NURS 310 exam 1 Flashcards Preview

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Flashcards in NURS 310 exam 1 Deck (101):
1

1st visit information & periodically

complete history

2

since last visit

interim history

3

acute, possibly life-threatening issue. really recent

focused history

4

ways to enhance communication

flexibility
specificity
clarity
curiosity about you
emotionalism
silence

5

how do you enhance communication with a patient?

have comfy setting
have patient sit down
avoid distractions
and talk to them while they are still clothed

6

how to enhance communication with an Inpatient?

pull up a chair when you talk to them

ask visitors to leave

make them comfy

7

should you include children into the interviews?

yes

8

should you only talk to adolescence with their parents?

NO. you must talk to them alone for some time. must tell parents what they tell you is confidential to a certain extent

9

goal of health history:

gain information & focus the examination

10

what do you ask to obtain health history?

WHERE are the symptoms

WHEN did it start

WHAT is the quality and intensity? makes it better or worse?

HOW did it come about?

WHY

11

what do you look for in a history and physical?

CC
HPI
PMH
FH
PSH
ROS

12

CC

chief concern

(reason for seeking care)

13

HPI

history of present illness

-chronologic course of events
-state of health just before present problem
-description of problem
-onset, duration, S&S, & what makes it better
-related factors
-medications

14

PMH

past medical history

includes dates of childhood and adult illnesses

immunizations, surgeries, injuries, medications, allergies, transfusions, screening tests, emotional status

15

FH

family history

illnesses, causes of death, high BP, heart disease, cancer, stroke, & diabetes

16

PSH

personal and social history

socioeconomic and cultural data

occupation, diet, exercise, caffeine, self exams, foreign travel, smoking, alcohol, recreational drugs, sexual history

17

ROS

review of systems

identify presence or absence of health-related issues in each body system.

pain, fever, chills, fatigue, night sweats, sleep patterns, weight, focus on patients problem, LMP for women

18

information patient offers about their condition

subjective data

19

observable and measurable data.

can be seen, heard, or felt by caregiver

objective data

20

how do you drape a patient seated?

cover legs or lap

21

supine?

chest to toes

22

prone?

torso covered

23

dorsal recumbent?

diamond shaped sheet

24

examination techniques?? (4)

INSPECTION
PALPATION
PERCUSSION
AUSCULTATION

25

Process of observation
what you see and smell
continuous throughout history and exam

inspection

26

what you feel with hands and fingers

palpation

27

use of sound waves to detect body tissue density

percussion

28

listening with stethoscope or ear

auscultation

29

how do hair skin and nails differ on an infant?

flaking and peeling skin. subcutaneous is poorly developed

30

how do hair skin and nails differ on an adolescent?

body hair growing in

31

pregnant women?

increased blood flow to skin, 90% have darkening

32

older adults?

fragile skin, dry, epidermis = thinner, less subcutaneous, less body hair, hard nails, & nails grow slower

33

skin color

ranges from light tan to dark brown

may have pink or yellow overtones

34

color hues in dark-skinned persons are best seen where?

sclera, conjunctive, buccal mucosa, tongue, lips, nail beds, palms

35

moisture of skin?

dry or wet

36

temperature of skin?

cool to warm

37

texture of skin?

smooth

38

turgor means?

fullness.

tenting or instant recoil

39

you should check what when you examine the skin?

color
symmetry
nevi (moles)

40

what should you check for on skin lesions?

size
shape
color
texture
elevation
exudates
location and distribution
changes in ABCDE

41

collection of blood in subcutaneous tissues.

vascular wall destruction, trauma, vasculitis

ecchymoses (bruise)

42

caused by capillary bleeding

intravascular defects, infection

small hemorrhagic spots

red-purple discoloration <0.5 cm diameter

petechiae

43

periocular petechiae is from?

being strangled

44

caused by capillary bleeding

intravascular defects, infection

red-purple discoloration >0.5 cm diameter

purpura

45

what would you check for on hair?

texture
quantity
distribution equal for gender?

