exam 4 Flashcards
(146 cards)
1
Q
costovertebral angle
A
angle between spine and 12th rib
tenderness here is related to kidney
2
Q
sharp crampy pain associated with kidney stones
A
ureteral colic
3
Q
pain that comes from internal organ and is hard to localize
A
visceral pain
4
Q
parietal pain
A
from inflammation of parietal peritoneum
aching pain
aggravated by movement or coughing
4
Q
parietal pain
A
from inflammation of parietal peritoneum
aching pain
aggravated by movement or coughing
5
Q
referred pain
A
hurts where problem isnt
6
Q
GERD characteristics
A
from gastric acid is esophagus, causes heartburn and regurgitation
occurs after meals and when laying down
avoid spicy foods, chocolate, smoking and alcohol
7
Q
peptic ulcer characteristics
A
ulcer in stomach or duodenum less than 5mm
located in epigastric and could go to back
may be gnawing, burning, aching, or hunger pain
pain may last a few weeks, go away then reoccur
food and antacids may bring relief
8
Q
dyspepsia
A
indigestion
9
Q
weight loss is common in what ulcer
A
gastric
10
Q
heartburn is common in what ulcer
A
duodenal
11
Q
acute appendicitis
A
inflammation of appendix, may be distended and obstructed
pain migrates from periumbilical to RLQ
Pain gets worse with time
movement hurts
low fever, anorexia, nausea, pain common
12
Q
acute cholecystitis
A
inflammation of gallbladder, usually from obstruction
RUQ pain, may radiate to rt shoulder
steady aching
fatty foods aggregate
anorexia, N/V, restlessness
13
Q
acute bowel obstruction
A
small intestine pain: periumbilical, upper abdomen
colon pain: cramping
eating makes it worse
vomiting, constipation,
14
Q
acute pancreatitis
A
inflammation of pancreas, autodigestion
epigastric pain that may radiate to back
leaning forward with trunk flexed may help
N/V, abdominal distention, fever
15
Q
chronic pancreatitis
A
irreversible destruction from recurrent inflammation
severe, chronic pain. in epigastric to back
alcohol and fatty foods make it worse
leaning forward with trunk flexed may help
diabetes may occur, diarrhea with fatty stool
16
Q
acute diverticulitis
A
inflammation of diverticula
cramping pain that comes steady, in LLQ
caused from low fiber, smoking
abdominal mass with tenderness, N/V, constipation
17
Q
regurgitation
A
acidity taste that comes up in mouth/throat
18
Q
color of old blood
A
dark red, coffee ground looking
19
Q
color of new blood
A
bright red
20
Q
odynophagia
A
painful swallowing
21
Q
tarry stool
A
common with GI bleeds
black, sticky and shiny
22
Q
what may jaundice cause fecal to look like
A
grey stool
23
Q
abdomen assessment: what should patient look like
A
no pillow under head, laying flat with pillow under knees
24
abdominal exam order
inspect, auscultate, percuss, palpate
25
abdomen contour
flat? round? concave?
