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Health Assessment > Midterm Exam > Flashcards

Midterm Exam Flashcards

1
Q

Comprehensive Health Assessment

A

everything including health history, head-to-toe assessment, a baseline for the patient

used for a patient entering a new facility

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2
Q

Problem-Based or Focused Health Assessment

A

based on problem or specific area of patient

used in ER or express clinic

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3
Q

Episodic Assessment

A

check on specific episode, check up after focused normally

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4
Q

Shift Assessment

A

thorough assessment at start of shift to detect changes

done every 12 hours

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5
Q

Screening Assessment

A

mammogram, pap smear, an assessment to detect early issues

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6
Q

Subjective vs. Objective Data

A

subjective: coming from patient (pain)
objective: info collected by you (via exam)

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7
Q

Primary vs. Secondary Data

A

primary: comes from patient directly
secondary: comes from another person (family member) or chart

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8
Q

Types of Prevention (Primary, Secondary, Tertiary)

A

primary: preventing disease from developing through promoting healthy lifestyle (diet, exercise, sleep)
secondary: screening efforts to promote early detection of disease (mammogram, pap smear, blood test)
tertiary: minimizing disability from acute or chronic illness or injury and allowing for most productive life within limitations (take meds, exercise, diet)

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9
Q

Standard Precautions

A

apply in all health care settings

hand hygiene
utilize PPE as necessary
proper management of patient care equipment

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10
Q

Techniques used for assessment

A

inspection, palpation, percussion, auscultation

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11
Q

Areas of hands to use for palpation (heat, vibration, texture, masses)

A

palmar surface of fingers and finger pads are more sensitive than fingertips (texture, size)
ulnar surface of hand to fifth finger is most sensitive to vibration
dorsal surface is better for assessing temperature

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12
Q

Temperature

A

regulated by hypothalamus
expected range from 96.4 - 99.5 F

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13
Q

Oral vs. Axilla vs. Rectal

A

Oral is considered accurate
Axilla is one degree lower than oral
Rectal is one degree higher than oral

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14
Q

Heart Rate/Pulse

A

heart rate: number of times in a minute a pulsation is felt
rhythm: regularity of pulsations or time between each beat
amplitude: strength of pulse and perfusion of blood to various parts of body (0, 1+, 2+, 3+)

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15
Q

Respiratory Rate

A

rate: breaths per minute
rhythm: regular or irregular pattern
depth: shallow, moderate, or deep

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16
Q

Oxygen Saturation

A

lower than 90% is considered abnormal and require further evaluation

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17
Q

Normal Blood Pressure

A

less than 120 and less than 80

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18
Q

Elevated Blood Pressure

A

120-129 and less than 80

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19
Q

High Blood Pressure (Hypertension Stage 1)

A

130-139 or 80-89

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20
Q

High Blood Pressure (Hypertension Stage 2)

A

140 or higher or 90 or higher

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21
Q

Hypertensive Crisis

A

higher than 180 and/or higher than 120

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22
Q

PQRST Symptom Analysis

A

P - provoking factors
Q - quality
R - region/radiating
S - severity
T - time/treatment

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23
Q

Questions to ask for P in PQRST Symptom Analysis

A

What factors precipitated the pain?
What were you doing at onset of pain?

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24
Q

Questions to ask for Q in PQRST Symptom Analysis

A

Describe pain (ache, sharp, burning)

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25
Q

Questions to ask for R in PQRST Symptom Analysis

A

Where is pain?
Does it radiate?

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26
Q

Questions to ask for S in PQRST Symptom Analysis

A

Rate pain on scale (0-10, FACES, etc)

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27
Q

Questions to ask for T in PQRST Symptom Analysis

A

How long have you had pain?
Is it constant/intermittent?
What have you done to treat pain?

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28
Q

Acute Pain vs. Chronic Pain

A

acute: recent onset and results from tissue damage, is usually self-limiting, and ends when tissue heals
chronic: may be intermittent or continuous pain lasting more than 6 months

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29
Q

Nociceptive Pain vs. Neuropathic Pain

A

nociceptive: somatic structures (bones, joints, muscles) or visceral organs (chest, abdomen, or pelvic areas)
neuropathic: abnormal processing of sensory input by the central or peripheral nervous system (caused by damaged nerves)

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30
Q

Referred Pain vs. Phantom Pain

A

referred: pain felt in location away from injury
phantom: pain felt in an amputated extremity

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31
Q

CAGE Questionaire

A

used to test for alcohol abuse

Have you every felt the need to CUT DOWN on your drinking?
Have you ever felt ANNOYED by criticism of your drinking?
Have you ever felt GUILTY about your drinking?
Have you ever felt the need to drink a morning EYE-OPENER?

