HA Exam #2 Flashcards
24-hour diet recall
-What a person has consumed within a 24-hour period
-during this recall, find out if this is a consistent diet
Food diaries
most detailed and very specific food recall
Direct Observation
watching someone eat/ watching someone be fed
What factors have been seen to help people reach and maintain good health and reduce chronic disease?
healthy eating patterns and regular physical activity
What are the 12 health history questions for nutritional subjective data?
- Eating Patterns
- Usual Weight
- changes in appetite, taste, smell, chewing and swallowing
- recent surgery, trauma, burns and infections
- Chronic illness
- vomiting, diarrhea, constipation
- food allergies
- medications and or nutritional supplements
- self care
- alcohol and drugs
- exercise and activity patterns
- family history
What are you observing in the skin during a nutritional assessment?
skin should be smooth, no bruises, rashes, or flaking
What are you observing in the hair during a nutritional assessment?
should be shiny, scalp intact and without lesions, and does not fall out easily
What are you observing in a pts eyes during a nutritional assessment?
corneas are clear and shiny, membranes pink and moist, no bumps or sores
What are you observing on the lips during a nutritional assessment?
should be smooth not chapped, cracked or swollen
Tongue (nutritional assessment)
should be red, not swollen or abnormally smooth and no lesions
gums (nutritional assessment)
should be pink and moist, no swelling or bleeding
nails (nutritional assessment)
smooth and pink
Derived body weight measures include…
-body weight as a percent of ideal body weight
-percent usual body weight
-recent weight change
Body mass index
marker of optimal weight for height and indicator for obesity and protein-calorie malnutrition
BMI= weight (kg)/height(m)^2
BMI of <18.5
underweight
BMI of 18.5-24.9
normal weight
BMI of 25.0-29.9
overweight
BMI of 30.0-39.9
obesity
BMI greater than or equal to 40
extreme obesity
What are the indicators for iron status?
hemoglobin and hematocrit
What are the indicators for cardiovascular risk?
Cholesterol with Triglycerides, LDL and HDL levels
Marasmus
protein-calorie malnutrition (skinny looking people and can be visibly seen)
Kwashiorkor
protein malnutrition (inside your body can not necessarily be seen on the outside)
Epidermis
-replaces every 4 weeks
-outermost layer; thin but tough
-houses keratin
Dermis
-inner supportive layer
-consists of connective tissue (collagen) and elastic tissue
-nerves, sensory receptors, blood vessels and lymphatics are housed here
SubQ
-adipose tissue
-stores fat for energy, insulation and temp control, and cushions and protects
What are the functions of the skin?
-Protection (Thermal, physical, chemical, UV, and microorganisms)
-Perception
-Temp regulation (loss thru sweat and gain thru storage in adipose tissue)
-identification
-communication
-wound repair
-absorption and excretion
-Vit D production
Lanugo
fine hair
Vernix Caseosa
white, cheesy substance
Linea nigra
mid-abdominal dark line from stomach growth
Striae Gravidarum
stretch marks
Keloids
scars with increased height and width
Pigmentary disorders
increased incidence of pigment problems
Pseudofolliculitis
razor burn/bumps, ingrown hairs
Melasma
patchy tan to dark brown discoloration of the face
What is ABCDE?
Asymmetry, border, color, diameter, and evolving
Pruritis
itching
What can hair loss on the lower extremities mean?
loss of circulation
What should you assess first?
hands
Nevus
mole
Pallor
white, anemia, shock, anxiety fear, exposure to cold etc
Erythema
redness, fever, inflammation
Cyanosis
blue, decreased perfusion, unoxygenated Hgb
Jaundice
yellow, excessive bilirubin; sclera and hard and soft palate of the mouth
Sunken fontanel
top of the infants head
Anasarca
generalized edema
Cherry angioma
bright red dots
ecchymosis
bruising
160 degree nail base is considered..
normal
a nail base greater than 180 is considered
late clubbing
What are the 3 parts of the sternum ?
manubrium, body and xiphoid process
How many ribs do you have and where are they located?
You have 12 pairs of ribs
-1-7 attached to the sternum
-8-10 attached to the costral margin above
-11-12 are floating
How many thoracic vertebra are there?
12
Acinus
functional respiratory unit (bronchioles, alveolar ducts, alveolar sacs, and alveoli)
Apgar Scoring system
-used for newborn’s initial respiratory assessment
*7-10: good condition
*3-6: moderately depressed
*0-2: severely depressed
What are the functions of respiration?
- Supplying oxygen
- removing CO2
- maintaining acid base balance
- maintaining heat exchange
What is a normal ratio for comparing the anteroposterior to the transverse diameter?
