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health assessment > exam 4 > Flashcards

exam 4 Flashcards

1
Q

costovertebral angle

A

angle between spine and 12th rib
tenderness here is related to kidney

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2
Q

sharp crampy pain associated with kidney stones

A

ureteral colic

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3
Q

pain that comes from internal organ and is hard to localize

A

visceral pain

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4
Q

parietal pain

A

from inflammation of parietal peritoneum
aching pain
aggravated by movement or coughing

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4
Q

parietal pain

A

from inflammation of parietal peritoneum
aching pain
aggravated by movement or coughing

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5
Q

referred pain

A

hurts where problem isnt

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6
Q

GERD characteristics

A

from gastric acid is esophagus, causes heartburn and regurgitation
occurs after meals and when laying down
avoid spicy foods, chocolate, smoking and alcohol

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7
Q

peptic ulcer characteristics

A

ulcer in stomach or duodenum less than 5mm
located in epigastric and could go to back
may be gnawing, burning, aching, or hunger pain
pain may last a few weeks, go away then reoccur
food and antacids may bring relief

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8
Q

dyspepsia

A

indigestion

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9
Q

weight loss is common in what ulcer

A

gastric

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10
Q

heartburn is common in what ulcer

A

duodenal

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11
Q

acute appendicitis

A

inflammation of appendix, may be distended and obstructed
pain migrates from periumbilical to RLQ
Pain gets worse with time
movement hurts
low fever, anorexia, nausea, pain common

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12
Q

acute cholecystitis

A

inflammation of gallbladder, usually from obstruction
RUQ pain, may radiate to rt shoulder
steady aching
fatty foods aggregate
anorexia, N/V, restlessness

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13
Q

acute bowel obstruction

A

small intestine pain: periumbilical, upper abdomen
colon pain: cramping
eating makes it worse
vomiting, constipation,

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14
Q

acute pancreatitis

A

inflammation of pancreas, autodigestion
epigastric pain that may radiate to back
leaning forward with trunk flexed may help
N/V, abdominal distention, fever

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15
Q

chronic pancreatitis

A

irreversible destruction from recurrent inflammation
severe, chronic pain. in epigastric to back
alcohol and fatty foods make it worse
leaning forward with trunk flexed may help
diabetes may occur, diarrhea with fatty stool

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16
Q

acute diverticulitis

A

inflammation of diverticula
cramping pain that comes steady, in LLQ
caused from low fiber, smoking
abdominal mass with tenderness, N/V, constipation

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17
Q

regurgitation

A

acidity taste that comes up in mouth/throat

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18
Q

color of old blood

A

dark red, coffee ground looking

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19
Q

color of new blood

A

bright red

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20
Q

odynophagia

A

painful swallowing

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21
Q

tarry stool

A

common with GI bleeds
black, sticky and shiny

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22
Q

what may jaundice cause fecal to look like

A

grey stool

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23
Q

abdomen assessment: what should patient look like

A

no pillow under head, laying flat with pillow under knees

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24
Q

abdominal exam order

A

inspect, auscultate, percuss, palpate

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25
Q

abdomen contour

A

flat? round? concave?

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26
Q

incisional hernia

A

around past surgical incisions
scar may be seen

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27
Q

ascitic fluid

A

migrates to lowest point, with gravity

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28
Q

when should you hear tympany in abdomen

A

over air filled or unsolid spaces

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29
Q

where should you hear dullness in abdomen

A

over solid areas

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30
Q

lightly palpate stomach

A

one hand, circular motion
looking for tenderness and masses

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31
Q

deeply palpate stomach

A

2 hands, push down 5-8 cm
looking for masses and enlarged organs
only do when necessary, could cause harm

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32
Q

what to do if you know a area is tender when palpating

A

touch it last, if you do it beforehand it will make them tense and you wont get as good of an assessment

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33
Q

assessment for peritoneal inflammation

A

ask them to cough
only palpate with one finger
try to localize pain

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34
Q

palpation of liver

A

hand underneath rib cage, ask patient to take deep breath using their stomach

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35
Q

mapping borders with ascites- percussion

A

dullness- where the fluid is
tymphany- where the fluid isn’t

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36
Q

what signs lead us to believe appendicitis

A

positive rovsing sign- pressing deeply into LLQ and withdrawing quickly, patient in pain

positive psoas sign- pain when lying on left side with right leg flexed back, in pain

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36
Q

what signs lead us to believe appendicitis

A

positive rovsing sign- pressing deeply into LLQ and withdrawing quickly, patient in pain

positive psoas sign- pain when lying on left side with right leg flexed back, in pain

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37
Q

sign to see for gallbladder inflammation

A

positive murphy sign- pain when fingers are poked in right side when taking deep breath in

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38
Q

how to know is mass is in abdominal wall or cavity

A

ask patient to tighten abdominal muscle, if mass is still palpable, its in the wall, if its not palpable its in the cavity

