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NURS 1145 > WK 1 Health Assessment > Flashcards

WK 1 Health Assessment Flashcards

1
Q

Cheif Complaint, Review of systems, Past Medical History, Past Surgical History, Social History, Functional ability are all what?

A

Health History

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2
Q

In a Health Assessment, health history what is the Keyword of discussion. Is the health history Subjective or Objective

A

Symptoms (what the paitent feels / communicates)

Subjective

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3
Q

components of a Health Assessment

A

Health History, Physical Examination, Documentation of Data

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4
Q

The ____ is usally a chronological description of the progress of the paitents present illness from the first sign and symptom to the present

A

HPI. History of Present Illness

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5
Q

Key Points: Systematic method, Data collected focuses on clients health compared with norms

A

HPI History of Present Illness

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6
Q

A digital version of a chart with patient information stored in a computer

A

EMR electronic medical record

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7
Q

4 techniques for physical examination

A

Inspection, Palpatation, Percussion, Ausculation

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8
Q

______ targets both the clinical and outcome stages of a disease. It is implemented in symptomatic patients and aims to reduce the severity of the disease as well as any associated sequelae

A

Tertiary prevention

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9
Q

condition which is the consequence of a previous disease or injury

A

Sequelae

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10
Q

This type of Technique for a Physical Assessment includes posture and smells

A

Inspection

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11
Q

Previous history, Onset, Location, Duration, Character, Alieviating / Aggravating Factors, Radation, Timing, Severity / Self - Treatment are all factors to what?

A

Parts of the History of Present Illness

Which is part of the (Health History)

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12
Q

In the 2nd part of the Health Assessment, Physical Examination what is the Keyword to this process? Is the process Subjective or Objective

A

Signs (Clinical Findings)
Objective

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13
Q

The bimanual technique for Palpatation places hands on which sides of an organ ir mass

A

Anterior and posterior

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14
Q

A digital record of health information

A

EHR Electronic Health Record

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15
Q

screening to identify diseases in the earliest. stages, before the onset of signs and symptoms, through measures such. as mammography and regular blood pressure testing.

A

Secondary Prevention

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16
Q

POLDCARTS

A

(Health History) Previous History of Illness

Onset
Location
Duration
Character
Alleviating/ Aggravating symptoms
Related symptoms
Timing
Severity

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17
Q

Intervening before health effects occur, through. measures such as vaccinations, altering risky behaviors (poor eating. habits, tobacco use), and banning substances known to be associated. with a disease or health condition.8,9

A

Primary Prevention

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18
Q

This technique uses hands to feel for texture, size, shape, consistency, location and Id painful areas

A

Palpation

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19
Q

Palpation: palmar surface of fingers and finger pads are more sensitive than finger tips True or False

A

True

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20
Q

Which side of the hand is better for assessing temperature

A

Dorsal

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21
Q

This technique is used to evaluate size, boarders, and consistency of internal organs, Determine Tenderness, Determine Extent of fluid in the body

A

Percussion

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22
Q

Which part of th3 hand is mos4 sensitive to vibration?

A

Ulnar surface of hand to 5th finger

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23
Q

The act of listening to the sounds of the body is called

A

Auscultation

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24
Q

Percussion Tones

Loud, high pitched sound heard over the abdomen

A

Tympanny

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25
Q

Percussion sound: is heard over the liver

A

Dullness

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26
Q

Depth of light and deep palpation

A

1cm and 4cm

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27
Q

4 sound characteristics of Auscultation

A

Intensidad, Pitch, Duration, Quality

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28
Q

Percussion sound: Heard over normal lung tissue

A

Resonance

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29
Q

This Chart for Farsightedness is placed 20ft away. Provides an Acuity Number

A

Snellen Chart

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30
Q

In-Direct Percussion the tip of the middle finger _____ the nurse strikes the interphalangeal joint , or just distal to joint that lies against clients skin

A

The plexor

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31
Q

What do the 2 numbers at the top of a Snellen Chart Represent?

A

Top: Distance from chart
Bottom: Distance normal person should be able to see

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32
Q

Percussion sound: is heard in over inflated lungs, as in emphysema

A

HyperResonance

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33
Q

Percussion sound: is heard over bones and muscles

A

Flatness

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34
Q

This instrument to inspect the internal structures of the eye consists of a series of lenses, mirrors, and light aperture

A

Ophthalmoscope

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35
Q

Earpeices, Binauruals, Tubing, and Head consisting of a Diaphragm and Bell make up this instrument used for Auscultation

A

Stethoscope

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36
Q

____ uses ultrasonic waves to detect and amplify hard to hear vascular sounds like Fetal Heart Tones and Peripheral Pulses

A

Doppler

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37
Q

The Green then Red Lines on the Snellen Chart serve what purpose?

