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Final Flashcards

1
Q

GYN subjective/history data

A 
menstrual history
obstetric history
- gravidity [pregnancies] and parity [births]
amenorrhea [menopause]
urinary symptoms
vaginal discharge
past GYN history
past pap exam and results
sexual activity
contraceptive use
STD's
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2
Q

breast exam abnormalities

A 
dimpling
edema
nipple retraction
fixation
deviation in nipple pointing
benign breast disease
cancer
fibroadenoma
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3
Q

female tanner stages

A 
I [10-13 year old]
- preadolescent pubic hair/breasts
II 
- sparse, straight pubic hair
- small mound-sized breasts
III [12-14 year old]
- dark curled pubic hair
- bigger, separated breasts w/o contour
IV
- abundant coarse, curly pubic hair
- areola forms on breasts
V [14-17 year old]
- triangle-shaped area of pubic hair reaching top thighs
- nipple projection of breasts
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4
Q

male tanner stages

A 
I [10.5-14 year old]
- no pubic hair
- pre-adolescent penis and testes
II 
- scanty pubic hair
- slight increase in penis and testes
III [12.5-15 year old]
- darker, curlier pubic hair
- longer penis and larger testes
IV 
- coarse, curly pubic hair
- larger penis and darkened scrotum
V [14-16 year old]
- pubic hair reaches thighs
- fully grown penis and testes
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5
Q

abnormalities in male genitalia

A 
cryptorchidism [absent testes]
testicular torsion
spermatic cord varicele [varicose veins on the testes]
testicular tumor
hydrocele [fluid from the abdomen in the scrotal cavity]
scrotal hernia
orchitis [inflammation of the testes]
benign prostatic hypertrophy
prostatis [enlargement of the prostate]
caarcinoma
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6
Q

types of cancer in males

A

testicular cancer
- most common cancer in young men between ages 20-39
- highest risk among white, Caucasian males
- risk factor: non-descended testes, family hx
prostate cancer
- common in men age 50 years or older
- highest risk among black males
- risk factors: diet high in fat, animal products, and calcium; diet low in fruits an vegetables; limited or low levels of physical activity
inguinal nodes cancer
- symptoms: hard, 1 cm or larger, discrete nodes

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7
Q

types of pain

A 
acute pain
- usually has a rapid onset
- short-term, self-limiting
- seen in nociceptive pain
chronic pain
- pain lasting more than 6 months
- slow onset
- types: malignant [i.e. tumor cells], non-malignant [i.e. musculoskeletal conditions]
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8
Q

sources of pain: nociceptive

A

nociceptive receptor are neurons that detect painful sensation from the periphery and transmit them to the CNS
designed to signal tissue damage or inflammation
located in the skin, connective tissue, muscle, and the thoracic, abdominal, pelvic viscera
may present wit somatic, cutaneous, or visceral pain

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9
Q

sources of pain: neuropathic

A

results from damage to the peripheral or central nervous system
often due to direct injury to the nerve fibers
constant irritation and inflammation causes the nerve cells to become altered/damaged

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10
Q

responses to pain

A

physiologic
- increased adrenaline level, blood glucose, blood pressure, heart rate, and respiratory rate, dilated pupils, muscle tension and rigidity, pallor
behavioral
- grimacing, moaning, crying, restlessness
affective
- exaggerated weeping, withdrawal, anxiety, depression, fear, anger, anorexia, fatigue

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11
Q

heart sounds

A

S1
- closure of the mitral and tricuspid valves
- beginning of systole
S2
- closure of the aortic and pulmonic valves
- beginning of diastole

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12
Q

heart failure

A

symptoms are often gradual in their development, as the body has great capacity to compensate for early changes in many diseases. often, pt.’s will wait until their breathing is severely impaired before seeking medical attention
there are two types: left-sided and right-sided

