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Health Assessment 1 > Final > Flashcards

Final Flashcards

1
Q

What is subjective data?

A

What the person says about themself EX: nausea, vomiting, dyspnea etc.

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2
Q

What is objective data?

A

What you as the health professional observe through inspection, palpation, lab values etc.

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3
Q

What is diagnostic reasoning?

A

The process of analyzing health data and drawing conclusions to identify diagnosis.

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4
Q

What phases are in the nursing process?

A 
Assessment
Diagnosis 
Outcome
identification 
planning
implementation 
evaluation
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5
Q

What is the assessment portion of the nursing process?

A

Collect data and document

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6
Q

What is diagnosis part of the nursing process?

A

Compare clinical findings with normal and abnormal variation and developmental events

  • interpret data
  • validate diagnosis
  • document diagnosis
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7
Q

What is the outcome part of the nursing process?

A
  • Identify expected outcomes
  • Individualize the person
  • Identify expected culturally appropriate outcomes
  • establish realistic and measurable outcomes
  • develop a timeline
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8
Q

What is the planning part of the nursing process?

A
  • Establish priorities
  • Develop outcomes
  • Set timelines for outcomes
  • Identify interventions
  • integrate evidence-based trends and research
  • document plan of care
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9
Q

what is the implementation part of the nursing process?

A
  • implement in a safe and timely manner
  • Collab with colleagues
  • use community resources
  • Coordinate care delivery
  • Provide health teaching and health promotion
  • Document implementation and any modification
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10
Q

What is the evaluation part of the nursing process?

A
  • Progress toward outcomes
  • conduct a systemic, ongoing, criterion based evaluation
  • Include patient and significant others
  • Determine results to patient and family
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11
Q

How many levels are there when setting priorities?

A

3 Levels

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12
Q

What is a first priority problem?

A

High priority, such as airway, breathing, and circulation

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13
Q

What is a second level priority?

A

Mental status, acute pain, infection risk, abnormal lab values, and elimination problems

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14
Q

What is a third level priority?

A

Lack of knowledge, mobility problems, and family coping.

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15
Q

What is evidence based practice?

A

The conviction that all patients deserve to be treated with the most current and best practice techniques led to development of EBP

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16
Q

what is holistic health?

A

Consideration of the whole person (mind, body, and spirit)

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17
Q

What does sending and receiving mean in the interview process?

A

Sending means to be aware of your verbal communication such as your verbage, tone, facial expressions; but sending is not the only thing with communication it also requires that the receiver understands and can process what you are sending.

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18
Q

What are some factors of the physical environment when conducting an interview?

A
  • comfortable room temp
  • sufficient lighting
  • quiet environment
  • remove distractions
  • 4 to 5 ft of distance
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19
Q

Should you ask open ended or close ended questions?

A

open ended to allow narrative

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20
Q

What are the 10 traps of interviewing?

A
  1. providing false assurance
  2. Giving unwanted advice
  3. using authority
  4. using avoidance language
  5. distancing
  6. using professional jargon
  7. Using leading or biased questions
  8. talking too much
  9. interrupting
  10. using why questions
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21
Q

What is health literacy?

A

the ability to understand instructions, navigate the health care system and communicate concerns with the health care provider

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22
Q

What does SBAR stand for?

A

Situation
Background
Assessment
Recommendation

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23
Q

When assessing symptoms what information should you be attaining? (8 items)

A
  1. Location
  2. Character or quality of the pain
  3. Quantity or severity
  4. Timing
  5. Setting
  6. Aggravating or relieving factors
  7. Associated factors
  8. Patients perception
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24
Q

describe a mental organic disorder.

A

Caused by brain disease of known specific organic cause (dementia, alcohol, drugs)

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25
Q

Explain psychiatric mental disorder

A

In which an organic etiology has not yet been established. (anxiety, schizophrenia etc)

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26
Q

What are the two ways to calculate BMI?

A

BMI=weight (pounds)/Height (inch) x 703

BMI= Weight (kilo)/ Height (meters)2

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27
Q

What BMI is classified as underweight?

A

<18.5 kg/m2

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28
Q

What BMI is classified as normal?