A

Color and field perception

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38
Q

This instrument used to inspect the external auditory canal and tympanic membrane consist of: Magnifying Lens, Light Source, Speculum instered into the Auditroy Canal

A

Otoscope

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39
Q

The Nasal Speculum comes in 2 Varities:
1. Simple Nasal Speculum which with a pen light inspects the lowe4 and middle turbinates of the nose.

  1. Broad-tipped, cone-shaped device that is placed on th3 end of a _____
A

Otoscope

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40
Q

This instrument has 2 purposes: Auditory Screening and Assessment of Vibrations

A

Tuning Fork

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41
Q

When using a Doppler to hear Vascular sounds, Coupling Gel is applied to skin and then _____ is slid over the skin until blood flow is heard in ear peices

A

Transducer

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42
Q

Inability to feel the monofilament on the feet suggest this problem

A

Reduced peripheral sensation

43
Q

This chart held 14 inches away is used to measure near sightedness

A

Jaeger and Rosenbaum

44
Q

Produces a bright light that is used to differentiate between Tissue, Fluid, and Air in a body cavity

A

Transiluminator

45
Q

_____ Determines the degree of Flexion or extension of a joint

A

Goniometer

46
Q

Percussion or Reflex hammer is used to test….

A

Deep tendon reflexes

47
Q

small, flexible wire-like device attached to a handle that bends at 10g pressure that is used to test sensación on the feet is called this

A

Monofilament

48
Q

This device is used to inspect the lower and middle Tubinates of the nose.

A

Nasal Speculum

49
Q

Comprehensive data pertaining to the patients health and / or suitation.

Part of the nursing process

A

Assessment

50
Q

___ refers to the systematic method of collecting and analyzing data for the purposes of planning paitent-cented care CORRECT

A

Heath Assessment

51
Q

Behavior motivated by desire to increase well-being and actualiza of human potential

A

Health Promotion

52
Q

Provide patient-centered care, work in interdisciplinary teams, evidence based practice, apply quality improvements, use informatics. Are considered what?

A

The 5 core competicies

53
Q

Nursing Process: Nurse analysis of the assessment data to determine issues

A

Diagnosis

54
Q

Consist of screening efforts to promote early detection of disease
Health Promotion:

A

Secondary Prevention

55
Q

Prioritize Hypothesis is which part of the nursing process

A

Outcomes / Planning

56
Q

Comprehensive, Problem-Based / Focused, Episodic / follow-up, Shift , Screening are all types of what?

A

Assessments

57
Q

Clinical Judgement has 4 parts Naptime Interrupted, Raccoons Raided Rations!

A

Noticing, interpreting, responding, reflecting

58
Q

Nursing Process: The RN IDs expected results for a plan individualized to the health care consumer or suitation

A

Outcome ID

59
Q

Behavior motivated by desire to actively avoid illness, detect it early, live comfortably with it

A

Health Protection

60
Q

Nursing Process: Coordination of Care, Health Teaching, Consultation (APRN) & Prescriptive Authority(APRN) are this part

A

Implementation

61
Q

Health Promotion: Primary Prevention

A

Prevent disease through promtion of healthy lifestyle

62
Q

Organization of data from the health Assessment my be done in 2 mannerz

A

1.Body system format (cardiovascular, musculoskeletal, visual)

  1. Coonceptual Format: Oxygenation, perfusion, mobility)
63
Q

Recognize Cues is which part of the nursing process

A

Assessment

64
Q

Assessment, Diagnosis, Outcomes/ Planning, Implantation, Evaluation are known as

A

Nursing process

65
Q

Taking Action is which part of the nursing process

A

Implementation/ Interventions

66
Q

Directed towards minimize the disability from acute/chronic disease or injury and helping paitents maximize health

A

Tertiary Prevention

67
Q

Comprehensive data pertinent to the paitents health or situation

A

Assessment

68
Q

6 Types of Assessments: CPF-ESS Assessments:

A

Comprehensive, Problem-Based, Focused Assessments, Episodic/ follow-up, Shift, Screening

69
Q

nurse adds which information in the paitents health history

  1. Paitent keeps scratching left arm
  2. Paitents skin is warm to touch
  3. Paitent reports itching of her eyes
  4. Paitents temp is 100 F °
A
  1. Because its health history and this is a Subjective finding that is appropriate
70
Q

Hand hygine, PPE, Managing Contaminated Equipment, Environmental Controls, Respitory hygine/Cough Etiquette, and _______.
Primary elements of Standard Precautions

A

Patient Placement

71
Q

The Transmission Based Precautions are guidelines for control of infections among paitents with known or suspected infections. Name the 3 guidelines in the book

A

Contact, Airborne, Droplets

72
Q

In which part of the Nursing Process is concerned about:The Paitient Response to what is happening. Exp. Paitent with asthma is restless and anxious. The Response restless/ anxious are the key factors

A

Diagnosis

73
Q

Patient had a stroke and has impaired swallowing and impaired mobility is which part of the nursing process

A

Diagnosis

74
Q

This part of the Nursing Process is concerned with Establish the Goal.

