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Health Assessment > Midterm > Flashcards

Midterm Flashcards

1
Q

What are the two primary components of health assessment?

A

Health history and physical exam

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2
Q

What are the three phases of an interview?

A

Introduction, discussion, and summary

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3
Q

What is the single most important skill for successful interviewing?

A

Therapeutic communication

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4
Q

What are three types of questions you may use in an interview?

A

Open ended, close ended, or directive

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5
Q

Techniques that enhance data collection?

A 
Active listening
Facilitation
Clarification
Restatement
Reflection
Confrontation
Interpretation
Summary
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6
Q

Types of health histories?

5

A 
Comprehensive 
Focused
Follow up 
Shift
Screening
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7
Q

Components of comprehensive health history?

8

A 
Biographic data
Reason for seeking care
History of present illnesses
Present health 
Past medical history
Family history
Personal/psychosocial history
Body systems review
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8
Q

History of present illness acronym

A

Onset
Location
Duration

Characteristics
Aggravating and alleviating
Related symptoms
Treatment
Severity
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9
Q

Four techniques of physical assessment

A

Inspection
Palpation
Percussion
Auscultation

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10
Q

What is considered light palpation?

What is It used for?

A

About 1 cm

Assess skin, pulsations, and tenderness

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11
Q

What is considered deep palpation?

What is It used for?

A

Pressing about 4 cm deep using one or two hands

Organ size and contour

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12
Q

Five percussion tones

A 
Tympany: loud, Over abdomen
Resonance: normal lung tissue
Hyper resonance: overinflated lungs (emphysema)
Dullness: over liver
Flatness: over bones and muscles
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13
Q

4 things you listen for with auscultation

A

Intensity
Pitch
Duration
Quality

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14
Q

3 types of thermometers to measure body temperature

A

Electronic
Tympanic
Temporal

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15
Q

Two components of stethoscope head and what they are for

A

Diaphragm: flat bigger surface
Used for high pitched - breath, bowel, normal heart sounds

Bell: concave smaller surface
Used for lower pitched - extra heart sounds, vascular sounds (bruit)

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16
Q

The nursing process?

A 
Assessment
Diagnosis
Outcome identification
Planning
Implementation
Evaluation
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17
Q

General inspection

4 initial impressions that guide nurse

A

Physical appearance and hygiene
Body structure and position
Body movement
Emotional and mental status and behavior

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18
Q

Expected temperature ranges:

Average temperature:

A
  1. 4 to 99.1 F

98. 6 F or 37 C

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19
Q

Where on the body is the apical pulse taken?

A

Located over the 5th intercostal space at the midclavicular line

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20
Q

Where do men typically breathe?

Women?

A

Men: diaphragmatically
Women: thoracic

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21
Q

What is blood pressure?

A

It is the force of blood against arterial walls

Reflects relationship between cardiac output and peripheral resistance

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22
Q

What is systolic pressure?

Diastolic?

A

Systolic: maximum pressure exerted on arteries when ventricles eject blood from heart
Diastolic: minimum amount of pressure exerted in vessels when ventricles relax

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23
Q

What describes orthostatic bp?

A

A series obtained from a bp taken while a patient is sitting, then taken when standing, then taken when standing for over a minute
A 20-30 mm Hg drip indicates orthostatic hypotension

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24
Q

Which bp sound is heard first?

A

Systolic is the first korotkoff sound

Diastolic is the last korotkoff sound

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25
Q

Factors that may affect bp

A

Age: bp increases
Gender: men typically have higher until women hit menopause
Race: hypertension is twice as high in blacks
Diurnal: pressure is lower in the morning and highest in the late afternoon

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26
Q

Errors in bp

Cuff size?

A

Cuff size too big: inaccurate low reading

Too small: inaccurate high reading

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27
Q

What is oxygen saturation?

A

The amount of oxygen carrying hemoglobin in the blood

Should be 98% or higher

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28
Q

What are the 6 types of pain?

A 
Acute 
Chronic
Nociceptive
Neuropathic
Referred
Phantom
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29
Q

What are the 4 standards for pain assessment?

A

Pain is assessed
Initial assessment then reassessment considering personal, cultural, spiritual, and ethnic beliefs
Education of all relevant providers
Education of patients and families in managing pain

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30
Q

Pain threshold:

A

A point at which a stimulus is perceived as pain - does not vary

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31
Q

Pain tolerance:

A

Duration or intensity of pain a person can endure before outwardly responding - May increase or decrease

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32
Q

What does the integumentary system consist of? 5

A 
Skin
Hair
Nails
Sweat glands
Sebaceous glands
33
Q

What is the Braden scale used for?

What is the scale?

A 
Predicting pressure ulcers
Measures sensory perception, moister, activity, mobility, nutrition, friction and shear
Score each and calculate risk total
Range 6-23 lower scores are worse
Very high risk: 9 or less
No risk: 19-23
34
Q

Acronym used for examining lesions

A 
Asymmetry
Border
Color
Diameter
Evolving
35
Q

Mental status: degree of competence that a person shows (4)

A

Intellectual
Emotional
Psychological
Personality

36
Q

3 commonly reported problems of mental health:

A

Depression
Anxiety
Altered mental status

37
Q

Are men or women more at risk for depression?

A

Women 2:1

38
Q

How to determine altered mental status. Patient must be alert and oriented to what 4 things?

A

Person, time, place, and situation

If all four: A&Ox4

39
Q

How do you assess for short term memory?

A

Ask patient to repeat three unrelated objects you had told them to remember previously

40
Q

What might you use for an alcoholic interview?

A

An AUDIT

41
Q

What is the snellen eye chart used for?