A

18.5 to 24.9 kg/m2

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29
Q

What BMI is classified as overweight?

A

25 to 29.9 kg/m2

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30
Q

What BMI is classified as Obese (class 1)?

A

30 to 34.9 kg/m2

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31
Q

What BMI is classified as obese (class 2)?

A

35 to 39.9 kg/m2

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32
Q

What BMI is classified as extreme obesity?

A

> = 40 kg/m2

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33
Q

What are the two main processes pain develops by?

A

Nociceptive and and or neuropathic

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34
Q

What is acute pain?

A
  • Less than 3 months

- Short term- Injury, protective to prevent further injury, sudden

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35
Q

What is Chronic pain?

A
  • Not helpful
  • Long term
  • Greater than 3-6 months
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36
Q

What is cutaneous pain?

A

-Sharp/ Burning skin pain

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37
Q

What is somatic pain?

A

-Pain associated with muscle and bone, deeper, aching

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38
Q

What is visceral pain ?

A

-Organ pain, diffuse, hard to localize, frequent and severe

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39
Q

What is radiating pain?

A

-Pain that moves

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40
Q

What is referred pain?

A

-Pain that is in a different location than the injury or offense

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41
Q

What is intractable pain?

A
  • Pain that is difficult to treat

- Pancreatitis, cancer

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42
Q

What is neuropathic pain?

A
  • Pain in the nerves, strangulation or starvation of a nerve

- herpes, back injury, neuro disorders

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43
Q

What is phantom pain?

A

Pain in a place that the limb no longer exists in amputees

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44
Q

What is the priority when it comes to pain?

A

What will kill them?

What will keep them alive?

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45
Q

In a pain assessment what does PQRST stand for?

A
  • Provocation (Palliation, precipitating factors)
  • Quality, Quantity
  • Region, radiation
  • Severity, pain scale
  • Time scale
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46
Q

What does OLDCART stand for?

A 
Onset
Location 
Duration
Characteristics 
Aggravating factors
Relieving factors 
Treatments
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47
Q

What does ICE stand for?

A
  • Impact (on daily living)
  • Coping stratagies
  • Emotional response (sad, anxiety)
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48
Q

What are food restrictions of Buddhism?

A
  • All meat
  • Alcohol
  • Pungent spices (garlic, onion, scallions, chives, leeks)
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49
Q

What are the food restrictions of Catholicism?

A
  • Meath on some denominational holidays

- Alcohol

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50
Q

What are the food restrictions of Hinduism?

A
  • Lacto-vegetarianism often favored
  • Alcohol and intoxicating substances
  • Garlic, onion and spicy foods
  • fasting on some holidays
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51
Q

What are the food restrictions of the Islam?

A
  • All pork and pork products
  • Meat (not slaughtered)
  • Alchohol
  • Coffee and tea
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52
Q

What are the food restrictions for mormons?

A
  • Alcoholic beverages

- Hot bevs, coffee and tea

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53
Q

What are the food restrictions for orthodox judaism?

A
  • all pork and pork products
  • Meat (not slaughtered)
  • All shellfish
  • Dairy and meat at the same time
  • Leavened bread and cake during passover
  • Food and bev on yom kippur
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54
Q

What are the food restrictions of seventh day adventist?

A
  • all pork and pork products
  • shellfish
  • meat
  • dairy
  • alcohol
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55
Q

What does cyanosis of the skin mean?

A

Decreased oxygen results in a bluish tone

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56
Q

What does blanch skin mean?

A

Push on the skin and it turns lighter

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57
Q

What is Hurtuism?

A

Overgrowth of hair

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58
Q

What is the ABCDE for skin stand for?

A 
Asymmetry
Border
Color
Diameter
Elevation and evolution
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59
Q

What is alopecia?

A

Loss of hair in random areas

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60
Q

What is HSV-1?

A

Oral herpes

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61
Q

What is HSV-2

A

Genital herpes

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62
Q

When assessing the hair what do you look for?

