circular - press finger pads of 3 middle fingers against outer edge of breast, press gently in circular motion until you reach nipple
wedge - middle 3 fingers on areola, palpate from center outward, repeat until entire breast is covered
vertical strip method - 3 finger pads pressed against the top outer edge of breast, palpate downward and then upward, until you cover the entire breast

172
Q

what is mastitis

A

inflammatory condition of the breast - occurring mostly in lactating women

173
Q

what is gynecomastia

A

noninflammatory enlargement of one or both male breasts

GNUR101 - Health Assessment (5 decks)

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