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32
Q

AUDIT Tool

A

Alcohol
Use
Disorders
Identification
Test

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33
Q

Mini-Mental State Exam

A

measures cognitive impairment or DEMENTIA

memory
ability to form sentences
simple math problems
repeat simple sentences
reading
writing
copying (drawing)
judgment (give scenario to see what they would do)

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34
Q

Holmes Social Readjustment Rating Scale

A

STRESS assessment

an assessment tool that lists events that could happen in a patient’s life that could affect that patient’s mental health in terms of stress

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35
Q

Role of Neurotransmitters

A

essential role in human emotions and behavior; help transmit messages

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36
Q

Neurotransmitters that affect mental health

A

norepinephrine
serotonin
dopamine
histamine
acetylcholine
Gamma-aminobutyric acid (GABA)

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37
Q

Depression Signs and Symptoms

A

feelings of helplessness and hopelessness and recurrent suicidal thoughts

mood and affect are altered, with extreme sadness or anxiety and agitation

somatic complaints: altered appetite, sleep problems, constipation, headache, and fatigue

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38
Q

Bipolar Disorder Signs and Symptoms

A

episodes of mania, depression, or mixed moods

manic phase: excessive emotional displays, excitement, or hyperactivity accompanied by elation or delusions of grandeur

depressive phase: apathy and feeling of profound sadness, loneliness, guilt, and lowered self-esteem

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39
Q

Delusions

A

beliefs so strong you can’t convince them otherwise

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40
Q

Schizophrenia Signs and Symptoms

A

severe disturbance of thought and associative looseness
impaired reality testing (hallucinations, delusions)
limited socialization

Clinical Findings: flat, blunted or bizarre emotions, disorganized thinking, jumbled or illogical speech, impaired reasoning, autistic thinking: delusions and hallucinations, severe ambivalence

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41
Q

Hallucinations

A

experiences of apparent perception of something that doesn’t exist

can affect any of the 5 senses

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42
Q

Anxiety Signs and Symptoms

A

uneasiness or discomfort from mild anxiety to panic

4 Levels: mild, moderate, severe, panic

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43
Q

Delirium Signs and Symptoms

A

ACUTE AND TREATABLE

disturbance of consciousness and rapidly developing change in cognition

altered level of consciousness, impaired memory, fluctuating attention span, may have hallucinations or delusions, “sundowning” may increase, speech may be rapid, inappropriate or rambling

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44
Q

Dementia Signs and Symptoms

A

CHRONIC AND NONREVERSIBLE

memory impairment, slow onset, consciousness intact but memory, judgment, and calculation impaired, flat affect, may have delusions, speech is slow and incoherent

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45
Q

Stress Signs and Symptoms

A

irritable, angry, impatient, or wound up
overwhelmed
anxious, nervous or afraid

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46
Q

Primary Lesions

A

EXPECTED variations of the skin

moles, freckles, patches, and comedones (acne)

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47
Q

Secondary Lesions

A

some are considered expected

scar

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48
Q

Vascular Lesions (& examples)

A

many are considered common

petechiae, purpura, ecchymosis, angioma

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49
Q

Petechiae vs. Purpura

A

petechiae: tiny, flat, reddish-purple, nonblanchable spots in skin LESS THAN 0.5 cm

purpura: flat, reddish-purple, nonblanchable discoloration in skin GREATER THAN 0.5 cm

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50
Q

Ecchymosis

A

BRUISE

reddish-purple, nonblanchable spot of variable size

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51
Q

Angioma

A

benign tumor consisting of a mass of small blood vessels; can vary in size from very small to large

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52
Q

Stage 1 Pressure Ulcer

A

intact skin w/ nonblanchable redness, usually over a bony prominence; area may be painful, firm, soft, warmer, or cooler compared to adjacent tissue

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53
Q

Stage 2 Pressure Ulcer

A

partial-thickness loss of dermis; presents as a shiny or dry shallow open ulcer w/ pink wound bed w/out slough or bruising; may also present as an intact or open/ruptured serum-filled blister

54
Q

Stage 3 Pressure Ulcer

A

full-thickness skin loss involving damage to or necrosis of subcutaneous tissue; subcutaneous fat may be visible, but bone, tendon, or muscles are not exposed; slough may be present; wound may include undermining and tunneling

55
Q

Stage 4 Pressure Ulcer

A

full-thickness tissue loss w/ exposed bone, tendon, or muscle; slough or eschar may be present w/in wound bed; undermining or tunneling often present

56
Q

Unstageable Pressure Ulcer

A

full-thickness tissue loss in which the actual depth of the ulcer is completely obscured by slough and/or eschar in the wound bed