A 
Color
Distribution 
Thickness/ texture
Dry 
Bleached of dyed
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63
Q

Describe the epidermis

A
  • Thin but tough

- formed by the basal cel layer, horny cell layer

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64
Q

Describe the dermis

A
  • supportive layer consisting mostly of connective tissue or collagen
  • enables the skin to resist tearing
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65
Q

Describe the subcutaneous layer

A
  • adipose tissue
  • stores fat for energy
  • provides insulation and temp control
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66
Q

What is an eccrine sweat gland?

A

-coiled tubules that open directly onto the skin surface and produce a dilute saline solution called sweat

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67
Q

What is the apocrine sweat gland?

A

-glands that produce a thick milky secretion and open into the hair follicles

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68
Q

Describe and annular lesion

A

-circular, beings in center and spreads

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69
Q

What is a confluent lesion?

A

Lesions that run together

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70
Q

What is a gyrate lesion?

A

Twisted, coiled, spiral, snakelike

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71
Q

What is a zosteriform lesion?

A

Linear arrangement along unilateral nerve route

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72
Q

What is a macule?

A

Solely a color change, flat and circumscribed

EX: freckles

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73
Q

What is a papule?

A

Something you can feel; elevated

EX: mole

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74
Q

What is a patch?

A

Macules that are larger than 1cm

EX: Mongolian spot, vitiligo

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75
Q

What is a plaque?

A

Papules coalesce to form surface elevation wider than 1cm

EX: psoriasis, lichen

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76
Q

What is a nodule?

A

Solid, elevated hard or soft, larger than 1cm

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77
Q

What is a wheal?

A

superficial raised, transient, slightly irregular shape from edema

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78
Q

What is a tumor?

A

Larger than a few cm in diameter, firm or soft, deeper into dermis

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79
Q

What is Utircaria?

A

Hives

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80
Q

What is a vesicle?

A

Elevated cavity containing free fluid

EX: blister

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81
Q

What is a Bulla?

A

Larger than 1cm diameter
superficial in epidermis, thin walled
EX: friction blister

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82
Q

What is a cyst?

A

Encapsulated fluid filled cavity in dermis or subcutaneous layer

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83
Q

What is a pustule?

A

Turbid fluid (pus) in the cavity

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84
Q

What is a keloid?

A

A benign excess of scar tissue beyond sites of original injury Most occurs in darker people

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85
Q

How many stages are there in ulcers? and what do they mean?

A

Stage 1: Intact, skin is red
Stage 2: loss of epidermis
Stage 3: PI extends into subcutaneous tissue
Stage 4: Full thickness and tissue loss

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86
Q

True of false: the head should be midline and normociphalic

A

True

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87
Q

What are the fontanels in a baby?

A

Anterior

posterior

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88
Q

When does the anterior fontanel close?

A

9 months to 2 years

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89
Q

When does the posterior fontanel close?

A

2 months

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90
Q

What is the metabolic master?

A

Thyroid

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91
Q

Does hyperthyroidism increase or decrease metabolic rate?

A

Increase

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92
Q

Does hypothyroidism increase or decrease metabolic rate?

A

Decrease

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93
Q

If a patient had wt loss, exophalmos, insomnia and is tachycardic does this patient have hyperthyroidism or hypothyroidism?

A

Hyperthyroidism

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94
Q

If a patient has increased wt gain, fatigue, periorbital edema , constipation and is bradycardic does the patient have hyperthyroidism or hypothyroidism?

A

Hypothyroidism

95
Q

What is a migraine?

A 
Vascular 
Sensitive to light 
most common in females 
most common one sided and behind eye
gradual onset lasts 30 min to days
96
Q

What is a tension headache?

A 
Muscloskeletal
band like
constant/ throbbing
stress
peaks 1-2 hr and lasts 4-72
97
Q

What is a cluster headache?

A 
Unilateral 
Burning/ piercing 
multiple in a day
More rare 
peaks and lasts 45-90 min
98
Q

What is hydrocephalus?

A

Obstruction of drainage of the cebrospinal fluid; results in increase intercranial pressure

99
Q

What are some characteristics of down syndrome?

A 
upslanting eyes
inner epicantal folds
flat nasal bridge
thick tongue 
short broad neck
100
Q

What does PERLA stand for?

A 
Pupils
Equal
Round
Reactive
Light 
Accommodation
101
Q

What color should the sclera be?

