pt 1 Flashcards
disadvantage of assessment tools are
responses may be subjective bc of self reporting
disadvantage of assessment tools are
efficacy and reliability are not measured in the ADL and IADL
disadvantage of assessment tools are
interaction is needed to complete ADL and IADL assessments
disadvantage of assessment tools are
FAQ and FSS are determining functional status.
balancing a check book, prepare a meal, and grocery shopping are all
in the IADL assessment
dressing ones self and brushing teeth are
in BADL assessment
promoting rest and sleep and exercise and ambulation are interventions for what
poststroke pt 30 days after and now in home care rehab
• The nurse is caring for an 85-year-old woman 6 weeks following a hysterectomy secondary to ovarian cancer. The patient will need chemotherapy and irradiation on an outpatient basis. The nurse should identify and address which barriers to healing? (Select all that apply.)
Has no transportation to the oncology clinic, lives alone and has no nearby relatives, and experiences stress incontinence
“individual’s ability to perform the normal daily activities required to meet basic needs; fulfill usual roles in the family, workplace, and community; and maintain health and well-being.” is ____
functional ability
“Cognitive, social, physical, and emotional ability to carry out the normal activities of life required to meet basic needs; fulfill usual roles in family, workplace, and community; and maintain health and well being” is ____
functional ability
basic activities of daily living
BADL
relate to personal care and mobility
BADL
bathing, mouth care, and toilet are
BADL
dressing and eating are
BADL
these relate to personal care and mobilty
BADL
there are instrumental activities of daily living
IADL
these relate to more complex skills essential for living
IADL
managing money, grocery shopping and cooking are
IADL
house cleaning and laundry are
IADL
taking meds and using telephone are
IADL
accessing transportation are
IADL
developmental abnormalities, trauma or disease are
think increase or decreasefunctional impairment
Situations that increase risk for functional impairment
social and cultural factors are
think increase or decrease functional impairment
Situations that increase risk for functional impairment
advanced age, cog function, and depression level/mental health issues are
think increase or decrease risk of functional impairment
Situations that increase risk for functional impairment
comorbidities and SES factors are
Situations that increase risk for functional impairment
preclinical disability is
task modification w/o report or difficulty performing a specific activity
preclinical disability has been found to be an ___ predictor of future decline and disability
impt
preclinical disability is a
think if this increases or decreases FI
Situations that increase risk for functional impairment
self report tools provide info on the patients ____ of functional ability
perception
problems with self report measures stem from the ______ of an individuals personal characteristics and perferences and environmental factors
effect
problems with self report measures lie in the _____
interpretation that can vary
problems with self report measures are ability can be ____ or underreported by individuals based on personal reasons
overreported
performance based tools involve
actual observations of tasks, and completion judged by objective data
performance based assessments
think avoid or cause inaccurate measurement in self report
avoid potential for inaccurate measurement inherent in self report
performance based assessment can
measure functional ability with repetition and if task completed on time
functional ability changes across the lifespan, mostly in what stages
infant, toddler, preschool, school age, adolescent, young adult
in kids and infants, you see ____ milestones
developmental
in young and middle adulthood, you want to ___ problems ass with aging
ID
for older adults, functional status refers to the safe, ___ performance of ADL
effective
for the older population, do ___ focused on factors that will decline the functional ability
think screening or assessing
screening
this should be done on all ppl
comprehensive, interprofessional assessment, focused on observed functional, social, or cognition changes
if problems with ability develop, milestones in ____, gross and fine motor skills, and cog domains will be reviewed.