What it will look like when the paitent meets their goal

A

Outcome Identification

75
Q

black-light used to detect fungal infection

A

Woods lamp

76
Q

Part of the nursing process. What interventions you will do to help your paitent meet their goals

A

Planning

77
Q

Type of data in which what you can see or validate

A

Objective

78
Q

The Nursing Diagnosis is the patients ______ to what is happening

A

Response

79
Q

The Diaphragm on the stethoscope is uswd to hear these types of sounds.

The bell on the stethoscope is used to hear these types of sounds

A

Diaphragm = high pitched, breath, bowel, norm heart beats

Bell = soft low pitched sounds like “extra heart beat and vascular sounds”

80
Q

This technique invloves using the plexor to evaluate adult sinus

A

Percussion

81
Q

What is the difference between the Outcome and Planning in the nursing ?

A

Outcome: Goals. What the Paitent will look like to be better.
Paitent will ambulate by himself in 1 month

Planning: “Interventions” what the Nurse will do to help paitent meet their goals.

The process of Nurse related actions to achieve the goals set in the Outcome

82
Q

Paitent interview for a Focused assessment should start with what?

A

History of Present Illness

Poldcarts

83
Q

What sounds does the doppler detect

A

Fetal heart sounds and peripheral pulses

84
Q

Type of data in which what you are told

A

Subjective

85
Q

This technique of the physical assessment is used to determine extent of fluid in a body cavity

A

Percussion

86
Q

Chickenpox (Varicella) , Measles (Rubeola) Flu all have this type of Precautions

A

Airborne

87
Q

COMPONENTS OF HEALTH ASSESSMENT

A

1) HEALTH HISTORY (Subjective) They tell you what is wrong

2) PHYSICAL EXAMINATION (Objective) you examine them

3) DOCUMENTATION OF DATA

88
Q

The bell of a stethoscope is used for…

The diaphragm is used for…

A

Bell = Low sounds

Diaphragm = High sounds

89
Q

Health History includes

A

Biographical Information:

Chief Complaint (CC):

Present Illness (PI):

History of Present Illness: POLD CARTS

Past Medical History

Medications and Allergies:

Family History (FH):

Social History (SH):

Review of Systems (ROS): Conduct a systematic review of all body areas

Psychosocial History:

Developmental History (for Pediatric Patients)

Nutritional History:

Cultural and Spiritual Beliefs:

Environmental Exposures

90
Q

Nursing Process

Acronym

A

ADO PIE

91
Q

History of Present Illness

Acronym

A

POLD CARTS

92
Q

It involves a proactive approach to healthcare that goes beyond the treatment of illness and focuses on preventing health problems, promoting healthy behaviors, and enhancing quality of life.

A

Health Promotion

93
Q

Comprehensive data pertaining to the paitents health or situation

A

Assessment

94
Q

Getting a prescription for Concerta and then having to come back in 2 weeks to talking about it is which type of assignment?

A

Episodic / Follow-up

95
Q

In this type of assessment we cover all the body systems in 4 minutes.

A

Shift assessment

96
Q

Clinical Manifestaciones (2)

A

Signs & Symptoms

97
Q

Crepitus, Palpation

Describe feeling

A

Crackling or grating sound caused by bones rubbing against each other, also called creaky joints.

Bubble wrap

98
Q

Atelectasis = More or Less fremitus

Correct answer

A

Less

99
Q

During 2 handed Percussion

the finger that taps is called:

The finger that is being tapped and pressed against the skin is called:

A

Pleximeter

Plexor

100
Q

How much does 1 liter weight in metric

A

1 Kg

101
Q

Disease someone may not feel a tuning fork on the lower extremities

A

Diabetes

102
Q

Health Assessment contains 3 parts

A

Collection of Objective Date

Collection of Subjective Data

Documenting Findings

103
Q

Primary, Secondary, Tertiary Prevention

Condoms, Pre-exposure Vaccines, Male Circumcision

Postexposure vaccines, Regular BP checks, mammogram, Pap smear, colonoscopy

Screening of patients with diabetes for diabetic retinopathy to prevent blindness, prevention of opportunistic infections in HIV patients, oxygen therapy to COPD patients

A

Primary
Implemented before disease starts
Condoms, Pre-exposure Vaccines, Male Circumcision

Secondary
Early detection & intervention
Postexposure vaccines, Regular BP checks, mammogram, Pap smear, colonoscopy

Tertiary
Addresses existing conditions
Screening of patients with diabetes for diabetic retinopathy to prevent blindness, prevention of opportunistic infections in HIV patients, oxygen therapy to COPD patients

NURS 1145 (11 decks)

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