general health assessment Flashcards
adolescent age 11-10
first exam
how often
what to look for
first exam 11-14 years
three visits 11-14, 15-17, 18-21
height, weight, skin, oral cavity (gingivitis and dental caries) abuse, neglect, depression , look for eating disorders, BP normal is less than 120/80
adolescent age 11-10
vaccine for HPV
gardisil 9 age 9-14 15-26 series of tow six months apart series of 3 at 0,2 and 6 months
adolescent age 11-10 syphilis screening for both
when sexually active, PRN or with pap smear
reccomend breast and testicular exam
self exam monthly
adolescents 11-19 and hiv
depends on level of sex or drugs, talk abouut prevention
adolescents 11-19 meningococal (menactra/menveo
all adolescents ages 11-18- controversial- revac 1x for high risk, college freshman living in dorms 5 years from last vax
adolescents 11-19 pneumococcal vax
age 19-64 if smoking, asthma, COPD or ETOH
adolescents and PPD
once during adolescence, and every two years or with exposure
age 20-39 physical females
pap smear (with with GC and chlamydia screens)
cytology - conventional or liquid based
HPV co test (Cytology +HPV test administerd together
self breast exam
clinical breast exam
and HPV vax
tetanus and diptheria boster timing
every 10 years
mammography timing
annually for age 45-54 and q 2 theirafter
USPSTF q2 50-74
ACOG annually 50-74
all males over 50years of age should have a digital rectal exam and a PSA test.
annually
colorectal cancer screening
annual FOBT
flex sig q5 years
colonoscopy q 10 starting at age 45
major mortality cause age 12-19
MVC suicide accidents homicide malignancy CV or congenital disease
major mortality cause age 20-39
MVC's Homicide suicide injuries heart disease AIDS
major mortality cause age 40-59
heart disease accidents lung cancer CVA breast and colorectal CA COPD
Elderly adult over 60 years
Heart disease CVA COPD pneumonia or influenza lung and colorectal CA
my plate
half your plate is fruits and veggies
switch to skim milk or 1%
half your grains are whole grains
vary protein in food choices
diet recs for carbs
55-60%
diet recs for fats
less than 30% of total calories with less than 10 percent being saturated fats
diet recs for proteins
0.8-1.0g/kg/day
protien needs with illness
overall nutritional and protein needs increase with illness, trauma etc
benifits of exercise
decreases LDL's increases basal metabolic rate' reduces stress improves cardiovascular fitness decreases the signs of aging
AHA exercise recs
at lease 30mins or more on most days
if you are over 35 and have never exercised you should
complete physical with history
physical exam
exercise stress test
antigens
substences capable of inducing a specific immune response
antibodies
molecules synthesized in reaction to antigen
active immunity
conferrd by atbody formation stimulated with a specific antigensuch as typhoid fever immunization and toxoids
passive immunity
maternal or from gamma globulin
PPSV vax who gets it
over 65 years old 19-64 who smoke or have asthma heart, lung, kidney, liver disease, chronic disease, like DM, cirrhois, sickle cell, CSF leak, cochlear implant and ETOH weak immune system or no spleen nursing home or LTC patients
hep A vaccine
for military personel, travelers to endemic areas, dudes banging dudes,
hep B vaccine
health care workers, and high risk pts including sexually active adults
mumps va for health care workers before and after 1957 birth
born before- 1 dose unless evidence of immunity, clinically diagnosed mumps or positive serology
born after 57- 2 doses of vax unless documented immunity
in mumps outbreak
give people 2 doses of vax unless immune
mumps post vaccine titers
post vax serology may be negative, vax gives lower antibody titers than natural infection.
meningococcal vax
approved for ages 2-55, reccomended routinely fr adolescents age 11-12 at the annual visit, and a “catch up” for college students, military personnel, immunocompromised, travelers to africa, clinical effectivness is questionable
herpes zoster vax shingrix
CDC preferred , reccomended for immnocompetent adults, aged 50 or older, even if pt has had zostavax previously
herpes zoster vax zostavax
for age 60 or older, efficacy waynes after 5 years.
cultural considerations AA
may discontinue meds when symptoms resolve
touch is viewed as essential, personal space may be minimal
rely on religion and ministers
health is a gift from god
cultural considerations AA folk remidies
cod liver oil to prevent colds
copper or siler braclets to protect from harm
voodoo for hatians
cultural consideratins hispanics
discontinue meds when symptoms abate- particular problems for diabetics
high esteem for matriarchs
balance of hot and cold and wet dry concepts
PCNis a Hot med
cultural consideations hispanics mal de ojo
evil eye
illness prevention strategies include eating well, working, sleeping with relics and being religious
cultural considerations hispanics caranderas
holistic healer- erbs etc
cultural consideration hispanic adiction
it is a concern
may expect injections as a componenet of effective treatment oral may be viewed as less effective
cultural considerations asians
eye contact my be seen as disrespectful
diabetes is less common
well insured only 18% uninsured
longer life expectancy and lower death rates
cultural consideratioons asians religion
shinto relgion- pleasing good spirits is essential to good helath
japanese cultural considerations
may prefer femal to femal providers
drug safety is more important than effectivness
may explain habid of using lower doses to get fewer side effects
chinese cultural considerations
yin is cold yang is hot
cold illness is diarrhea- treated with erbs and food
hot illness HTN treated with cold erbs and food
may diagnose illness by pulses texture and or color of tongue
traditional chinese medicine
may teach that you can permenantly remote the underlying disorder symptoms and the disease as well.
often try traditional medicine first
philipino
agin yin and yang
amulets can be a shield
native americans CC
50years or older can be an elder
ilness may be imbalance between spirtual and physical world