26
incisional hernia
around past surgical incisions
scar may be seen
27
ascitic fluid
migrates to lowest point, with gravity
28
when should you hear tympany in abdomen
over air filled or unsolid spaces
29
where should you hear dullness in abdomen
over solid areas
30
lightly palpate stomach
one hand, circular motion
looking for tenderness and masses
31
deeply palpate stomach
2 hands, push down 5-8 cm
looking for masses and enlarged organs
only do when necessary, could cause harm
32
what to do if you know a area is tender when palpating
touch it last, if you do it beforehand it will make them tense and you wont get as good of an assessment
33
assessment for peritoneal inflammation
ask them to cough
only palpate with one finger
try to localize pain
34
palpation of liver
hand underneath rib cage, ask patient to take deep breath using their stomach
35
mapping borders with ascites- percussion
dullness- where the fluid is
tymphany- where the fluid isn't
36
what signs lead us to believe appendicitis
positive rovsing sign- pressing deeply into LLQ and withdrawing quickly, patient in pain
positive psoas sign- pain when lying on left side with right leg flexed back, in pain
36
what signs lead us to believe appendicitis
positive rovsing sign- pressing deeply into LLQ and withdrawing quickly, patient in pain
positive psoas sign- pain when lying on left side with right leg flexed back, in pain
37
sign to see for gallbladder inflammation
positive murphy sign- pain when fingers are poked in right side when taking deep breath in
38
how to know is mass is in abdominal wall or cavity
ask patient to tighten abdominal muscle, if mass is still palpable, its in the wall, if its not palpable its in the cavity
39
Hep A
Transmitted by contaminated food or water
abdominal pain, nausea, fever, jaundice, loss of appetite
no treatment needed, rest and drink fluids
vaccine is available
not chronic but may cause damage
40
Hep B
Liver infection from virus
transmitted by blood, sexual contact, mother to child
often no symptoms, but jaundice, abdominal pain, fatigue, loss of appetite may appear
vaccine available
Can become chronic, leading to cancer and cirrhosis
41
Hep C
liver infection transmitted by blood/bodily fluids from someone with hep C
no vax available
there is a cure
chronic, may cause cancer, or cirrhosis
typically no symptoms, but if do, flu like
42
what meds chronically lead to ulcers or gi bleeds
asprin, NSAIDs
43
best test for colorectal cancer
colonscopy
44
pessary
for urinary incontinence
small plastic device placed in vagina that creates pressure on bladder decreases urinary incont,
45
complete loss of muscle function
paralysis or plegia
46
normal bowel sound activity
5-34 clicks or gurgles a min
if hypoactive, listen for 3-5 mins
47
internal shoulder rotation
reaching up arm to touch the opposite scapula
48
what are bouchard nodes affiliated with
osteoarthritis
49
rigidity
muscle hypertonic in both directions through whole range of motion
50
spacisty
muscle hypertonic in one direction not thru whole range of motion
51
strain
injury to tendon
52
sprain
injury to ligament
53
connects muscle to bone
tendon
54
bone to bone
ligament
55
bursae
fluid filled sac between bone/tendon/soft tissue/muscle
56
synovial joint
freely movable
57
spheroidal joint
ball and socket, synovial
58
hinge joint
gliding movement, synovial
59
condylar joint
convex surface matched with concave surface, synovial
60
cartilaginous joint
slightly movable
61
fibrous joint
immovable
62
atrophy
decrease in size
63
hypertrophy
increased muscle tone with increased strength
64
pseudohypertrophy
big muscles without strength
65
paresis
weakness
66
hemiparesis
weakness on one side
67
hemiplegia
paralysis on one side
68
paraplegic
paralysis in legs
69
quadriplegic
paralysis in all 4 extremites
70
0 muscle strength
no contraction detected
71
1 muscle strength
slight movement
72
2 muscle strength
movement when gravity is eliminated
cant lift, but can move
73
3 muscle strength
active movement with gravity
can lift , but cant resist
74
4 muscle strength
can move against gravity, but only has some resistance
75
5 muscle strength
active movement against full resistance without evidence of fatigue
76
hyperextension of shoulder
raising arms behind you
77
wrist flexion
point towards floor
78
radial deviation
bringing fingers midline
79
ulnar deviation
bringing fingers away from midline
80
what causes carpal tunnel
pinched nerve
81
assessing capal tunnel
thumb adduction
tinel sign- tapping over medial nerve
phalen sign - wrist flexed and held back of hands together for 60 secs, ask about numbess
82
kyphosis
hunchback
83
lordosis
inward curvature
84
scoliosis
lateral curvature
85
neck flexion
bringing head to chin
86
neck lateral flexion
ear to shoulders
87
palpating inguinal structures: NAVEL
Nerve
Artery
Vein
Empty space
Lymph nodes
88
dorsiflexion
foot pointed to ceiling
89
bone and muscle health promotion topics
exercise
nutrition
weight management
90
osteoarthritis
inflammation in joint
91
osteoporosis
weak bones due to absorption issues
to help: take vitamin D and calcium, exercise, limit alc and caffeine, agents
