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NSG > Phys Asses #2 > Flashcards

Phys Asses #2 Flashcards

1
Q

High incidence of occurrence across patient care settings

A

Alcohol Use and Abuse

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2
Q

Many patients will have significant history of ___ that has impact on their health status.

A

drinking

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3
Q

____ and ____ data reflect adverse consequences of excessive alcohol use.

A

Morbidity and mortality

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4
Q

A high number of medications are classified as ___.

A

alcohol interactive.

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5
Q

Alcohol dependence increases the risk for __, ___, and ___.

A

ED visits, ICU admissions, and sepsis.

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6
Q

Become more problematic = Binge drinking associated with __

A

increasing health risks

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7
Q

Most abused and used psychoactive drug

A

Alcohol

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8
Q

Pts use alcohol at an earlier an

A

earlier age

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9
Q

Impact of health and well-being

A

Alcohol

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10
Q

___ of meds will interact with alcohol

A

45%

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11
Q

50% of individuals over the age of __

A

12

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12
Q

Dosed dependent- the amount consumed

A

Alcohol

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13
Q

Moderate drinking associated with

A

hypotension, cardiomyopathy, can lead to increase in left ventricular mass, dilation of ventricles, and thinning of cardiac walls

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14
Q

Drinking 2.1 standard drinks in a day leads to

A

32% increase in developing breast cancer

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15
Q

__ of Americans over the age of 18 are current alcohol drinkers

A

56%

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16
Q

Defining Illicit Drug Use: Seven categories of illicit drug use

A

Marijuana/hashish, cocaine (including crack), heroin, hallucinogens, methamphetamines, inhalants, or prescription-type drugs used nonmedically.

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17
Q

___ show highest prevalence.

A

12 years and older

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18
Q

Illicit drug use has serious consequences for

A

health, relationships, and future jobs, school, and career.

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19
Q

___ percent over the age of 12 have reported using illicit drug

A

> 10.1

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20
Q

Negative impacts of numerous factors-

A

cancer (Comorbidities)

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21
Q

Most misused drug, 80% of drug users use-

A

Marijuana

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22
Q

LOC changes, Increase or decrease responsiveness to medications

A

Illicit Drug Use

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23
Q

Increased rate of deaths from drug overdose as opposed to

A

motor vehicle accidents

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24
Q

Increase in Rx for pain medication

A

Contributing factors to Rx abuse and Opioid crisis:

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25
Q

Increase Marketing strategies to promote medications

A

Contributing factors to Rx abuse and Opioid crisis:

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26
Q

Misrepresentation of “addictive” nature

A

Contributing factors to Rx abuse and Opioid crisis:

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27
Q

Combination addictions—drinking and taking alcohol-interactive medications.

A

Contributing factors to Rx abuse and Opioid crisis:

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28
Q

Monitor for signs of misuse or abuse

A

Prescription Drug Abuse and Opioid-Related Deaths

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29
Q

Very common in pts

A

Prescription Drug Abuse and Opioid-Related Deaths

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30
Q

More than __ individuals have drug abuse

A

1 out of 12

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31
Q

Alcohol releases dopamine which causes

A

euphoria

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32
Q

As pts use or misuse drugs the feeling of euphoria decreases.

A

The receptors are desensitized

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33
Q

Can help identifying drug use and abuse and help provide support to over

A

come addictions.

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34
Q

Gold standard of diagnosis is well defined in

A

Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V)

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35
Q

Alcohol problems underdiagnosed both in primary care settings and in hospitals

A

Substance Abuse

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36
Q

___ often unrecognized until patients develop serious complications (liver failure, kidney issues, heart issues)

A

Excessive alcohol use

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37
Q

Women who drink 8 or more alcoholic bev per week or 4 or more alcoholic bev on occasion are considered at

A

risk drinkers

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38
Q

Takes more to achieve same desired effect-

A

tolerance

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39
Q

Decreased effect with same amount of alcohol-

A

alcohol tolerance

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40
Q

Pg 88- alcohol use disorder assessment. Ask pt several questions regarding alcohol use.

A

Depending if yes or no to questions will determine severity

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41
Q

If they answer yes or no to 2-3 of the questions its considered mild

A

4-5 moderate, >6- severe

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42
Q

Effect of alcohol on developing brain

A

development and maturity

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43
Q

Associated risk between alcohol use and other high-risk behaviors leading to

A

sexual high-risk.
academic problems in school.
injuries from trauma.
continuation of alcohol abuse/disease in later life

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44
Q

Brain is not fully developed for

A

Developmental Competence: Adolescents

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45
Q

12-17 yr olds diagnosed with AUD-

A

3.4% are also going to have an illicit drug disorder, 2.5% will have alcohol disorder

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46
Q

Developmental Competence: Pregnancy

A

Dangers to mother as well as to fetus

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47
Q

Developmental Competence: Pregnancy

A

Development of Fetal Alcohol Syndrome spectrum

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48
Q

Potential adverse consequences of alcohol use to fetus are well known.

A

Development of Fetal Alcohol Syndrome spectrum

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49
Q

Physical deformities as well as learning and behavioral problems

A

Development of Fetal Alcohol Syndrome spectrum

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50
Q

____ of alcohol has been determined safe for pregnant women.

A

No amount

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51
Q

Any women contemplating pregnancy or who is pregnant should be screened for alcohol use.

A

Abstinence should be recommended.

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52
Q

An increasing number of older adults are

A

drinking.

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53
Q
  1. Decreased metabolic function (liver, amount of water available, and renal function). Increases bioavailability of alcohol. Increased effect for extended period of time. Can lead to injury
A

Characteristics that increase risks associated with alcohol use:

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54
Q
  1. Muscle mass decline. Leads to increased concentration of alcohol in pts body.
A

Characteristics that increase risks associated with alcohol use:

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55
Q
  1. Polypharmacy can interact with alcohol.
A

Characteristics that increase risks associated with alcohol use:

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56
Q
  1. Increase risk for cognitive decline.
A

Characteristics that increase risks associated with alcohol use:

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57
Q
  1. Increase risk for falls, incidence of depression and GI issues
A

Characteristics that increase risks associated with alcohol use:

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58
Q

Three domains: alcohol consumption, drinking behavior or dependence, and adverse consequences (Maximum score: 40)

A

Quantitative format uses numbers to identify a response.

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59
Q

Useful in primary care with adolescents and older adults

A

Quantitative format uses numbers to identify a response.

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60
Q

Relatively free of gender and cultural bias

A

Quantitative format uses numbers to identify a response.

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61
Q

AUDIT-C: shorter form for acute and critical care units (maximum score: 12)

A

Quantitative format uses numbers to identify a response.

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62
Q

___ will help detect less severe alcohol problems (hazardous and harmful drinking) as well as alcohol abuse and dependence disorders.

A

The AUDIT

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63
Q

Helpful with emergency department (ED) and trauma patients because it is sensitive to current as opposed to past alcohol problems.