46

what would you look for on nails?

color of nail bed
shape

47

absence of melanin, causes patches on unpigmented skin

vitiligo

48

tiny bright red round papules

cherry angiomas

49

small, hard projections of epidermis

cutaneous horns

50

this type of nail is from respiratory disease.

COPD pages.

"clubbing"

51

fungal infection on toes

onychiomycosis

52

striae

stretch marks

53

pregnant women have a pigmentation down their belly; this is called?

linea nigra

54

how do older peoples skin change?

loss of skin elasticity
& loss of subcutaneous adipose

chest & lungs?

55

right lung has how many lobes?

3

56

how many lobes in left lung?

2

57

how do infant/children's lungs/chest change?

changes from placenta circulation to pulmonary.

chest is ROUND

58

what happens to pregnant women's lungs/chest?

diaphragm pushes up

59

what about older adults lungs/chest?

mucous membranes become dry.

"barrel-chested"

60

should you use accessory muscles when breathing?

NO

61

should you have nasal flaring when you breathe?

NO

62

should your chest wall retract "pull back" or "cave-in" when you breathe?

yes

63

difficulty and labored breathing

dyspnea

64

increased SOB when patient lies down

orthopnea

65

persistent; rare; above 20 respirations/min

tachypnea

66

rate below 12 respirations/min

bradypnea

67

crackly or crinkly sensation (bubbly feeling) form a rupture somewhere in respiratory system or infection w/ gas-producing organism

crepitus

68

check for symmetry of this with hands on back in W shape.

thoracic expansion

69

trachea should always be...

midline

70

auscultation should be listened to where?

on anterior: 4 sites
and posterior: 6 sites

71

breath sound heard across the lungs surface

vesicular breath sounds

72

breath sounds over bronchi

bronchovesicular breath sounds

73

- discrete, discontinuous popping noise(heard more often during inspiration)
- do not clear with coughing
- fine-high pitches
- coarse-low pitched

crackles

74

deeper, more prolonged and continuous

larger airways

may clear with coughing

rhonchi

75

continuous, high-pitched or low pitched, musical sound

caused by narrowed airway

wheezes

76

bent limb

flexion

77

straight limb

extension

78

the angle between joint and bone is greater than normal

hyperextension

79

away from the body

abduction

80

toward the body

adduction

81

toward midlien

medial

82

away from midline

lateral

83

inward

inversion

84

outward

eversion

85

laying on back

pronation

86

laying on front of body

supination

87

musculoskeletal HPI?

joint symptoms
back pain
trauma or injury
skeletal or muscular symptoms

88

musculoskeletal PMH?

surgery?
all Past medical history possible

89

musculoskeletal FH?

osteoporosis
RA
arthritis

90

musculoskeletal PSH?

tobacco use
alcohol
occupation

91

inspection of musculoskeletal?

posture
gait (walking)
symmetry
muscles

92

palpation of musculoskeletal?

muscles, bones, joints
muscle tone
temp
tenderness
swelling
pain
crepitation

93

grating of irregular joint surfaces or broken bone fragments.

crepitation (crepitus)

94

types of ROM?

active and passive

95

note what 3 things on range of motion?

pain
spastic movement
crepitation

96

how to test muscle strength?

movement against resistance
flexion
extension
symmetry
grade muscle function

97

check for this as a patient opens mouth. crepitus. make them move their jaw laterally and out and in

TMJ

98

check for head position, alignment of head with shoulder, symmetry, ROM, palpate muscles.

cervical spine

99

inspect & palpate alignment of this. evaluate ROM

thoracic and lumbar spine

100

palpate muscles and joints for this. ROM

shoulders & elbows

101

inspection: symmetry, position of fingers, enlargement of joints. ganglion cyst. palpate joint & muscles. ROM

hands and wrists