Think lang
language
how can you reduce risk and intervention
think….teach how to maintain high or low levels of FA
teach pts and families about factors maintaining high level functional ability
how can you reduce risk and intervention….teach about
well balanced nurtition and exercise
how can you reduce risk and intervention….teach about
checkups and stress management
how can you reduce risk and intervention….teach about
think what kind of activity
participate in meaningful activity
how can you reduce risk and intervention….teach about
fall prevention and don’t do drugs
how can you reduce risk and intervention….teach about
self care assisstance for IADL and BADLs
how can you reduce risk and intervention….teach about
assistive devices
if there is an ID’ed risk, you want to reduce it as a ___
priority
pts need teaching and guidance to develop ____ action plans designed to decrease the specific risks
effective
ongoing assessment of an individuals functionality can provide continual adjustment of resources to _____ independance over dependance
maximize
a ___ month old child can pay attention to faces
2
a ___ month old child can follow things with eyes and recognize ppl at a distance
think youngest age
2
a ___ month old child can begin to act bored (cries and fuss) if activity doenst change
think earliest tested on
2
a ___ month old child can hold head up and begins to pushing on then lying on tummy
think youngest age
2
a ___ month old child can make smoother movements with arms and legs
2
a ___ month old child can look around at things nearby
think second youngest age tested
6
a ___ month old child can bring things to mouth
6
a ___ month old child can show curiosity about things and tries to get things that are out of reach
think second youngest age tested
6
a ___ month old child can begin to pass things from one hand to another
think second youngest age
6
a ___ month old child can roll over in both directions
think second youngest
6
a ___ month old child can stand, support weight on legs and might bounce
6
a ___ month old child can roll back and forth , sometimes crawling backward before moving forward
6
a ___ month old child can watch the path of something as it falls
think middle age tested
9
a ___ month old child can look for things he sees you hide
think middle age tested
9
a ___ month old child can play peek-a-boo
9
a ___ month old child can put things in mouth
9
a ___ month old child can move things smoothly from one hand to another
think middle age
9
a ___ month old child can pick up things like cereal between thumb and index figer
9
a ___ month old child can stand while holding onto things
9
a ___ month old child can get into sitting position
9
a ___ month old child can sit without support
9
a ___ month old child can pull to stand
9
a ___ month old child can crawl
9
a ___ year old child can count 10 or more things
5
a ___ year old child can draw a person with at least 6 body parts
5
a ___ year old child can print some letters or numbers
5
a ___ year old child can copy a triangle and shapes
5
a ___ year old child knows about things used every day, like money and food
5
a ___ year old child can stand on one foot for 10 seconds or longer
5
a ___ year old child can hop and maybe skip
5
a ___ year old child can do a somersault
5
a ___ year old child can use a fork and spoon and table knife
5
a ___ year old child can use the toilet on their own
5
a ___ year old child can swing and climb
5
the ability of individuals and/or their caregivers to engage in the daily tasks required to maintain health and well-being or to manage the physical, psychological, behavioral, and emotional sequelae of a chronic disease based on their knowledge of the condition, its consequences, and the plan of care co-developed with their health care team.”
self management
this is assessing if the pt can take care of themselves in the BADL and IADL
functional ability
the scope for ___ ___ is from completed dependence to complete independence
functional ability
the scope for __ ___ is from disability to full function
functional ability
the ability to care for oneself is influenced by what?
developmental stage and environment
the ability to care for oneself is influenced by what?
social and cognitive factors
the ability to care for oneself is influenced by what?
psychosocial and physical health
interventions for functional ability are
mulitdisciplinary approach
interventions for functional ability are
dependent on the cause like visual-hearing, mobility, cognitive, mental health and physical
nursing interventions for functional ability are
assist with IADL and BADL, fall prevention and education
The advantage to self reporting are
Less time to complete and no tools needed
The disadvantage for self reporting are
Pt perception of ability
The advantage of performance based assessment tools are
It involves direct observation of pt
The advantage of performance based assessment tools are
Measuring with repetition
The advantage of performance based assessment tools are
Timed tasks
The MoCA are use for ________ cog impairement
Mild
The TUG assess for risk of _____ and the ability to maintain balanced gait
Falls
The MMSE assess ____ impairment
Cognitive
The Lawton assess ____ living skills
Independent
The Katz is used for older adults and the ability to perform ____
ADL
Once pts ability to self manage own care is determined, you need to ______
Find the best way to teach/edu them
The nurse wants to help the pt discover their ability to change a behavior or lifestyle with
Self management
With self management, you need to believe you can make the change and have the power to do so….this is called
Self efficacy
With self management you need to determine learning needs like:
Age and developmental stage
With self management you need to determine learning needs like:
think EL and HB
Edu level and health beliefs
With self management you need to determine learning needs like:
Motivation and readiness to learn
With self management you need to determine learning needs like:
Health risks and knowledge and skills
When facilitating learning you…..
Have a partnership and readiness to learn as the learner
When facilitating learning you…..
think relevant or nonrelevant info
Have relevant info to the learner
When facilitating learning you…..
think neg or pos encounter and to start or end with what ur pt knows
Need a pos encounter and to start with what your pt knows
When facilitating learning you…..
think lang and culture
Use lang the pt understands and to be culturally sensitive
Self management involved pt edu and the need to
think: want pt to be ready or not ready to learn; want to see barriers or nonbarriers to health; and beneficial or non beneficial to change
be aware of if the pt is ready to learn and if they see a barrier in their health and if it will be beneficial to change poor health behaviors
this is the ability of the pt to manage their health care
self management
this is the ability to manage symptoms, treatment, physical and psychological aspects, and lifestyle changes
self management
if pt is going to self manage health, it needs to be their own ___ and ____
actions and initiative
the day to day tasks a person must undertake to control or reduce the impact of disease on physical health status
self management
the individuals ability to manage symptoms, treatment psychological and physical consequences and changes with chronic conditions.
