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Health Assessment > Test 2 > Flashcards

Test 2 Flashcards

1
Q

Postmenopausal bleeding

A

Bleeding after menopause, can mean uterine cancer

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2
Q

Atrophic vaginitis

A

Dry vagina

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3
Q

Uterine prolapse

A

Lack of pelvic strength, uterus falls through vagina, recommend kegals

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4
Q

Permission statement

A

Used for adolescent interview, start with something like “Often boys your age experience…”

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5
Q

Ambiguity approach

A

Used for adolescent interview, “When did you…” rather than “Do you…”

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6
Q

What percent of infertility is male related

A

20%

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7
Q

Fluorescent yellow

A

Excess water- soluble vitamins excreted

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8
Q

Cloudy

A

Urinary tract infection

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9
Q

Bright orange, blue, green

A

Medication, dyes

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10
Q

Red/pink

A

Blood

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11
Q

Orange/Tea colored

A

Liver disease/biliary disorder

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12
Q

What position do you give genital exam on males

A

Standing up

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13
Q

Epispadius

A

Urethra is higher

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14
Q

Hypospadius

A

Urethra is lower

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15
Q

Infibulation

A

Removing clitoris

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16
Q

What do you offer when giving pap smear

A

A mirror

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17
Q

What do you ask pt to do when giving pap smear

A

Have patient take deep breaths and bear down to increase comfort

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18
Q

When are pap smears given

A

Every 3 years starting at age 21 or becoming sexually active

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19
Q

Liver location

A

RUQ

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20
Q

Spleen location

A

LUQ, behind stomach

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21
Q

Gallbladder location

A

Right below liver

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22
Q

Stomach location

A

LUQ behind liver, in front of spleen

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23
Q

Small intestine location

A

Part of all quadrants

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24
Q

Ascending colon location

A

RUQ

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25
Q

Descending colon location

A

LLQ

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26
Q

Appendix location

A

RLQ

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27
Q

Pancreas location

A

Over aorta, in middle/LUQ

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28
Q

Adrenal glands location

A

Right above kidneys

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29
Q

Kidneys location

A

Right kidney is slightly lower, beside pancreas

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30
Q

Epigastric

A

Upper region of abdomen

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31
Q

Umbilical

A

Middle region of abdomen

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32
Q

Hypogastric or suprapubic

A

Lower region of abdomen

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33
Q

Order of physical exam for abdomen

A
  1. Inspection
  2. Auscultation
  3. Percussion
  4. Palpation
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34
Q

How to check contour

A

Slightly elevate head with pillow

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35
Q

How should umbilicus look

A

Midline, no discoloration or drainage

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36
Q

Striae

A

Stretch marks

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37
Q

What else should you do when inspecting abdomen

A

Have pt hold up head, take deep breath, and cough to look for masses

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38
Q

Types of contour

A
  1. Flat
  2. Concave
  3. Rounded
  4. Protuberant
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39
Q

Causes of abdominal distension

A
  1. Obesity
  2. Air/gas
  3. Pregnancy
  4. Feces
  5. Ascites (fluid)
  6. Mass
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40
Q

Umbilical hernia

A

Intestines bulging through umbilical

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41
Q

Incisional hernia

A

Incision from surgery has intestines coming through because muscle didn’t heal

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42
Q

Diastasis recti

A

Intestines pushing through split in muscle

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43
Q

Where do you start when auscultating for bowel sounds

A

RLQ

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44
Q

How many bowel sounds should you hear in a minute

A

5-30

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45
Q

Hyperactive bowel sounds

A

More than about 30 in a minute

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46
Q

Hypoactive bowel sounds

A

Less than about 5 in a minute

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47
Q

What could hypoactive bowel sounds mean

A

Postsurgical or have not eaten in a while

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48
Q

When can you declare that there are no bowel sounds

A

After listening for 5 minutes and not hearing any

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49
Q

Paralytic ileus

A

Anesthesia paralyzes the ileus

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50
Q

Bruits

A

Abnormal, can indicate hypertension, usually over blood vessels

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51
Q

Friction rub

A

Grinding sound, usually over vessels

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52
Q

Predominant sound in abdomen

A

Tympany, but dullness over organs

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53
Q

How to find liver span

A

Percuss down from midclavicular line and stop when you go from resonance to dullness and then percuss from abdomen and stop when you go from tympany to dullness

