Module 1 Study Guide (Chapters 1,2,3,4,5) Flashcards
How to address cultural considerations when taking a health history?
The provider needs to know what cultural values are important to the patient. This can be obtained through interactions and by simply asking the patient about their culture and how it affects their healthcare and how you can support them as their healthcare provider.
Physical VS cultural characteristics
Physical characteristics are the objective anatomy and color of a patient’s skin. This is useful information but is wrong to judge or make healthcare decisions based off physical characteristics. This is because each patient is unique, just because patients may look the same does not mean they will behave the same or have the same needs.
Cultural characteristics of an individual is what makes them unique and who they are. This includes their language, mannerisms, dress, hobbies, religion, etc. By treating each and every patient as a unique case it can improve provider/patient relationships.
What is the respect model?
The respect model is a mnemonic used to remember how to build strong relationships with each patient by focusing on effective communication.
R - rapport - this involves connecting socially, withholding judgement, and taking the time to see the patient’s POV.
E - empathy - the patient has come to you for help, verbalize and legitimize the patients’ feelings
S - support - what barriers is the patient working against? How can these barriers be overcome? Reassure the patient that you are and will be there for them.
P - Partnership - be flexible, work together to address the patients’ health issues
E - explanations - make sure the patient understands the information being presented
C - cultural competence - seek to understand the patient’s culture. Know your own biases
T - trust
What is subjective data? What parts of the history and physical exam are subjective data?
This is data that is gathered through conversation, reported by the patient. This cannot be directly confirmed but is still valuable information in determine the issue and building relationships with the patients.
The patient identifiers, chief complaint, history of present illness, past medical history, social history, family history, allergies, medications, and ROS are subjective data.
What is objective data? What parts of the history and physical exam are objective data?
Objective data is data that can be seen, measured, and/or directly confirmed.
The physical exam, labs and diagnostic tests, problem list, assessment (diagnosis), and plan are objective portions of the H&P.
What is the ROS?
The ROS is the review of systems. This breaks down the patient’s body systems one-by-one and summarizes if they are experiencing any current or past symptoms in the specific body area. Documented as positive vs negative findings. There are 14 total body systems included.
1. Constitutional
2. Eyes
3. Ears, nose, throat
4. Cardiovascular
5. Respiratory
6. GI
7. GU
8. Musculoskeletal
9. Integumentary
10. Neurological
11. Psych
12. Endocrine
13. Hematologic
14. Allergic/immunologic
How can the H&P be altered to better suit a pediatric patient? At what age do children become reliable historians? Family dynamics? Development? What should be added to the history in this population? What are tanner stages?
Pediatric patients can be especially nervous or untrusting since the process is new to them and they don’t know you. Getting on their level and playing with them can help build trust and allow for a better rapport.
Around age 7 children can be trusted to be reliable historians.
Family dynamics can be picked up during interactions throughout the H&P.
It is important to note the development physically and mentally/socially of the child. The recorded history should be adapted to reflect the child’s age and development.
Major neonatal to school age issues. Growth and development. Behavior. School performance. Should be added to the history.
Tanner stages are a way to assess an adolescent’s development during puberty.
How is the H&P altered for pregnant women?
History - gravidity/parity. Menstrual, gynecologic, and obstetrical history. Social, physical, and mental adjustment to pregnancy.
Physical - fundal height, fetal HR, pelvic measurement, uterine size
What is the CAGE screening tool?
The CAGE screening tool is used to assess for alcohol dependence.
C - cutting down. Does the patient ever consider reducing the amount they drink.
A - annoyance by criticism.
G - guilt. Ever feel guilty about the amount or frequency of drinking.
E - eye openers. Waking up in the morning and started drinking.
What is the HITS screening tool?
The HITS screening tool is used to assess for physical violence between partners. In the past year how often has your partner:
H - hurt you physically?
I - insulted you?
T - threatened you with violence?
S - scream or curse at you?
What is the PVS screening tool?
The PVS screening tool is the partner violence screen. Used to assess for domestic violence.
1. - have you been kicked, hit, punched or physically hurt by someone within the past year?
2. - Do you feel safe in your current relationship?
3. - Is there a partner from a previous relationship that is making you feel unsafe?
How to take a sexual history? What are the 5 ps?
When taking a sexual history questions should be direct and unapologetic. This is approached from a professional manner and the goal is to better understand and treat the patient.
The 5 Ps:
1. Partner(s) - How many sexual partners do you have? How long have you been together?
2. Prevention against pregnancy - Are you using any anti-contraceptive measures?
3. Practices -
4. Past history of STIs - Have you ever had an STI?
5. Protection against STIs - What protection do you use to prevent STIs?
How are angry clients handled?
Standard precautions
Precautions used when assessing any patient. The equipment used can vary depending upon the situation.
Who is at risk fora latex allergy? How can latex be transmitted? How can latex allergies be prevented? What are the forms of latex reactions?
Healthcare providers are at risk for latex allergies as well as patients who have received repeated exposure to latex. This is because the body develops an antibody that recognizes and responds to latex in subsequent exposures.
Latex exposure is normally via direct contact with latex containing gloves. It can be spread through the air if latex particles are circulating from latex use.
Latex allergies can be prevented by limiting latex exposure and use.
Contact dermatitis - skin irritation at the site of latex exposure. Does not involve the immune system.
Delayed hypersensitivity - does involve the immune system. Resembles poison ivy. Symptoms can present 24-48 hours after exposure.
Systemic reactions - anaphylaxis type reaction where the body builds antibodies to the latex antigen. IgE involved. Can cause hives, angioedema, asthma, Gi symptoms, and permanent lung damage.
What is the otoscope? What is the purpose of the pneumatic attachment of the otoscope?
The otoscope is an examination device used to assess the patient’s ear canals. The pneumatic attachment of the otoscope is used to assess the fluctuating capacity of the tympanic membrane. When the tympanic membrane is puffed with air, it causes it to move.
What sounds are best heard with the diaphragm of the stethoscope? What about the bell? How does applying more pressure with the bell of the stethoscope affect what is heard?
The diaphragm of the stethoscope is best used to hear higher pitch sounds than the bell. These sounds include heart, GI, respiratory sounds. The bell is best used to listen for low pitch sounds like murmurs and some Gi sounds. The bell of the stethoscope should not be pushed into the skin too hard; this dampens the noise vibrations which can lead to a worse auscultation.