A

White

102
Q

What color should the conjunctiva be?

A

Pink

103
Q

What does jaundice in the eyes indicate?

A

Liver

hemolytic

104
Q

What does pink sclera indicate?

A

irritation
infection
allergies

105
Q

What does red conjunctiva indicate?

A

Inflammation and infection

106
Q

What does pallor mean in relation to the eyes?

A

Decrease in 02 blood flow
Decrease in BP
Anemia

107
Q

What does exophalmos mean?

A

Bulging eyes

108
Q

What does periorbital edema stand for?

A

Edema around eyes

puffy

109
Q

What does ptosis stand for?

A

Drooping

EX: Bells palsy or stroke

110
Q

What does glaucoma mean?

A

Increased pressure in the eyeball
very painful
pupil misshapen
peripheral vision loss

111
Q

Does glaucoma make you lose peripheral vision or central vision?

A

peripheral

112
Q

What is Macular degeneration?

A

Loss of central vision

caused by diabetes

113
Q

What is cataracts?

A

1 cause of curable blindness

114
Q

What is presbypia?

A

Loss in near vision in older people

115
Q

What does nystagmus mean?

A

Wiggling eyes

116
Q

What is mydriasis?

A

Dialated pupil

caused by meth, cocaine

117
Q

What is miosis of the eye?

A

Shrinking of the pupil

Caused by narcotics such as morphine etc

118
Q

Is the snellen test used for near vision or far vision ?

A

Far

20ft away

119
Q

Is the Rosenbaum test used for near or far vision

A

Near

12 -14 inches away

120
Q

Is the image formed in the retina upside down or right side up?

A

upside down

121
Q

What is a tophi?

A

Build up of uric acid

122
Q

What happens when you prop a bottle?

A

Ear infections

baby tooth decay

123
Q

When inspecting the tympanic membrane in adults what do you do?

A

pull up and back

124
Q

When inspecting the tympanic membrane in infants what do you do?

A

pull down and back

125
Q

What are you looking for when inspecting the tympanic membrane?

A

pearly gray
translucent
flat
intact

126
Q

What would indicate the tympanic membrane is infected

A

cloudy or reddness

127
Q

How do you avoid tophi?

A

avoid pork

128
Q

what is cerumen?

A

Ear wax

129
Q

What color should ear wax be in Caucasians?

A

orange and waxy

130
Q

What ethnicity has a decrease in ear wax and tends to be more flaky?

A

Asians

131
Q

What ethnicity has gray /tan and flaky ear wax?

A

African americans

132
Q

T or F: effusions get abx

A

False

133
Q

What is Rinne?

A

Vibration

air conduction to bone conduction 2:1

134
Q

What is Vertigo? and how is it tested?

A

Trouble balancing

tested through the rhomberg test

135
Q

What is otitus media?

A

Inner ear infection
Pain on swallowing
Observe change in tympanic membrane (reddish, pinkish, yellowish)

136
Q

What is otitus externa?

A 
Outer ear infection 
Pain on palpation 
drainage 
inflammation 
AKA swimmers ear
137
Q

What is Halo?

A

Head trauma and ear bleeding

Blood surrounded by CSG

138
Q

What is defined as “old hearing”

A

Presbycusis

Decrease in high frequency hearing

139
Q

What is tinitus?

A

Ringing in ears

Trauma, loud noises

140
Q

What does COCA stand for?

A

Color
Odor
Consistency
Amount

141
Q

What does clear nose drainage indicate?

A

Allergies and or emphysema

142
Q

What does green nose drainage mean?

A

Infection

143
Q

What causes a perforated septum?

A

cocaine

Meth

144
Q

What is anosmia?

A

Loss of smell

145
Q

What is Epistaxis?

A

Bloody nose

146
Q

What should you assess on someone with epistaxis ?

A

HTN and BP

147
Q

What is patency?

A

Open airway

148
Q

What is rhinitis?

A

Inflammation of the mucus membrane in the nose

149
Q

What is sinusitis?

A

Inflamed sinus

150
Q

What is rhinnorhea?

A

Runny nose

151
Q

What cranial nerve controls the sense of smell?

A

olfactory

152
Q

If the tonsils are enlarged what does that indicate?

