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Flashcards in assessment techniques Deck (88):
1

4 skills for physical exam

inspection, palpation, percussion, and auscultation

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purpose of inspection

develop a general survey, begins moment you meet a person

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what to do during inspection (general)

compare both sides

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what does inspection require

good lighting, adequate exposure, occasional use of certain instruments to enlarge view

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purpose of paplation

assess texture, temp, moisture, organ location, and size, swelling, vibration, rigidity, lump/masses, tenderness/pain

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3 types of palpation

light, deep, bi manual

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light palpation

detect temp, texture, mobility, shape/size, edema

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how deep for light palpation

less then 1/2inch

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deep palpation

organ location/size, lump/masses, severe tenderness/pain

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how deep for deep palpation

more then 1/2 inch

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ballottement

detect severe swelling or of a free floating object i.e. fetus/fluid in knee cap

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rebound tenderness

press down firmly on skin when release quickly if pain increases

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3 parts of hand used for palpation

dorsal, balls and ulnar, fingertips

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dorsal part of hand for palpation

temp

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balls and ulnar for palpation

vibration

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fingertips for palpation

sensation

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3 types of percussion

direct, indirect, ballottement

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direct percussion

direct taping over body surface

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what type of hand is used for direct

non dominant and fingertips

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indirect percussion

middle finger of dominant hand as striking force, bounce it off of stationary hand

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plexor

finger doing tapping

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pleximeter

middle finger

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resonance

hallow i.e. normal lung

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hyper resonance

booming i.e. increased air; emphysema

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tympany

drum like i.e. air filled intestines/ gastric air bubbles

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dullness

thud like i.e. dense liver, full bladder

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flatness

short sound i.e. muscle

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types of pain

acute, chronic

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symptom analysis

PQRSTU

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P in PQRSTU

provoking factors

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Q in PQRSTU

quality

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R in PQRSTU

radiation

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S in PQRSTU

severity/ symptoms

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T in PQRSTU

timing

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definition in temperature

difference between heat production and heat loss

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what affects temperature

CVA, thyroid disease

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conduction

two objects meet together

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convection

like a fan

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hypothalamus

bodys thermostat

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hyperthemia

trauma, surgery, stroke

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influences on temperature

exercise, age, menstrual cycle, diaertal, environment

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average pulse

50-90 beat per minute

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cardiac output

stroke volume X rate

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bradycardia

low pulse < 50

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tachycardia

high pulse > 90

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sinus arrhythmia

increase at peak of inspiration, slows to normal on expiration is normal for kids and young

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what to do if pulse is irregular

count for a full minute

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force

strength of hearts volume

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3+ pulse

full, bounded

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2+ pulse

normal

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1+ pulse

weak, thready

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0+ pulse

absent

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normal rate for respirations

10-20 breaths per minute

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Eupnea

normal breathing

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normal volume for depth of respirations

300- 500 ml

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what does depth reflect

tidal volume: amount of air inhaled with each breath

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what is the abnormal rate of respiration

< 8 or more than 40 breaths per minute

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bradypnea

less than 10

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Dyspnea

difficulty breathing

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Cheyne-stroke

pattern of breathing slow/ fast

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orthopnea

shortening of breath when lying flat

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blood pressure definition

force of blood pushing against the side of the vessel wall

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systolic definition

max. pressure felt on the artery during the left ventricular contraction

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diastolic pressure

elastic recoil or resting pressure that the boy exerts constantly between each contraction

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pulse pressure

difference between the systolic and diastolic pressures and reflects the stroke volume

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how to tell if the BP cuff fits

compare length of cuff with the circumference of patients arm, length should be 80% circumference of arm

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arteriosclerosis

stiff vessels rigid

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atherosclerosis

fatty build up

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ausculatory gap

period when korotkoff sounds disappear during auscultation

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thigh pressure

BP will be higher

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hypo tension

high blood pressure

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hypotension

low blood pressure

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purpose of taking orthostatic hypo tension

if feeling faint

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how to take orthostatic hypo tension

BP taken lying down, for at least 3-5 min, sitting after 30-60 sec, standing immediately

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DBP over age

rises over adulthood but begins to decline at 60yr

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SBP over age

rises

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aging adult is at high risk for what?

heat stroke

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senile purpura

dark red discolored areas/ spots seen in aging adult

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erythema

intense redness

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diaphoresis

sweating excessively

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seborrhea

oily skin

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xerosis

dry skin

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what is ABCDE rule used for

detecting melanoma

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what does ABCDE stand for

Asymmetry, border, color, diameter, evolving

85

hirsutism

excessive hair

86

alopecia

no hair

87

normal degree for nail

160

88

clubbing nail

180