A

The AUDIT

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64
Q

If currently intoxicated= information inaccurate.

A

The AUDIT

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65
Q

Refer to the AUD identification test

A

AUDIT Questionnaire

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66
Q

Helps mild to severe alcohol issues

A

AUDIT Questionnaire

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67
Q

Utilized from adolescences to older adults

A

AUDIT Questionnaire

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68
Q

Does ask a question and requires a number for an answer. Not open to interpretation.

A

AUDIT Questionnaire

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69
Q

Anything greater than 8 in a male or greater than a 4 in females or anyone over the age of 60 indicates hazardous alcohol consumption

A

AUDIT Questionnaire

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70
Q

When performing these assessment make sure private and non confrontational

A

AUDIT Questionnaire

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71
Q

Standard Clinical Diagnostic Criteria Goal:

A

Determine whether there is a maladaptive pattern of alcohol use causing clinically significant impairment or distress to the pt

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72
Q

has your drinking repeatedly caused or contributed to the following?”
Risk for bodily harm, relationship trouble, role failure, and/or run-ins with law

A

Ask, “In the past 12 months:

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73
Q

“Have you not been able to stick to drinking limits, or have you repeatedly gone over them?”- can indicate tolerance if not able to

A

Ask, “In the past 12 months:

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74
Q

Shown tolerance, signs of withdrawal, kept drinking despite problems, spent a lot of time drinking or anticipating drinking or recovering drinking and/or spent less time on other matters or activities that had been important or pleasurable

A

Ask, “In the past 12 months:

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75
Q

Screening women for alcohol problems

A

TWEAK questions help identify at-risk drinking in women, especially pregnant women.

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76
Q

TWEAK Questions

A

Tolerance, Worry, Eye-opener, Amnesia, Kut down

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77
Q

Tolerance:

A

how many drinks can you hold? Or how many drinks does it take to make you feel high?

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78
Q

Worry:

A

have close friends or relatives complained about your drinking?

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79
Q

Eye-opener:

A

do you sometimes take a drink in morning when you first get up?

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80
Q

Amnesia:

A

has a friend or family member told you about things you said but could not remember?

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81
Q

Kut down:

A

do you sometimes feel the need to cut down?

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82
Q

Scored with 1 point except for tolerance and worry bc each 2 points

A

TWEAK Questions

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83
Q

Score greater than 2 points indicates a drinking problem

A

TWEAK Questions

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84
Q

Greater than 3 indicates tolerance

A

TWEAK Questions

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85
Q

SMAST-G Questionnaire

A

Screening aging adults

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86
Q

Use the ____for older adults who report social or regular drinking of any amount of alcohol.

A

SMAST-G questionnaire

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87
Q

___ have specific emotional responses and physical reactions to alcohol.

A

Older adults

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88
Q

10 questions with yes/no responses that address these factors.

A

SMAST-G questionnaire

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89
Q

Two or more “yes” questions indicate alcohol problem

A

SMAST-G questionnaire

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90
Q

Consequences of substance abuse are so debilitating and destructive to patients and their families that a short statement of assistance and concern is given here.

A

Advise and Assist (Brief Intervention)

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91
Q

If your assessment has determined the patient to have at-risk drinking or illicit substance use, state your conclusion and recommendation clearly.

A

Advise and Assist (Brief Intervention)

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92
Q

Non confrontational, make sure they understand and what you recommend

A

Advise and Assist (Brief Intervention)

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93
Q

Drinking more that is medically safe and it is recommended that they quit drinking

A

Advise and Assist (Brief Intervention)

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94
Q

Can assist and willing to assist in achieving stop drinking goal

A

Advise and Assist (Brief Intervention)

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95
Q

Includes vital signs and oxygen saturation , N/V, tremors, Lvl of anxiety and agitation, paroxysmal sweats, auditory and tactile visual disturbances, headache and orientation status

A

10 measured criteria with individual scoring to arrive at a composite score

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96
Q

Individual subscales include 7 criteria with the exception of Orientation which includes 4 criteria

A

10 measured criteria with individual scoring to arrive at a composite score

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97
Q

Score of 0 to 7 can monitor every 4 hours.

A

Based on continued assessment provides trended results to determine level of monitoring that is needed.

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98
Q

All scores below 8 for 72 hours, you can discontinue.

A

Based on continued assessment provides trended results to determine level of monitoring that is needed.

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99
Q

Pts withdrawling from alcohol, most sensitive in order to assess objective measurements

A

Clinical Institute Withdrawal Assessment Scale (CIWA)

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100
Q

Used in monitoring progress of withdrawl

A

Clinical Institute Withdrawal Assessment Scale (CIWA)

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101
Q

Perform continued assessments

A

Clinical Institute Withdrawal Assessment Scale (CIWA)

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102
Q

Allows to avoid over medicating withdrawal pts

A

Clinical Institute Withdrawal Assessment Scale (CIWA)

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103
Q

Clinical Signs of Withdrawal- Alcohol-

A

Delirium tremens (DTS), anxiety, diarrhea, depression, seizures, tremors, tachycardia, headache, insomnia

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104
Q

Clinical Signs of Withdrawal- Sedatives-

A

similar to alcohol- anxiety, irritability

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105
Q

Clinical Signs of Withdrawal- Nicotine-

A

Headache, vasodilation, anger, irritability

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106
Q

Clinical Signs of Withdrawal- Cannabis-

A

Mild or occasional use- None. Heavy use- irritability, sleep disturbances, weight loss, loss of appetite or sweating

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107
Q

Clinical Signs of Withdrawal- Cocaine-

A

Anxiety, depression, fatigue, insomnia

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108
Q

Clinical Signs of Substance-Abuse Disorders:

A

“Substances” refers to non-medical agents taken to alter mood or behavior.

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109
Q

Clinical Signs of Withdrawal- Opiates (morphine, heroin, meperidine)-

A

Dilatated pupils, runny nose, excessive tears, tachycardia, sweating, hair on body to stand up. Extreme runny nose

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110
Q

Intoxication:

A

maladaptive behavioral changes due to effects on CNS from substance

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111
Q

Abuse:

A

daily or recurrent use such that impairment and decreased functioning has occurred leading to ongoing problems

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112
Q

Dependence:

A

physiological reliance

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113
Q

Tolerance:

A

requires more to get the desired effect

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114
Q

Withdrawal:

A

cessation of substance leads to physiological effects

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115
Q

Substance-

A

to alter mood or behavior

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116
Q

Intimate partner violence, child abuse and older people abuse is a

A

significant risk factor

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117
Q

Intimate Partner Violence: Four main categories

A

Physical violence, Sexual violence, Stalking, Psychological aggression

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118
Q

Physical violence:

A

force resulting in injury or death

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119
Q

Sexual violence:

A

attempted or completed acts without permission

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120
Q

Stalking:

A

repeated unwanted attention through various methods

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121
Q

Psychological aggression:

A

emotional abuse of an aggressive nature

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122
Q

Also includes teen dating violence is on the

A

rise

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123
Q

Can be physical, sexual, psychological, or emotional

A

teen dating violence

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124
Q

Youths who experience this are more likely to experience mental health issues and/or participate in unhealthy behaviors.

