N 307 EXAM 4 Flashcards
What is Leukorrhea?
Normal discharge with ovulation.
Prostate disorder symptoms?
-Incomplete bladder emptying.
-urinary frequency/urgency
-weak stream or straining to initiate
-hematuria (blood in urine)
-nocturia (frequent nighttime peeing)
-bony pelvis pains
How can females prepare their body for pregnancy?
-stop smoking
-stop drinking
-increase folic acid and calcium
-lose weight if obese
How is Gravida-Para notated?
G= gravida = total number of pregnancies
P= para = outcomes of pregnancies
“F” = full term
“P” = premature
“A” = abortion
“L” = living child
Where does lymph from internal genitalia and upper vagina drain?
Into the pelvic and abdominal lymph nodes.
Where does lymph from the vulva drain?
Into the inguinal lymph nodes.
What are some cervical cancer risks?
-Failure to screen
-multiple sex partners
-cigarette smoke exposure
-immunosupression
-long term oral contraceptive use
-HPV
What is Primary Dysmenorrhea?
Pain with menses due to increased prostaglandin during the cycle causing uterine contractions.
What is Secondary Dysmenorrhea?
Pain with menses due to a secondary cause such as:
-endometriosis, adenomyosis, pelvic inflammatory disease, polyps.
What is primary amenorrhea?
Failure of periods to initiate.
What is secondary amenorrhea?
failure to have menses after they initiated. could be due to birth control use, medications, hormone shots, hypothyroidism, being overweight or underweight.
What is menarche?
When menstruation begins.
What is Menorrhagia?
excessive flow.
What is the best order to ask females their reproductive history?
- Menstrual
- obstetric
- sexual
(unless client comes in specifically for a sexual issue, then it is appropriate to follow clients lead.)
What conditions can cause hoarseness? (and their duration.)
Chronic- over 2 weeks-
hypothyroidism
reflux
vocal chord nodules
head and neck cancers
thyroid masses
neurological disorders such as parkinsons.
Acute -less than 2 weeks-
voice overuse
acute viral laryngitis
What is Epistaxis?
Bloody nose
What would be pertinent history for epistaxis?
anticoagulation therapy (aspirin)
nasal sprays
recent surgery
recent injury
bleeding disorder
What are you looking for when assessing pupils?
PERRLA
pupils equal, round, and reactive to light and accomodation.
What is cranial nerve 1?
Olfactory- sense of smell
what is cranial nerve 5?
Trigeminal nerve-
motor and sensory nerve
motor is temporal and masseter.
sensory has 3 divisions of face ( ophthalmic, maxillary, and mandibular)
What is cranial nerve 11?
Spinal accessory nerve.
motor movement of sternocleidomastoid (SCM) and Trap muscles.
What is cranial nerve 7?
Facial nerve- motor and sensory
facial expression eyes closing and mouth closing.
taste on anterior 2/3 of tongue.
what is cranial nerve 12
hypoglossal- motor
tongue movement
What is cranial nerve 9?
Glossopharyngeal.
motor- pharynx
sensory-TASTE!
pharynx, posterior eardrums and posterior tongue
What is presbycusis?
slow, age related hearing loss
What symptoms are associated specifically with inner ear infections?
Hearing and balance issues.
what is Otitis externa?
Swimmers ear.
external ear infection.
inflammation of the ear canal.
symptoms- pain on movement of the pinna and tragus “tug test”
history of water exposure.
what is Otitis Media?
inflammation of middle ear.
more common in children due to short eustacian tubes. bacteria travel up eustacian tubes and causes infection.
signs- pain, redness, fever, no eating, no sleeping, tugging on ear, restless and irritable.
Risk factors for Otitis Media.
pacifiers
daycare
not vaccinated
history of ear infections
parent smokes around them
sudden relief from an earache is a good thing. T/F?
False!
-this means ruptured eardrum.
what is cranial nerve 10?
Vagus nerve. sensory and motor
motor- palate, pharynx, larynx
sensory- pharynx and larynx
SWALLOWING
What is cranial nerve 8?
vestibucochlear nerve.
HEARING AND BALANCE
What is cranial nerve 3?
Oculomotor nerve.
raises upper eyelid,
PUPIL CONSTRICTION
What is cranial nerve 2?
Optic nerve.
only sensory
VISION
What is cranial nerve 6?
Abducens nerve. -motor-
lateral deviation of eyes.
What is cranial nerve 4?
Trochlear nerve. -motor-
downward, internal rotation of the eye.
Location of supraclavicular lymphnodes
deep in angle formed by clavicle and SCM.
location of posterior cervical lymphnodes.
Along the anterior edge of trapezius.
location of deep cervical chain lymphnodes.
deep and mid SCM muscle. hook thumb around muscle to locate.
location of superficial cervical lymphnodes.
superficial to the SCM. closer to jawline but below tonsilary area.
location of tonsillar lymphnodes
under the mandible angle of jawline.
location of submandibular lymphnodes.
midway between the angle and tip of mandible. underside of the jawline midway.
location of submental lymphnodes
tip of chin
location of posterior auricular lymphnodes
behind the ears (as if you are tracing glasses) superficial to the mastoid process.
location of preauricular lymphnodes.
in front of ears. by the temporal mandibular joint.
location of the occipital lymphnodes.
base of head by the occiput.
What is papilledema?
bilateral swollen optic nerves with bulging optic disc edema. can be from increased intercranial pressure (ICP).
Often signal a serious brain issue.
Venous stasis leads to engorgement and swelling.
Disc swollen with margins blurred.
Anisocoria is when there is a difference of less than 1mm in diameter of the pupils when compared to one another.