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13
Q

right-sided heart failure symptoms

A 
jugular [neck vein] distention
enlarged liver
anorexia and nausea
edema of hands, fingers, legs and sacrum
distended abdomen
nocturia
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14
Q

left-sided heart failure symptoms

A 
fatigue
weakness
angina
confusion
hacking cough at night
dyspnea
crackles in lungs
frothy, pink-tinged sputum
tachypnea
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15
Q

heart conduction system

A

the SA node [anatomical pace-maker] starts the sequence by causing the atrial muscles to contract
the signal travels to the AV node, throguh the bundle of His, down the bundle branches, and through the purkinje fibers, causing the ventricles to contract
this signal creates the electrical current that can be seen as an EKG or ECG

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16
Q

anatomy of the lungs

A

the right lung has 3 lobes
the left lung has 2 lobes
posteriorly, only the upper and lower lobes of either lung can be auscultated

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17
Q

thorax palpation technique

A

symmetric chest expansion
crepitus
tenderness
tactile fremitus

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18
Q

normal breath sound: bronchial

A

heard over trachea and larynx
short inspiration and long expiration
sounds are rough
may only be auscultated anteriorly

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19
Q

normal breath sound: brochovesicular

A

heard over major bronchi between scapulae and upper sternum 1st and 2nd ICS
inspiration and expiration match the length

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20
Q

normal breath sound: vesicular

A

heard over periphery of lung
majority of lungs have vesicular sounds
long inspiration and short expiration

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21
Q

abnormal breath sound: fine crackles [rales]

A

discontinuous, short popping sound
usually heard during inspiration
caused by inhaled air colliding with previously deflated airways, sound occurs when airway pops open
not cleared by coughing
seen in: pneumonia [auscultated in the superior lung fields], heart failure, chronic bronchitis

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22
Q

abnormal breath sound: course crackles

A

discontinuous bubbling or gurgling sound
mostly hear on inspiration
caused by inhaled air colliding with secretions in the trachea or bronchi
cleared by coughing/suctioning but returns

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23
Q

abnormal breath sound: sibilant wheezes

A

high-pitched, musical sound
heard on inspiration and expiration
caused by air trying to squeeze through a passage narrowed by airway obstruction from collapse, or swelling
seen in: acute asthma, chronic bronchitis

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24
Q

abnormal breath sound: sonorous rhonchi

A

low-pitched rumbling
caused by passage of airflow obstruction by thick secretions
cleared by coughing but returns
seen in: bronchitis, obstruction from tumor, cystic fibrosis