A

Same color just big

153
Q

If the tonsils are inflamed what does that indicate?

A

Discolor

154
Q

What is gingivitis?

A

Inflamed gums
poor hygiene
medications
pregnancy

155
Q

What two things cause a black hairy tongue?

A

ABX and not brushing

156
Q

What is thrush?

A

Yeast infection

Common in breastfed children

157
Q

What is leukoplakia?

A

Pre cancerous

dysplastic cells

158
Q

What does it mean to have trouble speaking?

A

Dysphasia

159
Q

What does it mean to have trouble swallowing?

A

Dysphagia

160
Q

What does dry mucus membranes in the mouth indicate?

A

Dehydration
anemia
hypovolemia
meds- SNS stimulants

161
Q

What is cleft lip palate?

A

Neutral tube defect

folic acid deficiency before pregnancy

162
Q

What angle should the anterior chest be assessed at?

A

45*

163
Q

What should the AP:T be?

A

1:2

164
Q

Where should you percuss?

A

posterior chest and ribs

165
Q

What is the name of the sound you should hear when percussing?

A

Resonance

166
Q

Is inhalation active or passive?

A

Active

167
Q

Is exhalation active or passive?

A

Passive

168
Q

What does a greater than 90* costal vertebral angle indicate?

A

Barrel chest

169
Q

What drives us to breathe?

A

CO2 levels

170
Q

What do crackles mean?

A

Fluid or mucus in the alveoli

171
Q

What does absent breath sounds mean?

A

No airflow or ventilation occurring in that area

172
Q

What does wheezes mean?

A

Turbulent airflow in the airways (trachea/ bronchiols)

173
Q

What does diminished breath sounds mean?

A

Decrease in airflow or excess tissue often indicates atelectasis

174
Q

What is hyper-resonance?

A

Loud hollow sound on percussion means excess air/space often emphysema or pneumonia

175
Q

What does it mean if a percussion is dull?

A

over an organ

176
Q

What does it mean if a percussion is flat?

A

Over a bone

177
Q

What does crepitus mean?

A

A crackle feeling on palpation of chest occurs after a pneumothorax

178
Q

What is the leading cause of asthma in children?

A

2nd and 3rd hand smoke

179
Q

How do you calculate someones pack year?

A

packs per day x # yrs smoked = pack year

180
Q

What is another name for crackles?

A

Rales

181
Q

What disease process creates crackles (rales)?

A

Pulmonary edema

pneumonia

182
Q

What disease process creates wheezes?

A

asthma

bronchitis

183
Q

What disease process creates absent breath sounds?

A

pneumothorax
pleural effusion
hemothorax
obstruction

184
Q

What disease process creates diminished breath sounds?

A

obesity
emphysema
atelectasis

185
Q

What disease process creates stridor?

A

aspiration

laryngitis

186
Q

What is a pleural rub?

A

inflammation of the pleura

187
Q

What does all people love time magazine mean?

A 
Aortic
pulmonary 
erbs 
tricuspid 
mitral
188
Q

What does S1 mean?

A

Closure of atrial valves

189
Q

What does S2 mean?

A

Closure of semilunar valves

190
Q

What is a murmur?

A

Turbulent bf over a valve

191
Q

What is a bruit?

A

turbulent bf over an artery (swooshing)

192
Q

When does s3 occur?

A

During diastole

forceful filling of ventricle

193
Q

When does s4 occur?

A

When indicating a major heart issue

194
Q

What does the lub mean?

A

Pump ventricular contraction

195
Q

What does the dub mean?

A

Fill- ventricular relax

196
Q

What are common signs of left sided heart failure?

A 
HA
orthopnea
pulse deficit
Cyanosis 
pain (dull, achy)
Crackles 
pink frothy sputum
197
Q

What are common signs indicating right sided heart failure?

A 
Fatigue, HA, confusion
JvD
Dyspnea 
Gastro stress
Hepsplenomegaly 
Increase in capillary refill time
edema
acites
198
Q

What is ascites?

A

Abdominal swelling

199
Q

What is atherosclerosis?

A

Pathogen change
plaque and increase in LDL
HTN

200
Q

What is arteriosclerosis?

