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NUR 305 > Test #3 > Flashcards

Test #3 Flashcards

1
Q

What are abnormal bowel sounds?

A

high pitch, distention bowel sounds mean bowel obstruction

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2
Q

Where do you listen for bowel sounds?

A

all 4 quadrants of the abdomen

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3
Q

Define Rebound.

A

a sensation of pain felt when pressure is suddenly removed

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4
Q

How do you percuss the spleen?

A

have to turn the patient on their right side and percuss on the left side below the ribs. Should hear dullness

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5
Q

How do you palpate the spleen?

A

you can only feel the spleen if it is 3 times the normal size, it is normal not to feel the spleen

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6
Q

How do you percuss the liver?

A

Scratch test, you can find the edge of the liver by this.

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7
Q

How do you palpate the liver?

A

push up under the ribs. The normal size of the liver is 6-12 cm.

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8
Q

How do you percuss the kidneys?

A

posteriorly below the rib cage

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9
Q

How do you palpate the kidneys?

A

posteriorly or deep palpation

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10
Q

How do you percuss the aorta?

A

Its hard to percuss the aorta because it is deep, you need to percuss from the back

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11
Q

How do you palpate the aorta?

A

deep palpation, is there is rebound = very bad

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12
Q

What are some techniques on relaxing your patient?

A

put chin to chest, clinch teeth,

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13
Q

How do you check for hernias on your patient?

A

palpation & inspection

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14
Q

Describe the muscle strength grading scale.

A 
0 paralyzed
1 contract muscle, but cannot move it
2 move it, but cannot move it against gravity
3 move it up against gravity
4 move it against some resistance
5 against full resistance
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15
Q

What is the normal arm and leg difference measurements?

A

1 cm

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16
Q

Describe Gait

A

a person’s manner of walking

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17
Q

Describe stride length

A

is the average length of one step, that is, the distance between your right and left foot contacting the ground.

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18
Q

Describe base support

A

area of ground surface covered by the body silhouette in an erect subject; the wider the base of support, the greater the stability of the erect body; the centre of gravity is more easily maintained within the base of support

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19
Q

How do you assess balance

A

Romberg Test

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20
Q

How do you assess coordination

A

fluid movement, no issues walking

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21
Q

How do you assess accuracy of movement

A

fluid movement, no issues walking

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22
Q

Define Romberg Test

A

stand with feet together, hands by side, close eyes
if they have a problem they will fall
no problem they will stay up, a little sway is okay.

23
Q

Describe Lordosis

A

excessive inward curvature of the spine.

seen in pregnant people

24
Q

Describe Scoliosis

A

abnormal lateral curvature of the spine, shows an “S”

25
Q

Describe Kyphosis

A

excessive outward curvature of the spine, causing hunching of the back.

26
Q

What are some carpal tunnel tests

A

Phalen Test: test for carpal tunnel
put back side of hands together and if you have pain/numbness you have it.
Tinel Test: test for carpal tunnel
tap on nerve and if you feel electrical shock, you have it

27
Q

What are some fluid on the knee tests

A

Bulge Sign: excess fluid in knee

Patelar Tap: test fluid in the knee joint

28
Q

Describe ROM of the major joints

A 
Pivot: skull meets spine
Hinge: elbow & knee
Condyloid: wrist and fingers
Plane/gliding: vertebrae 
Ball and socket: hip & shoulder
Saddle: thumb
29
Q

What are some normal changes with aging

A

weaker, osteoarthritis, degenerative joint disease, osteoporosis (porous bone) occurs more in women, shrinking (normal 1 cm every 10 years after 40) if you’re losing too much there’s a problem, hunch back (kyphosis).

30
Q

Define Goniometer

A

an instrument for the precise measurement of angles

31
Q

What is the Pre-Hospital Stroke Assessment

A

Cincinnati Stroke Scale

32
Q

Define the different types of sensory: superficial

A

Light touch: cotton balls
Pain: pins, tooth picks, paper clips
Temperature: hot on one, cold on the other.
temperature & pain run on the same tract, don’t have to do both; one or the other.

33
Q

Describe the 1st cranial nerve

A

olfactory: sensory smell

34
Q

Describe the 2nd cranial nerve

A

optic: sensory sight

35
Q

Describe the 3rd cranial nerve

A

oculomotor: pupils; extra-ocular muscles

36
Q

Describe the 4th cranial nerve

A

trochlear: extra-ocular muscles

37
Q

Describe the 5th cranial nerve

A

trigeminal: facial sensations & motor, muscles of mastication (forehead, cheek, & chin)

38
Q

Describe the 6th cranial nerve

A

abducen: extra-ocular muscles

39
Q

Describe the 7th cranial nerve

A

facial: motor, facial muscles, sensory, taste anterior tongue. (making faces)

40
Q

Describe the 8th cranial nerve

A

acoustic: hearing (balance)

41
Q

Describe the 9th cranial nerve

A

glossopharyngeal: swallowing, voice, gag reflex, taste posterior tongue

42
Q

Describe the 10th cranial nerve

A

vagus: swallowing, voice, gag reflex

43
Q

Describe the 11th cranial nerve

A

accessory: motor, neck muscles

44
Q

Describe the 12th cranial nerve

A

hypoglossal: motor, tongue muscle

45
Q

What is the DTR (deep tendon reflexes) normal responses

A 
Checking the reflex's of the spinal cord. 
Biceps (flexion)
Triceps (extension)
Brachioradialis (supinates/flexion)
Patellar (extension)
Achilles (plantar flexion)
46
Q

Describe Babinski Refles

A

fanning out of toes; okay in babies, bad in adults

47
Q

Describe the Glasgow coma scale

A

(higher the score, the better): universal scale, determines level of consciousness

48
Q

Describe orientation

A

who they are, where are they

49
Q

Describe Memory

A

president, what today’s date is

50
Q

Describe Mental status

A

are they acting normal towards family; drooling, etc

51
Q

Define the different types of sensory: deep

A

Vibratory sensations: tuning fork place on bony part

Kinesthetics: able to sense body position in space.

52
Q

Define the different types of sensory: discriminatory

A

Stereognosis: identify object by touch, with eyes closed
Graphesthesia: write something in their hand & have them identify what you wrote. draw a number or letter.
2 point discrimination: two tooth picks, only feel 1 have a problem.
Point localization: point to where the person is pushing/touching.
Extinction: ability to feel on both sides.
Neglect: don’t feel the other side, could be sitting on their hand

53
Q

Grading scale of Deep Tendon Reflexes

A 
0-bad
1- slow
2-normal
3- hyperactive
4-bad

NUR 305 (1 decks)

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