NUR 220 - Quiz 2 Flashcards

1
Q

what does ANO stand for?

A

alert and oriented

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2
Q

ANO x1

A

knows who they are

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3
Q

ANO x2

A

name + where they are

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4
Q

ANO x3

A

name, place, time

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5
Q

ANO x4

A

name, place, time, situation

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6
Q

ANO is used to gather what?

A

neurological baseline

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7
Q

mneumonic used to assess level of conciousness (LOC)

A

AVPU

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8
Q

what does AVPU stand for?

A

A- awake
V- verbal stimulation
P- painful stimulation
U- unresponsive

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9
Q

what is the Glasglow Coma Scale used to measure?

A

eye opening, verbal response, motor response

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10
Q

how does scoring work for the Glasglow Coma Scale?

A
  • higher the better
  • decrease of 2 points is significant
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11
Q

what is the earliest and most sensitive indicator of alterations in cerebral function?

A

change in Level of Consiousness

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12
Q

what must be done before obtaining a health history?

A

neuro assessment

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13
Q

is health history subjective or objective data?

A

subjective

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14
Q

what is the purpose of health history?

A

to get a database which is used to create a plan, prevent disease, resolve problems, and minimize limitations

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15
Q

what are the three phases of an interview?

A
  • oritentation phase
  • working phase
  • termination phase
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16
Q

purpose of orientation phase

A

gain patient trust and set agenda

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17
Q

purpose of working phase (2)

A
  • gather accurate, relevant, and complete info on patients condition
  • pick up on verbal + nonverbal cues
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18
Q

purpose of termination phase (3)

A
  • summarize findings with patient
  • check for accuracy
  • tell them you will be back
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19
Q

what are some factors than can affect patient answers?

A
  • personality
  • feeling at time of interview
  • nature of information being asked
20
Q

factors that can affect your interviewing

A
  • task complexity
  • time constraints
21
Q

common phrase used for open-ended questions

A

“tell me more”

22
Q

purpose of open-ended quesitons

A

allow patient to describe their condition and concerns to you

23
Q

purpose of direct close-ended questions

A

to get a patient to describe problem more accurately and fully

24
Q

why are leading questions risky?

A

patient may give you the answer they think you want to hear

25
what is probing?
asking more open ended questions as patient is telling their story to get more info
26
facilitation
verbal + nonverbal phrases that encourage talking
27
restatement
repeat what patient said back to them
28
reflection
repeate what patient said and encourage more information
29
confrontation
tell patient what they are saying is not adding up with data
30
interpretations
share your take on the data so that patient may confirm or deny
31
summarize
summary of what was discussed
32
how should you deal with anger?
directly to identify source
33
how should you deal with crying?
be compassionate and delay questioning until theyre ready
34
pneumonic for present illness/ health concert
PQRST
35
what does PQRST stand for?
P- provoke Q- quality (what does it feel like) R- radiate S- severity (0-10) T- time
36
what are some age related variations when interviewing?
- older adults need more time and childhood history may not be necessary - children may have adult answering for them
37
age group for depression
25-44
38
what is PHQ-9 (patient health question) used to screen for?
- screens for depression - 4 or more checks in grey section = depression
39
what is GAD-7 used to screen for?
- anxiety - 15 and up = anxiety - 10 and up = referred
40
what is the Mini-Cog
- assess cognitive impairment - three word recognition, clock drawing, three word recall - score 3 or less = impaired
41
Mini-Mental State Exam
- 30 = perfect score - 23 and below = cognitive issue
42
AUDIT screening tool
- 8 and above = harmful alcohol use
43
CAGE questionaire mneumonic
C- cut down drinking A- annoyed by people criticizing G- guilty E- eye opener (drink first thing in AM)
44
what score indicates alcohol abuse on CAGE questionaire
2 or more
45
COWS
- clinical opiate withdrawl scale - assesses physical dependence to drugs
46
HITS screening tool
- screens for abuse - 10 or more = partner violence