A

teen dating violence

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125
Q

Assess signs of violence in use

A

teen dating violence

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126
Q

Sexting or cyber abuse can be a

A

means of access.

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127
Q

__ women and ___ men have been abused by intimate partner

A

33%
25%

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128
Q

Defined at state and federal levels—The Child Abuse Prevention and Treatment Act

A

Child Abuse and Neglect

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129
Q

Recently amended to include sex and human trafficking

A

Child Abuse and Neglect

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130
Q

Enhance protection for infants with Fetal Alcohol Spectrum Disorder

A

Child Abuse and Neglect

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131
Q

Neglect:

A

failure to provide for children’s basic needs

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132
Q

Physical abuse:

A

nonaccidental injury that leads to harm of a child

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133
Q

Sexual abuse:

A

fondling, sexual acts, exploitation, and trafficking

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134
Q

Emotional abuse:

A

pattern of behavior that harms a child’s sense of self-worth or development

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135
Q

Be cautious when providing care to children if they experienced

A

child abuse

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136
Q

Nurses are considered mandatory reporters, report any suspected abuse and neglect to

A

law enforcement

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137
Q

When suspecting, be sure to document using exact words.

A

If child is able to give a description use the child’s words, verbatim

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138
Q

Involves both intentional and failure to act by a caregiver or trusted person. Can include abuse and neglect.

A

Older Adult Abuse and Neglect

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139
Q

Underreported with 60% performed by a family member

A

Older Adult Abuse and Neglect

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140
Q

Forms of older adult abuse

A

Physical abuse, Sexual abuse or abusive sexual contact, Psychological or emotional abuse, Neglect, Financial abuse or exploitation

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141
Q

Physical abuse:

A

intentionally assaulted, injured, threatened, or restrained

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142
Q

Sexual abuse or abusive sexual contact:

A

any sexual contact against one’s will

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143
Q

Psychological or emotional abuse:

A

includes verbal and nonverbal behaviors intended to humiliate, isolate, or affirm control

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144
Q

Neglect:

A

failure of caregiver to meet basic older adult needs

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145
Q

Financial abuse or exploitation:

A

unauthorized use and/or improper use of older adult’s funds/resources

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146
Q

Increased needs, changes in LOC

A

Older Adult Abuse and Neglect

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147
Q

If suspect abuse still report

A

Older Adult Abuse and Neglect

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148
Q

Immediate effects as well as residual effects of acts of violence leading to complications and more __

A

Chronic health problems

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149
Q

Gender r/t gynecologic and obstetrical conditions with impact on fetus

A

Preterm, low birth weight, and perinatal death

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150
Q

Violence= more likely to suffer from mental health problems

A

Depression, suicide, PTSD, and substance abuse

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151
Q

Children who are abused are more likely to experience ongoing poor health as they age.

A

Impact on brain development, behavioral learning delays, and higher risk for chronic disease

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152
Q

Rape victims More likely to use __

A

Marijuana

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153
Q

__ of rape victims to use cocaine than no rape victims

A

6x

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154
Q

child maltreatment can lead to a decreased quality of life.

A

can last into adulthood

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155
Q

Barriers to Treatment of Intimate Partner Violence

A

Societal stressors, Legal status, Lack of access to culturally appropriate care

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156
Q

Poverty level leading to increased difficulties in daily struggles and conflict in relationships

A

Societal stressors

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157
Q

Past experience with discrimination based on lack of understanding of cultural diversity

A

Societal stressors

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158
Q

Poor past experiences with understanding cultural diversities- they feel segregated.

A

Societal stressors

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159
Q

Immigration status may prevent individual from seeking care based on fear of deportation.

A

Legal status

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160
Q

Violence Against Women Act (AWA) provides legal support.

A

Legal status

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161
Q

Traditional roles foster dependency.

A

Lack of access to culturally appropriate care

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162
Q

Need for bilingual cultural interpreters in clinical practice settings

A

Lack of access to culturally appropriate care

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163
Q

Important to have interpreters

A

Lack of access to culturally appropriate care

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164
Q

When addressing care be mindful about cultural differences

A

Lack of access to culturally appropriate care

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165
Q

Ethnic and racial minorities are at greater risk for no

A

Treatment for Intimate Partner Violence

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166
Q

____ women and men are at greater risk for IPV

A

Multiracial American Indians, Alaskan natives and non Hispanic black

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167
Q

When documenting abuse, use specific words regarding the

A

victim

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168
Q

Documentation: IPV, Child Abuse, or Older Adult Abuse

A

Provide detail, Transcribe verbatim, Physical exam, Provide digital photographic documentation in the medical record, May have to separate

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169
Q

Provide detail

A

Non-biased progress notes, injury maps(identifying injuries, skin assessment), and photographic evidence (Further investigation)- make sure to obtain consent.

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170
Q

Transcribe verbatim

A

Information received from individual

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171
Q

Physical exam

A

Thorough documentation using forensic technology terms

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172
Q

Provide digital photographic documentation in the medical record

A

Obtain consent

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173
Q

May have to separate

A

The patient from the parent, spouse, and/or caregiver—follow protocol

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174
Q

All women of childbearing age (14 to 46) should be screened.

A

US Preventative Task Force Guidelines (USPTF)

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175
Q

Insufficient evidence to support screening of older adult or vulnerable adults

A

US Preventative Task Force Guidelines (USPTF)

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176
Q

No current recommendations for children

A

US Preventative Task Force Guidelines (USPTF)

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177
Q

Early detection is the key in terms of prevention of

A

long-term complications.

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178
Q

Health care providers are

A

mandatory reporters.

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179
Q

All women of child bearing age from

A

14-46 should be screened

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180
Q

Should be taken place with or without symptoms occurring

A

Routine Screening for Intimate Partner Violence (IPV)

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181
Q

How to Assess for Intimate Partner Violence

A

Gathering of subjective data

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182
Q

Use of open-ended questions to start the conversation-

A

to get as much info from the individual as possible

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183
Q

Interview the individual separately from the

A

perpetrator.

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184
Q

Listen for cues which may indicate a pattern or responses that don’t match the

A

“physical” injury that is present.

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185
Q

Be aware of state laws and requirement to

A

report.

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186
Q

Be aware of the IPV tool used in your clinical setting.

A

Intimate Partner Violence Screening tools

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187
Q

May be as simple as a single question—“Do you feel safe at home?”

A

Intimate Partner Violence Screening tools

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188
Q

USPTF prefers standardized tools

A

HITS and STaT

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189
Q

range from never to frequently.