1:2 or 5:7
Cheyene-strokes respirations
cyclic gradually wax and wane in regular pattern with periods of apnea
Where is the respiratory center in the brain?
pons and medulla
Biot’s Respirations
irregular patterns with periods of apnea
Chronic obstructive breathing
normal inspiration with prolonged expiration (from increased airway resistance)
Barrel Chest
anteroposterior to transverse diameter is equal
Pectus excavatum
“funnel chest” sunken sternum (inward)
Pectus Carninatum
“pigeon breast” forward protrusion
Symmetric expansion
note any lag in expansion
Tactile Fremitus
a palpable vibration, produced by the larynx
Decreased Fremitus
any obstruction of vibration
Increased fremitus
occurs with compression or consolidation of lung tissue
Pleural Friction fremitus
results from inflammation of the pleura
What does hyperresonance over the adult lung indicate?
emphysema or pneumothorax
Diaphragmatic excursion
map out the lower lung border in inspiration and expiration by use of percussion
What should the difference be between inspiration and expiration ?
it should be equal bilaterally and be 3-5 cm
Crackles
high pitches popping
Rhonchi
long, low pitched, course gurgling
Friction Rub
harsh grating sound
Wheezes
high-pitched whistling sound
Bronchophony
have pt say 99 (increased transmission of voice with increased density or consolidation)
Egophony
have pt say “ee” (sounds like an a with consolidation)
Whispered pectoriloquy
have pt whisper a phrase (normally faint, muffled increased with consolidation)
Cervical nodes:
drain the head and neck
Axillary nodes
drain the breast and upper arm
Epitrochlear node
drains the hand and lower arm; located in the antecubital fossa
Inguinal nodes
drain the lower extremities, the external genitalia and the anterior abdominal wall
Bilateral edema
indicated a systemic problem
Unilateral edema
indicates an obstruction or inflammation
What do enlarged nodes indicate?
infection, immunologic disease or malignant disease
What does a full bounding pulse indicate?
exercise, anxiety, fever and hyperthyroidism
What does a weak and thready pulse indicate?
shock and peripheral arterial disease
Epitrochlear lymph nodes are located in the
anticubital fossa
Inguinal lymph nodes are located in the
groin
What does an enlarged epitrocheal node indicate?
infection of the hand or forearm
Signs of arterial insufficiency
pallor, coolness, diminished pulse and strength
Unilateral swelling
signifies a local problem
Bilateral swelling
indicates a systemic problem
Bruit
indicated turbulent blood flow from partial occlusion
Venous ulcers
located on medial malleolus
Arterial ulcers
located on tips of toes, metatarsal heads, or lateral malleoli
Modified Allen Test
evaluates the adequacy of collateral circulation prior to cannulating the radial artery
*persistent pallor or sluggish return of color indicates occlusion of collateral circulation
Precordium
region on the anterior chest, over the heart and great vessels
Mediastinum
the middle third of the thoracic cavity between the lungs, contains the heart and great vessels
Base of the heart
the top
Apex of the heart
bottom of the heart
What are the 2 atrioventricular valves?
tricuspid and mitral
What are the two semi-lunar valves?
pulmonic and aortic valve
P wave
depolarization of the atria
PR interval
from the start of P wave to the beginning of QRS
QRS
depolarization of ventricles
T wave
repolarization of ventricles
QT interval
electrical systole of the ventricles
S1 heart sound
closure of the Mitral and Tricuspid valves
S2 heart sound
closure of the aortic and pulmonic valves
S3 heart sound
“ventricular gallop”
caused by ventricles being resistant to filling during the rapid filling phase
systolic heart failure
S4 heart sound
“atrial gallop”
present at the end of diastole with resistance of the ventricles to filling
diastolic heart failure
Murmurs
result from turbulent blood flow caused by :
-increased velocity
-decreased viscosity
-structural defects
What are heart sounds described by:
-frequency or pitch
-intensity or loudness
-duration
-timing
What side of the stethoscope is used for soft, low-pitched sounds?
the bell (specifically for murmurs and extra heart sounds)
What is your cardiac output?
4-6 L/min (stroke volume x HR)
Preload
venous return, the volume of blood in the ventricle at the end of diastole
Frank-Starling Law
the greater the stretch, the stronger the cardiac contraction
After load
The resistance the heart has to pump against
Foramen Ovale
opening in the atrial septum, closes within 1st hour after birth
Ductus arteriosus
opening between the aorta and pulmonary artery, usually closes within 10-15 hrs after birth
What happens to your arterial pressure during pregnancy?
it decreases (reaches lowest point during 2nd trimester)
What is a characteristic sign of angina?
clenched fist
What is a heave or lift?
a sustained forceful thrusting of the ventricle during systole
where is the aortic valve located
second right intercostal space
where is the pulmonic valve located
second left intercostal space
where is the tricuspid valve located
left sternal border
where is the mitral valve located
fifth interspace near the left midclavicular line
Patent Ductus Arteriosus
persistence channel between left pulmonary artery to the aorta
Arteriosus septal defect
abnormal opening in atrial septum
Ventricular septal defect
abnormal opening in ventricular septum