self management
ability of individuals and/or their caregivers to engage in the daily tasks required to maintain health and well-being or to manage the physical, psychological, behavioral, and emotional sequelae of a chronic disease based on their knowledge of the condition, its consequences, and the plan of care co-developed with their health care team
self management
ability of individuals and/or their caregivers to engage in the daily tasks required to maintain health and well-being or to respond to the changing physical, psychological, behavioral, and emotional sequelae of a chronic disease based on their knowledge of the condition, its consequences, and the plan of care developed in cooperation with their healthcare team within the context of the daily demands of life
self management
the pt needs knowledge of chronic conditions and treatments for
self management
the pt must mon the condition and respond to info about disease state with
self management
the pt must be bale to convey impt info about condition and management to HCP with
self management
the interaction of health behaviors and related processes that patients and families engage in care for a chronic condition is
self management
having the confidence in ones knowledge and abilities to reach a desired outcome is
self efficacy
linked to self efficacy
pt engagement
having the knowledge, skills, ability, and willingness to be an active participant in ones health and care
pt engagement
any combo of learning experiences designed to help pts and caregivers improve health/condition
health edu
you want to enhance their knowledge, skills and confidence or influence attitutes
health edu
pt takes responsibility for their health/condition and HCP is the vehicle thru which self management occurs
pt provider relationship
system of coordinated health care interventions and communications for pts with chronic conditions that require significant self management efforts
disease management
this can increase thru education, doing tasks well, be part of health with HCP, link to services
self efficacy
the primary goal of what is to improve population health and reduce healthcare costs by mitigating the future complications of chronic conditions through effective self-care
disease management
this is based on the idea that an individuals expectations influence their behavior
Social Cognitive Theory
there is high efficacy ass with
Social Cognitive Theory
in good health remain confident can maintain health with pos health behaviors this is ass with
Social Cognitive Theory
there are person factors, behavior and environmental factor ass with( and all are intercorrelated)
Social Cognitive Theory
this is based on idea that individuals expectations influence their behavior
Social Cognitive Theory
there is observing other and modeling behavior ass with
Social Cognitive Theory
this takes into account a persons past experience and that factors into whether behavioral action will occur
Social Cognitive Theory
interventions for self efficacy are
pt engagement and health edu
interventions for self efficacy are
pt provider relationship and disease management
health enhancement and wellness interventions are
pts attend well visits and screening appts
predisease/disease preventions are
edu on factors that contribute to disease and risk of developing disease based on health status and risks
disease/new diagnosis interventions are
edu on disease and its management
acute event management interventions are
edu on new or old meds, changes or same lifestyle, and what health services(A)
edu on mew meds, changes in lifestyle, and ancillary health services
nursing interventions are finding the causes and ____ of common chronic disease
consequences
nursing interventions are med or symptom management and social ____
support
nursing interventions are
lifestyle and health promoting behaviors and comm with providers
there are four areas of self management one being ____
health enhancement and wellness
there are four areas of self management one being ____
predisease/disease prevention
there are four areas of self management one being ____
disease/new diagnosis
there are four areas of self management one being ____
acute event management
health enhancement and wellness include
welllness visits and screening appts
health enhancement and wellness include
lifestyle behaviors like good BMI, diet, exercise, sleep, manage stress, and reduce injury
health enhancement and wellness can be a _____
think 1 on 1 or 2 on 1
one on one
predisease/disease prevention includes
risk of developing full disease based on current health status and risk
predisease/disease prevention
is a state in which individuals dont meet the full diagnostic criteria for a diagnosistic but have one plus clinical markers indicating they arent healthy
predisease/disease prevention includes
prediabetic, prehypertension, and precancer lesions
predisease/disease prevention includes
can the pt make the changes and use suncreen
predisease/disease prevention includes
take low dose meds, dont smoke, and exercise and diet
predisease/disease prevention includes
consider the pt as a whole or parts, and the ____ to make changes is critical to successful management over time
consider pt with chronic disease holistically and understanding the capacity for making changes is critical to successful management over time
disease/new diagnosis includes
think making what kind of lifestyle changes
making significant lifestyle changes
disease/new diagnosis includes
edu abt disease
disease/new diagnosis includes
• considering patients with chronic disease holistically and understanding their capacity for making changes is critical to successful management over time
acute event management includes
stroke and MI
acute event management includes
asthma and hip fractures
acute event management includes
frequently life changing occurances
acute event management includes
achieving the best health possible given disease and preventing a recurrance of the event, the comorbidities, or even mortality
acute event management includes
self manage new meds
acute event management includes
changing lifestyle behaviors
acute event management includes
greater health are utilization due to increased monitoring, specialty care and ancillary health services
self management interventions include
education on preventative and supportive health measures
acute event management includes pt centered care plan that includes
think respect and partner
respect pt wishes and desires and they are a partner in their care
discharge planning needs to begin ______ the pt is alert, and able to learn and day one
the day
when discharging a pt, keep in mind the ways to facilitate ____
learning
when looking at self management, look at the ____ context to determine level of support pts need to successfully manage health
social
poverty involves __ AND IS PART OF SOCIAL CONTEXT
think paying for what two things
paying for health care and health insurnace
neighborhood violence and transportation to HCP are part of ___ context
social
once pt is discharged, they must adhere to their health care regime of ___, diet and exercise
think meds or treatment
meds
the extent to which a person actions coincide with HCP advice to maintain behaviors by result of participation and agreement
adherence
The nurse is assessing learning needs for a patient who has coronary artery disease. The nurse finds that the patient has recently made dietary changes to decrease fat intake and has stopped smoking. Which is the best initial response by the nurse?