T/F?
True
and it can be seen in 20% of healthy individuals.
What is Glaucoma?
increased pressure within the eye leads to backwards depression of the optic disc.
Tunnel vision
Optic neuropathy with gradual loss of vision
What is macular degeneration?
degeneration of the macula (which is responsible for clear vision)
causes blurred or reduced central vision.
usually age related
What is convergence testing?
( i think of it as the “boop” test)
move your finger or a pencil slowly straight forward to the nose having the client follow it.
Poor convergence is common in hyperthyroidism.
Cataracts are what?
opacities of lenses.
they make vision blurry
(think CAT is furry, so Cataracts make vision blurry)
What is Nystagmus?
involuntary rapid repetitive eye movements
How much longer should air conduction be than bone conduction in a normal hearing individual?
twice as long.
What is the Weber test assessing?
hearing, specifically bilateral air conduction testing by putting a tuning fork on top of the head.
What does the whisper test assess?
Air conduction
Which hearing test assesses both air and bone conduction?
Rinne test.
What identifying characteristic would you use to find the thyroid cartilage?
The notch on its superior edge.
The thyroid gland is usually larger in women than men. T/F?
True
How would you expect the thyroid gland to feel in someone with Hashimotos disease?
Firm.
How would you expect the thyroid gland to feel in someone with Graves disease?
Soft.
If someone has a tender thyroid, you would expect…
Thyroiditis.
What is a Prodrome?
Early sign or symptom of unusual feelings leading to a headache. such as euphoria, craving food, fatigue or dizziness.
If a patient with a headache has an increase of pain from coughing, sneezing, or changing position, this could indicate what?
brain tumor or acute sinusitis.
What should you assess when a client complains of cluster headaches?
Miosis, ptosis, rhinorhea, and lacrimation, eyelid edema, comjuctival infection.
What are associated manifestations of headache associated with TBI?
vision changes; nausea and vomiting; attention span deficits; drainage from ears, nose, eye or mouth; tremors; seizures; or gait changes.
What would you expect to assess in a patient complaining of migraine headaches?
recurrence, photophobia, throbbing, prodrome, auras.
What are the bordering landmarks of the posterior triangle of the neck?
SCM muscle; trapezius muscle; and the clavicle
What muscle crosses the lower portion of the posterior triangle that can be mistaken for a lymphnode or mass?
omohyoid muscle.
Enlarged tender lymph nodes commonly accompany what?
Pharyngitis.
Enlargement of a supraclavicular node, espeially on the left, could suggest what?
Metastasis from a thoracic or an abdominal malignancy.
what would you identify 2 soft lumps approximately 3cm in diameter on the side of a patients as?
Pilar cysts.
What are contraindications for Mydriatic drops? (dilation of pupil)
head injury and coma in which pupillary reactions are being observed, and any suspicion of narrow angle glaucoma.
What is the normal color of an optic disc?
yellowish orange to creamy pink
you examine the optic disc and see white, what does this suggest?
The death of optic nerve fibers.
What would the vision of a legally blind person be?
20/200 or less
what visual acuity numbers would you refer a patient to an opthalmologist with?
anything worse than 20/30
nodular episcleritis is seen with what disorders?
rheumatoid arthritis and systemic lupus erythematosus.
what does the opthalmoscope need to be set on initially for assessment?
The brightest light,
the white light
the circle
“0” diopters
What hand does the nurse hold the opthalmoscope in to assess each eye?
use the right hand and your right eye for assessing the right eye. use the left hand and your left eye for assessing the left eye.
If sudden vision loss is unilateral and painless what would that suggest?
vitreous hemorrhage from diabetes or trauma; macular degeneration; retinal detachment; retinal vein occlusion; or retinal artery occlusion.
The bulbar conjunctiva is also known as what?
the Sclera
Within the eyelids lie firm strips of connective tissue called what?
tarsal plates
Each tarsal plate contains a parallel row of glands called what?
Meibomian glands.
What are the steps for examining the optic disc and the retina?
Find the red reflux, look through that to visualize the arteries and veins, follw the blood vessels as they get wider. follow them MEDIALLY TOWARD THE NOSE and look for the round yellowish orange structure (optic disc)
When a patient is unable to see half of the visual field on one side it is called what?
Hemianopsia.
What is entropion?
Inward turning of the lid margin, common in elderly people.
what is Ptosis?
Drooping of the upper lid
list the grades of tonsils and what they mean.
+1 = tonsils are visible
+2 = Tonsils are between the tonsillar pillars and the uvula.
+3 = tonsils are touching the uvula
+4 = tonsils touch eachother
What structure in the inner ear senses the position and movements of the head and helps maintain balance?
Labrynth.
What drugs might cause stuffiness?
oral contraceptives, alcohol, reserpine, guanathidine.
Which sinuses are readily accessible to clinical examination?
Frontal and Maxillary
What is the range of human speech?
500-3000 Hz.
What frequency tuning fork is used to test hearing?
512 Hz tuning fork
What is amliopa
Lazy eye. Reduced vision in one eye causing abnormal vision development early in life
What is strabismus
When the eyes do not properly align. One eye looks a different way than the other
What is confrontation?
Visual acuity comparison of patient and nurse eyesight.
What condition can be seen as densities in the lenses. Or opacities of the lenses visible through the pupil that cause blurry vision?
Cataracts.
What is convergence?
Ability to turn eyes inward together.
What is exophthalmos?
Bulging eyeballs as seen in Graves’ disease. (A condition that occurs in hyperthyroidism)
What conditions could affect the optic nerve where an enlarged blind spot occurs?
Glaucoma, optic neuritis, papilledema.
