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Holistic Lecture > Exam 3 > Flashcards

Exam 3 Flashcards

1
Q

what are some age-related eye changes

A

presbyopia, fibers thicken and yellow, cataract formation, Glaucoma, macular degeneration

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2
Q

Explain how to assess the pupillary light reflex and consensual light reflex

A
  1. the pupillary reflex occurs in darken room and examiner shines light from side and directly into the eye, pupil constricts 2. the consensual light reflex is the constriction of the other pupil (if it doesn’t problem with the CN III
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3
Q

test for accommodation

A

focus on distant object than shifts to close object, at near distance pupils should constrict and axes should converge

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4
Q

snellen test

A

top number- distance from chart, bottom number- normal distance an eye can see the chart line, large denominator= poorer vision refer for worse than 20/30

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5
Q

hand held vision screener

A

for near vision, 14 inches away, normal is 14/14

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6
Q

confrontation test

A

gross measure of peripheral vision, use finger to look six different ways

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7
Q

corneal light test

A

called Hirschberg test, tests parallel alignment of eye axes, same level of light shining in both eyes

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8
Q

cover test

A

used if fails corneal light reflex test, stare at nose cover one eye, both eyes should be looking in the direction of the nose

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9
Q

6 cardinal positions of gaze

A

tests EMO’s- extraoccular movements

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10
Q

conductive hearing loss

A

dysfunction because of impact of cerumen

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11
Q

sensorineural or perceptive loss

A

pathology of inner ear CN8, age related nerve damage, or ototoxic drugs called presbycusis

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12
Q

Vertigo

A

spinning twirling b/c dysfunction of labyrinth, Obj= feels room spinning Sub= feels like individual is spinning

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13
Q

Age related hearing changes

A

cilia lining of ear becoming more coarse and stiff accumulation of cerumen, cerumen gets drier b/c of atrophy of apocrine glands, frequent ear infections, presbycusis- nerve degenerations

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14
Q

types of cercumen

A
  1. dry gray flaky (thin masses in ear cannel) found in Asian and Native Americans
  2. wet honey brown to dark brown found in Caucasians and African Americans
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15
Q

tinnitus

A

ringing crackling and buzzing in ears caused by ototoxic meds(damage inner ear), ear infections, Meniere’s disease

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16
Q

proper way to clean the ear canal

A

warm mineral oil and hydrogen peroxide then irrigate using warm water (with bulb or water pick) never irrigate w/ infection

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17
Q

meaning of tragus or pinna being tender

A

otalgia (pain in the external ear) from otitis externa or swimmers ear (inflammation of outer ear and canal) and furuncle (pain, redness, infected hair follicle on tragus)

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18
Q

Romberg test

A

assesses CN8 and intactness of the cerebellum and proprioception, client stand straight with hands at sides and open and close eyes for 20 seconds normal is no swaying and keeps balance

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19
Q

age related changes in mouth nose and throat

A

nose seems more prominent, loss of taste and smell, tooth loss

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20
Q

Assess CN 1

A

only assessed with complaint of loss of smell, client close eyes and hold a cotton ball with alcohol or coffee

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21
Q

deviated septum

A

have client close one nostril and sniff in check for airflow

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22
Q

grading system for tonsils

A

1+ visible (normal) 2+halfway between tonsillar pillars and uvula 3+touching uvula 4+touching each other

23
Q

cleft lip and palate

A

most common in Asian American and American Indians less common in Caucasians and least common in African American

24
Q

torus palatinus

A

boney ridge in middle of hard palate, higher in Asians and women

25
Q

Leukoedema

A

milky blusish white opaque buccal membranes, seen more in dark pigmented people

26
Q

whisper test is used to

A

detect high tone loss with a high frequency

27
Q

PERRLA

A

pupils, equal, round, reaction, light, accommodation

28
Q

apex of lung

A

located above clavicle anterior, c7 posterior

29
Q

base of lung

A

level of diaphragm, 6th rib anterior, 8th rib lateral, 10th posterior

30
Q

lobes of the lung

A

right lung= RUL RML RLL, Left lung= LUL LLL

31
Q

bronchial breath sounds

A

high, in>ex

32
Q

bronchovesicular breath sounds

A

in=ex

33
Q

vesicular breath sounds

A

lower in<ex

34
Q

normal finding for palpation of chest

A

resonance- low pitch clear hollow sound

35
Q

hyperresonance

A

abnormal, lower pitch, too much air is present, such as emphysema or pneumothorax

36
Q

dull

A

abnormal, thud, sign of density as with pneumonia, pleural effusion, atelectasis or tumor

37
Q

hyperinflation

A

with chronic emphysema

38
Q

right middle lobe pneumonia

A

occurs with dullness behind the right breast

39
Q

fine crackles

A

heard in inspiration sounds like rolling strands of hair together, partly from collapsed aveoli reopening

40
Q

coarse crackles

A

loud low gurgling sound like Velcro opening from inhaled air touching secretions, called rhonhi

41
Q

wheeze high pitched

A

musical sound may occur with narrow airways with asthma upper portion of airway

42
Q

wheeze low pitch

A

musical snoring heard throughout respiration from airflow obstruction, may clear with cough (productive sputum)

43
Q

stridor

A

high pitched crowing sound louder in neck, obstruction of upper airway from allergic reaction

44
Q

atelectatic crackles

A

common in older adults, disappear with a few deep breaths

45
Q

Rust color sputum

A

Sign of infection

46
Q

Risk factors for breast cancer

A

Older than 50, history of breast cancer, BRAC gene, first degree relative, dense breast tissue, positive biopsy, high dose radiation to chest, early menarche, oral contraceptive, never breast fed, long term use of estrogen, greater than one alcohol drink, obesity

47
Q

History of present health concern with the breast

A

Lumps swelling thickening redness warmth dumpling rash pain tenderness nipple discharge

48
Q

Past history for health concern with breast

A

History of breast disease, injury, trauma, surgery, menarche, menopause, childbirth, LMP

49
Q

Best time for a self breast exam

A

After menstrual cycle, non tender less firm, or pick a consistent day

50
Q

Clinical exam of the breast

A

Have another nurse present, inspect( sitting and laying down- arms over head then with hands on hips), palpate (3 fingers light medium and deep, tail of spence-most breast cancer occurs, axilla areola and lymph nodes), instruct to self exam

51
Q

Assessing a man versus a women for a breast exam

A

Less tissue, important to check nodes and nipple

52
Q

What is gynecomastia

A

Age related hormone changes in adolescent boys and older men; with obesity, Cushing syndrome, liver cirrhosis, hyperthyroidism, or adrenal disease. Can also be from medications

53
Q

Changes in older women’s breast

A

After menopause estrogen decrease which leads to atrophy of the glandular tissues replaced by fibrous connective tissue. This causes decreased breast size and sagging. Softer and easier to find lumps

54
Q

Signs of retraction and inflammation of the breast

A

Dimpling, fixation, edema, deviation in nipple pointing, nipple retracting

Holistic Lecture (4 decks)

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