“You did an excellent job of changing your eating habits and quitting smoking. This is so important for your heart health. Nice work!”
• A patient being treated for tuberculosis (TB) with a standard four-drug regimen continues to have positive sputum smears for acid-fast bacilli. Which actions should the nurse implement?
o Assist the patient with short-term goals and plan teaching according to these goals.
A patient being treated for tuberculosis (TB) with a standard four-drug regimen continues to have positive sputum smears for acid-fast bacilli. Which actions should the nurse implement?
Provide the patient with all the educational materials about drug-resistant TB.
A patient being treated for tuberculosis (TB) with a standard four-drug regimen continues to have positive sputum smears for acid-fast bacilli. Which actions should the nurse implement?
think what do you ask about meds?
Ask the patient whether medications have been taken as directed.
A patient being treated for tuberculosis (TB) with a standard four-drug regimen continues to have positive sputum smears for acid-fast bacilli. Which actions should the nurse implement?
Ask the patient about any barriers to obtaining medications
• The nurse determines a patient has not been taking antihypertensive medication as prescribed. How should the nurse proceed?
o Review and reinforce the need to take the medication as prescribed.
• The nurse determines a patient has not been taking antihypertensive medication as prescribed. How should the nurse proceed?
o Assess the patient’s perception and attitude towards the risks associated with missing doses of medication
• The nurse determines a patient has not been taking antihypertensive medication as prescribed. How should the nurse proceed?
o Evaluate the teaching plan to determine if there is a need to reeducate the patient
• A patient is admitted to the long-term care setting. The nurse notes that the patient does not read or write well. Which nursing actions are priority while developing a teaching plan to increase adherence?
o Include the family in the orientation to the unit and include them in the teaching process.
• A patient is admitted to the long-term care setting. The nurse notes that the patient does not read or write well. Which nursing actions are priority while developing a teaching plan to increase adherence?
o Assess what grade level the patient can read and write and tailor teaching strategies accordingly
• A patient is admitted to the long-term care setting. The nurse notes that the patient does not read or write well. Which nursing actions are priority while developing a teaching plan to increase adherence?
o Assess what the patient knows about their health issues
• A patient is admitted to the long-term care setting. The nurse notes that the patient does not read or write well. Which nursing actions are priority while developing a teaching plan to increase adherence?
think determine motivation or non motivation and the readiness or not readiness to learn
o Determine the patient’s motivation and readiness to learn
has a pos connotation
adherence
this is the self initiated action to promote wellness, recovery, and rehab
adherence
the is the persistence in the practice and maintenance of desired health behaviors and is the result of active participation and agreement
adherence
this involves pt edu, if they are ready to learn
think A
adherence
part of adherence is seeing if there are ____to maintaining health
barriers
part of adherence is to see if it will be ____ to change poor health behaviors
beneficial
with adherence, ____
o In order to help individuals and families to achieve optimal states of health, it needs to be through their own actions and initiative. Remember therapeutic communication mutuality, working in partnership with patient
the theory of planned behavior involves how actions are ___
guided
the attitudes in Theory of Planned Behavior are
behavioral beliefs
the subjective norms in Theory of Planned Behavior are
normative beliefs and the motivation to adhere
the perceived behavioral control in Theory of Planned Behavior are
think about the influence on control _____ and confidence
influence on control beliefs and confidence
attitudes, subjective norms, and perceived behavioral all lead to
think what intentions
behavioral intentions
behavioral intentions and perceived behavioral control all lead to
think what word do they have in common
behavior
the attitude in Theory of Planned Behavior is the ____ to completing treatment/motivation
think contract or agreeing
agreement
the subjective norms in Theory of Planned Behavior are the ____ of social pressure pt feels to proceed
amt
the perceived behavioral control in Theory of Planned Behavior is
the level of control pt feels they have over treatment or choice of treatment
this predicts the occurence of a specific behavior if that behavior is intentional
Theory of Planned Behavior
the key assumptions of _____ RT the prediction of whether a person intends to do something
think theory of ____ behavior
Theory of Planned Behavior
this predicts the intention to perform a behavior
think theory of planned ____
Theory of Planned Behavior
this looks at intentions and motivation that precede the actual behavior
Theory of Planned Behavior
this reveals whether the pt has a pos or neg attitude abt revealing his nonadherent behavior
think ____ of planned behavior
Theory of Planned Behavior
this is ass with seeing how the pt manages his DM
think theory of what behavior
Theory of Planned Behavior
the ___ beliefs with Theory of Planned Behavior are: fam/friends/SO would approve of him telling the nurse
think what is normal
normative
the ppl’s opinions are impt to the pt are ass with