A

HITS—4 item questionnaire

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190
Q

Can be used with teens.

A

HITS—4 item questionnaire

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191
Q

Asks how often partner physically hurt you. Insult or talk down to you. Threaten with harm. Scream or curse.

A

HITS—4 item questionnaire

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192
Q

Scored from 0-5. score greater than 10 indicates intimidate partner violence.

A

HITS—4 item questionnaire

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193
Q

Have you ever been in a relationship where partner has pushed or slapped you. Threatened you, thrown broken or punched things.

A

STaT—3 item questionnaire

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194
Q

Answering yes to any indicates positive screening for IPV.

A

STaT—3 item questionnaire

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195
Q

All adolescents should be screened for IPV.

A

STaT—3 item questionnaire

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196
Q

Ask about abuse in open needed question

A

STaT—3 item questionnaire

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197
Q

The nurse is assessing a patient who admits to being physically abused by her spouse. The patient says, “I wish I would have agreed with my husband, because then I wouldn’t have been hit.” What is the nurse’s best response?

A

“It is not your fault that your husband lost control. Changing your actions will not prevent him from abusing you again.” – provide reassurance

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198
Q

Older adult as a vulnerable population as they lose

A

independence

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199
Q

Recommended routine screening by multiple agencies but no specific tool specified

A

Assessment of Older Adult Abuse and Neglect

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200
Q

Assessment of abuse or neglect in cognitively challenged persons is complicated.

A

Assessment of Older Adult Abuse and Neglect

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201
Q

Validated in primary care

A

Older adult abuse suspicion index

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202
Q

For use with cognitively intact patients

A

Older adult abuse suspicion index

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203
Q

Includes 6 questions with 5 questions asked of the patient and the last question answered by the physician

A

Older adult abuse suspicion index

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204
Q

Can be complicated to assess in elderly population (abuse/neglect)

A

Older adult abuse suspicion index

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205
Q

Greater risk for financial abuse, theft, forcible transfer of property, corrosion to steal assets

A

Older adult abuse suspicion index

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206
Q

Dementia and Alzheimer’s cannot do this assessment

A

Older adult abuse suspicion index

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207
Q

Provide anticipatory guidance (support)

A

Health care providers

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208
Q

Ideal individual to be able to monitor, observe, and assess for potential problems

A

Health care providers

209
Q

Developmental screening tools to identify delays

A

Use appropriate resources to educate caregiver/parent

210
Q

Parent/caregiver teaching and education in order to seek resources for addictions, behavioral issues, etc

A

Use appropriate resources to educate caregiver/parent

211
Q

If child is verbal, history should be obtained away from caregivers through open-ended questions or spontaneous statements. So they could understand. Need two witnesses with

A

child and caregiver.

211
Q

Medical history is important part of examination.

A

Assessment of Child Abuse and Neglect

212
Q

Preschool age with bruises on bony provinces =

A

Play

213
Q

Bruising on ___ are rare and should arise concern to HC provider

A

Buttocks, hands, feet, and abdomen

214
Q

Child who is immobile who has significant bruising or underlying illness, warrants

A

comprehensive assessment

214
Q

Significant fractures or fracture in different stages in healing may need to have a

A

bone scan on radiologic bone assessment to see past injuries

215
Q

Multiple injuring with multiple stages of healing=

A

suspicions for abuse

216
Q

When documenting history and physical findings of child abuse and neglect

A

use words child has used to describe how his or her injury occurred.

217
Q

Remember the possibility that the abuser may be accompanying the child.

A

If child is nonverbal, use reports of caregivers.

218
Q

Know your institutional protocol for obtaining history in cases of suspected child maltreatment

A

Some protocols may delay a full interview until it can be done by a forensically trained interviewer.

219
Q

Be aware of normal range of findings based on

A

developmental age.

219
Q

Abuse may be hidden under clothing.

A

Visual examination of the entire body is required.

220
Q

Atypical bruising pattern or bruise in the shape of an object (flyswatter, hand, whip)

A

Visual examination of the entire body is required.

221
Q

Significant injury observed in non-mobile individual

A

Visual examination of the entire body is required.

221
Q

Use appropriate terminology r/t bruising.

A

Maintain consistency for accurate interpretation to maintain consistency.

222
Q

Include baseline laboratory testing

A

CBC with platelet count, basic blood chemistries, serum LFTs, coagulation panel and UA

223
Q

Laceration-

A

produced by tearing/slitting. Blunt impact over a boney surface

224
Q

Pattern injury-

A

Distinct shape- whip, hand, extension cord

225
Q

TYPES OF INJURIES

A

Laceration, Contusion, Hematoma, Abrasion, Patterned

226
Q

Laceration

A

a deep cut or tear in skin or flesh.

227
Q

Contusion

A

Bruise, injury to soft tissue. No breakage in skin

228
Q

Hematoma

A

Blunt force trauma, localized collection of blood, clotted in organ, tissue,

228
Q

Abrasion

A

Rug burn

229
Q

Patterned

A

Injury from an object

230
Q

Front of body is more susceptible to bruising due to

A

falling forwards

231
Q

This 19-item yes/no instrument is used extensively by nurses in the health care system.

A

Danger assessment (DA)

232
Q

It starts with a calendar so women can more accurately see how frequent and severe violence has become over the past year.

A

Danger assessment (DA)

233
Q

This is also an excellent assessment of frequency and severity of violence for health care providers.

A

Danger assessment (DA)

234
Q

The more yes answers, the more serious the danger of the woman’s situation.

A

Danger assessment (DA)

235
Q

Over 55% of all female homicides are related to IPV

A

Danger assessment (DA)

236
Q

Over 11% of those victims have experienced violence of the month preceding the homicide

A

Danger assessment (DA)

237
Q

If we fail to assess pt for risk of violence, it is a missed opportunity in order to intervene and decrease risk of danger

A

Danger assessment (DA)

238
Q

The higher the number of yes answers is going to measure the amount of danger in the women’s situation, same tool law enforcement uses.

A

Danger assessment (DA)

239
Q

Not going to be used in all patients.

A

Danger assessment (DA)

240
Q

Important from first seeing them for the first time

A

General Survey and Measurement

241
Q

Begins as soon at the pt walks into the room

A

General Survey and Measurement

242
Q

Monitor for different areas which includes physical appearance, body structure, mobility, and behavior

A

General Survey and Measurement

242
Q

The general survey is a study of the

A

whole person

242
Q

Covers general health state and any obvious physical characteristics

A

general survey

243
Q

Provides an overall impression

A

general survey

243
Q

Includes areas of physical appearance, body structure, mobility, and behavior

A

general survey

244
Q

Includes objective parameters that apply to the whole body

A

general survey

245
Q

Overall impression, H to T

A

general survey

245
Q

Observe body stature, nutritional status

A

general survey

246
Q

Once learned = Second nature

A

general survey

247
Q

Objective Data: Physical Appearance

A

Age, Sex, LOC, Skin color, Overall appearance

247
Q

Age:

A

What age they appear to be and what age they are

248
Q

Sex:

A

Sexual development level and age make sure its appropriate.

