Physical Health Assessment/HEENT chap 30 (575-618) Flashcards by Tatiana ose

Typically, a complete heath assessment begins with what type of framework?

A health assessment usually begins with a head-to-toe framework

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According to cancer screening guidelines, at what age can men get screened for colorectal cancer?

At age 50: fecal bld test beginning at age 50, sigmoidoscopy or BE every 5 yrs, colonoscopy every 10 yrs

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According to cancer screening guidelines, at what age can women get screened for breast cancer?

Clinical breast examination every 3 years from 20 to 40 and then annually beginning at age 40/mammogram annually after 40

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According to cancer screening guidelines, at what age can you get examined for cancers of the thyroid, testicles, ovaries, lymph nodes, oral region, and of the skin?

Men and women over age 20 should be examined every 3 years and annually over age 40

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Scenario of assessment: Pt c/o of abd pain. How are you suppose to assess?

Inspect, auscultate, palpate the abd; assess V/S

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Pt is admitted w/head injury. What do you assess?

Assess LOC using Glasgow Coma Scale, assess PERRLA, assess VS

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The nsg prepares to administer a cardiotonic drug to a pt. After doing your 3 checks, 5 rights, what else are you suppose to assess?

Assess apical pulse, know parameters, compare w/baseline data

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The pt has just had a cast applied to LE. What are you to assess?

Assess for peripheral perfusion of toes, capillary test, pedal pulse if able, and VS

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The pt’s fluid intake is minimal. What are you to assess?

Assess pt’s tissue turgor, I&Os, and VS

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Why is it important to have the pt empty their bladders prior to a health examination?

Pts will feel more relaxed and facilitates palpations of the abd and pubic area

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What’s the sequence of assessment for examining children?

With children, I’m to proceed from least invasive/uncomfortable to the more invasive (head, neck, heart, lungs, ROM before ears, mouth, abd, and genitals)

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What are the four primary methods used in an examination?

Inspection, palpation, percussion, and auscultation

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In order to assess the female genitals, rectum, and reproductive tract, what position should the pt be in?

Dorsal recumbent (Back-lying position w/knees flexed and soles of feet on the surface) or Lithotomy (back-lying position w/feet in stirrups and hips in line w/edge of table)

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In order to assess the head, neck, ax, anterior thorax, lungs, breasts, heart, VS, abd, extremities, peripheral pulses, in what position should the pt be in?

Supine (back-lying position w/legs extended)

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In order to assess the head, neck, posterior/anterior thorax, lungs, breasts, ax, heart, VS, U/LE, and reflexes, what position should the pt be in?

sitting

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How do you perform a light palpation?

Use dominate hand’s fingers parallel to the skin surface and press gently while moving the hand in a circle. If determining a mass, never hold pressure, palpate the area several times instead.

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Characteristics of masses should be documented as: location, size, shape, consistency, surface, mobility, pulsatility, tenderness

Location (site on the body, dorsal/ventral surface), size (length/width in cm), Shape (oval, round, elongated, irregular), Consistency (soft, firm, hard), Mobility (fixed, mobile), Pulsatility (present or absent), Tenderness (degree of tenderness to palpation)

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How do you use palpation to test for skin temp?

Use the back of hand as the skin is thinnest

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When are areas of tenderness palpated?

Areas of tenderness are palpated last

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The act of striking the body to elicit sounds that can be heard or vibrations that can be felt is called

percussion

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Striking the area to be percussed w/the pads of two, three, or four fingers or w/the pad of the middle finger in rapid strikes is using which type of percussion

direct percussion (commonly used on the sinuses)

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To strike an area to be percussed using an object held against the body such as a pleximeter (middle finger of nondominate hand) while using the tip of the plexor (middle finger of dominate hand) to strike is what type of percussion

indirect percussion (commonly used on the thorax)

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A flatness sound (extremely dull quality) elicit by percussion may be located from:

muscle or bone

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A dullness sound (thud-like quality) elicit by percussion may be located:

liver, heart

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A resonance sound (hollow quality) elicit by percussion may be located:

normal lung

A hyperresonance sound (booming quality) elicit form percussion may be located:

emphysematous lung

A tympany sound (musical quality) elicit from percussion may be located:

stomach filled w/gas (air)

The process of listening to the sounds produced within the body is called:

auscultation

What is the difference between direct and indirect auscultation?

direct auscultation is the use of the unaided ear (listening to a respiratory wheeze or grating movement of a joint) whereas indirect auscultation is the use of a stethoscope (BS, valve sounds of the heart, BP)

What sounds can be best transmitted by both the diaphragm and bell of a stethoscope?

the diaphragm best transmits high-pitched sounds (bronchial sounds) whereas the bell best transmits low-pitched sounds (some heart sounds)

Auscultated sounds are documented according to pitch, intensity, duration, and quality.