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39
Q

Hep A

A

Transmitted by contaminated food or water
abdominal pain, nausea, fever, jaundice, loss of appetite
no treatment needed, rest and drink fluids
vaccine is available
not chronic but may cause damage

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40
Q

Hep B

A

Liver infection from virus
transmitted by blood, sexual contact, mother to child
often no symptoms, but jaundice, abdominal pain, fatigue, loss of appetite may appear
vaccine available
Can become chronic, leading to cancer and cirrhosis

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41
Q

Hep C

A

liver infection transmitted by blood/bodily fluids from someone with hep C
no vax available
there is a cure
chronic, may cause cancer, or cirrhosis
typically no symptoms, but if do, flu like

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42
Q

what meds chronically lead to ulcers or gi bleeds

A

asprin, NSAIDs

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43
Q

best test for colorectal cancer

A

colonscopy

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44
Q

pessary

A

for urinary incontinence
small plastic device placed in vagina that creates pressure on bladder decreases urinary incont,

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45
Q

complete loss of muscle function

A

paralysis or plegia

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46
Q

normal bowel sound activity

A

5-34 clicks or gurgles a min
if hypoactive, listen for 3-5 mins

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47
Q

internal shoulder rotation

A

reaching up arm to touch the opposite scapula

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48
Q

what are bouchard nodes affiliated with

A

osteoarthritis

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49
Q

rigidity

A

muscle hypertonic in both directions through whole range of motion

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50
Q

spacisty

A

muscle hypertonic in one direction not thru whole range of motion

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51
Q

strain

A

injury to tendon

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52
Q

sprain

A

injury to ligament

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53
Q

connects muscle to bone

A

tendon

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54
Q

bone to bone

A

ligament

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55
Q

bursae

A

fluid filled sac between bone/tendon/soft tissue/muscle

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56
Q

synovial joint

A

freely movable

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57
Q

spheroidal joint

A

ball and socket, synovial

58
Q

hinge joint

A

gliding movement, synovial

59
Q

condylar joint

A

convex surface matched with concave surface, synovial

60
Q

cartilaginous joint

A

slightly movable

61
Q

fibrous joint

A

immovable

62
Q

atrophy

A

decrease in size

63
Q

hypertrophy

A

increased muscle tone with increased strength

64
Q

pseudohypertrophy

A

big muscles without strength

65
Q

paresis

A

weakness

66
Q

hemiparesis

A

weakness on one side

67
Q

hemiplegia

A

paralysis on one side

68
Q

paraplegic

A

paralysis in legs

69
Q

quadriplegic

A

paralysis in all 4 extremites

70
Q

0 muscle strength

A

no contraction detected

71
Q

1 muscle strength

A

slight movement

72
Q

2 muscle strength

A

movement when gravity is eliminated
cant lift, but can move

73
Q

3 muscle strength

A

active movement with gravity
can lift , but cant resist

74
Q

4 muscle strength

A

can move against gravity, but only has some resistance

75
Q

5 muscle strength

A

active movement against full resistance without evidence of fatigue

76
Q

hyperextension of shoulder

A

raising arms behind you

77
Q

wrist flexion

A

point towards floor

78
Q

radial deviation

A

bringing fingers midline

79
Q

ulnar deviation

A

bringing fingers away from midline

80
Q

what causes carpal tunnel

A

pinched nerve

81
Q

assessing capal tunnel

A

thumb adduction
tinel sign- tapping over medial nerve
phalen sign - wrist flexed and held back of hands together for 60 secs, ask about numbess

82
Q

kyphosis

A

hunchback

83
Q

lordosis

A

inward curvature

84
Q

scoliosis

A

lateral curvature

85
Q

neck flexion

A

bringing head to chin

86
Q

neck lateral flexion

A

ear to shoulders

87
Q

palpating inguinal structures: NAVEL

A

Nerve
Artery
Vein
Empty space
Lymph nodes

88
Q

dorsiflexion

A

foot pointed to ceiling

89
Q

bone and muscle health promotion topics

A

exercise
nutrition
weight management

90
Q

osteoarthritis

A

inflammation in joint

91
Q

osteoporosis

A

weak bones due to absorption issues
to help: take vitamin D and calcium, exercise, limit alc and caffeine, agents
diagnosed by bone density screening

92
Q

reproductive assessment pieces to discuss

A

Sex and response(and with what gender), STIs, menstrual cycle, any noticeable concerns/symptoms, contraception methods, pregnancy

93
Q

Prostate cancer symptoms and risk factors

A

symptoms- incomplete emptying of bladder, urinary frequency/urgency, weak stream, hematuria, nocturia, bony pain in pelvis

2nd leading cause of cancer death in men
risk increases after age 65, in AA men, BRCA gene, and having a family history