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54
Q

What is the normal liver span

A

6-15 cm

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55
Q

Pediatric liver span

A

5 cm at 5 years old

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56
Q

How to find spleen span

A

Between 9th and 11th intercostal space, just left of the mid axillary line, work your way up until you hear dullness

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57
Q

Costovertebral tenderness

A

First percuss over the kidneys, pain means there is a kidney infection

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58
Q

Rectal exam positions

A
  1. Left lateral
  2. Standing
  3. Lithotomy (females only)
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59
Q

Healthy people 2020 goals (skin hair nails)

A
  1. Reduce occupational skin disease
  2. Reduce health care associated infection
  3. Reduce sun exposure
  4. Teaching healthy habits
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60
Q

What to look for when inspecting hair

A
  1. Color
  2. Odor
  3. Texture
  4. Distribution
  5. Lesions
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61
Q

What to look for when inspecting nails

A
  1. Shape and contour
  2. Consistency
  3. Capillary refill
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62
Q

What to look for when inspecting skin

A
  1. Color
  2. Odor
  3. Temp
  4. Moisture
  5. Texture
  6. Thickness
  7. Edema
  8. Mobility and turgor
  9. Vascularity or bruising
  10. Lesions
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63
Q

What to look for in temperature of skin

A
  1. Hypothermia

2. Hyperthermia

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64
Q

Diaphoresis

A

Excessive sweating

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65
Q

Pallor

A

Paleness

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66
Q

Erythema

A

Reddened skin

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67
Q

Cyanosis (skin)

A

Blue tint

68
Q

Jaundice

A

Yellow tint

69
Q

Dark skinned variation: pallor

A

Brown skin may be yellowish brown and dull, black skin appears ashen

70
Q

Dark skin variation: Cyanosis

A

Dark and lifeless, no warm undertone

71
Q

Dark skin variation: Jaundice

A

Yellowish in palms and palate, can be seen in sclera

72
Q

Dark skin variation: Erythema

A

Purple tinge; verify by palpating for warmth

73
Q

Caucasions are more at risk for

A

Skin cancer

74
Q

African americans are more at risk for

A
  1. Keloids
  2. Acanthosis nigrans
  3. Mongolian spots
75
Q

Asians are more at risk for

A
  1. Sparse body hair

2. Mongolian spots

76
Q

Braden scale measures

A
  1. Sensory perception
  2. Moisture
  3. Activity
  4. Mobility
  5. Nutrition
  6. Friction and shear
77
Q

Stage 1 pressure ulcer

A

A defined area of persistent redness, in darker skin tones it may appear with red, blue, or purple.

78
Q

Stage 2 pressure ulcer

A

Superficial abrasion, blister or shallow crater

79
Q

Stage 3 pressure ulcer

A

Full thickness skin loss, a deep crater

80
Q

Stage 4 pressure ulcer

A

Full thickness skin loss with extensive destruction, to muscle, bone, or supporting structures

81
Q

What to inspect with lesions

A
  1. Color
  2. Elevation
  3. Pattern or shape
  4. Size
  5. Location and distribution on body
  6. Exudate
82
Q

Evaluating lesion using ABCDE

A 
A: Asymmetry
B: Border
C: Color
D: Diameter 
E: Elevated
83
Q

Normal diameter of lesion

A

1/8-1/4 of an inch

84
Q

Annular or circular/oval

A

Oval or rounded lesion

85
Q

Gyrate

A

Squiggle, associated with parasites

86
Q

Target

A

Bullseye appearance

87
Q

Discrete

A

Rounded bumps not associated with each other

88
Q

Grouped

A

Bumps in a group

89
Q

Polycyclic

A

Bumps that run together, no defined edges

90
Q

Confluent

A

Run together, not raised, spread across an area

91
Q

Linear

A

Striae; makes a line

92
Q

Zosteriform

A

Follows a nerve ending

93
Q

Macule

A

Flat, distinct, discolored area of skin less than 1 cm wide (freckle)