Pitch (number of vibrations per second), Intensity (amplitude: loudness or softness of sound), Duration (length: long or short), Quality (subjective description of sound: whistling, gurgling, snapping)

A normal head size is referred to as:

normocephalic

You're assessing the head and you find edema of the eyelids. This finding is:

abnormal and may indicate kidney or cardiac disease

You're assessing the head and you notice a protrusion of the eyeballs (exophthalmos) w/elevation of the upper eyelids resulting in a staring or startled expression: This finding is:

abnormal and may be caused by hyperthyroidism

You're assessing the head and you noticed that the face is dry and puffy w/thinning hair of the scalp and eyebrows. This finding is:

abnormal and may be caused by hypothyroidism or myxedema

Protrusion of the eyeballs w/elevation of the eyelids is called and indicates what?

exophthalmos that may be caused by hyperthyroidism

You're assessing the head and you noticed that the pt's face is round with reddened cheeks. You also notice excessive hair growth on upper lips and chin. This finding is:

abnormal and called moon face that may be caused by increased adrenal hormone production or administration of steroids

You're doing a head assessment and you notice that the eyes, cheeks, and temples seem sunken in. This finding is:

abnormal and may be cause by prolong illness, starvation, or dehydration.

The degree of detail the eye can discern in an image is called?

visual acuity

The area an individual can see when looking straight ahead is called?

visual field (2nd optic nerve)

You are assessing the pt's eyes and the pt says that he cannot see very clearly from afar without the aid of glasses. The pt has?

myopia (nearsightedness)

You're pt is over 45 years of age and complains that he cannot close objects due to the loss of elasticity of his lens. Your pt has?

presbyopia and usually begins at age 45+

Your assessing your pt's eyes and the pt says he cannot see objects clearly that are near him w/o the aid of glasses. Your pt has?

hyperopia (farsightedness)

An uneven curvature of the cornea that prevents horizontal/vertical rays from focusing on the retina and occurs in conjunction w/myopia and hyperopia is called?

astigmatism

An inflammation of the bulbar and palpebral conjunctiva that may display redness, itchiness, tearing, mucopurulent discharge that may cause eyes to become encrusted during sleep is called?

Conjunctivitis resulting from a virus, foreign bodies, chemicals, bacteria and so on.

Excessive tearing and discharge of the nasolacrimal sac due to an inflammation of the lacrimal sac is called

dacryocystitis

A redness, swelling, and tenderness of the hair follicle at the edge of the eyelid is called a:

hordeolum (sty)

An opacity (cloudiness) of the lens or capsule, which blocks light rays, that tend to occur in pts 65+ (or in infants if the mother contracted rubella during pregnancy) is called?

cataracts

A disturbance in the circulation of aqueous fluid which causes intraocular pressure, is the most frequent cause of blindness in people of 40+ displayed by difficulty focusing on close objects/dark rooms, and seeing rainbow-colored rings around lights is called?

glaucoma

Eyelids that lie below the pupil margin due to aging, edema from drug allergy or systemic disease or 3rd cranial nerve impairment is called?

ptosis

An outturning of the eyelid associated with scarring injuries or aging (eversion) is called?

ectropion

An interning of the eyelid associated with scarring injuries or aging (inversion) is called:

entropion

Enlarged pupils resulting from injury, glaucoma, cocaine, atropine, amphetamines (upper drugs) is called?

mydriasis

Constricted pupils as a result of inflammation of the iris or morphine/heroin (downer drugs) is called:

miosis

Pupils that are abnormally unequal in size (some are normal) may be caused by a central nervous disorder is called?

anisocoria

You are assessing the eyes of your pt and you notice that your pt's cornea is bulging. This finding is:

abnormal and may result from increased intraocular pressure

The normal amount of blinking is between?

15-20 blinks per minute

Jaundiced sclera is indicative of what? Pale sclera is indicative of what? Reddened sclera is indicative of what?

Jaundiced sclera=liver disease/pale sclera=anemia/reddened sclera=pot or rheumatoid disease

A thin, grayish white ring around the margin of the eye (not normal for people under 40) is called?

arcus senilis

Normal pupil diameter is between:

3-7mm

Eyes that are crossed is called?

strabismus

Rapid involuntary rhythmic eye movement possibly resulting from neurological impairment is called:

nystagmus

What's the name of the instrument used to examine the ear?

The otoscope is used to examine the ear.

What does the gland of the ear canal secrete for lubercation and protection?

cerumen

The interrupted transmission of sound waves through the outer and middle ear structures are called?

conductive hearing loss possibly caused by a tear in the tympanic membrane, obstruction, swelling of the auditory canal

Damage to the inner ear, auditory nerve (8th cranial nerve), or the hearing center of the brain is called

sensorineural hearing loss

A pt c/o ringing in the ear. This is known as?

tinnitus

You're assessing your pt's ears and you noticed that the pt's ears are set lower than the outer canthus of the pt's eyes. This finding is?

abnormal and indicative of congenital abnormality such as Down Syndrome

You're assessing your pt's tympanic membrane and you notice that the color is pearly grey and semitransparent. This finding is:

normal

You're assessing your pt's tympanic membrane and you notice that the color is pinkish with a amber tint to it. This finding is:

abnormal. Should be pearly grey in color.