249
Q

Level of consciousness:

A

Alert, oriented?

250
Q

Skin color:

A

Pallor, Jaundice, Erythematic, Cyanosis, Pink,

251
Q

Overall appearance:

A

Gait, symmetric movement and appropriate. General statement of pt overall appearance related to comfortable.

252
Q

Objective Data: Body Structure

A

Stature, Nutrition, Symmetry, Posture, Position

253
Q

Stature:

A

Nutrition is appropriate. Over weight, underweight, emaciated, cachectic.

254
Q

Nutrition:

A

Body fat distribution. Appropriate? A lot in abdomen?

255
Q

Symmetry:

A

Moving extremities together, same manner, and increased or decreased muscle mass on one side.

256
Q

Posture:

A

Appropriate and appropriate their age, appear comfortable.

257
Q

Position:

A

Kyphosis? Slumped appearance-depression s/sx, lordosis.

258
Q

Tripod breathing-

A

COPD

259
Q

HF=

A

Paroxysmal dyspnea

260
Q

Objective Data: Mobility

A

Gait: normally base is as wide as shoulder width

261
Q

Foot placement:

A

accurate; walk smooth, even, and well-balanced; and associated movements, such as symmetric arm swing, are present

262
Q

Range of motion:

A

note full mobility for each joint, and that movement is deliberate, accurate, smooth, and coordinated.

263
Q

No involuntary movement-

A

tics, muscle spasms- document.

264
Q

Able to maintain balance without assistance- normal pt walking. If they do pay attention

A

Mobility

265
Q

If wide base- dizziness, altered LOC

A

Mobility

265
Q

If paralysis- unable to move extremity could be sensory, musculoskeletal or cva

A

Mobility

266
Q

Objective Data: Behavior

A

Facial expression, Mood and affect, Speech, Dress, Person Hygiene

267
Q

Facial expression

A

Note expressions both while face is at rest and while person is talking

268
Q

Mood and affect

A

immediate expression of emotion; mood refers to the more sustained emotional makeup of the patient’s personality.

269
Q

Speech:

A

articulation (ability to form words) clear and understandable

270
Q

Stream of talking is fluent, with an even pace

A

Speech

271
Q

Conveys ideas clearly

A

Speech

271
Q

Word choice appropriate to culture and education

A

Speech

272
Q

Person communicates in prevailing language easily by himself or herself or with interpreter.

A

Speech

273
Q

Maintain eye contact if appropriate
Make sure pt is comfortable

A

Behavior

274
Q

Dress:

A

Make sure the clothing fits too large- lost weight, too small- edema or more fat. More holes in belt- weight gain/edema

275
Q

Amish women wear clothing from

A

nineteenth century.

276
Q

Indian women may wear

A

saris.

277
Q

Culturally determined dress should not be labeled as bizarre by

A

Western standards or by adult expectations

278
Q

Personal hygiene:

A

Can be a sign of depression and environment they live in.
able to care for themselves and live a healthy life.
If familiar with a patient and has hygiene issues and usually does not- experiencing depression, malaise, or current illness.

279
Q

Always remain unbias to people that are

A

not normal

280
Q

Instruct person to remove his or her shoes and heavy outer clothing before standing on scale.

A

Objective Data: Measurements Weight

281
Q

When sequence of repeated weights is necessary, aim for approximately same time of day and same type of clothing worn each time.

A

Objective Data: Measurements Weight

282
Q

Show person how his or her weight matches up to recommended range for height.

A

Objective Data: Measurements Weight

282
Q

Record weight in kilograms and pounds.

A

Objective Data: Measurements Weight

283
Q

Same clothes, scale, time

A

Objective Data: Measurements Weight

284
Q

Balnce or electronic standing scale for people that can stand

A

Objective Data: Measurements Weight

285
Q

Always compare current and previous weight to make sure it is accurate

A

Objective Data: Measurements Weight

286
Q

Unexplained weight loss-

A

short term illness

287
Q

Unexplained weight gain-

A

edema or fluid retention

288
Q

Height and Body mass index

A

Objective Data: Measurements

289
Q

Align extended headpiece with top of the head.

A

Height

289
Q

Use wall-mounted device or measuring pole on scale.

A

Height

290
Q

___ is practical marker of optimal weight for height and an indicator of obesity or protein-calorie malnutrition.

A

Body mass index

291
Q

Can overestimate body fat in people who are very muscular.

A

Body mass index

292
Q

Can underestimate body fat in older adults who are lean

A

Body mass index

292
Q

__ normal BMI

A

19-25

293
Q

When measuring height.-

A

Shoeless, standing straight, looking straight ahead, and feet and shoulders up against the hard surface.

294
Q

Assesses body fat distribution as indicator of health risk.

A

Objective Data: Waist Circumference

295
Q

Excess abdominal fat is an independent risk factor for disease, over and above that of body mass index (BMI).

A

Objective Data: Waist Circumference

296
Q

Waist circumference measured in inches at smallest circumference below rib cage and above iliac crest

A

Objective Data: Waist Circumference

297
Q

Hip circumference measured in inches at largest circumference of buttocks

A

Objective Data: Waist Circumference

298
Q

How and where they carry their weight.

A

Objective Data: Waist Circumference

299
Q

Increase risk for disease- large waist circumference

A

Objective Data: Waist Circumference

300
Q

Measure in inches at the end of expiration

A

Objective Data: Waist Circumference

300
Q

Diseases: Heart disease and type 2 diabetes

A

Objective Data: Waist Circumference

301
Q

Waist Circumference: A measurement ____ is increasing risk of type 2 diabetes, heart disease, dyslipidemia, and hypertension.

A

> 35 in women and >40 in men

301
Q

Increased in pts with BMI 25-35.

A

Objective Data: Waist Circumference

302
Q

Interpret based on age and developmental ability

A

General survey r/t infants and children

302
Q

Behavior and parental bonding

A

General survey r/t infants and children

303
Q

Measurement—weight and length (height)- best indicator in physical growth in infants and children.

A

General survey r/t infants and children

303
Q

Best view of child’s general health. Compare to growth charts and watching trends

A

General survey r/t infants and children

304
Q

Physical growth based on CDC growth charts

A

Head circumference and chest circumference

305
Q

Up until age of 2 obtain weight measurement laying down (supine position)

A

using horizontal measuring board

306
Q

If caregiver/parent appears to be grossed out, irritated, disgusted by the child-

A

raise red flags

306
Q

Assess parental and child bond-

A

appears appropriate

307
Q

Head measurement is also important

A

General survey r/t infants and children

308
Q

At birth and then Conducted at each well child check until age 2 years.

A

Head meaurements

309
Q

Then annually up to 6 years of age

A

Head measurements

310
Q

Compare with expected size for age.