94
Q

Papule

A

Small, raised, solid pimple or swelling, often forming part of a rash on the skin and typically inflamed but not producing pus

95
Q

Urticaria

A

Hives

96
Q

Nodule

A

Growth of abnormal tissue

97
Q

Wheal

A

Transient, circumscribed, elevated papules or plaques, often with erythematous borders and pale centers.

98
Q

Pustule

A

A vesicle filled with pus

99
Q

Fissue

A

Crack

100
Q

Erosion

A

Skinned first layer of skin

101
Q

Stasis ulcer

A

Caused by bad circulation

102
Q

Excoriation

A

Severe scratching

103
Q

Atrophic scar

A

Striae

104
Q

Lichenification

A

A skin condition that occurs in response to excessive itching or rubbing of the skin and results in thick, leathery patches of skin

105
Q

Tail of spence

A

Area around axilla

106
Q

Sentinel lymph node

A

The first lymph node(s) to which cancer cells are most likely to spread from a primary tumor

107
Q

Sentinel lymph node biopsy (SLNB)

A

Can be used to help determine the extent, or stage, of cancer in the body

108
Q

Healthy people 2020 goals (breasts)

A
  1. Reduce breast cancer death rate
  2. Reduce # late stage breast cancers
  3. Increase # of women who get screening
109
Q

What to look for in breast inspection

A
  1. Appearance
  2. Skin
  3. Lymphatic drainage areas
  4. Nipple
  5. Retractions
110
Q

Signs of retraction and inflammation

A
  1. Dimpling
  2. Fixation (not moving)
  3. Edema (peau d’orange)
  4. Deviation in nipple pointing
  5. Nipple retraction
111
Q

Breast palpation position

A

Supine

112
Q

Breast palpation patterns

A
  1. Wedge (start from nipple going out)
  2. Circular
  3. Verticle strip
113
Q

Male breast

A

Gynecomastia

114
Q

Precordium

A

The area of the heart

115
Q

S1

A

Mitral, tricuspid valves closing

116
Q

S2

A

Aortic and pulmonic valves closing

117
Q

External and internal carotid artery

A

Located near the top

118
Q

Internal and external jugular vein

A

May see pulsations, located near clavicle

119
Q

Cardiovascular non modifiable risk factors

A
  1. Age
  2. Male gender
  3. Heredity (race, history)
120
Q

Cardiovascular modifiable risk factors

A
  1. Smoking
  2. High cholesterol
  3. High BP
  4. Inactivity
  5. Obesity
  6. Diabetes
121
Q

Pre hypertension BP

A

120-139/80-89

122
Q

Stage 1 hypertension BP

A

140-159/90-99

123
Q

Stage 2 hypertension BP

A

> 160/>100

124
Q

What to inspect in cardio assessment

A
  1. Carotid arteries

2. Jugular veins

125
Q

What to assess on carotid arteries

A
  1. Pulsations
  2. Palpate
  3. Auscultate for bruit
126
Q

What to assess on jugular veins

A

Inspect for jugular venous pulses

127
Q

What to inspect on chest

A
  1. Pulsations
  2. Lifts
  3. Heaves
128
Q

Normal heart sounds

A
  1. First heart sound
  2. Second heart sound
  3. Splitting of second heart sound
129
Q

What happens at the beginning of diastole

A

S2

130
Q

What happens at end of diastole/beginning of systole

A

S1

131
Q

Location of heart

A

Between 2nd-3rd intercostal space on right sternal border to left mid clavicular line