diagnosed by bone density screening
92
reproductive assessment pieces to discuss
Sex and response(and with what gender), STIs, menstrual cycle, any noticeable concerns/symptoms, contraception methods, pregnancy
93
Prostate cancer symptoms and risk factors
symptoms- incomplete emptying of bladder, urinary frequency/urgency, weak stream, hematuria, nocturia, bony pain in pelvis
2nd leading cause of cancer death in men
risk increases after age 65, in AA men, BRCA gene, and having a family history
94
when and how should men do testicular exams
monthly, in front of a mirror
95
inspecting hernias in men
inspect in standing position
looks for bulging and asymmetry
96
foley catheter and penis issue
skin of meatus can errode due to movement of penis
97
epispadias
urethra opening on upper side of penis instead of top
98
hypospadius
urethra opening is on underside of penis instead of tip
99
HPV vaccine
prevents cancer causing infections
2 dose
age 11&12 men and women before first sexual encounter
or
3 dose
woman can get it from age 13-26
men from ages 13-21
100
SANE
sexual assault nurse examiner
101
should we establish about number of sexual partners
yes in the past 3-6 months
102
what can cause sexual dysfunction
general health, medication, attitude, knowledge of activity, relationship, setting
103
what needs mandatory reported when coming to sexual health
rape
104
how do we assess reproductive system
externally
105
Para (P)
outcome of pregnancy
full term, premature, abortion, living child
106
gravida (G)
Total number of pregnancies
107
amenorrhea
absence of periods
108
menses duration
number of days flow last
109
menses frequency
measured from first day of one menses to first day of next menses, usually 24-32 days
110
abnormal uterine bleeding
bleeding between menses or infrequent or prolonged postmenopausal bleeding
111
premenstrual syndrome (PMS)
cluster of emotional, behavioral, and physical symptoms occurring 5 days before menses for 3 consecutive cycles
112
dysmenorrhea
pain with menses
113
postmenopausal bleeding
bleeding occurring 6 months or more after cessation of menses
114
perimenopause
period of years marking transition to menopause
115
menopause
absence of period for 12 consecutive months, usually in ages 48-55
116
menarche
onset of menses
117
menses
monthly flow of bloody fluid from uterus
118
3 parts of women's reproductive history
menstrual, obstetrics, sexual
119
5 phases of women's reproductive house
prepuberty, puberty, childbearing, perimenopausal, menopasual
120
what age do most women start mammograms
45, but could start earlier if at risk for
121
do you still palpate with breast implants
yes
122
what happens to breast with radiation
tissue will be tighter and firmer
123
what is concerning about mastectomy scars
they are a common sight of reoccurence
124
visible signs of breast cancer
nipple retraction and deviation, abnormal contours, skin dimpling, edema on sides from blockage of lymphatic system- texture feels like orange peel
125
breast cancer
most common after age 60 but can happen sooner
usually single, firm, irregular shape, nontender, possible retraction
126
breast cyst
cyst in breast- more exams needed because hard to tell
usually in mid adult age
can be by itself or with clusters, can be soft or firm, mobile, usually tender, no retraction, round
127
fibroadenoma
mimic breast cancer but is benign
more common in younger woman but older women can get it as well
round, well delineated, usually nontender, very mobile, no retraction, firm, usually single
128
lymph node suggesting breast cancer
palpable, larger than 1cm
129
how to document modules found in breast
by quadrant and clock face
document size, shape, delinenation (clear borders?), tenderness, mobility
130
what direction to palpate breast
from axillary to sternum
131
how to palpate breast
2nd,3rd and 4th finger pad in circular motion in vertical strip pattern. Pressure depends on the denseness of the tissue
132
what positions should women be at so you can inspect there breast
arms at side
arms on hip
leaning forward
arms over head
133
gene for breast cancer
BRCA
134
what can help find breast cancer
mammogram, biopsy, self exams, clinical exams
135
benign breast disease
noncancerous lumps in breast
requires more breast exams bc they are more difficult to distinguish
136
medications that put women at higher risk for breast cancer
HRT, OC
137
what is nipple retraction
Inverted nipple
138
what lymph nodes need to be palpated in breast exam
lateral, central, subscapular, pectoral
139
should nurses do breast exams on men
yes, distinguish the difference between muscle and breast tissue
140
Gynecomastia
development of breast tissue in men
141
supernumerary
extra nipple, areola present
usually mistake as a mole
no pathologic significance
142
are breast always smooth
no, they are made of glandular and fat tissue, so there may be some roughness, but look out for any new lumps that were not previously there
143
what part of the breast do most tumors develop
tail of spence
144
when should breast exams be done
a week after period, consistently each month for women
for men, monthly
