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Health Assessment > Study Guide Objectives: Lessons 1 and 2 > Flashcards

Study Guide Objectives: Lessons 1 and 2 Flashcards

1
Q

Name situations in which a nurse’s assessment of a client is crucial:

A
  1. Giving/holding meds
  2. Calling for help
  3. Communicating
  4. Charting
  5. Identifying “watchers”
  6. Assigning patients
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2
Q

When was physical assessment incorporated into the nursing curriculum?

A

1970’s

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3
Q

Name 3 problems in incorporating physical diagnosis techniques from the medical profession into nursing curriculum in al almost identical format:

A
  1. Nursing curriculum is the same as medical curriculum and nurses are expected to learn it in less time.
  2. Technology
  3. Evidence based assessment
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4
Q

What positive impact has technology had on nursing?

A

Technology has allowed us a means of measuring the effectiveness of a particular physical assessment to determine its accuracy and usefulness.

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5
Q

What negative impact has technology had on nursing?

A

There may be an over-reliance on technology for answers when simple physical assessment may be as accurate and less invasive.

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6
Q

What is meant by evidence based assessment?

A
  • The use of research and theory is used to guide the selection of assessments to be used.
  • The decision to use an assessment is based on information and data and does not rely on gut instinct
  • Optimize decision-making by emphasizing the use of evidence from well designed and conducted research.
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7
Q

What are Health Assessment’s 2 mottos?

A
  1. Begin with the end in mind

2. Mind like water

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8
Q

What is meant by “Begin with the end in mind”?

A

Determine the goal and then develop a plan to get there.

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9
Q

What is meant by “Mind like Water”?

A

Be flexible.

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10
Q

Regarding evidence based assessments, fill in the blanks:

  1. No ____ is perfect
  2. _______ always takes precedence
  3. ___________ ratios are the key
A

Test
Context
Likelihood

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11
Q

In a sensitive test, _______ results are the most meaningful.

A

Negative

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12
Q

What does a sensitive test detect?

A
  1. Tends to detect all people WITH a disease

2. May also identify people as having a disease when they do not (false Positive).

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13
Q

In a specific test, ________ results are the most meaningful.

A

Positive

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14
Q

What does a specific test detect?

A
  1. Tends to detect all people WITHOUT a disease

2. May also identify people as not having disease when they actually do (false Negative)

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15
Q

Which test, sensitive or specific, can give a false negative?

A

Specific

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16
Q

Which test, sensitive or specific, can give a false positive?

17
Q

Give an example of a disease in which a sensitive test is the most beneficial for detection. Why?

A

HIV

Why? We do not want to miss a patient with the disease (and thus risk infecting others).

18
Q

Give an example of a disease in which a specific test is the most beneficial for detection? Why?

A

Pancreatic Cancer

Why? Do not want to inform someone they have pancreatic cancer when they do not.

19
Q

Why is a test’s likelihood ration important to know?

A

Likelihood ratios take into account sensitivity and specificity.

20
Q

What likelihood ratio has no value?

21
Q

What is an example of an assessment skill with strong research support?
What is the test for this called?
Why is it strong?

A

ACL Tear
Strong: Lachman Test (+ LR: 9.6 and - LR: 0.15)
This method is strong, because both the positive and negative are both useful, and close to a diagnostic level

22
Q

What is the Lachman test?

A

Test where the examiner flexes the patients leg in a certain way to test for ACL deficiency.

23
Q

What is an example of an assessment skill with weak research support?
What is a better test?

A

Right upper quadrant pain for cholecystitis
Lab result of white blood count is a WEAK predictor of cholecystitis (+LR=1.8)
Murphy’s sign

24
Q

What is Murphy’s sign?

A

Fingers will bump gallbladder if it is inflamed

25
Q

What does the Fagan Nomogram predict?

A

Test results

26
Q

What is Homan’s sign?
What does it test for?
What does Knappier want us to know about it?

A
  • A positive sign is present when there is pain in the calf on forceful and abrupt dorsiflexion of the patient’s foot at the ankle while the knee is extended.
  • DVT
  • It is a weak test
27
Q

What does “context takes precedence” mean?

A

If the test says something crazy then the test is crazy. Ex: A man is pregnant.

28
Q

What is pleuritic pain?

29
Q

What is diaphoresis?

A

Sweating to an unusual degree

30
Q

If a patient is experiencing chest pain, what is the chance they are having an MI? _____%

31
Q

What is SBP?

A

Systolic Blood Pressure

32
Q

What is ST elevation referring to?

A

The ST wave

33
Q

What does asymmetric chest expansion mean?

A

Lopsided chest

Health Assessment (26 decks)

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