Fundamentals Chapter 30

Question 1

Alcohol

Answer 1

Oral cavity/Ingestion of alcohol, diabetes

Question 2

Ammonia

Answer 2

Urine/Urinary tract infection, renal failure

Question 3

Body odor

Answer 3

Skin, particularly in areas where body parts rub together (e.g., underarms and uPoor hygiene, excess perspiration (hyperhidrosis), foul-smelling perspiration (bromhidrosis)nder breasts)/

Question 4

Feces

Answer 4

Vomitus/oral cavity (fecal odor)

Bowel obstruction

Rectal area
Fecal incontinence

Question 5

Foul-smelling stools in infant

Answer 5

Stool/Malabsorption syndrome

Question 6

Halitosis

Answer 6

Oral cavity/Poor dental and oral hygiene, gum disease

Question 7

Sweet, fruity ketones

Answer 7

Oral cavity/Diabetic acidosis

Question 8

Stale urine

Answer 8

Skin/Uremic acidosis

Question 9

Sweet, heavy, thick odor

Answer 9

Draining wound/Pseudomonas (bacterial) infection

Question 10

Musty odor

Answer 10

Casted body part/Infection inside cast

Question 11

Fetid, sweet odor

Answer 11

Tracheostomy or mucus secretions/Infection of bronchial tree (Pseudomonas bacteria)

Question 12

Techniques of Physical Assessment

Answer 12

four techniques used in a physical examination are inspection, palpation, percussion, and auscultation.

Question 13

Inspection

Answer 13

occurs when interacting with a patient, watching for nonverbal expressions of emotional and mental status. Physical movements and structural components can also be identified in such an informal way. Most important, be deliberate and pay attention to detail.

Question 14

Guidelines for Inspection

Answer 14

Make sure that adequate lighting is available, either direct or tangential.

• Use a direct lighting source (e.g., a penlight or lamp) to inspect body cavities.
• Inspect each area for size, shape, color, symmetry, position, and abnormality.
• Position and expose body parts as needed so all surfaces can be viewed but privacy can be maintained.
• When possible, check for side-to-side symmetry by comparing each area with its match on the opposite side of the body.
• Validate findings with the patient.

Question 15

PALPATION

Answer 15

involves using the sense of touch to gather information. Through touch you make judgments about expected and unexpected findings of the skin or underlying tissue, muscle, and bones.

Question 16

PERCUSSION

Answer 16

involves tapping the skin with the fingertips to vibrate underlying tissues and organs. The vibration travels through body tissues, and the character of the resulting sound reflects the density of the underlying tissue. The denser the tissue, the quieter the sound. By knowing how various densities influence sound, it is possible to locate organs or masses, map their edges, and determine their size. An abnormal sound suggests a mass or substance such as air or fluid within an organ or body cavity.

Question 17

Auscultation

Answer 17

Involves listening to sounds the body makes to detect variations from normal. Some sounds such as speech and coughing can be heard without additional equipment, but a stethoscope is necessary to hear internal body sounds.

Question 18

cyanosis

Answer 18

(bluish discoloration) in the lips, nail beds, palpebral conjunctivae, and palms. In recognizing pallor in the dark-skinned patient, observe that normal brown skin appears to be yellow-brown and normal black skin appears to be ashen gray. Also assess the lips, nail beds, and mucous membranes for generalized pallor; if pallor is present, the mucous membranes are ashen gray. Assessment of cyanosis in the dark-skinned patient requires observing areas where pigmentation occurs the least (conjunctiva, sclera, buccal mucosa, tongue, lips, nail beds, and palms and soles). In addition, verify these findings with clinical manifestations (Seidel etal., 2011).

Question 19

Pallor (decrease in color)

Answer 19

Reduced amount of oxyhemoglobin/Anemia/Face, conjunctivae, nail beds, palms of hands

Question 20

Loss of pigmentation

Answer 20

Vitiligo/Congenital or autoimmune condition causing lack of pigment/Patchy areas on skin over face, hands, arms

Question 21

Yellow-orange (jaundice)

Answer 21

Increased deposit of bilirubin in tissues/Liver disease, destruction of red blood cells/Sclera, mucous membranes, skin

Question 22

Red (erythema)

Answer 22

Increased visibility of oxyhemoglobin caused by dilation or increased blood flow/Fever, direct trauma, blushing, alcohol intake/

Face, area of trauma, sacrum, shoulders, other common sites for pressure ulcers

Question 23

Tan-Brown

Answer 23

Increased amount of melanin/Suntan, pregnancy/Areas exposed to sun: face, arms, areolas, nipples

Question 24

Hyperopia

Answer 24

Hyperopia is farsightedness, a refractive error in which rays of light enter the eye and focus behind the retina. Persons are able to clearly see distant objects but not close objects.

Question 25

Myopia

Answer 25

Myopia is nearsightedness, a refractive error in which rays of light enter the eye and focus in front of the retina. Persons are able to clearly see close objects but not distant objects

Question 26

Presbyopia

Answer 26

Presbyopia is impaired near vision in middle-age and older adults, caused by loss of elasticity of the lens and associated with the aging process.

Question 27

Retinopathy

Answer 27

Retinopathy is a noninflammatory eye disorder resulting from changes in retinal blood vessels. It is a leading cause of blindness

Question 28

Strabismus

Answer 28

Strabismus is a (congenital) condition in which both eyes do not focus on an object simultaneously; these eyes appear crossed. Impairment of the extraocular muscles or their nerve supply causes strabismus.

Question 29

Cataracts

Answer 29

A cataract is an increased opacity of the lens, which blocks light rays from entering the eye. Cataracts sometimes develop slowly and progressively after age 35 or suddenly after trauma. Cataracts are one of the most common eye disorders. Most older adults (65 years old and older) have some evidence of visual impairment from cataracts.

Question 30

Glaucoma

Answer 30

Glaucoma is intraocular structural damage resulting from elevated intraocular pressure. Obstruction of the outflow of aqueous humor causes this. Without treatment the disorder leads to blindness.

Question 31

Macular Degeneration

Answer 31

Macular degeneration is blurred central vision often occurring suddenly, caused by a progressive degeneration of the center of the retina. It is the most common visual impairment of individuals over age 50 and the most common cause of blindness in older adults. There is no cure.