Vital signs/Derm Practicum

Question 1

Intro

Answer 1

1. Wash hands
2. Introduce self as PA-S
3. Explain exam and obtain consent
4. Verbalize patient would be appropriately draped/exposed

Question 2

General assessment

Answer 2

1. Not age, race, gender, level of consciousness of Pt
2. Notes if Pt is alert and oriented to person, place, time and situation
3. Assess pain - noting guarding, grimacing, grunting, pallor, diaphoresis
4. For children CRIS/FLACC, if indicated
5. Observe emotional state

Question 3

Vital Signs

Answer 3

1. Would check height and weight and calculate BMI with chart
2. Check Temperature, noting 97.2-99.9 F, 36.2-37.7 C normal
3. Check Pulse noting 60-100 beats per minute normal in an adult, noting regular vs irregular and amplitude
4. Check respiratory rate noting 12-20 breaths per minute normal in adults
5. Check Pulse Ox noting 95% and up is normal
6. Check BP noting < 140/90 is normal

Question 4

Skin (total)

Answer 4

First: state would inspect entire body including scalp

Inspect:

1. Color
2. Uniformity
3. Thickness
4. Symmetry
5. Hygiene
6. Lesions
7. Odor

Palpate:

1. Moisture
2. Temperature
3. Texture
4. Turgor
5. Elasticity/Mobility

Question 5

Skin (inspection)

Answer 5

First: State would inspect entire body including scalp

1. Color
2. Uniformity
3. Thickness
4. Symmetry
5. Hygiene
6. Lesions
7. Odor

Question 6

Skin (Palpation)

Answer 6

1. Moisture
2. Temperature
3. Texture
4. Turgor
5. Elasticity/Mobility

Question 7

Hair (Total)

Answer 7

Inspect:

1. Color
2. Distribution
3. Density

Palpate:

1. Texture

Question 8

Hair (Inspection)

Answer 8

1. Color
2. Distribution
3. Density

Question 9

Hair (Palpation)

Answer 9

1. Texture

Question 10

Nails (Total)

Answer 10

Inspect:

1. Pigmentation
2. Symmetry
3. Ridging, pitting, peeling
4. Lateral nail folds for redness, swelling, warts
5. Measure nail base angle for clubbing

Palpate:

1. Texture
2. Firmness
3. Thickness
4. Adherence to nail bed

Question 11

Nails (Inspection)

Answer 11

1. Pigmentation
2. Symmetry
3. Ridging, pitting, peeling
4. Lateral nail folds for redness, swelling, warts
5. Measure nail base angle for clubbing

Question 12

Nails (Palpation)

Answer 12

1. Texture
2. Firmness
3. Thickness
4. Adherence to nail bed

Question 13

Order of operations

Answer 13

1. Intro
2. General Assessment
3. VS
4. Skin inspection
5. Skin palpation
6. Hair inspection
7. Hair palpation
8. Nail inspection
9. Nail palpation

Question 14

Run through the whole thing!

Answer 14

1. Intro:
   
   1. Wash hands
   2. Introduce self as PA-S
   3. Explain exam and gain concent
   4. Verbalize patient would be appropriately draped/exposed
2. General Assessment:
   
   1. Note age, race, gender, level of consciousness
   2. Note if patient is alert and oriented to person, place, time and situation
   3. Assess pain - noting gaurding, grimicing, grunting, pallor, diaphoresis
   4. Pain skill for child CRIS/FLACC, if indicated
   5. Observe emotional state
3. Vital Signs
   
   1. Note would obtain height and weight and calculate BMI with chart
   2. Check Temperature, noting 97.2-99.9 F and 36.2-37.7 normal
   3. Check pulse noting 60-100 beats per minute is normal in an adult, also note regular vs irregular and amplitude
   4. Check respiratory rate noting 12-20 breaths per minute normal in an adult
   5. Check Pule Ox noting 95% and up is normal
   6. Check BP noting < 140/90 is normal
4. Dermatology exam
   
   1. State would inspect entire body including scalp
      
      1. Skin:
         
         1. Inspect:
            
            1. Color
            2. Uniformity
            3. Thickness
            4. Symmetry
            5. Hygiene
            6. Lesions
            7. Odors
         2. Palpate
            
            1. Moisture
            2. Temperature
            3. Texture
            4. Turgor
            5. Elasticity/Mobility
      2. Hair:
         
         1. Inspect:
            
            1. Color
            2. Distribution
            3. Density
         2. Palpate
            
            1. Texture
      3. Nails
         
         1. Inspect:
            
            1. Pigmentation
            2. Symmetry
            3. Ridging, pitting, peeling
            4. Lateral nail folds for redness, swelling, warts
            5. Measure nail bed angle for clubbing
         2. Palpate
            
            1. Texture
            2. Firmness
            3. Thickness
            4. Adherence to nail bed
5. Relax you did it!!!