Head to toe

Question 1

when are any assessments done?

Answer 1

on admission
at the beginning & throughout the shift
upon occurrence of episodic health challenges
with changes in pt. status

Question 2

Chest auscultation

Answer 2

APETM

Aortic, pulmonic, eras, tricuspid & mitral

Question 3

Factors influence quality of assessment

Answer 3

• nurse knowledge & competency
• presenting health problem & concurrent health challenges
• stability of the pt.
• communication barriers or cognitive limitations
• effects of meds (analegesic)
• time contstrains
• pain, anxiety, fear

Question 4

When is a H to T done

Answer 4

pt. first entry into clinic or hospital

Question 5

when is quick priority assessment done

Answer 5

every * hr. Carried out as a rapid assessment to familiarize one self with a patient at shift change or change in assigment

Question 6

when is a focused assessment done

Answer 6

when there is a particular problem or issues with a status change

Question 7

developmental concerns for young child

Answer 7

• may be fearful
• sit on parents lap up to 3 year
• provide a toy
• focus on parent while child has toy
• head to toe
• hisotry includes developement
• evaluate motor skills, posture, alignment of legs, speech vision & hearing

Question 8

with experience

Answer 8

you can know what to omit when u don’t have time

Question 9

general survey is

Answer 9

objective

Question 10

health history includes

Answer 10

1) biographical data
2) reason for seeking care
3) present health or history of illnes
4) past hisotyr
5) family history
6) review of systems
7) functional assessment / ADLS
8) meds