57
Q

Vesicle vs. Pustule vs. Bulla

A

vesicle: elevated, circumscribed, superficial, not into dermis; filled w/ serous fluid; LESS THAN 1 cm in diameter

pustule: elevated, superficial lesion; similar to vesicle but filled w/ purulent fluid

bulla: vesicle GREATER THAN 1 cm in diameter (BLISTER)

58
Q

Macule vs. Papule vs. Patch

A

macule: flat, circumscribed area that is a change in the color of the skin; LESS THAN 1 cm in diameter

papule: elevated, firm, circumscribed area LESS THAN 1 cm in diameter

patch: flat, nonpalpable, irregular-shaped macule MORE THAN 1 cm in diameter

59
Q

Braden Scale

A

an assessment tool for predicting the risk of pressure ulcers

60
Q

Signs of Melanoma (ABCs)

A

A - asymmetry (not round or oval)
B - border (poorly defined or irregular border)
C - color (uneven, variegated)
D - diameter (usually greater than 6 mm)
E - evolving (skin lesion that looks different from others or is changing in size, shape, or color)
F - feeling (itching, tingling, or stinging)

61
Q

Assessing Skin Turgor

A

picking up and slightly pinching skin on forearm or under the clavicle; skin should be elastic and return to place immediately when released

62
Q

Plaque

A

a circumscribed, elevated, plateaulike, solid lesion GREATER THAN 1 cm in size

63
Q

Wheal

A

elevated lesion caused by localized edema (HIVES)

64
Q

Nodule

A

slightly elevated lesions on or in skin; LARGER THAN papules

65
Q

Tumor

A

abnormal growths of tissue that can be malignant (cancerous) or benign (harmless)

66
Q

Cyst

A

abnormal, fluid-filled sacs that can develop in tissues in any part of the body

67
Q

Clubbed Nails

A

abnormal, rounded shape of nail bed

caused by respiratory disease and cardiovascular disease

68
Q

Migraine - Where? Duration? Quality of Pain? Who? Other info?

A

Where? - unilateral
Duration? - several hours to several days
Quality of Pain? - throbbing
Who? - all but women > men
Other info? - nausea and vomiting, dizzy, aura, photosensitivity

69
Q

Cluster Headache - Where? Duration? Quality of Pain? Who?

A

Where? - unilateral (eye, temple, etc)
Duration? - 30-60 min; multiple times per day
Quality of Pain? - stabbing/burning
Who? - adolescent to YA; men > women

70
Q

Tension Headache - Where? Duration? Quality of Pain? Who? Other info?

A

Where? - back or front of head
Duration? - several days
Quality of Pain? - vice-like pressure
Who? - 20-40 year olds (either sex)
Other info? - muscle tension

71
Q

Sinus Headache - Where? Duration? Quality of Pain? Who? Other info?

A

Where? - frontal/maxillary
Duration? - until drainage
Quality of Pain? - pressure
Who? - everyone
Other info? - eye sensitivity

72
Q

Post-Traumatic Headache (concussion) - Where? Duration? Quality of Pain? Who? Other info?

A

Where? - entire head
Duration? - several days
Quality of Pain? - dull to painful ache
Who? - athletes/MVA
Other info? - nausea and vomiting, blurred vision, photophobia, dizzy, decrease concentration, giddiness

73
Q

Palpebral Fissure

A

opening between eyelids

74
Q

Conjunctivae

A

two, thin, transparent mucous membranes lie between eyelids and eyes

75
Q

Sclera

A

tough, fibrous outer layer; white of eye

76
Q

Cilia

A

nasal hairs

77
Q

Turbinates

A

concha; line lateral walls of nasal cavity, providing large surface area of nasal mucosa for heat and water exchange

78
Q

Salivary Glands

A

parotid, sublingual, submandibular; release saliva through small ducts in response to presence of food

79
Q

Oropharynx

A

back of mouth

includes uvula and tonsils

80
Q

Larynx

A

voice box

81
Q

Lymph Nodes

A

tiny oval clumps of lymphatic tissue, usually grouped along blood vessels

82
Q

Dizziness vs. Vertigo

A

Dizziness: faintness, light-headedness

Vertigo: sensation of movement, usually rotational like whirling/spinning

83
Q

Tinnitis

A

ringing in the ear

84
Q

Presbyopia

A

loss of elasticity of the lens of the eye due to aging

85
Q

Ptosis

A

lid of either eye covering part of the pupil

86
Q

Corneal Arcus

A

white, opaque ring encircling the limbus

87
Q

Miosis

A

pupil is constricted (< 6 mm)

88
Q

Mydriasis

A

pupil is dialated (> 6 mm)

89
Q

Nystagmus

A

involuntary movement of eyeball in horizontal, vertical, or rotary direction

jerking movement (alcohol use)