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25
abnormal breath sound: stridor
high-pitched crowing sound, often louder in the neck than over the chest wall heard on inspiration caused by upper airway obstruction, from swollen tissue or lodged foreign body seen in: epiglottitis, foreign body
26
abnormal breath sound: pleural friction rub
``` grating or creaking sound heard on inspiration and expiration caused by rubbing together of inflamed or roughened pleurae heard best at anterolateral wall seen in: pleuritis ```
27
abnormal breath sound: absent
reduction in the intensity of breath sounds commonly described as reduced air entry seen in: bronchial occlusion, collapsed lung or lobe, pleural effusion, or pneumothorax [heard in the inferior lung field]
28
arterial disease symptoms
dependent rubbor or elevation pallor thin, brittle skin extremity hair loss thickened, opaque toe nails ulcers occur on toes or on a bony prominence - are painful and have a punched-out appearance or regular margins intermittent claudication [a condition caused by ischemia of the muscles; characterized by attacks of pain, brought on by mobility
29
venous disease symptoms
stasis dermatitis- brown, flaky pigmentation of skin legs may have a bluish cast and dilated veins chronic swelling ulcers are found around the lower leg near the ankle due to trauma of the edematous skin - has irregular margins and may be painless
30
grading pulses
``` 0= absent +1= weak, thready +2= normal +3= bounding ```
31
abdominal inspection technique
``` first step contour skin characteristics and color symmetry umbilicus ```
32
abdominal auscultation technqiue
second step auscultate bowel sounds with diaphragm and vascular sounds, over the aorta, renal, ilian, and feemoral arteries, with bell
33
abdominal percussion technique
third step note areas of tympany and dullness [over an organ or fat] perform CVA tenderness exam
34
abdominal palpation technique
fourth step light palpation - assess for tenderness, masses, and muscular resistance deep palpation - assess for organ enlargement, masses, bulges, or swelling
35
urinary system abnormalities
``` nocturia hesitancy urgency dribbling dysuria [painful urination] hematuria incontinence urinary retention ```
36
ear inspection technique
size and shape | skin condition
37
ear palpation technique
pinna and tragus mastoid process check for lympadenopathy
38
otoscopic examination technique
note discharge, lesions, wax, redness, or swelling note the tympanic membrane - color and characteristics intactness and integrity position of cone of light note position visualize umbo, manubrium, and short process of the malleus
39
hearing acuity test technique
test during regular speech and during a whispered voice test
40
vision assessment technique
``` central visual acuity - use snellen eye chart peripheral vision acuity - confrontation test color vision - use ishihara plates ```
41
eye abnormality: myopia
person cannot see far-away objects
42
eye abnormality: hypertropia
a condition of misalignment of the eyes [strabismus]
43
eye abnormality: ptosis
upper lid droop pasts the iris
44
eye abnormality: chalazion
inflammation of the sebaceous glands
45
eye abnormality: hordeoleum
stye
46
eye abnormality: conjunctivits
pink-eye | inflammation of the conjunctiva
47
eye abnormality: iritis
circum-corneal redness
48
eye abnormality pterygium
a triangular patch of hypertrophied bulbar subconjunctival tissue, extending from the medial canthus to the border of the cornea or beyond, with its apex pointing toward the pupil
49
eye abnormality: cataract
complete or partial opacity of the ocular lens
50
eye abnormality: hyphema
collection of blood behind the iris
51
eye abnormality: aniscoria
unequal pupil size
52
eye abnormality: miosis
constricted pupils
53
eye abnormality: mydriasis
dilated pupils
54
prioritization of pt.'s
``` first-level priority problems - airway problems - breathing problems - cardiac/circulation problems second-level priority - mental status changes acute pain acute urinary elimination problems untreated medical problems abnormal laboratory values risks of infection, safety, or security third-level priority - activity/rest ```
55
4 types of assessments
complete - baseline - identifies potential or actual problems episodic - focused or limited scope to specific complaint - used in our pt. facilities or in hospital for specific complaint follow-up - conducted at regular or set intervals - limited in its focus emergency - rapid collection of data simultaneously with life-saving measures
56
thyroid examination
place fingers between the edges of the trachea and the sternomastoid muscles on either side have the pt. slightly tilt their head forward and to the right have pt. swallow from a glass of water repeat on other side thyroid gland should not be palpable
57
lymph nodes
``` preauricular posterior auricular occipital jugulodigastric submandibular submental superficial cervical chain deep cervical chain posterior cervical supraclavicular ```
58
cerebellar testing
``` balance - gait - tandem walking - romberg test rapid alternating movement - knee-hand test - finger-to-finger test coordination and skilled movements - finger-to-nose test - finger-nose-finger test heel down shin test ```
59
frontal lobe
``` personality behavior emotion intellectua; ffunctions broca's area [motor speech] precentral gyrus [primary motor area] ```
60
temporal lobe
hearing taste smell wernicke's speech [speech discrimination]
61
occipital
visual recception
62
parietal lobe