A

Physiologic change

201
Q

What are the symptoms of MI?

A

decrease perfusion
increase in BP
Neurologic
Angina

202
Q

When assessing a pulse what are you looking for?

A

Rate
Rhythm
Symmetry
Amplitude

203
Q

What rhythm indicates death?

A

Asystole

204
Q

What rhythm indicates a shock needs to happen?

A

Ventricular fibrillation

205
Q

What causes atrial fibrillation?

A

Stroke

206
Q

What is arterial flutter?

A

Regularly, irregular rhythm

207
Q

What is the definition of hyperventilation??

A

Movement of large volumes of air

208
Q

What is the definition of hypoventilation?

A

Movement of small volume of air

209
Q

What does orthopnea mean?

A

Difficulty breathing laying down

210
Q

What does tachypnea mean?

A

Breathing quickly

211
Q

What does bradypnea mean?

A

Breathing slowly

212
Q

What does cheyne stokes mean?

A

End of life breathing

213
Q

What does atrial fibrillation mean?

A

Failure of the atria to contract

214
Q

What is hypotension?

A

Inadequate perfusion to the brain or organs accompanied by a lower than usual BP

215
Q

What is hypertension?

A

BP greater than 119/79

216
Q

What is tachycardia

A

HR over 100

217
Q

What is bradycardia?

A

HR less than 60

218
Q

What is pulse deficit?

A

Apical pulse that is higher than a peripheral pulse

219
Q

What is heart failure?

A

Inability of the heart to meet metabolic demand

220
Q

What is a myocardial infarction?

A

Death of heart cells

221
Q

What is atelectasis ?

A

Collapse of individual alveoli

222
Q

What is pnemothorax?

A

Collapse of lobe of a lung

223
Q

Which patient has onset left sided HF?
A. JVD, crackles, venous hum over the inferior vena cava
B. Hyper-resonance over lung fields, ascites, pulse deficit
C.Crackles, elevated temp, productive cough
D. Crackles, orthopnea, productive cough

A

D.Crackles, orthopnea, and productive cough

224
Q

Which pt should be assessed immediately?
A. A rt hip fracture waiting on surgical consult, hip pain 9/10
B. Post appendectomy reporting leg pain 7/10
C. Emphysema exacerbation with o2 sat at 92%
D. Bowel Obstruction stating the NG tube has green stuff in it

A

B.

225
Q 
A client presents post traumatic car accident with the following: crepitus, tachypnea, deviated trachea to the right. What do you suspect?
A. left pneumothorax
B. R Atelectasis 
C. R Pneumothorax 
D. L Atelectasis
A

A

226
Q 
What can cause pallor? 
A. Anemia
B. Raynauds phenomena 
C. Venous insufficiency 
D. DVT
E. Polycythemia 
F. HTN
G. sepsis
A

A,B,G

227
Q 
What finding are expected with heart failure?
A. Absent Breath sounds
B. Pink frothy sputum
C. Orthopnea 
D. JVD
E. Crackles
F. Peripheral edema 
G. Carotid bruit
H. Clear breath sounds
A

B,C,D,E,F

228
Q

What is the primary concern with a patient who has pallor?
A. Decreased perfusion of oxygenated blood
B. Decreased oxygen saturation of blood
C. Replacing lost red blood cells
D. Lowering the BP

A

A

229
Q 
Which patient has macular degeneration?
A. difficulty seeing near
B. difficulty seeing far
C. Loss of peripheral vision
D. Loss of central vision
A

D

230
Q

What does increased tactile fremitus indicate?

A

Fluid or consolidation of the lung

231
Q

When do you call a physician?

A
  • When there is an unexpected finding
  • When there is an order you want to clarify
  • When their condition is worsening
232
Q 
A client is suffering from hypoxia which assessment finding would the nurse NOT expect?
A. tachycardia
B. Hyperventilation
C. Restlessness
D.Pallor
A

D.

233
Q

Which patient has myopia?
A. difficulty seeing far
B. Only able to read the top line of the snellen chart
C. Only able to read the top line of the rosenbaum chart
D. Loss of central vision

A

A or B

Health Assessment 1 (1 decks)

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