think ____ of planned behavior
aka…other people’s opinion’s matter
Theory of Planned Behavior
Whether the patient finds it difficult to discuss his diabetes self-management and adherence with the nurse, resulting in an appropriate treatment plan is ass with
Theory of Planned Behavior
the ___hypothesis’s that ppl are more likely to initiate a health related behavior due to certain factors
think HBM
health belief model
perceive they could become ill or be susceptible to the problem (e.g., perceived susceptibility) is a factor in ____
think HBM
health belief model
believe that the illness has serious outcomes or will disrupt their daily functioning (e.g., perceived severity) is a factor in
think HBM
health belief model
believe that the required recommendation will be effective in reducing symptoms (e.g., perceived benefits) is a factor in
think HBM
health belief model
believe that there are few barriers to initiating the recommendation (e.g., perceived barriers) is a factor in
health belief model
Having the confidence in ones knowledge and abilities to reach a desired outcome is
self efficacy
the adherence spectrum defining characteristics are
compliance, persistence, and concordance
obediance with a prescribed treatment promotes an undertone of blame toward the pts behavior doesnt meet HCP expectations
compliance
measure of conformance
compliance
behavior of conforming to treatment for a recommended length of time
compliance
measure of continuation
persistence
primarily within the context of chronic disease management therapires
persistence
time from initiation to discontinuation of a recommended or prescribed treatment
persistence
confirming how often a pt renews or refills the prescriptions is a measure of
persistence
this is when the HCP and pt have a mutual agreement on regimen
concordance
non adherence is ____ omission
complete
partial adherence is intentional
and due to _____dose/frequency
adjusting
partial adherence is non intentional and ____
purposeful or nonpurposeful
non purposeful
pt RT nonadherence consequences are
aka what happens if the pt doesnt adhere
increase mortality and morbidly, conflict, embarrassment, changes in quality of life
health profession RT consequences of nonadherance are
aka what happens when the health professional doesnt adhere
ambivalence, misinterpretation, avoidance, lack of empathy, and decisional conflict
health care system RT non adherence consequences
think increased costs for what services
increase costs for health care services
behavior of conforming to treatment
compliacne
measure of continuation of prescribed treatment is
persistence
mutual agreement and alliance with pts based on realistic expectations
think how all concordances agree on definitions
concordance
interrelated concepts that influence the degree of adherence
think C and S
culture and spirituality
interrelated concepts that influence the degree of adherence
think C and FD
cognition and fam dynamics
interrelated concepts that influence the degree of adherence
think DS and pts FA
developmental stage and pts functional ability
functional performance is
the actual ADL carried out by person
functional impairment is
think abnormaities or norma & caused by what
physical abnormalities that underlie limitations and caused by disease
function refers to
think interaction between condition and performance
POS OR NEUTRAL INTERACTON BETWEEN A PERSON’S HEALTH CONDITION AND ABILITY TO PERFORM ACTIVITIES
FUNCTION IS
WHAT THE PERON CAN DO WITH HEALTH CONDITION
disability is
neg aspects to a persons health condition and social or physical limitations
two dimensions of functional ability are
THINK A and A
attributes and antecedents
defining characteristics of functional ability are
THINK a
attributes
the capacity to perform specific abilities are
attributes
actual or required performance of functional abilities are
attributes
events that must happen bf functional ability can exist
think bf/ante cedars
antecedents
development of physiological process: neural , cog, endocrine, musculoskeletal and metabolic are all
think ante cedars
antecedents
acquisition of development milestones and skills are
think ante cedars
antecedents
put na
na
jj
j
kk
kk
llll
lll
llllllllllllllllll
lllllllllllllllll
ppppppppppppp
ppppppppppppppppppppppppppppppppppppppppp
g
gg
g
g
g
g
y
y
the MMSE are used for older adults and to test __ function
cog
an interdisciplinary lens includes: ___, mental health, medicine, and pharmacy
nursing
in ___, you see a diagnosis with adherance behavior as the expected outcome
think N
nursing
in mental health, it is impt them between pt nonadherence and the feelings of __ when about the nonadherence
embarassment
in medicine, research of certain disease states attempts to answer Qs on how to predict, measure, intervene, and ___ pts who are nonadherent
think Trick or ___
treat
in pharmacy, the ____ is on developing non adherence measuring tools to improve the adherence
think Ford _____
focus
functional ability influence sexuality and _____
think E(poop)
elimination
functional ability influence ___ and vise versa
think P and gas exchange
perfusion
functional ability influence family dynamics and ______ and vise versa
think C
coping
cognition, development, and ____ influence functional ability
think c
culture
nutrition and mobility influence___ ___ and vise versa
think FA
functional ability
sensory perception and gas exchange affect ____ ___ and vise versa
think FA
functional ability
BADL and IADL are essential for ___ ___
ind living
the assessment of milestones in how kids are able to move, speak, act, and play are
developmental milestones
one action/question you see with developmental milestones for a 2 mth old is
think what does the head do with sound?