A

Visual acuity: far

Stand 20 feet away

42
Q

What is the rosenbaum vision screener used for?

A

Visual acuity: close
Hold card 14in away
If you see a person older than 40 hold the chart farther away - has presbyopia - decrease in accommodation

43
Q

What is PERRLA?

A

Pupils Equally Round and Reactive to Light and Accommodation

44
Q

How do you inspect auditory acuity?

A

The whisper test or the finger rubbing test

Cover your mouth and whisper
Hold fingers 3-4 in away and rub

45
Q

What do you do if decreased hearing is observed?

A

Rinne test

Uses a tuning fork to assess air conduction compared to bone conduction

46
Q

What is patency of nares?

A

Determination of air flow through the nose
Nostril clear? Patent
Nostril congested? Nonpatent

47
Q

What are some topographic markers for listening to the lungs?

A

Clavicle: listen for apex

48
Q

Documentation of pack years for smoking is done using what equation?

A

years pt smoked x # packs per day

49
Q

At what degree should the ribs be?

A

Ribs should be at a downward slope

45 degrees relative to spine

50
Q

How many lobes does the left lung have?

The right?

A

Left: 2 lobes
Right: 3 lobes

51
Q

Anterior thorax shape should have what ratio?

A

Anteroposterior to lateral

1:2

52
Q

What are adventitious sounds?

A

Aka rales

Wheezing, rhonchi, or pleural friction rub

53
Q

What are the 3 types of normal breath sounds?

A

Bronchial
Bronchovesicular
Vesicular

54
Q

What is resonance?

A

The low pitched, clear, hollow sound of healthy lung tissue

55
Q

What is pleural effusion?

A

The accumulation of serious fluid in pleural space between visceral and parietal pleurae

56
Q

What are the atrioventricular valves?

A 
The tricuspid (right)
Mitral (left)
57
Q

What are the semilunar valves?

A 
The aortic (left)
Pulmonic (right)
58
Q

What does the lymph system do?

A

Works with pvs in removing fluid from interstitial spaces

59
Q

What is the sa node?

The av node?

A

Sa: the pacemaker, discharges 60-100 impulses per minute
Av: prevents excessive atrial impulses to rv and lv

60
Q

What happens if the sa node fails?

A

At node can generate ventricular contraction at a slower rate
40-60 impulses per minutes

61
Q

What happens if sa and av nodes are ineffective?

A

Bundle branches may contract but at a very slow rate

20-40 impulses per minute

62
Q

What is left sided heart failure?

A

Insufficient flow to aorta - backs into pulmonary capillaries
Pt feels fatigue, sob, orthopnea, doe
Exam: s3 sounds present, palpable thrill, displaced apical pulse

63
Q

What is right sided heart failure?

A

Failure to pump blood into pulmonary arteries causes backflow into inferior and superior vc
Exam: s3 sounds at lower arsenal border, weight gain, systolic murmur, peripheral edema

64
Q

What is angina pectoris?
Clinical findings in men?
Women?

A

Ischemia of the heart
Men: pressure in chest, suffocating/constricting sensation
Women: sharp jaw pain, burning chest, dyspnea, soap hoses is, nausea, fatigue, epigastric pain; or none at all

65
Q

What constitutes an MI?

Which side is more affected?

A

Myocardial ischemia sustained, resulting in death of myocardial cells

Lv is more commonly affected than rv

66
Q

What does a stent with balloon angioplasty do?

A

It is inserted when there is a build up and blockage of blood flow through the artery. The balloon is inflated once in place, the balloon is then removed and the inflated stent It in place.

67
Q 
PVS issue: hypertension
What is now normal bp?
What is considered high?
Stage 1?
Stage 2?
Crisis?
A

Normal: less than 120/80
High: systolic between 120-29 and diastolic under 80
Stage one: systolic 130-39 or diastolic 80-89
Stage two: systolic >140 or diastolic >90
Crisis: systolic >180 and/or diastolic >120

68
Q

What are symptoms of arterial insufficiency?

A 
Cramps in calf
Pain worse with activity
Relief by rest: intermittent claudication 
Not relieved by rest: rest pain
Worse with legs elevated
69
Q

What are symptoms of venous insufficiency?

A

Intensifies with prolonged standing/sitting
Pain worse in dependent position
Pain better when legs are elevated
Worse at the end of the day

70
Q

What is done during a pvs exam?

A

Inspection for gen appearance, skin, and breathing effort
Palpate temporal and carotid pulses for amplitude
Inspect jugular vein for pulsations
Measure bp

71
Q

What is expected with neck vein distention?

A

Pulsations are visible as well as the vein itself

72
Q

What is the putting edema scale?

A

1+ barely perceptible 2mm
2+ deeper, but rebounds quickly 4mm
3+ deep, rebounds 10-20 sec 6mm
4+ deep, rebounds >30 sec 8mm

73
Q

What is the amplitude scale?

A 
0+ absent
1+ diminished, barely palpable 
2+ normal
3+ full volume
4+ full volume, bounding
74
Q

What is the acronym for the cardiac assessment - listening to the heart?

A

APE To Man

Aortic
Pulmonic
Erb’s point
Tricuspid
Mitral
75
Q

Where is S1 in the heart beat?

Where is It louder?

A

The beginning of systole

Louder at the apex

76
Q

Where is S2 at within the heart sound?

Where is It louder?

A

S2 is at diastole

Louder at the base

77
Q

Where is the apical pulse taken at?

A

The 5th intercostal space at the left midclavicular line

78
Q

What is pmi?

A

This is the point of maximal impulse

This is at the apex

Health Assessment (3 decks)

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