A

Head measurements

311
Q

Series of measurements which gives accurate information of the pattern. 32-38 cm is normal measurement.

A

Head measurements

312
Q

2 cm larger than the circumference of the chest.

A

Head measurements

313
Q

Compare to head circumference

A

Chest measurements

313
Q

Chest grows faster than the head

A

Chest measurements

314
Q

Around the nipple line of the child

A

Chest measurements

315
Q

Only important to compare to the head to monitor growth and appropriate.

A

Chest measurements

316
Q

Right at their eyebrow line-measure head at

A

34 head measurement and chest 32= normal finding for newborn

317
Q

Normal consequence of aging changes r/t posture and gait-

A

weakens, muscle atrophy, postural changes- kyphosis, fluctuation of knees and hips to compensate for that change.

318
Q

Ambulate with a wider base to compensate for decrease balance.

A

General survey r/t aging adults

319
Q

Measurement—weight and height

A

General survey r/t aging adults

319
Q

Trunk appears shorter and extremities are very long-

A

kyphosis and losing muscle mass

319
Q

Sharper features and bony landmarks may be more prominent.
Older adults enter 80 or 90s may appear shorter-

A

shortening and thinning of vertebrae

320
Q

Dwarfism

A

Hypopituitary dwarfism and Achondroplastic dwarfism-

320
Q

Lacking growth hormone, occurs in childhood.
Halts the growth.
Height and weight may fall into the 3rd percentile for their age. S/sx Delayed puberty, Hypothyroidism, And adrenal insufficiency.

A

Hypopituitary dwarfism

321
Q

Halts the growth.

A

Hypopituitary dwarfism

322
Q

Height and weight may fall into the 3rd percentile for their age.

A

Hypopituitary dwarfism

323
Q

S/sx Delayed puberty, Hypothyroidism, And adrenal insufficiency.

A

Hypopituitary dwarfism

323
Q

genetic disorder convert cartilage into bone.

A

Achondroplastic dwarfism

324
Q

Result in normal trunk size and very short arms and leg.

A

Achondroplastic dwarfism

325
Q

Short stature.

A

Achondroplastic dwarfism

326
Q

Relatively large head, frontal bossing.

A

Deal with lumbar lordosis and abdominal protrusion.

327
Q

Deal with lumbar lordosis and abdominal protrusion.

A

Deal with lumbar lordosis and abdominal protrusion.

328
Q

Too much growth hormone in adulthood.

A

Gigantism versus acromegaly (hyperpituitarism)

329
Q

Already completed normal growth.

A

Gigantism versus acromegaly (hyperpituitarism)

330
Q

Bones in head, face, hands and feet are most effected

A

Gigantism versus acromegaly (hyperpituitarism)

331
Q

Excessive secretion of growth hormones in adulthood after normal completion of bone growth

A

acromegaly

332
Q

Bones in face, head, hands and feet (no changes in height)

A

acromegaly

333
Q

Internal organs can also enlarge-

A

acromegaly

334
Q

Metabolic disorders may be present- Diabetes mellitus, Hyperpituitarism, greater risk for diabetes

A

acromegaly

335
Q

Skull is rigid box that protects brain.

A

Structure and function: Head

335
Q

Made up of Cranial Bones

A

Structure and function: Head

336
Q

Sutures- where the bones of the skull meet, immovable joints

A
336
Q

Two pairs of salivary glands accessible to examination on the face:

A

Parotid glands
Submandibular glands

337
Q

Parotid glands

A

are in cheeks over mandible, anterior to and below ear; the largest of salivary glands, they are not normally palpable. When extending head, If palpable indicates diagnosis of HIV or mumps.

338
Q

Submandibular glands

A

beneath mandible at angle of jaw

339
Q

Responsible for sensation of the face and motor function (biting + chewing)

A

Trigeminal nerve

340
Q

Trigeminal nerve

A

Or Cranial nerve V (5)

341
Q

Most complex cranial nerve

A

Trigeminal nerve

342
Q

Inability to note sharp/dull sensations indicates damage to nerve

A

Trigeminal nerve

343
Q

Assessing both sides of the face to compare

A

Trigeminal nerve

343
Q

Neck delimited by

A

Base of skull and inferior border of mandible above, and by manubrium sterni, clavicle, first rib, and first thoracic vertebra below

343
Q

Think of neck as conduit of many structures.

A

Neck

344
Q

Connects respiratory, cardiovascular, lymphatics, neurovascular, digestive system-

A

neck function

345
Q

Major neck muscles

A

Sternomastoid and trapezius are innervated by cranial nerve XI.

346
Q

Sternomastoid enables

A

Head rotation and flexion and divides each side of neck into two triangles: anterior and posterior triangles

346
Q

Two trapezius muscles move

A

shoulders and extend and turn head.

347
Q

If shoulder and neck pain= damage to

A

cranial nerve 11

348
Q

Assessing pt by- shrug shoulders against resistance

A

cranial nerve 11

349
Q

Thyroid: Endocrine gland

A

Straddles trachea in middle of the neck
The gland has two lobes

350
Q

Should not have significant pain and should shrug shoulders with resistance

A

cranial nerve 11

351
Q

Synthesizes and secretes
Thyroxine (T4) and triiodothyronine (T3), which are hormones that stimulate rate of cellular metabolism

A

Thyroid: Endocrine gland

352
Q

If thyroid is enlarged-

A

listen for a bruit using the bell of the stethoscope. Bruit- Increased blood flow or hyperplasia.

353
Q

Highly vascular.
If hyperthyroidism do not press on thyroid bc it can release more hormones

A

Thyroid: Endocrine gland

354
Q

Men thyroid -

A

in small palpable v within upper edge of thyroid cartilage- Adams apple

355
Q

Hugs the second and third tracheal reeves

A

Thyroid gland

356
Q

Major part of immune system

A

Lymphatic System

357
Q

Rich supply of lymph nodes- head and neck contains 60-70 lymph nodes

A

Lymphatic Systematic System

358
Q

Be aware of lymphatic drainage takes place.

A

Lymphatic Systematic System

359
Q

If enlarged lymph node, assess above it.

A

Lymphatic Systematic System

360
Q

Lymphatic Purpose-

A

detect and eliminate foreign substances from the body

361
Q

Leads to Lymphatic drainage.

A

Lymphatic Systematic System

362
Q

Proximal to enlarged lymph nodes-

A

swollen lymph nodes

363
Q

Normal, should be movable discrete and can have varying levels of firmness but should be soft

A

lymph nodes

364
Q

Should not be tender

A

lymph nodes

365
Q

Firm lymph nodes-

A

cancer

366
Q

If swollen check source up stream

A

lymph nodes

367
Q

Separate from the cardiovascular system but work together

A

Lymphatic Systematic System

368
Q

Only area able to access examination of lymph nodes, are the

A

head, neck, arms, inguinal area, axilla area

369
Q

Located like beads on a string

A

Lymphatic Systematic System

370
Q

Bones of neonatal skull are separated by sutures and fontanels, spaces where the sutures intersect.