does the child turn their head toward sounds?
one action/question you see with developmental milestones for a 6 mth old is
think what do they do when name is called?
does the child respond to their name?
one action/question you see with developmental milestones for a 9 mth old is
are they able to pick up things with their hands/fingers?
one action/question you see with developmental milestones for a 5 yr old is
can the child tell what’s real and make believe?
harry and marilee ___ fit the criteria for developmental milestones. they are too old
dont
the MoCA is for ____ ages
55-85
the MoCA is for
screening all levels for cog impairment
the MoCA looks at
think A and C
attention and concentration
the MoCA looks at
think what kind of function and memory or nonmemory
executive functions and memory
the MoCA looks at
think VCS and O
visuoconstructional skills and orientation
the MoCA looks at conceptual thinking and _____
think caculator
calculations
older adults have trouble remembering ___
think ppl or animals
animals
the MoCA action will be to ___
name as many words as you can
the score scale for the the MoCA is from
0-30
27-30 is a __ result
normal for the MoCA
21-26 is a ____
MCI for the MoCA
0-20 indicates
dementia with the MoCA
marilee and harry are able to take the
think coffee
MoCA
you can use the MoCA is for
think drinking coffee at the park
parkinsons
the TUG is for what age range?
60-90 yr olds
the TUG is where a pt wears
regular footwear and can use a walking aid
TUG test steps
- stand up from chair
- walk to line on floor
- turn
- walk back to the chair
- sit down
fall risk is indicated in older adults with TUG GT >__seconds
12
harry would do the TUG test but not ____
marilee
the MMSE is for _____ yr olds
18-92 but esp. older adults
the MMSE test cog ____
impairment
the single cutoff for the MMSE is
LT 21
if an MSSE score is LT 21 there is an ____ of dementia
increased odds
if an MMSE score is GT ____ THERE IS A DECREASED ODD OF DEMENTIA
25
if an MSSE score is 21 IT IS ___ FOR 8TH GRADE
ABNORMAL
if an MSSE score is LT 23, THAT IS ABNORMAL FOR WHAT AGE
HIGH SCHOOL EDU
IF THE mmse IS LT 24, it is ___ for college edu
abnormal
to test the MMSE, ask things like…
where are we now? Stare? country? city? hospital?
to test the MMSE, repeat things like…
“no ifs, and or buts”
harry should use the MMSE not ____
marilee
0-10 of a MMSE score is severe and the pt is not likely ____
testable and under 24 hr supervision and has ADL assistence
10-20 of a MMSE is moderate and the formal assessment may be helpful if ____
there are specific clinical indications and there will be clear impairment and will require 24 hour supervision
20-25 MMSE score is mild and you will do a formal assessment to determine pattern ad extent of deficits and requires_______
some supervision, support and assistance
25-30 of MMSE score is questionably significant and do a assessment if sign of impairment are present. this affects the _______
most demanding ADL
katz is ____
index of ind in ADL
katz is used for
older adults and those who cant perform ADL’s
this assesses ability to perform ADL(I or D) and for slef care
katz
this is included with katz
bathing, dressing, toilet, transfer, continence and feeding
a question ass with katz is
can the pt move in/out of bed or chair unassisted, or with just transfer aid?