132
Q

What does enlargement of jugular veins show you

A

If there is something wrong with one side of the heart

133
Q

What heart attack symptoms are unique to women

A

Indigestion, fatigue

134
Q

Orthopnea

A

Having to sleep elevated

135
Q

Diaphoresis

A

Sweating

136
Q

Who is more at risk for heart disease

A

African Americans

137
Q

Risk for smokers for heart disease is

A

2-4 times higher

138
Q

What do you do when auscultating neck vessels

A

Use the bell of the stethoscope

139
Q

Thrill

A

Seeing chest vibrate

140
Q

PMI

A

Point of maximum impulse; 5th intercostal space left mid clavicular line; apex of heart

141
Q

What step do you not necessarily have to do

A

Percuss

142
Q

APE-To-Man

A
  1. Aortic area
  2. Pulmonic area
  3. Erb’s point
  4. Tricuspid area
  5. Mitral area
143
Q

Aortic area location

A

Right sternal border 2nd intercostal space

144
Q

Pulmonic area location

A

Left sternal border 2nd intercostal space

145
Q

Erb’s point location

A

Left sternal border 3rd intercostal space

146
Q

Tricuspid area

A

Left sternal border 5-6th intercostal space

147
Q

Mitral area

A

Left mid clavicular line, 5th intercostal space

148
Q

S2 is louder than S1 at

A

Aortic and pulmonic area

149
Q

S1 = S2

A

Erb’s point

150
Q

S1 is louder than S2 at

A

Tricuspid and mitral

151
Q

First heart sound

A

“Lub”; AV valves; heart louder at apex

152
Q

Second heart sound

A

“Dub”; SL valves; louder at base

153
Q

Splitting heart sound

A

Splitting of heart sound at inspiration

154
Q

How do you auscultate chest

A

With diaphragm first, then bell (bell tells if there is murmur)

155
Q

Extra heart sounds

A
  1. Third heart sound

2. Fourth heart sound

156
Q

Third heart sound

A

“Kentucky”; normal in children and young adults (under 30); in older adults it could signifiy fluid overload in ventricle which could lead to heart failure or regurgitation

157
Q

Fourth heart sound

A

“Grace note” “Tennessee” Normal in adults and children under 30; over 30 could mean stiff ventricle

158
Q

What to inspect on arms and legs

A
  1. Skin
  2. Profile skin (clubbing)
  3. Capillary refill
  4. Symmetry
  5. Pules (grade from 0-3+; compare bilaterally)
159
Q

Modified Allen test

A

Have pt make a fist and release ulnar side and compress radial side, should have normal blood flow

160
Q

What to palpate on extremities

A
  1. Skin
  2. Temperature
  3. Even hair distribution
  4. Venous patterns
  5. Capillary refill
  6. Profile sign (clubbing)
  7. Symmetry
  8. Pulses
  9. Edema
161
Q

Lower extremity pulses

A
  1. Femoral artery
  2. Popliteal
  3. Dorsalis pedis (on top of foot)
  4. Posterior tibial (medial side of ankle)
162
Q

Pitting edema grades

A

1+: 2mm
2+: 4mm
3+: 6mm
4+: 8mm

163
Q

Homan’s sign

A

Pull back on feet and raise straight leg, looking for pain

164
Q

Chronic arterial vascular insufficiency signs and symptoms

A
  1. Deep muscle cramps
  2. Cool extremities
  3. Pale extremities
  4. Loss of hair
  5. Shiny skin
165
Q

Chronic venous arterial vascular insufficiency signs and symptoms

A
  1. Aching tired full feeling
  2. Ulcers
  3. Edema
  4. Varicose veins
166
Q

Acute arterial vascular insufficiency signs and symptoms

A

EMERGENT

  1. Pain (throbbing)
  2. Pallor
  3. Pulselessness
  4. Poiliothermia (cold)
  5. Paralysis
  6. Parasthesia (altered sensation)
167
Q

Acute venous vascular insufficiency signs and symptoms

A

Needs prompt attention

  1. Deep muscle tenderness
  2. Red warm swollen
  3. Pain increases with dorsiflexion (Homan’s sign)

Health Assessment (3 decks)

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