A

These membrane-covered “soft spots” allow growth of brain during first year; gradually ossify. For childbirth and growth

371
Q

Posterior Closure of fontanels-

A

1-2 months will close and be triangular shaped

372
Q

Anterior Closure of fontanels-

A

diamond shaped, will close 9 months- 2 years of age

373
Q

Well developed at birth and grows to adult size when the child is

A

6 years old

374
Q

facial hair also appears on boys : first on upper lip, then on cheeks and lower lip, and last on the chin.

A

In adolescence

375
Q

noticeable enlargement of the thyroid cartilage occurs, and with it, the voice deepens.

A

In adolescence

376
Q

Facial bones and orbits appear more prominent.- lose fat, muscle, decreased elasticity, decreased moisture(water). If lost teeth the facial features change even more

A

Older Adults

377
Q

During fetal period the head growth will be

A

fast

378
Q

When assessing lymph nodes may be palpable in children up until they reach puberty,

A

can be a normal finding even if no s/sx of illness.

379
Q

Grows rapidly at 10-11. Puberty it starts to atrophy,

A

lymph nodes.

380
Q

Leading cause of acute pain and lost productivity

A

Headache

381
Q

Classified by etiology and often misdiagnosed,

A

Headache

382
Q

Headache classified by location and etiology.

A

tension, migraine, cluster headache.

383
Q

Headache Health History

A

Determine surgeries, hx of headaches, recent infection, radiation, smoking.

384
Q

Complain of acute onset of headache, neck stiffness/pain, and fever-

A

suspect meningeal infection

385
Q

Severe headache with no Hx of headache-

A

Hemorrhage, CVA

385
Q

Note facial expression and appropriateness to behavior or reported mood.

A

Inspection of the Face

386
Q

Goal in headache’s-

A

prevent neurological dysfunction, address asap.

386
Q

Facial structures

A

Always should be symmetric.

387
Q

Note any involuntary movements (tics) in facial muscles; normally none occur. Gather more info and document.

A

Inspection of the Face

388
Q

Asymmetry- stroke, bells palsy- damage to cranial nerve 7.

A

Inspection of the Face

389
Q

Head and neck symmetry

A

Inspection and Palpation-Neck

390
Q

Range of motion- not pain/discomfort

A

Inspection and Palpation-Neck

391
Q

Observe for enlargement of glands and/or pulsations.

A

Inspection and Palpation-Neck

392
Q

Thyroid gland-enlargement

A

Difficult to palpate; check for enlargement, consistency, symmetry, and presence of nodules
Position patient for best approach (posterior)

393
Q

Palpate nodes noting location, size, shape, delimitation, mobility, consistency, and tenderness.

A

Inspection and Palpation-Neck

393
Q

Gentle palpation in neck and lymph nodes

A

Inspection and Palpation-Neck

394
Q

Trachea- midline

A

Inspection and Palpation-Neck

395
Q

Palpate both sides to compare

A

Inspection and Palpation-Neck

396
Q

Using a gentle (esp. pain and discomfort) circular motion of finger pads, palpate lymph nodes.

A

Examining Lymph Nodes

397
Q

Do not vary sequence or you may miss some small nodes.

A

Examining Lymph Nodes

398
Q

Up to 1 cm in size

A

Examining Lymph Nodes

398
Q

If palpable, note location, size, shape, and if discrete or matted together.

A

Examining Lymph Nodes

399
Q

Measure infant’s head at each visit up to age

A

2 years and yearly up to age 6 years.

400
Q

Note infant’s head posture and head control; infant can turn head side to side by

A

2 weeks.

401
Q

Two common variations in newborn cause shape of skull to look markedly asymmetric due to birth trauma:

A

Caput succedaneum
Cephalohematoma

402
Q

Caput succedaneum:

A

Swelling across suture lines in newborns. Self limiting- swelling will go down.

403
Q

Cephalohematoma:

A

Trauma occurring hours after birth and gradually increase in size. Bleeding. Periosteum holds the blood.

404
Q

Molding- for child birth and growth

A

Skull

405
Q

Positional molding (positional plagiocephaly)

A

flat spot from laying down. common

406
Q

Fontanels

A

Observe anterior and posterior fontanel. Depressed or sunken in= dehydrated or malnourished.

407
Q

Head and neck control

A

Observe for appearance of tonic neck reflex which disappears between 3 and 4 months of age.

408
Q

By age of ___ infants should maintain head control.

A

4 months

409
Q

Should hold head up when erect and steady themselves if pulled up.

A

Physical Examination: Infants and Children

410
Q

While crying lying down or vomiting may notice bulge in fontanels- increased intercranial pressure.-

A

Physical Examination: Infants and Children

410
Q

Physical Examination: Pregnant Female- During second trimester- chloasma may show on face.

A

A blotchy, hyperpigmented area over cheeks and forehead that fades after delivery

411
Q

Physical Examination: Aging Adult: Temporal arteries

A

may look twisted and prominent.- esp. losing muscle tone to face or body fat

412
Q

Thyroid gland may be palpable normally during pregnancy.

A

bc highly vascular and has increased blood flow. Increase in hyperplasia

413
Q

In some aging adults, a mild rhythmic tremor of head may be normal.

A

Benign finding

414
Q

Older adult: Neck may show an increased concave curve

A

to compensate for kyphosis.

415
Q

Maintain patient safety by indicating patient perform ROM and position changes slowly

A

minimize potential for dizziness.

416
Q

Decreased elasticity loss of sub fat and decreased moisture

A

Older adult

417
Q

Changing positions slowly- avoid falls and dizziness.

A

Older adult

418
Q

Types of headaches:

A

Tension, Migraine, Cluster

419
Q

Tension Headache definition

A

HA of musculoskeletal origin; may be a mild-to-moderate, less disabling form of migraine

420
Q

Tension Headache location

A

Usually both sides, across frontal, temporal, and/or occipital region of head: forehead, sides, and back of head

421
Q

Tension Headache character

A

Band-like tightness, viselike, nonthrobbing, nonpulsatile

422
Q

Tension Headache duration

A

Gradual onset, lasts 30 mins to days

423
Q

Tension Headache quantity/severity

A

Diffuse, dull aching pain
Mild to moderate pain

424
Q

Tension Headache timing

A

Situational, in response to overwork, posture

425
Q

Tension Headache aggravating symptoms or triggers

A

Stress, anxiety, depression, poor posture.
Not worsened by physical activity

425
Q

Tension Headache associated symptoms

A

Fatigue, anxiety, stress.
Sensation of band tightening around head, of being gripped like a vise.
Sometimes photophobia or phonophobia