90
Q

Strabismus

A

eye that moves to focus after being uncovered

LAZY EYE

91
Q

Presbycusis

A

hearing loss associated with aging

92
Q

Assessment Techniques of the Head/Face

A

Jaw movement
Palpate Sinuses
Palpate temporal arteries
transillumination of sinuses

93
Q

Assessment of the Eyes

A

PERRLA
Accommodation
Consensual pupils
Six Cardinal fields of Gaze
Corneal Light Reflex
Red Reflex

94
Q

Visual Acuity Test

A

Distance/ Near / Peripheral Vision

Snellen Chart

95
Q

Aniscoria

A

unequal pupils

96
Q

PERRLA

A

Pupils are
Equal and
Round and
Reactive to
Light and
Accommodation

97
Q

Consensual Pupils

A

both eyes/pupils work/move the same way

98
Q

Accommodation

A

look at something far away then close to nose to see if pupils change with the distance of the object

99
Q

Six Cardinal Fields of Gaze

A

do eyes move smoothly and together?

100
Q

How to test for Eye Alignment?

A

Corneal Light Reflex

if abnormal? cover-uncover test

101
Q

Red Reflex

A

red glow over pupil when light illuminates retina

102
Q

Conjunctivitis

A

pink eye

103
Q

Cataract

A

cloudy lens

104
Q

Assessment of Hearing

A

Proper technique for use of otoscope
whisper test
finger-rub test
Weber (above head)/ Rinne (behind/front of ear) test with tuning fork

105
Q

Otitis Media

A

infection of MIDDLE EAR

S&S:
ear pain
tympanic membrane appears inflamed, red, and may be bulging or immobile
pain does NOT change w/ manipulation of ear

106
Q

Bacterial Infection Nasal Drainage

A

thick or purulent green-yellow discharge

107
Q

Epistaxis Nasal Drainage

A

NOSE BLEED

bloody

108
Q

Allergic Rhinitis Nasal Drainage

A

watery

109
Q

Foreign Body Nasal Drainage

A

foul-smelling, unilateral discharge

110
Q

Appendicitis

A

appendix becomes inflamed and filled w/ pus

111
Q

Cholecystitis

A

inflammation of gallbladder

112
Q

Cholelithiasis

A

GALL STONES

113
Q

Diverticulitis

A

inflammation of diverticula (in muscular wall of colon)

114
Q

Epigastric

A

lying upon or over stomach

contains duodenum, portion of liver, pancreas, and portion of stomach

115
Q

GERD (gastroesophageal reflux disease)

A

reflux of gastric acid into lower esophagus (CHRONIC)

116
Q

Hiatal Hernia

A

protrusion of stomach through esophageal hiatus of diaphragm into mediastinal cavity

117
Q

Nephrolithiasis

A

KIDNEY STONES

118
Q

Pancreatitis

A

acute or chronic inflammation of pancreas

119
Q

Peptic Ulcer

A

ulcer in lower end of esophagus, in stomach, or in duodenum

120
Q

Peritoneum

A

abdominal lining, serous membrane forming a protective cover

121
Q

Rebound Tenderness

A

sign of inflammation in peritoneum in which pain is elicited by sudden withdrawal of hand pressing on abdomen

122
Q

Hematemesis

A

vomiting blood

123
Q

Proper Order for Assessing Abdomen

A

inspect, auscultate, palpate, percuss

124
Q

What is the position for an abdominal assessment?

A

supine

125
Q

Auscultation Sounds - Frequency? Why do we do it? Absent? Expected Findings?

A

Frequency? - auscultate 15 sec per quadrant and count amount of sounds
Why do we do it? - to assess for intestinal motility
Absent? - must listen for 4-5 minutes, no intestinal motility
Expected Findings? - between 5-30 sounds (normoactive)

126
Q

Borborygmi

A

intense, episodic

very hyperactive (pt may have blockage)

127
Q

Pulsations - normal/abnormal findings (abdomen)

A

normally vascular sounds are not heard

abnormally you would hear bruits

128
Q

Use of stethoscope for bowel sounds vs vascular sounds

A

bowel sounds: diaphragm
vascular sounds: bell

129
Q

What sounds do you expect to percuss and where?

A

Resonance: over normal lung tissue
Tympany: over abdomen
Flat: solid tissue like bones/muscles
Dull: over dense areas (heart/liver)

130
Q

7 Fs for Abdominal Distension (bloating)

A
  1. flatus (gas)
  2. fluid (ascites)
  3. fetus (pregnant)
  4. fat (obesity)
  5. fibroid tumor (uterus)
  6. fatal growth (cancerous)
  7. feces

Health Assessment (10 decks)

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