94
Q

when and how should men do testicular exams

A

monthly, in front of a mirror

95
Q

inspecting hernias in men

A

inspect in standing position
looks for bulging and asymmetry

96
Q

foley catheter and penis issue

A

skin of meatus can errode due to movement of penis

97
Q

epispadias

A

urethra opening on upper side of penis instead of top

98
Q

hypospadius

A

urethra opening is on underside of penis instead of tip

99
Q

HPV vaccine

A

prevents cancer causing infections
2 dose
age 11&12 men and women before first sexual encounter

or

3 dose
woman can get it from age 13-26
men from ages 13-21

100
Q

SANE

A

sexual assault nurse examiner

101
Q

should we establish about number of sexual partners

A

yes in the past 3-6 months

102
Q

what can cause sexual dysfunction

A

general health, medication, attitude, knowledge of activity, relationship, setting

103
Q

what needs mandatory reported when coming to sexual health

A

rape

104
Q

how do we assess reproductive system

A

externally

105
Q

Para (P)

A

outcome of pregnancy
full term, premature, abortion, living child

106
Q

gravida (G)

A

Total number of pregnancies

107
Q

amenorrhea

A

absence of periods

108
Q

menses duration

A

number of days flow last

109
Q

menses frequency

A

measured from first day of one menses to first day of next menses, usually 24-32 days

110
Q

abnormal uterine bleeding

A

bleeding between menses or infrequent or prolonged postmenopausal bleeding

111
Q

premenstrual syndrome (PMS)

A

cluster of emotional, behavioral, and physical symptoms occurring 5 days before menses for 3 consecutive cycles

112
Q

dysmenorrhea

A

pain with menses

113
Q

postmenopausal bleeding

A

bleeding occurring 6 months or more after cessation of menses

114
Q

perimenopause

A

period of years marking transition to menopause

115
Q

menopause

A

absence of period for 12 consecutive months, usually in ages 48-55

116
Q

menarche

A

onset of menses

117
Q

menses

A

monthly flow of bloody fluid from uterus

118
Q

3 parts of women’s reproductive history

A

menstrual, obstetrics, sexual

119
Q

5 phases of women’s reproductive house

A

prepuberty, puberty, childbearing, perimenopausal, menopasual

120
Q

what age do most women start mammograms

A

45, but could start earlier if at risk for

121
Q

do you still palpate with breast implants

A

yes

122
Q

what happens to breast with radiation

A

tissue will be tighter and firmer

123
Q

what is concerning about mastectomy scars

A

they are a common sight of reoccurence

124
Q

visible signs of breast cancer

A

nipple retraction and deviation, abnormal contours, skin dimpling, edema on sides from blockage of lymphatic system- texture feels like orange peel

125
Q

breast cancer

A

most common after age 60 but can happen sooner
usually single, firm, irregular shape, nontender, possible retraction

126
Q

breast cyst

A

cyst in breast- more exams needed because hard to tell
usually in mid adult age
can be by itself or with clusters, can be soft or firm, mobile, usually tender, no retraction, round

127
Q

fibroadenoma

A

mimic breast cancer but is benign
more common in younger woman but older women can get it as well
round, well delineated, usually nontender, very mobile, no retraction, firm, usually single

128
Q

lymph node suggesting breast cancer

A

palpable, larger than 1cm

129
Q

how to document modules found in breast

A

by quadrant and clock face
document size, shape, delinenation (clear borders?), tenderness, mobility

130
Q

what direction to palpate breast

A

from axillary to sternum

131
Q

how to palpate breast

A

2nd,3rd and 4th finger pad in circular motion in vertical strip pattern. Pressure depends on the denseness of the tissue

132
Q

what positions should women be at so you can inspect there breast

A

arms at side
arms on hip
leaning forward
arms over head

133
Q

gene for breast cancer

A

BRCA

134
Q

what can help find breast cancer

A

mammogram, biopsy, self exams, clinical exams

135
Q

benign breast disease

A

noncancerous lumps in breast
requires more breast exams bc they are more difficult to distinguish

136
Q

medications that put women at higher risk for breast cancer

A

HRT, OC

137
Q

what is nipple retraction

A

Inverted nipple

138
Q

what lymph nodes need to be palpated in breast exam

A

lateral, central, subscapular, pectoral

139
Q

should nurses do breast exams on men

A

yes, distinguish the difference between muscle and breast tissue

140
Q

Gynecomastia

A

development of breast tissue in men

141
Q

supernumerary

A

extra nipple, areola present
usually mistake as a mole
no pathologic significance

142
Q

are breast always smooth

A

no, they are made of glandular and fat tissue, so there may be some roughness, but look out for any new lumps that were not previously there

143
Q

what part of the breast do most tumors develop

A

tail of spence

144
Q

when should breast exams be done

A

a week after period, consistently each month for women
for men, monthly

health assessment (4 decks)

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