426
Q

Tension Headache relieving factors, effort to treat

A

Rest, massaging muscles in area, NSAID meds

427
Q

Migraine Headache definition

A

HA of genetically transmitted vascular and trigeminal nerve origin. HA plus prodrome, aura, other symptoms: 2-3 times as common in women as in men

428
Q

Migraine Headache location

A

Commonly one sided but may occur on both sides. Pain is often behind the eyes, the temples, or forehead

429
Q

Migraine Headache duration

A

Rapid onset, peaks 1-2 hrs, lasts 4-72 hrs, sometimes longer

429
Q

Migraine Headache character

A

Throbbing, pulsating

429
Q

Migraine Headache quantity/severity

A

Moderate to severe pain

430
Q

Migraine Headache aggravating symptoms or triggers

A

Hormonal fluctuations (premenstrual)
Foods (alcohol, caffeine, MSG, nitrates, chocolate, cheese)
Hunger, letdown after stress, sleep deprivation, sensory stimuli (flashing lights or perfumes), changes in weather, and physical activity

431
Q

Migraine Headache timing

A

=2 per month, lasts 1-3 days
=1 in 10 patients have weekly headaches

432
Q

Migraine Headache associated symptoms

A

Aura (visual changes as blind spots or flashes of light, tingling in an arm or leg vertigo)
Prodrome (change in mood, behavior, hunger, cravings, yawning)
N/V photophobia, phonophobia, abdominal pain
Person looks sick
Family hx of migraine

432
Q

Migraine Headache relieving factors, effort to treat

A

Lie down, darken room, use eyeshade, sleep, NSAID early, avoid opioid

433
Q

Cluster Headache definition

A

Rare HA that is intermittent, excruciating, unilateral, with autonomic signs

434
Q

Cluster Headache location

A

Always one sided. Often behind or around the eye, temple, forehead, cheek

435
Q

Cluster Headache character

A

Continuous, burning, piercing, excruciating

436
Q

Cluster Headache duration

A

Abrupt, onset, peaks in minutes, lasts 45-90 mins

437
Q

Cluster Headache quantity/severity

A

can occur multiple times a day

438
Q

Cluster Headache timing

A

1-2/day, each lasting 1/2 to 2 hrs for 1 to 2 months; then remission for months or years

439
Q

Cluster Headache aggravating symptoms or triggers

A

Exacerbated by alcohol, stress, daytime napping, wind or heat exposure

440
Q

Cluster Headache associated symptoms

A

Ipsilateral autonomic signs: nasal congestion, runny nose, watery or reddened eye, eyelid drooping, miosis
Feelings of agitation

441
Q

Cluster Headache relieving factors, effort to treat

A

Need to move, pace floor

442
Q

Obstruction of drainage of cerebrospinal fluid results in excessive accumulation, increasing intracranial pressure, and enlargement of the head.

A

Hydrocephalus

443
Q

Dilated scalp veins.

A

Hydrocephalus

444
Q

Face looks small in relation to their head. Setting sun eyes-sign.

A

Hydrocephalus

445
Q

Most common chromosomal abnormality with characteristic facial abnormalities.

A

Down syndrome

446
Q

Facial features: flat nasal bridge, small broad nose, up slanting to the eyes, inner epicanthal folds, thicker tongue that may protrude and broad neck and webbing small hand with palmar crease

A

Down syndrome

447
Q

Plagiocephaly

A

Positional or deformational due to sleeping position. Laying on one side, flattened head

448
Q

Abnormal Findings: Pediatrics

A

Craniosynostosis, Atopic (allergic) facies, Fetal alcohol spectrum disorders (FASD), Allergic salute and crease

449
Q

Craniosynostosis

A

Premature closing of one or more cranial sutures that leads to head malformation. Does not allow growth

450
Q

A variety of presentations seen in children who have chronic allergies

A

Atopic (allergic) facies

451
Q

Include exhausted face, allergic shiners, morgan lines, central facial pallor, and allergic gapping, which can lead to can lead to malocclusion of the teeth and malformed jaw bc its still forming.

A

Atopic (allergic) facies

452
Q
  • blue shadows below the eyes from sluggish venous return,
A

allergic shiners

453
Q

double or single crease on the lower eyelids

A

morgan lines

454
Q

open mouth breathing

A

allergic gapping,

455
Q

Narrow palpebral fissures, epicanthal folds, thin upper lip, and midfacial hypoplasia

A

Fetal alcohol spectrum disorders (FASD)

456
Q

Allergic salute and crease

A

Appearance of transverse line on the nose in response to chronically repeated use of hand to push the nose up and back

457
Q

Not possible to palpate adult

A

thyroid gland

458
Q

If painless or rapidly growing nodule it can be cancerous esp. present in a

A

young person

459
Q

Hard and fixed, not mobile-

A

cancerous nodules

460
Q

Physical presentation neck and face

A

Thyroid Disorders: Graves Disease

461
Q

Goiter

A

Thyroid Disorders: Graves Disease

462
Q

Eyelid retraction

A

Thyroid Disorders: Graves Disease

463
Q

Exophthalmos- protruding of the eyes

A

Thyroid Disorders: Graves Disease

464
Q

Carotid gland inflammation-

A

hiv and mumps

465
Q

Intolerance to heat
fine-straight hair
bulging eyes
facial flushing
enlarged thyroid
tachycardia,
systolic BP increase,
breast enlargement,

A

Hyperthyroidism

466
Q

weight loss,
muscle wasting,
flinger clubbing,
tremors,
increased diarrhea,
menstrual changes (amenorrhea)
localized edema

A

Hyperthyroidism

467
Q

Physical presentation neck and face

A

Hypothyroidism

468
Q

Puffy edematous face

A

Hypothyroidism

469
Q

Periorbital edema

A

Hypothyroidism

470
Q

Coarse facial features

A

Hypothyroidism

471
Q

Coarse hair and eyebrows

A

Hypothyroidism

472
Q

Decrease in thyroid hormone

A

Hypothyroidism

473
Q

Decreasd metabolic rate

A

Hypothyroidism

473
Q

Cause; hashimoto thyroiditis

A

Hypothyroidism

473
Q

Severe non pitting edema

A

Hypothyroidism

474
Q

S/sx: fatigues, cold intolerance, puffy, swollen face, hands, feet.

A

Hypothyroidism

475
Q

Coarse facial features and slow refexes. Cold-thyroid furnace

A

Hypothyroidism

476
Q

Intolerance to cold
receding hairline
facial & eyelid edema
dull-blank expression
extreme fatigue
thick tongue-slow speech

A

Hypothyroidism

477
Q

anorexia
brittle nails & hair
menstrual disturbances
hair loss
apathy
lethargy
dry skin (coarse & scaly)
muscle aches & weakness
constipation

A

Hypothyroidism

478
Q

Late manifestations of Hypothyroidism

A

Subnormal temp
Bradycardia
Weight gain
Decreased LOC
Thickened skin
Cardiac Complications

NSG (13 decks)

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