sensation | post-central gyrus [primary sensory area]
63
cerebellum
motor coordination equilibrium balance
64
aphasia
a disorder of language, dominant in the left cerebral hemisphere - broca's aphasia [loss of ability to produce verbal conversation] - wernicke's aphasia [loss of ability to understand verbal communication
65
deep tendon reflexes
biceps- elicits forearm flexion triceps- elicits forearm extension brachoradialis- elicits forearm flexion and supination quadriceps- elicits lower leg extension and palpable quadriceps contraction achilles- elicits planter flexion babinski's reflex- elicits plantar flexion of the toes and slight inversion of the forefoot
66
macule
a less than 1 cm spot, perceptibly different in color from the surrounding tissue a spot more than 1 cm is considered a patch
67
papule
a less than 1 cm, circumscribed, solid elevation on the skin | more than 1 cm is considered a tumor
68
wheal
a circumscrbied papule or irregular plaque of edema of the skin
69
vesicle
a less than 1 cm, circumscribed elevation of the skin containing fluid more than 1 cm is considered a bulla
70
cyst
encapsulated fluid-filled lesion that extends down into the dermis
71
pustule
a small, circumscribed elevation of the skin, containing pururlent material
72
common shapes and configurations of lesions
annular - lesion round in shape confluent - lesions randomly scattered throughout the body discrete - singularly found, randomly spread through the body
73
nose assessment technique
assess for mid-line, symmetry and lesions or deformities check patency inspect nasal muscosa, septum, turbinates - mucosa should be smooth, moist, and red and should have no swelling, discharge, or bleeding - septum should show no bleeding, perforation or significant deviation - turbinates should match mucosa
74
subjective data
``` "symptoms" what the pt. complains of history chief complaint review of symptoms PQRSTU - provocative or palliative - quality and quantity - region and radiation - severity and scale - timing and type of onset - understanding ```
75
objective data
``` "signs" what you assess physical examination laboratory reports radiologic findings, etc. primarily factual and descriptive ```
76
skin inspection technique
``` color - general pigmentation -wide-spread color change localized colro change - vascularity or bruising lesions - location/distribution on body - color - elevation - shape and pattern - size - exudate ```
77
developmental pearls: skin
loss of elastin, collagen, subcutaneous fat reduction of muscle tone wrinkling occurs because the under-lying dermis thins sweat glands decrease in number senile purpura, which is uncommon in younger adults
78
developmental pearls: hair and nails
decreased functioning melanocytes causing hair to turn grey and thin change in hair distribution female facial hair nails may appear thickened, yellow, and brittle because of decreased circulation in extremities
79
developmental pearls: head and neck
a mild rhythmic tremor of hear [senile tremors] may occur; it is benign during examination, direct aging individual to perform ROM slowly
80
developmental pearls: neck, mouth, throat
tooth surface becomes abraded gums recede cavities form around the neck of the tooth, exposing the nerve and making the tooth hypersensitive some tooth loss may occur from osteoporosis decrease in taste and salivary secretion oral mucosa becomes drier and fragile
81
developmental pearls: ear
``` decreased hearing - presbyacusis- loss of ability to perceive or discriminate sounds high-pitched sound diminishes first decreased speech discrimination presents social/safety implications ```
82
developmental pearls: eye
development of cataratcs, glaucoma, macular degeneration, presbyopia [loss of near-sightedness] visual acuity decreases, particularly after 70 years of age pupils small in old age eyebrows may show loss of hair arcus senilis may occur
83
developmental pearls: lungs
decline in respiratory muscle strength results in decreased ability to cough loss of elasticity causes more rigid lung decreased alveoli causes less gas exchange decreased ventilation causes dyspnea with exertion kyphosis due to osteoporosis can cause decrease lung expansion
84
developmental pearls: heart
stiffening of the coronary arteries slight increase in left ventricular wall thickness thickening of the valves gradual rise in systolic blood pressure common with aging increase incidence of arrhythmias: ectopic beats are more common and may compromise [decrease] cardiac output chest often increases in anteroposterior diameter with aging arteriosclerosis- peripheral blood vessels more rigid dorsalis pedis and posterior tibia pulses are more difficult to palpate loss of hair on legs, thin shiny skin, thick nails
85
developmental pearls: abdomen
esophageal emptying is delayed increasing risk for aspiration abdominal musculature loses must of its tone increased fat deposition in abdominal area gastric acid secretion decreases which may interfere with vitamin B12 absorption
86
male genitourinary abnormalities
benign prostatic hypertrophy can be progressive incomplete voiding results in bacteria in the bladder and an increased risk of urinary tract infection urinary bladder stones are formed from the crystallization of salts in the residual urine
87
phalen's test
procedure in which the wrist is maintained in flexion paresthesia occurring in the distribution of the median nerve within 60 seconds may be indicative or carpal tunnel syndrome

NURS112 (4 decks)

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