harry and marilee need to do katz. true or false
true
adherence is affected by
think C and C
culture and cognition
adherence is affected by
think pt FA and FD
pt functional abiity and fam dynamics
adherence is affected by
think DS and S
developmental stage and spirituality
aortic is at __ ICS
2nd
pulmonic is at ___ ICS
2nd
erbs point is at __ ICS
3rd
tricuspid is at __ICS
4th
mitral is at ___ ICS
5th
use __ to listen to S1 and 2 /normal sounds
diaphragm
use the bell to listen to abnormal sounds like _____
gallops, murmurs, thrills, and bruits
S1 is the
“lub”, mitral/tricuspid closure
S2 is the
“dub”, aortic/pulm closure
gallops are what
extra heart sounds like S3
S3 are ___gallops(ken-tuck’-y)
ventricular
atrial gallops say
ten’-es-see
murmurs are ____ or impeded flow(blowing or swishing sound)
increased
thrills are
palpable vibrations
bruits are
turbulent peripheral blood flow
use bell to listen to
S3 adn S4
questinons for a cardiac assessment
ask abt stress and diet
questinons for a cardiac assessment
how often do you exercise and what is the effect
questinons for a cardiac assessment
do you have cardiac history or take heart meds?
questions for a cardiac assessment
ask about pain(PQRST)?
in a cardiac assessment, you look for clamyness, _____, and pulse and veins
diaphoretic
in a cardiac assessment, _____ for bruits
use bell of stethoscope
in a cardiac assessment, you _____ apex of heart for PMI
palpate
in a cardiac assessment,when you ausulcate heart sounds, you _____
think four steps
- pt breathes normal
- 5 precordial landmarks
- use diaphragm and note S1 and 2 presence
- use bell to auscultate abnormal sounds(S3, S4, murmurs, gallops, pericardial friction rub)
with aging you see a _____ in systolic blood pressure
rise
with aging you see a _____ of coronary blood vessels and LV
thickening
with aging you see a ____ in CO and contraction strength
decrease
with aging you see the heart valves ___
stiffen
with aging you see a decrease in peripheral ____
circulation
it is harder to push blood into heart s normal with ____
aging
thrills are felt or listened to?
felt
bruits are ____in the carotid
listened to
thrills and carotids are in the _____
artery
pleural friction rub is dry, ___, rubbing
grating
pleural friction rub is due to ___
inflammation
rhonchi/stridor is course, low pitched, and ____
fluid or mucus
rhonchi/stridor can ___ with cough
clear
crackles/rales are ___, coarse”bubbly”
fine
wheezes are _____ pitched and like whistling
high
wheezes are ___ or obstructed airways
narrow
wheezes are ___ on expiration
louder
with the resp. sys, you auscultate for
crackles, wheezes, rhonchi, and pleural friction rub
you listen with the diaphragm and go back and forth on lobes in what system
respiratory
get a HH and physical exam , subjective data, and obj data with assessing the ___ ____
resp. system
get a degree of resp. distress with the
exam and HH
impt health info and functional health patterns, and genetic risk are part of
subj data
get a past HH including….
resp., allergies, body systems
meds like OTC, prescribed, drugs, and O2 is
think sibj or obj data
subj data
surgery and treatments are
think subjective or obj data
subj data
health perception -health management pattern includes
smoking history/exposure and immunizations
health perception -health management pattern includes
change in resp status and resp problems
health perception -health management pattern includes
characteristics of cough and sputum and international travel
A ____ yr old can find things even when hidden under mulitple layers
2
A ____ yr old can sort out shapes and colors
2
A ____ yr old can comeplete sentences and rhymes in familiar books
2
A ____ yr old can play a simple make believe game
2
A ____ yr old can become hand dominant
2
A ____ yr old can follow 2 step directions
2
A ____ yr old can name items in a pic book like cats and dogs
2
A ____ yr old can stand on tip toes
2
A ____ yr old can kick a ball and run
2
A ____ yr old can climb on furniture without help
2
A ____ yr old can walk on stairs holding on
2
A ____ yr old can throw overhand
2
A ____ yr old can make or copy lines and circles
2
Genetic risk includes fam history of cystic fibrosis, asthma, and COPD and included in the ____ data and functional health patterns
Subj
When inspecting the resp. Sys, you want to look at appearance(______)
Position, evidence of resp. Distress and retractions
When inspecting the resp. Sys, you want to look for thorax shape, diameter, symmetry, and ____
Movement
When inspecting the resp. Sys, you want the A/P diameter to transverse to be ____:___
2:1
When inspecting the resp. Sys, you look at the ____ oximetery, RR, depth and rhythm
Pulse
When inspecting the resp. Sys, you look at cough presence, clubbing and cyanosis and ____midline
Trachea
When inspecting the resp. Sys anteriorly and posteriorly, note muscle mass, bone ____, and nodules
Defects
When inspecting the resp. Sys, look at masses and crepitus and ask about ____
Tenderness
When auscultating the resp. Sys, look for breath _____
Sounds
Bronchial breath sounds are
High pitched and loud and hollow
Bronchial breath sounds are _____ longer than inspiration
Expiration
Bronchial breath sounds are from the _____
Trachea
Bronchovesicular breath sounds are _____/blowing over large airways
Medium
Bronchovesicular breath sounds are ____ expiration and inspiration
Equal
Vesicular breath sounds are soft/_____, breezy
Low
Vesicular breath sounds are over the ____fields
Lung
Vesicular breath sounds are _____longer than expiration
Inspiration
EF of aging in the resp. Sys are ____chest expansion and functional alveoli
Reduced
EF of aging in the resp. Sys are ____ in cilia function
Decrease
EF of aging in the resp. Sys are ____ in cough reflex
Decrease
EF of aging in the resp. Sys are _____ due to osteoporosis and weak cartilage
Kyphosis
Crackles in lungs are due to _____ edema and fluid
Pull
Rhonchi sounds like a
Snore
Bronchial breath sounds are over the _____
Trachea
Bronchiovesicular breath sounds are over the main _____
Bronchi
Vesicular breath sounds are over the ___bronchi, bronchioles and lobes
Lesser
Vesicular breath sounds are over the whole ____area
Lung and trachea
Abdomen structures are the ANS which includes ____ and ____
Parasympathetic and sympathetic
Parasympathetic are the excitatory part and are ____
think C
Cholingeric
Sympathetic is inhibitory and _____
Adrenergic
The enteric NS____ motility and secretion along the entire GI tract
Regulates
The main function of the GI system is what three things?