To check the external canal of a child less than 3 years of age, how is the pinna to be pulled?

ChilD (pull Down on the pinna) less than 3. AdUlt (pull Up over 3 years of age)

Generalized hearing loss will first show symptoms in the loss of high-frequency sounds: f, s, sh, and ph sounds. This is called:

presbycusis (happens with aging)

Nosebleeds from older adults may be indicative of what?

HTN or other arterial vessel changes

The parotid, submadibular, and sublingual glands empty where?

The three pairs of salivary glands empty out into the oral cavity.

Advanced periodontal disease in which the teeth are loos and pus is evident when the gums are pressed is called?

pyorrhea

The disorder of the supporting structures of the teeth is called:

periodontal disease

Periodontal disease is characterized by red, swollen gingiva, bleeding, receding gum line, and formation of pockets between the teeth. This characteristics are known as:

gingivitis

Inflammation of the tongue is called?

glossitis

Inflammation of the oral mucosa is called?

stomatitis

Inflammation of the parotid salivary glands is called:

parotitis

You are assessing the mouth of your pt. You asked your pt to purse their lips but the pt is unable to do so. This finding is:

abnormal and indicative of facial nerve damage.

White patches on the inner lips and buccal mucosa is called:

leukoplakia

You're assessing the mouth of your pt and you notice that the pt's tongue is deviated from the center. This finding is:

abnormal and indicative that there's damage to the 12th cranial nerve.

You're assessing the mouth of your pt and you notice that the pt's tongue is smooth and red. This finding is:

abnormal and indicative that there's a iron, B12, B3 deficiency. The tongue should be a pinkish color with raised papillae

What color should both palates of the mouth be?

The soft palate should be a light pink color and smooth; the hard palate should be an even lighter pink color with a more irregular texture.

What is superior and inferior to the trachea?

The suprasternal notch is inferior to the trachea whereas the thyroid gland is immediately superior to the trachea.

Having the pt move his chin to his chest and his ear to his shoulder is assessing the functionality of what muscles?

Moving the chin to chest=sternocleidomastoid. Ear to shoulder=sternocleiomastoid

What movement would you have the pt do in order to assess the functionality of the trapezius muscle?

Have the pt point his chin upward or have the pt shrug his shoulders against the resistance of my hands.

Upon percussion, you hear an extremely dull sound produced by very dense tissue such as muscle or bone. This sound is called:

flatness

Upon percussion, you hear a thudlike sound produced by dense tissue such as the liver, spleen, or heart. This sound is called:

dullness

Upon percussion, you hear a hollow sound produced by the lungs when filled with air. This sound is called:

resonance

Upon percussion, you hear a booming sound that's usually heard over a lung w/emphysema. This sound is called:

hyperresonance

Upon percussion, you hear a musical/drum-like sound produced from an air-filled stomach. This sound is called:

tymphany

You're assessing a pt and you notice that they have protrusion of the eyeballs with elevation of the eyelids. They appear to be startled. This finding is:

Exophthalmos; abnormal and indicative of hyperthyroidism

How often should people have their eyes examined:

under 40 yo, eyes should be examined every 3-5 years

You're assessing the eyes of your pt and you notice that the L pupil is very large compared to the R. This finding is:

anisocoria; abnormal and may be indicative of a nervous system disorder (slight anisocoria is normal)

What are you looking for when you're shining the light on the pupil approaching from the side as you observe the response of both pupils:

you're assessing pupil's direct and consensual reaction to light (3rd and 4th cranial nerves)

What are you assessing for when you hold your penlight from the bridge of your pt's nose and have the pt stare at the penlight and then at something from a distance

You're assessing pupil's reaction to accommodation

What are you assessing for when you have the pt follow the penlight as you move it towards or away from the pt's nose:

You're assessing the pupil's reaction to accommodation

What are you assessing for when you use a penlight to move infront of the pt in 6 different directions as the pt's eyes follow you?

You're assessing six ocular movements to determine for eye alignment and for strabismus and nystagmus

What is a Rosenbaum test for:

tests near vision (visual acuity)

You're assessing the eyes of an older pt and he tells you that he has difficulty reading w/o glassess, has a hard time seeing in the dark, and has a hard time seeing things using his peripheral vision. This finding is:

normal in the elderly

Which accommodation (near or far) improves with old age, and decreases with old age:

Accommodation to near objects decreases but to far objects increases as we get older.

You're assessing an older pt and she tells you that she has been experiencing many nose bleeds for the past season. This finding is:

Could be normal and indicative of HTN disease or other arterial vessel changes

You're assessing the mouth of your pt and you ask him to stick out his tongue. You notice that his tongue doesn't stay in the middle, trembles, and seems to favor the L side more. This finding is:

abnormal and indicative of damage to the 12th nerve