Ingestion, digestion, and absorption
Ingestion and propulsion of food by _____ and deglutition(swallowing)
Mastication
Swallowing includes: _____, pharynx, and esophagus
Mouth with salivary glands
Digestion happens in the_____
Stomach
Absorption happens in the ____
SI
Gastric secretions involve what kind of cells?
Chief and parietal
Chief feels secrete
Pepsinogen
Parietal cells secrete ____, water and intrinsic factor
HCl acid
In digestion you see ____ and chemical breakdown of food into absorbable substances
Physical
With digestion you see ____ in the mouth as where it starts
Saliva
With digestion you see protein broken down by pepsin in ____
Stomach
With digestion you see carbs, __ and proteins broken down in SI
Proteins
The LI does ____regulation
Water
The SI does _____
Absorption
The stomach does ____
Digestion
Elimination happens in the ___
LI
When listening to the abdomen, you want to use the ___ in all four quadrants
Diaphragm
Bowel sounds are
Irregular normally
When inspecting the abdomen, you want to look for
Distension
When inspecting the abdomen, you want to look for
Ab irregularly or contour
When inspecting the abdomen, you want to look for
Skin problems
When inspecting the abdomen, you want to ask
Is the ct guarding or splinting abdomen?
When inspecting the abdomen, you want to note
Umbilicus(the shape, color, discharge, position, and masses present)
When inspecting the abdomen, you want to look for
Shape/contour of abdomen and if there is a presence of hernias
When inspecting the abdomen, you want to assess the skin for
Lesions and scars
When inspecting the abdomen, you want to assess for
Masses and color
When inspecting the abdomen, you want to assess the skin for ascites and stretch marks. True or false
True
When inspecting the abdomen, you want to look for
Presence of visual peristalsis or pulsations
The abdomen can be flat, rounded, ____ or protruberant
Scaphoid
When ausculatating the abdomen, you want to look for
Movement of air and fluid (bowel sounds)
When ausculatating the abdomen, you want to listen is all 4 quadrants and expect
Several sounds per min
When ausculatating the abdomen, you want to look for the quality in each quadrant and see if hyperactive or absent ____
Sounds
When palpating the abdomen, you want to palpate all _____
Quadrants
When palpating the abdomen, you want to use a ______ motion
Circular
When palpating the abdomen, you want to look for masses or tenderness as this is seen in “_____”(tension of muscles)
Guarding
When palpating the abdomen, you want to look for and note verbal or nonverbal pain _____
Cues
When palpating the abdomen, you want to look for rebound tenderness which indicates
Inflammation/irritation in cavity
Subj data with abdomen assessments are
Health info(HH, meds, surgery) and functional health patterns
Obj data with abdomen assessments are inspecting and palpating the ____
Mouth
Obj data with abdomen assessments are
The exam order(I,A,P); good lighting; supine and relaxed
Obj data with abdomen assessments are
Knees slightly flexed, warm hands, and empty bladder
Aging considerations with GI sys are
Weak Ab muscles and more adipose tissue
Aging considerations with GI sys are
think teeth
Dental caries and periodontal disease
Aging considerations with GI sys are
Decreased taste buds and less smell sense
Aging considerations with GI sys are
Less saliva(Xerosotmia) and constipation
Aging considerations with GI sys are
Slower esophageal and SI motility
Aging considerations with GI sys are
Inability to obtain food and decreased food intake
Aging considerations with GI sys are
Gallbladder disease and liver size decreased
Aging considerations with GI sys are
Decreased HCl acid secretions
